chatwithketch

Q: Hello! Doc my friend is having a condition of bleeding from anus. She visited a doctor and they said it’s constipation but after a month the bleeding started

A: Hello! Thanks for writing in.

The first question I have for you is whether the blood is bright red or altered (almost brownish/black)? If it’s bright red, it is likely coming from the anus or somewhere close by. If it’s altered blood, it’s likely coming from higher up in the digestive system eg bleeding from a peptic ulcer. You should see your doctor immediately, if you experience this.

Common causes of bright red bleeding include:

·      Anal fissure

·      Piles (haemorrhoids)

·      Cancer of the rectum or colon

·      Gastro-enteritis: infection of the stomach and intestines

·      Inflammatory bowel diseas

·      Anti-coagulant drugs

You cannot make the diagnosis of what is serious and what is not. So, I suggest you see your doctor to examine you and make a diagnosis.

I will discuss the first two conditions (anal fissure and piles) below;

Constipation can lead to conditions where the stool is so hard that it causes a tear of the skin lining the anus (anal fissure) leading to blood seen with the stool.

Prevention is focused on ensuring that you have enough fibre in your diet (fruits, vegetables, whole grain), getting at least 30 minutes of exercise daily and drinking at least 8 glasses of water daily. When you have the urge to poo, try not to delay it for too long. Go and try to take your time to do your business!

How can you help this?

§  Include some fibre in your diet. Fruits and vegetables, oatmeal, local rice and other whole grain meals are helpful.

§  Drinking at least 8 glasses of water daily. Remember that this number, 8, is not cast in stone. It’s just a helpful guide. If you’re in a hot area, you’ll probably drink more

§  Get at least 30 minutes of exercise/activity per day or on at least 5 days of the week.

§  If these do not help, you may want to see your doctor for a proper examination as some diseases like Diabetes Mellitus may also cause constipation.

Now for piles…

Piles, known as haemorrhoids in medical lingo are swollen veins in the anal canal. They can be internal, external or both internal and external can co-exist. Internal haemorrhoids occur when veins swell within the rectum and external haemorrhoids are found under the skin around the anus.

These haemorrhoids develop when there is undue pressure in the pelvic and anal area as can occur when people strain to pass faeces (if they have diarrhoea or are constipated), in pregnancy (especially the last 6 months), in obese people, people who eat diets low in fibre and people who practice anal intercourse. When women strain in labour, haemorrhoids can also be made worse. For those who love to visit the toilet with their newspapers and spend ages reading them in there, well, you’ve got breaking news!  Sitting on the toilet seat for prolonged periods can also cause haemorrhoids. As people grow older, the support structures for these veins also grow weaker…naturally 😀

Some internal haemorrhoids can be small veins which stay within the rectum. Usually these internal haemorrhoids, stay inside the anus causing no problems. Other internal haemorrhoids can be big veins that sag and protrude out of the anal canal. Straining would cause their delicate surfaces to bruise and bleed. Sometimes, the straining is sufficient to cause the haemorrhoids to protrude out of the anal canal. This is probably what has been described above in the question. When the haemorrhoids are compressed by anal muscles, the pain is made worse and the pressure can lead to cutting off of blood supply to the haemorrhoids.

External haemorrhoids can clot due to irritation forming a hard, painful lump under the skin around the anus.

People with haemorrhoids will complain of streaks of blood in the stool after stooling, blood on the tissue after cleaning up, anal pain, anal itching or a lump around the anus.

Treatment involves the use of ointments to relieve pain, inflammation and itching. There are other minimally invasive and surgical options available that range from rubber band ligation to surgical removal of the haemorrhoids.
You can also limit the discomfort you have by keeping the anal area clean, using wet wipes (non-perfumed) to clean up after using the loo, sit on a bowl of plain warm water for about 15 minutes about twice or three times per day and also use some pain relief, if in pain.

