chatwithketch

With more and more people making concerted efforts to get healthier, going vegan is now more in vogue. What does it mean to go vegan and how much animal protein is safe to cut out of your diet? Read!

https://www.health.harvard.edu/staying-healthy/is-it-safe-to-go-vegan-in-older-age

Q: Good day Doc. Please, what is immune system? Can food we eat or water we drink affect our immune systems? For 2 days now, I’ve been passing out little blood with my faeces. Is it from my anus? What could be the cause> I’m worried. Thank you

A: Hello! Thanks for writing in.

The immune system is a collection of specialized cells, organs and substances that help protect us daily from germs and diseases. In people with compromised immune system, this function is lost such that germs that may not have ordinarily caused disease, are able to cause significant damage to the body. Reducing or coping better with our stress helps strengthen our immune system as does getting adequate amounts of sleep daily.
Fruits and vegetables, generally, are filled with anti-oxidants and phyto-nutrients which are substances that help fight diseases. So, loading up on these is always a great idea. Cooking the veggies minimally, juicing them and eating them fresh helps ensure that you are getting the maximum benefits from them. Remember that your vegetables should be washed with food safe disinfectant or salt and rinsed before cutting. Fruits should also be thoroughly washed before eating. Water melon and grape fruits are particularly good in strengthening and activating the immune system. Spinach, fish, cabbage, sweet potatoes, almonds, broccoli, mushrooms, oysters, garlic and low fat yoghurt are also immune-boosting foods

Now on blood in stool, 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.

Q: What causes hepatitis disease?

A: Hepatitis refers to inflammation (a situation that causes swelling, redness, heat and pain of affected area) of the liver cells caused by a viral infection or damage to the liver as a result of drinking too much alcohol.

The liver is an organ in the body which is usually found on the right side of your abdomen, just under the rib cage. Its job is to ensure that toxins taken into the body are rendered harmless, food is digested properly and the nutrients available in it, properly absorbed.

There are different types of hepatitis and some of them will not cause serious problems while others will cause long lasting damage to the liver and could lead to cancer.

The symptoms of liver disease include yellowness of the eyes and/or skin, dark urine, pale (light coloured) stool, itching, abdominal pain, abdominal swelling etc. You are more at risk of this if you work in a center where you handle body fluids (so this list includes healthcare workers). Other people who are more at risk include diabetics, obese people, people who take a lot of alcohol, drug abusers (this includes people who use illicit drugs and those who abuse prescription drugs), people who are in the habit of indiscriminate and unsafe sex etc

Hepatitis A: This is caused by eating food or drinking water contaminated by the faeces of someone who already has the infection. This is usually common in areas with poor sanitation. This infection would usually resolve after a couple of months but sometimes it could be very serious and life-threatening. Treatment is focused on symptoms like pain, itching etc

Prevention is vaccination with the Hepatitis A vaccine.

Hepatitis B: Hepatitis B infection is caused by the Hepatitis B virus (HBV) and it can cause very serious symptoms in people or it could very well pass unnoticed and be discovered by chance as in this question. The infections that occur in adults are usually acute and the body is able to clear the infection within 6 months. However, in a small proportion of adults and in a lot of infections occurring in children, the infection remains the body for a long time (chronic) leading to complications like liver failure and cirrhosis (long term liver disease in which there is scarring of the liver due to different types of liver disease) of the liver.

The symptoms include yellowness of the skin and eyes, dark urine, fatigue, body and joint aches etc. These symptoms vary in severity and appear about 3 months after infection.

Causes of HBV infections include contact with infected sharps like needles, sexual contact with an infected person, having multiple seal partners, sharing needles used for intravenous drug use.

If one suspects exposure to HBV infection, an immunoglobulin injection if taken within 24 hours can prevent the infection. Treatment depends on the type of HBV infection…whether acute or chronic. To confirm whether the infection is acute or chronic, the doctor runs a couple of tests.

