chatwithketch

Q: Hello Doc What causes the abdominal pains and how can someone prevent it. I have been experiencing pains more especially left abdominal for some couple of years…and also there is something (meat like/sore) growing around my Anus thought it will fade but nothing is happening and sometimes it hurts a lot after pooing. What’s the right procedure??

A: There are different causes of abdominal pain and constipation, which could lead to the fleshy thing coming out of your anus is one. Other causes of left sided abdominal pain include Celiac disease (a situation in which one cannot digest gluten –the protein in wheat), gas/bloating (y’all know what that means), lactose intolerance (a situation where people have problems tolerating milk), indigestion etc

The fleshy thing you refer to sounds remarkably like 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)

As quick next steps, please go visit your doctor for proper examination and diagnosis.

For tips on constipation, please click on this link

Daily Health Tips: Difficulty With Passing Stool

Have a great evening 😀

Q: Hello Dr kindly assist. I’m very worried about my digestive system. I drink water everyday but whenever I go to the toilet I’m always constipated. What could the problem?

A: Constipation occurs when faeces passes too slowly down the digestive tract causing the stool to become hard and brittle. It leads to a situation where a person has less than 3 bowel movements per week. The classic symptoms are straining to pass stool, having the feeling of incomplete emptying after a poo and sometimes having to press down on your abdomen to help emptying. Sometimes, constipated people also insert a finger into their rectum to help the process along. Constipation becomes chronic when it persists for weeks on end.

Constipation may be due to blockages in the rectum, diseases like Diabetes Mellitus etc. However, they could be due to lifestyle issues like not drinking enough water, not eating enough fibre in our diets and being sedentary. Being a woman and getting older also pre-disposes one to more episodes of constipation.

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! 😀

All the best!

So, no good news there. Not only is red meat associated with increased risk of other diseases, now it appears that it could lead to an early death. Doubt me? Well, read for yourself! https://www.health.harvard.edu/staying-healthy/harvard-researchers-red-meat-consumption-tied-to-early-death

Q: Hallo Dr. Kindly assist me. My brother in law has diabetes type 2 and is experiencing ED. he has  tried to take Viagra, Cialis but all in vain. His wife is stressed because she wants a baby. Pleases advice. Thank you.

A: Erectile dysfunction (ED) occurs when a man is no longer able to get or maintain an erection sufficiently enough to have sexual intercourse. It may be really dramatic in some men, such that where they used to want intercourse very frequently; they find that there is reduced sexual desire.

Oftentimes, this may be due to just stress and better stress coping mechanisms help. However, because this is a sensitive topic, many men do not seek medical help such that this causes significant strain in their relationships. Other causes include depressions, relationship challenges, high blood pressure, high cholesterol level, high blood sugar, obesity, some medications, tobacco use, substance abuse, alcoholism etc

Your doctor will probably order some tests to confirm possible cause(s) and then decide on a course of action. Now I know that quite a number of men are quick to go and buy Viagra (as in this case) and some even overdose on it thinking the more they take the better the performance. Please don’t do that! More seriously, these drugs are not for everyone and so if you have Diabetes Mellitus, heart disease, if you have had a stroke etc, please be sure to mention these to your doctor…and indeed you should not self-prescribe any of these (or indeed any other) drugs for yourself.

Treatment depends on cause. If this is emotional, psychological or due to stress etc, some degree of counselling may help. Other treatment options include oral medications like Sildenafil (Viagra), penis pumps, implants, injections etc. Please speak with your doctor to find out what options are available to you.

Remember that your partner may not understand what you’re going through and probably think that you no longer desire her. Be sure to re-assure her and let her be a part of your therapy. More importantly, try to be open about what is going on to your doctor so he can work with you to find the ideal solution.

Good night people

Did you know that when you open tin cans that you should pour out all the contents whether you finish it or not and store in a different container in the fridge? Once you open tin cans and it gets exposed to air, the tin (metal) content can now readily transfer to your food. So, for all of you who have always stored your opened tins of sardines in the tin cans, be sure to stop. You definitely do not want to be consuming harmful metals along with your food 

 Did you know that once you cook food, it should not be stored at room temperature for more than 2 hours? Are you aware of the different ways in which your food could become unsafe? Food hygiene is coming more and more under the radar because of increasing cases of food poisoning and issues experienced in keeping the integrity of the food chain even in very developed countries. Here are five issues you need to know about food hygiene. • Eggs. These are at the root of more than 30 percent of food poisoning cases. So get your children to stay off raw eggs. If you’ve got children like mine, it may not be as easy as it sounds especially when you’ve mixed up a batch of cakes and are trying to convince them that the batter they desperately want to lick off the bowl is not healthy! Ensure that egg dishes eg French toasts (when you choose to indulge), custards etc are well cooked with no hint of raw eggs. The risk of salmonella infection is ever so real.The argument about where to store eggs (in the fridge or at room temperature) have raged for a long time. The jury is still out. Generally, it is always a great idea to store your food in a cool compartment like the fridge. Be sure to keep the eggs away from strong smelling foods…or you may end up eating ‘oniony’ eggs etc 