To prevent this, ensure that your diet has sufficient amounts of fruits and vegetables. Remember that if you take a regular flat plate, half of this should be filled with fruits and vegetables, half of the plate with complex carbohydrates and the last half with proteins.

Limit the time you spend sitting on the toilet seat (read your newspapers elsewhere :D), use the toilet as soon as you feel pressed (that way the fluid in the stool is not absorbed making the stool hard) and then don’t strain when you do go. Drink sufficient quantities of water daily, exercise (to keep everything moving along nicely :D)

Remember though that there are other causes of blood in faeces. That’s why this case has to be checked out in the hospital so that a proper diagnosis can be made.

I hope this helps.

Have a good night y’all 

Q: Good afternoon Dr. How can I deal with nausea? I’m 7 weeks pregnant. I’m failing to eat the whole day

A: Repeating this post on morning sickness for this new motherMorning sickness during pregnancy can be really trying! I know…I suffered through it! Oh boy! Thank God I’m over all of that now…I’m a grandmother in waiting

Now, for the rest of you who still have to go through this, I’ll share some tips.

The standard teaching is to try eating some bland foods like Crackers biscuits or dry toast. That personally didn’t work for me. I preferred tart things…which some may want to avoid. I loved lemons during my pregnancies. They were the one thing guaranteed to ‘wake up’ my mouth and chase nausea far away. I also had a particular brand of very tart bubble gum, I indulged in 😀 These were key for me because, though I didn’t have the real bad case of morning sickness that sent you to the hospital, brushing my teeth in the morning always sent me into a bout of retching/vomiting. So, I always had a ready supply of the gum or lemon/lime to pop into my mouth once I was done brushing/retching! Not a very pleasant memory ;D

So, if lemons work for you to prevent nausea, go for it. Remember that moderation is key. A few drops (one or two) in a glass of water are enough to provide that tart kick that sends nausea far away. There is a catch here though…remember the heart burn associated with pregnancy. The acid content of lemon might make the heart burn and any pre-existing gastro-esophageal (stomach and esophagus/gullet) problems worse. So, this is all the more reason to be very moderate or stop if it exacerbates an already bad case of heart burn. Wherever and whenever in doubt, please be sure to see your doctor.

Other tips:

• Eat little amounts of food frequently as an empty tummy increases the likelihood of throwing up. Remember this is not an excuse to binge and over eat

• Avoid fatty and greasy foods.• Avoid smells that trigger nausea

• Cold foods may be preferable to hot as the former does not give off smells that may cause you to feel queasy.

• Get loads of fresh air and rest

• And drink sufficient fluids daily

More importantly, women going through this need love and support more than ever. If you can’t stand cooking now, because of this, get help etc.

All the best!

Q: Is this diet of fruits, vegetables and whole grains applicable to children? I feel that, because they are growing, they need sugar and the likes.

A: You are certainly right. They need sugar to fuel all that activity that makes parents continually yell,’what’s going on there?’ 

 But, it’s probably not the sugar that you meant…that is, refined sugar from baked goods, soft drinks etc. Remember that all food we eat, eventually gets converted to sugar in the body. The sugar from refined products cause sugar spikes and lows such that the people who eat them, get hungry very quickly after they felt full. So limit the sugar from these sources. Sugar from other sources like complex carbs are released slowly causing a feeling of fullness for longer.

As parents or caregivers, we have to model the right food behaviour for the children. We can’t tell them to take fruits and then turn around to take soda. In the same vein, we can’t eat junk and expect them to grow up and have healthy food habits. Another thing we do, which may promote the wrong image of food in children, is that we oftentimes give them sweets or candy as reward for good behaviour. So, it’s only natural for them to now desire this.

So what should they eat? Pretty much the same diet requirements as you but with varying calorie needs at different ages.