The Hepatitis B surface antigen. A positive test result confirms that an infection is present but does not tell us if it is acute or chronic.

The Hepatitis B surface antibody. A positive test confirms that an infection had occurred but the body had developed antibodies to fight off the infection. This person is no longer contagious.

The Hepatitis B core antibody. A positive result tells us that a past or present infection exists. This is mainly interpreted in conjunction with the other two tests.

If the core antibody is positive and the surface antibody is positive, it means that the body had encountered this infection and fought it off in the past. This is likely to be an acute infection.

If the core antibody is positive and the surface antigen positive, it is more likely to be a chronic infection.

Treatment for acute infections focus on alleviating the symptoms noted above. Treatment for chronic infections focus on use of antiviral drugs and other medications that improve liver function. If liver function Is badly affected, transplant might be an option.

So, the first focus for you is to confirm if this is an acute or a chronic infection. That will determine the way forward. Remember that you can improve liver function by staying off alcohol, exercising, eating a lot of fruits and vegetables and not self-prescribing.

To avoid this infection, reduce your risk factors: Know the Hepatitis status of partner and be faithful to that person, where necessary, use condoms, stop the use of illicit drugs, do not share needles and other sharps, be careful with tatooing et al.

Vaccines are available for this virus and is now listed on the National Program on Immunization schedule. All adults who also have risk factors as noted above should also take this vaccine.

Hepatitis C: This is spread through blood to blood contact eg sharing needles. In a few cases, people can fight off the infection, but in most people, the virus survives and causes chronic (long standing) infection which can lead to cirrhosis and liver failure. There is no vaccine for this infection.

Hepatitis D: This is caused by Heaptitis D virus and only occurs in people already infected by the Heaptitis B virus as it requires the latter to survive in the body.

It is spread through blood to blood and sexual contact. Long term infection with this can put one at risk of liver failure and cirrhosis. There is no vaccine against this but given its relationship with Hepatitis B, vaccination against Hepatitis B can provide some protection against this as well.

Hepatitis E: This is caused by eating food or drinking water contaminated by the faeces of someone who already has the infection. This infection is usually mild and would usually resolve without treatment but sometimes it could be very serious and life-threatening. It can also become long term especially in people with suppressed immune systems.

There is no vaccine for this infection. Focus is on ensuring good hygiene.

Other types of hepatitis include:

Alcoholic hepatitis due to taking excessive amounts of alcohol over years. This can lead to liver failure, cirrhosis or liver cancer. Prevention is reducing your alcohol intake or stopping completely J

Auto-immune hepatitis is is a situation in which the body begins to attack its own liver cells for no reason. Treatment is the use of drugs to suppress the body’s immune system.

What foods should a hepatitis patient take? A healthy balanced diet, really. Stay off alcohol though as this causes further damage to the liver. Be sure to drink sufficient amounts of water daily and discuss all drugs you’re taking with your doctor.

I hope this helps.

‘What are the facts about the glycemic load of foods? If you have diabetes, you probably know you need to monitor your carbohydrate intake. But different carbohydrate-containing foods affect blood sugar differently, and these effects can be quantified by measures known as the glycemic index and glycemic load. You might even have been advised to use these numbers to help plan your diet. But what do these numbers really mean — and just how useful are they? ‘

Read! https://www.health.harvard.edu/healthbeat/the-lowdown-on-glycemic-index-and-glycemic-load

Q Hello Dr Ketch! I have an issue that’s troubling me and I just want to know if I should be worried. Before I became sexually active, I had a manhood I was proud of in terms of length and girth even without erection. But, I discovered that it has shrunk. It’s now the size of a 7-year-old if not erected. I sometimes can’t feel it down there if am not aroused. I’m somehow comfortable it the size only when I’m sexually aroused. Anything to worry about?