 • Chicken. Poultry usually harbours the salmonella infection but because this meat is usually cooked before eating, it may not be a problem. However, cross contamination by using the same chopping board or work surface used to prepare chicken to prepare other foods could lead to a salmonella infection. This is also the case if the chicken is stored in the fridge in direct contact with other foods. Use different work surfaces for raw meats and other foods and please separate from other foods when storing in the freezer. • Raw or slightly cooked fish. Worms in raw fish can survive in the intestines of man and cause infections. Thus fish has to be properly cooked. All you sushi lovers please pay attention. Appropriate cooking methods include grilling and poaching. You know that way most people fry their fish until it sounds and feels like plantain chips when you’re eating it? Well, that certainly will destroy any worm in the fish but is not healthy for you. Sounds like you can’t win, yeah? • Raw or partially cooked meat. Provided meat is not minced, any surface contamination of the meat is easily eliminated by cooking. However, minced meat requires that the meat be cooked thoroughly all the way through. Lovers of tartar which are raw meat dishes should be especially wary. Wooden chopping boards are discouraged as cuts on them form rich reservoirs for germs. • Fruits and vegetables are not common sources of food contamination but could get contaminated if prepared on a contaminated surface or if not in optimal quality when eaten. So be careful The World Health Organization has a very handy 5 keys to safer food that sums all of this up: Keep your hands clean. Remember that even hands that look clean, could very have germs on them: wash them after using the toilet, playing with pets, before food preparation etc Separate raw and cooked foods so that you don’t transfer germs from foods like meat to other foods. Start off this separation when grocery shopping and pack these items differently, have different chopping boards for meats, veggies etc Cook foods properly and reheat (warm) foods that have been cooked earlier, thoroughly. This ensures that any germs, present are destroyed by the heat involved. Keep food at safe temperatures. Germs can comfortably grow in foods stored at room temperature. Refrigerating them slows down the multiplication of these germs and in some cases may stop the growth completely: cooked food should be piping hot, Frozen foods should be thawed in the refrigerator and not room temperature, cooked foods should not be stored at room temperature for longer than 2 hours etc Finally, use safe water and produce. So please make sure that you obey the cardinal rules of hygiene in the kitchen as in every other part of your life.

Q: Good evening Doc. Please, I have a question: heavy flow in menstruation – is it normal?.

A: Heavy menstrual flow, also known as menorrhagia, can be a source of major concern for the sheer inconvenience and the fact that it can lead to anaemia, as the body is unable to produce enough red blood cells to replace those being lost in the bleeding.

People who have this condition would usually use more than one pad/tampon per hour, would need to change their sanitary towel during the night, layer on about 2 pads at the same time, bleed for more than a week and with significant quantity of clots, be restricted on their daily activities and experience symptoms of anaemia like fatigue.

Probable causes of this include fibroids, cancer, bleeding disorders, use of Intra Uterine Contraceptive Device, hormonal imbalance which may also result from ovaries that don’t function normally leading to progesterone lack, some medications and of course, as a complication of pregnancy in which a woman miscarries or has an ectopic pregnancy (a pregnancy in another part of a woman’s body other than the uterus)

Treatment is really targeted at symptoms and underlying cause. Analgesics in the class of Non-steroidal anti-inflammatory drugs (e.g. ibuprofen) are given for the cramps and iron supplements are usually prescribed for the anaemia. Oral contraceptives could be given to regulate the cycle, oral progesterone to make up for the deficiency and correct hormonal imbalance and a special Intra Uterine Contraceptive Device (IUCD) called Mirena can help thin the uterine lining and reduce bleeding.

Surgical options also exist and can be used if the other treatment options are not successful.

If the underlying cause is a fibroid, clearly this will need to be addressed and same for the other causes.

So, see your gynaecologist so the cause can be determined and proper treatment started.

Have a great evening, people 

Q: Hey doctor, is it possible to ‘fall’ pregnant with a contraceptive implant in the arm?

A: The short answer is yes, but rarely.

For those who do not know, the contraceptive implant, as the name suggests, is implanted under the skin…. under the skin of the upper arm and protects against pregnancy for about 3 years.

This birth control method contains the hormone progestin which prevents the egg from being released from the ovary (if there’s no egg, then there’s nothing to fertilize, right? :D) and also makes the mucous in the uterus so thick that the sperm cannot swim through to get to the egg, even if it were released!

This method of birth control is good for breastfeeding mothers (because it does not contain estrogen which affects mother’s breast milk production) and is long lasting such that the woman does not need to take pills every day. However, this implant can cause unwanted side effects. While some women would have heavier, prolonged periods, some others experience fewer and lighter periods. Indeed, some may stop seeing their periods after one year of use. Other side effects include headaches, nausea, mood change, nausea, acne, infection at the site of insertion etc. These symptoms would usually stop within the first few months (3 to 6 months). If, however, these continue or your experience severe headaches or excessive bleeding, please see your doctor. Please note that, this method is not suitable for women with breast cancer.

If you experience a new lump in your breast, yellowing of the eyes, you have concerns about the location of the implants or just have questions to ask, please see your doctor.