Serve a variety of fruits and vegetables, especially those in season. They are cheap and readily available. Serve a variety of different coloured fruits and veggies. And remember that fruit juices are not as good as fresh fruits themselves (they are loaded with sugar and even if you don’t see sugar on the label, the ‘concentrate’ you do see is loaded with it!). An exception to this would be 100% fruit juice.

Seafood, beans, eggs and unsalted nuts are good protein sources. Dairy is also a good source of protein. Once a child is about 2 years old, please switch to skimmed or 1 to 2% milk. Cheese, yoghurt and soy drinks are also great dairy options.

Whole grains found in brown/local rice, oats, whole wheat bread and popcorn too (yep! popcorn :D. But be sure not to douse them with sugar or salt) etc provide complex carbs and fibre for that feeling of fullness and of course great bowel movement with no constipation 

Keep healthy snacks around the house like nuts, fruits and vegetables that can be dipped in sauces.

Have a great week ahead, peeps 

Q: Good morning Doc. Please, what will I do? Anytime I finish giving my child breast milk and keep him on his bed, he will vomit all the milk. After a little while, he will begin to search for another feed, but he is healthy. Please, tell me what to do because he stresses me.

A: Thanks for writing in.

Please don’t be stressed 🙂

 The post below written in response to a mum like yours, should answer your question. Enjoy….

Q: Good afternoon Dr Ketch. I have a 3-week old son who vomits sometimes after breastfeeding. Please I will like to know what causes it and what I can do to remedy it. I intend to do 6months exclusive breastfeeding. Thank you and remain blessed

A: Hi dear, congratulations on your new baby. This baby will do super-amazing awesome things…Amen!

Now, is your baby ‘vomiting’ or spitting up the milk? Bear in mind, that when I say spitting up, it’s not the type that you and I do. Spitting up in babies refers to an easy flow of the milk your baby just took out of his mouth accompanied by a burp sometimes. Vomiting, however, is more forceful and would move a couple of inches more from the baby’s mouth.

What causes reflux? There is a ring of muscle that separates the stomach from the esophagus (the food pipe). In babies, this muscle is not well developed and so allows food that has moved into the stomach to sometimes come back up. This would continue, sometimes, up till when the baby is about 12 months but is more common within the first 3 months of life. It is also common in babies who are over-fed 

You can help to reduce this by

If your baby, however, ‘vomits’ forcefully, is not gaining weight, gags, has difficulty swallowing or sleeping etc, please see his doctor for a review.

Please keep your commitment to the exclusive breastfeeding plan. It’s a sure winner. My love to your baby!

Have a great evening, y’all 

Q: Please good morning doc. Please i want to know if pelvic inflammatory disease causes infertility. Is there any treatment for that?

A: PID known as Pelvic Inflammatory Disease is an infection of the reproductive organs of a woman (uterus, fallopian tubes, ovaries and surrounding tissues) and it’s usually due to infections which may or may not be sexually transmitted (more likely to be the latter, though). The two most common causes of PID are 2 bacteria: Chlamydia and gonorrhea. Other bacteria found in the vagina and cervix (not associated with STIs) can also travel up the vagina and cause a PID.

People more at risk of this condition include people with multiple sex partners, people who use Intra Uterine Device as contraceptive, people who douche ( douching involves injecting fluid up the vagina to cleanse it. This process can carry bacteria up the vagina), people who have had an STI, young women less than 25yeras who are sexually active.
How do you know if you have this infection? Sometimes this is difficult as it may not give any symptoms. However, in other cases, patient could complain of vaginal discharge, painful urination and sex, fever, lower abdominal pain and irregular bleeds.
If this is left untreated, it may lead to ectopic pregnancy (pregnancy that implant outside the womb), fallopian tube damage and blockage with subsequent infertility and long term abdominal pain.

To diagnose the condition, your doctor may take samples from the vagina and cervix (mouth of the womb), carry out blood tests and he may also want to look-see using laparoscopy.