A: The issue of penile length has been a problem forever and people generally think that bigger is better. Is it? The average penile length is about 8 to 13cm when not erect and this can be pushed up to 13 to 18cm when erect, give or take a few. Does the penile size determine whether a man can father a child or not? Absolutely not…penile size does not affect fertility.

A woman’s vagina is about 7.5cm and would lengthen to about 10cm when aroused and so, generally, there should be no problems with sexual intercourse as the average length of a penis can adequately cover this gap.

Now the challenge…a lot of men who think they are small in this area are actually within the average measures but perception can make them think otherwise. For instance, the only way they can assess the size is by looking down at it and this automatically makes it look smaller. If you looked sideways in a mirror, you might just think, it looks longer. Men who are fat also appear to have smaller penises because the fat around the stomach may hide part of the base of the penis, making it look shorter.
It does appear that guys with small penises achieve about 100% increase in length during sexual excitement, probably nature’s way of compensating as opposed to men with longer ones who may achieve about 75% increase in length.

There are all sorts of touted treatments that help increase penile length including surgery, vacuum pumps, extenders, creams, pills etc. There is little evidence that people who go through this are satisfied with the result or that they work. Indeed, some can cause permanent damage.

So, what to do?

Take charge…lose weight if you’re overweight and have a heart-to-heart chat with your partner about this. You just may be surprised to hear that she doesn’t care. If you still feel bad about this, you may try talking with your doctor.

That’s it, guys 😀  Have a good night y’all 😀

Q: Can I be cured naturally if I have cervical lesion?

A: Hello! Thanks for writing in.

I assume you mean precancerous cervical lesions. As the name implies, this is not a cancer but indicates an abnormality in the cells of the cervix that could, ultimately, become a full-blown cancer.

Common types of precancerous cervical lesions are:

Atypical squamous cells: This refers to abnormalities in cells of the cervix, referred to as squamous cells. Squamous cells are thin, flat cells that resemble fish scales. They are found in the tissue that forms the surface of the skin, lining of hollow organs in the body, and lining of respiratory and digestive tracts. Atypical squamous cells could be due to Human Papilloma Virus (HPV), which is a common sexually transmitted infection that is spread through sexual, skin-to-skin contact. There is a vaccine to prevent this cancer now. Please ask your doctor where you can get it. Health conditions associated with HPV include genital warts, cervical pre-cancer and other cancers. A repeat pap smear is usually recommended after some months

Atypical glandular cells, which could be suggestive of a precancerous lesions in the uterus or upper cervix. Glandular cells are located in the inner part of the cervix or the lining of the uterus

Squamous intraepithelial lesion refer to changes in the cervix that could be precancerous. High grade squamous intraepithelial lesions are more likely to progress to cancer of the cervix.

Pap smears can detect cervical pre-cancers before they become actual cancers. If pap smear is suggestive of precancerous cervical lesions, further testing procedures will be indicated. Further tests that could be requested include repeat pap smear, cervical biopsy, HPV testing, colposcopy (using a magnifying device to get a better look at the cervix).

Now to the crux of your question, can you be cured naturally? I guess the question you really want to ask, if there are treatment procedures that exclude surgery. Yes. Available treatment procedures involve destroying the abnormal lesions in the cervix using a cold probe to freeze them (cryotherapy) or using an electrically charged wire or using laser.  The surgical option, conization, involves surgically removing the area with the abnormal cells.

You need to have a long chat with your doctor to find out what options are available to you. Remember that the fact that you have precancerous cervical lesion does not mean that you will end up The earlier you get treatment, the better your chances of avoiding cervical cancer.

All the best!

Have a good night y’all 

Every year, lots of people ring in the New Year with resolutions but then end the year hardly making a dent in that list of plans. Well, if you want this year to be different, you have to go about your resolutions differently. This time, with an actual action plan! Read what Harvard Health suggests: https://www.health.harvard.edu/healthbeat/seven-steps-for-making-your-new-years-resolutions-stick