Based on the results, he will prescribe a course of antibiotics which has to be adhered to and the dose completely finished even if one feels better before the complete dose is finished. It is important that there is no sexual intercourse until infection is treated and indeed, sexual partner should also be treated as well. Remember the ABCs of sex.

So, I suggest that you go see a gynaecologist. You can check the Teaching or Specialist Hospital closest to you. As noted here, the treatment is based on the result of your tests. Please schedule this specialist appointment as quickly as possible…the consequences of untreated PID are severe. If any damage to the reproductive organ has already occurred, starting treatment may not reverse them. So the earlier you deal with this, the better.

For related articles:
https://chatwithdrketch.com/2014/08/07/daily-health-tips-what-are-my-options-after-ectopic-pregnancy-and-failed-ivf/
https://chatwithdrketch.com/2014/07/02/daily-health-tips-should-i-use-emergency-contraception-as-my-regular-means-of-contraception/
I wish you the best!

Q: Hi Dr. Good day to you. Please Dr. I have been having a sharp pain on my leg right inside the bones for some time now. The pain is occasional and lasts for seconds. What might this be and what should I do about it? Thanks

A: Thanks for writing in. The pain in your right leg may need further evaluation.

There are quite a number of causes of pain in the leg. Pain in one leg may be due to an injury, a fall or hitting the leg against an object. This pain may be felt immediately after the incident that caused it and subside after a few days, with the proper care. It can also linger for some time, if perhaps there was a break in the bone which was not properly taken care of and affected some nerves.
Other causes include arthritis, leg swelling from different causes like infection, vein abnormalities, diseases like heart problems, diabetes, and liver problems. In long standing hypertension, or diabetes that is not properly managed, there could be nerve problems, often described as a cramp, feeling of lack of blood, or a feeling like pins pricking the feet. The pain could also result from a muscle cramp, which typically occurs at night and may last a few seconds to minutes. There is also condition known as familial recurrent knee dislocation, in which there is repeated dislocation of the knee, followed by a fall, due to lack of stability. It runs in families and can be very painful too. There are also some cancers that can give similar symptoms.

I would advise that you reduce stress on your legs as much as possible, i.e. avoid standing for too long. You could also start some mild exercises focusing on the legs. These may help to strengthen any lax ligaments and improve blood flow, thereby helping any nerve disease, if that’s responsible.

Good diet, rich in proteins and vitamins are also important. You may occasionally take a mild pain relief to reduce the pain (but do not make it a habit). If the pain worsens or continues despite pain tablets, please see your doctor.

In conclusion, I strongly recommend you see a doctor who will take a proper history and examine you thoroughly, and proffer a line of management for your symptoms.

Hope this helps, Best wishes

****The answer to this question was contributed by a doctor guest blogger.

Q: Hello Dr. Good day. Dr I need your help. I have this problem. Any time I have sex, I quickly discharge. And after that I wouldn’t be able to continue. Even if I force myself to go again I will feel like something was taken out of me after the second round.
Secondly, I normally have this headache and fever and after treating them, like one month after, the symptoms will be back. My hands will be shaking. My friends said that I should quit beer which I did but it still shakes. What is my problem Dr?

A: Premature ejaculation is the most common type of sexual dysfunction in men younger than 40years. Premature ejaculation is uncontrolled ejaculation either before or shortly after sexual penetration, with minimal sexual stimulation and before the person wishes. In most cases the cause may not be identified. It may be due to anxiety, guilt, depression, or if it has been a long time since last ejaculation. It may occur with a new partner, or only in certain sexual situations. In some cases, medical conditions, hormonal problems, injury or certain medications can cause it.

In most cases, it resolves on its own over time without medical treatment. Cutting down on alcohol, tobacco and illegal drugs may improve this. Counseling or behavioral therapy may help reduce anxiety related to premature ejaculation. Antidepressant drugs have also been found to delay ejaculation. There are also creams, gels and sprays which can be applied before intercourse. I would advise you visit a doctor who would be able to evaluate you and give you further advice.

The recurrent fever and headache could be poorly treated malaria, and infection, a problem with the immune system, or some more sinister problems. Have these checked with a doctor and do continue to cut down on your alcohol intake. It sure will help in the long run. Cheers!

****This post was contributed by a guest doctor blogger.

For a related post, please click on this link https://chatwithdrketch.com/2014/04/13/daily-health-tips-premature-ejaculation/

Have a great night, beautiful people 

Q: Hello Ma I’ve a pot belly and I want to trim it down. Please, advice on what to do. Thank you

A: I’ve been getting a lot of questions on pot bellies, big tummies after child birth or just big tummies…after nothing, full stop:D So, I’ll reproduce part of a post I’d written on this subject (the trio of diet, exercise and stress). Remember that you can always visit my bloghttp://www.chatwithdrketch.com and type in any subject you want to know about in the search box. You will be presented with all my posts on that subject. There’s a lot I’ve written on weight loss et al 

I hate to be the one to break it to you…but alcohol is not the only thing that gives you a pot belly!:D Pot belly is caused by consuming way too many calories and these can be from your chilled bottle of beer or from your huge bowl/basin of rice (especially polished white rice) or yam. It is important to know what to eat, how to eat it and how much of it to eat.

The bad thing about tummy fat, is that it is not on the outside. It is actually on the inside, around the organs. So, no amount of sit-ups can touch this fat…exercise can help tighten abdominal muscles (especially for those who just put to bed) but it won’t get to the fat around organs (visceral fat). This fat is associated with some disease conditions like Diabetes Mellitus etc.

A diet full of junk food (meat pies, doughnuts) is unhealthy on a lot of fronts. It contains empty calories which give you calories you don’t need and make you demand even more calories in a short while. They also cause your blood sugar to yo-yo (jumping up) jumping up and down in a way that doesn’t help blood sugar control. A diet that is also full of white carbs like white bread, polished rice etc is also not ideal for the same reason. So what should we eat? A balanced diet…a diet that contains all food groups in sufficient amounts for the body to use them efficiently.

I have had cause to describe the ideal plate of food several times: Half the plate should be filled with vegetables, a quarter with complex carbohydrates like beans, local rice (like Ofada/Abakaliki/brown/wild rice), sweet potatoes, oatmeal etc and the last quarter with protein (fish, chicken etc). Remember that carbs are necessary to provide the energy needed for our daily activities. So, do not ‘demonise’ (:D) them….however, not all carbs are created equal. Complex carbs are superior because they supply energy and fibre and some also supply minerals and vitamins.

Then remember portion control. Reduce the plate size you usually use, if you need to lose weight. This automatically reduces the quantity of food you can eat.

Remember also to make a conscious effort to chew your food properly and take your time. Don’t wolf it down…or inhale it  Chew intentionally so as to give your brain sufficient time to process the signal from your brain which says that you are full. Have you observed that when you rush your food, you move from being very hungry to being completely stuffed! There’s no in-between, where you realize that you’re full before you get to the stuffed part. That’s because your brain didn’t have enough time to process that info before you became ‘over-full’.

Note that, even if a food is considered healthy, it doesn’t mean you should eat as much of it as you want. For instance, beans is healthy on so many levels but it also high in calories and so you still need to stick to the portion described. Moderation in everything!!

Exercise is critical because it makes your heart strong, improves your body’s ability to break down food, resist diseases and generally provides a feel-good attitude. It also helps you lose weight. Mathematically, exercise helps to burn what you have eaten such that, if you do enough and watch your portions, at the end of the day, there will be a food balance between what you have burnt and what you have taken in. If you have not been engaged in any exercise for a long time, please see your doctor before you start any vigorous regimen. A minimum of 150 minutes of exercise per week is essential for good health. Try to get this exercise anyway you can: walking, dancing, skipping, arm wrestling, pillow fights etc. All the activities count and help you keep you fit, trim and healthy. If you use the gym, that’s great. You can get the instructor to put you on a regimen that involves aerobics, strength training (training with weights) and then focus on troublesome spots like your tummy etc. (in that order) or suggest useful regimens that are helpful.

Finally, I will talk about stress because quite a number of us are stressed out. Stress causes the release of a hormone called Cortisol which, amongst other things, causes fat to be deposited around our tummy. So, reduce your stress consciously by figuring out how to better cope with your sources of stress or even eliminating the stresses that you have control over. It’s your life after all.

I suggest you also click on this link to read my post on low glycemic eatinghttps://chatwithdrketch.com/2014/02/16/daily-health-tips-low-glycemic-eating-whats-that/

Have a good night, y’all 

Q: Evening Dr Ketch. I hope you’re good. I.am only 18. I have been having abdominal pains and I was told that I have ovarian cyst. I am on medication but they said if it doesn’t work then I’ll have to undergo an operation. I am scared because they told me I have less chances of conceiving. Could this be true?? (I’ve never had an abortion before). Please help!

A: Thanks for writing in, dear.

Ovaries are small bean-shaped organs on either side of your womb. Every month, your ovaries develop sacs called follicles from where eggs are released monthly and female sex hormones produced. After the egg is released every month, the sac disintegrates. But sometimes, the egg is not released and the sac remains or the egg is released and the sac does not disintegrate. This follicle becomes the fluid-filled cyst sac. Usually this is not a problem as it could form during every menstrual cycle and usually resolves on its own. These cysts are called the functional cysts. However, these cysts could get very big and in some instances become twisted or they could rupture causing problems. This latter type is called pathological cyst.

Examples of pathological cysts occur in Polycystic Ovarian Syndrome and endometriosis. In the former, small cysts appear all over the surface of the ovary and is also associated with irregular menstruation and high hormonal levels. In endometriosis, the tissues of the uterus (womb) are found outside of the uterus. These two pathological cysts are associated with fertility problems. Functional cysts are hardly associated with fertility issues except they become extremely large.

Treatment depends on your particular situation. You could get away with no surgery and no pills, if your doctor orders serial scans to continually observe the size of the cysts and sees a reduction in size. Otherwise, the other treatment options are the use of birth control pills to prevent the development of more cysts in future menstrual cycles and surgery as the final option.

Have a chat with your doctor and share your worries about these treatment procedures. He/she will guide you through this.

All the best!

Hello y’all 

How has your day been? I have had an absolutely fabulous day…lying down on my bed! 

By popular demand, I reproduce the recipe for yoghurt here. I have had a lot of people asking about it in recent times.

Remember that yoghurt is full of healthy bacteria that may help fight vaginal infections, prevent brittle bones (osteoporosis) in old age because of the calcium content and help digestion amongst other uses. And now for my home made brew…without fancy machines and stuff…

• Get your measuring cups, warm water, a clean dish towel,, some already made (store bought yoghurt with pro-biotics, an airtight container and milk. This recipe uses powdered milk
• Mix one cup of milk with 4 cups of warm water. Whisk it all up.
• Scoop out one cup of the mixture and add a quarter cup of your already made yoghurt with pro-biotics (Any already-made yoghurt will do, really)
• Then pour the mixture from the point above to the milk mixture and whisk.
• Pour in an air-tight container and cover with the tea towel.
• Do not move, mix or stir the mixture during the ‘setting’ process. Leave it for at least 4 hours. I usually leave mine overnight and wake up to a jar of fabulous home-made yoghurt!

So, mix up your own batch and after the first go, feel free to mix and match the recipe as you like. As you can see, there was no added sugar to mine  If you ant a healthy sugar kick, you can blend some fruits eg banana ith the yoghurt. Tastes….delumptious!

This recipe can also use bottled milk in which case it has to be warmed before (not boiled) before use and repeat all other steps as above.