Although this contraceptive is more than 99%effective, less than 1 out of 100 women who use the contraceptive implant for one year will get pregnant. If this happens, there’s a high risk that the pregnancy will be ectopic (implantation of a fertilized egg outside the uterus). However, given the more than 99% effectiveness, cases of ectopic pregnancy are rare. For more on ectopic pregnancy, please click on this link: 

Daily Health Tips: What Are My Options After Ectopic Pregnancy And Failed IVF?

So, the brief answer to your question is, ‘yes, pregnancy can happen with a contraceptive implant in place, but it is very rare’. I suggest you go see your doctor for a proper examination.

All the best!

Q: Good evening. Trust you are well. Kindly advise. I have just confirmed that I’m pregnant.  I’m a bit scared, I lost my pregnancy this year in march. It was about 5 months; it was one painful ordeal. My doctor told me to rest and not to get pregnant soon but I believe God has good plans for me. It came unexpected and I’m here embracing it well. Kindly advise – how can I take care of myself.  Thank you

A: Oh sweetheart, condolences. I feel really sad that the miscarriage happened! But it’s all good

There are no standard answers really, as to when to start trying to get pregnant after a miscarriage. If this is the first time you’re experiencing a miscarriage, some doctors still advice people to wait 3 to 6 months before trying again so that it’s easier to date the pregnancy etc. Others will just ask you to wait until you’ve had one menstrual period

It is normal to feel worried and a bit scared going into another pregnancy, but you have to trust that all will work out well this time. Surround yourself with good professionals (OBGYN) and loving family/friends. Then relax and enjoy the ride 😀

Generally, food focus during pregnancy is on the same things you ate before you got pregnant…assuming you were eating right :D. More fruits and veggies, complex carbohydrates (they are rich in fibre and keep you feeling full for a longer period of time) like beans, oatmeal, sweet potatoes, brown rice etc. Load up on proteins too (fish, chicken etc), calcium rich foods like yoghurt, skimmed milk etc

Eat 5 small meals a day: breakfast, snack, lunch, snack and dinner. This should keep the hunger pangs at bay and deal with the cravings. You probably will still crave stuff: Iyaalamala’s food 😀 , ice cream with all the toppings, a ‘ginormous’ (for the uninitiated, this is a word formed from a mixture of gigantic and enormous. Cute, right?) burger etc. and guess what? You can give in once in a blue moon, just don’t make it a habit! If you take in more calories than you need, you run the risk of having a big baby with all the complications associated with that during pregnancy and delivery and of course, it’s harder to get back to your pre-pregnancy weight after the baby.

I hope this helps.

All the best!

Have a good night y’all 😀

Q: Please Dr I need your help because I can’t sleep at night

A: Sleep problems may show up as difficulty falling asleep, difficulty staying asleep if one wakes up in the night, waking up too early and being unable to fall back asleep or waking up feeling very tired etc. This is called insomnia. These problems may (secondary insomnia) or may not (primary insomnia) be related to other health/disease conditions. Usually this person wakes up extremely tired and feels sleepy during the day. Women over 60 years of age are more prone, people who are stressed and travel long distances across time zones are also more likely to have insomnia.

This can be due to events of sudden onset like work or emotional stress, jet lag after travelling across time zones, medications, late meals, taking a lot of caffeine, alcohol and smoking etc. It can also be of a longer duration when the person finds himself unable to sleep for about 3 nights per week. The causes of the latter include depression and stress that has been going on for some time (divorce, death of a loved one etc). Other causes include medications, anxiety, pain or discomfort etc.

Treating insomnia depends on the cause. Your doctor may provide some counseling in helping you or could give you some drugs to help you relax for a short period of time…so you don’t get dependent on them. He may also want to try some behavioral therapies with you.

Insomnia without underlying medical conditions can be treated with lifestyle modifications like the under-mentioned ones:

• Have a regular sleep routine that allows you (an adult) about 7 to 9 hours of sleep daily. Go for the higher limit, by the way 😀 
• As much as you can, try sticking with a particular sleep schedule so that your body falls into that pattern
• Limit day time napping. Save it all up for the night 
• Limit your intake of fluids before bed to avoid waking up to urinate and being unable to get back to sleep.
• Cultivate good sleep habits (no TVs in room, no work before bed time, a warm bath before bed etc).
• Lay off the caffeine and alcohol before bed time too.
• Regular exercise helps relieve everyday tension but vigorous exercise before bedtime may lead to inability to sleep too.
• Make your room a haven for sleep and clear out all clutter and be sure that you have invested in a good mattress and pillows. It’s a good idea to ventilate the day’s issues before you actually start getting ready for bed, so you can mentally file every issue away in a ‘to-do’ or ‘done’ box ahead of the next day.

Insomnia due to underlying medical condition needs the medical condition to be addressed. In the case of depression, please ensure that you are taking the medications prescribed by your doctor.

I hope this helps. Good night y’all 😀

Q: What about cases where the amniotic fluid refuses to rapture and there are contractions?

A: For most women, their waters will break during labour at the peak of contractions. However, in some other women, it doesn’t.

In some, labour may proceed slowly leaving the doctor to take a call on that amniotic sac that refuses to break. This will usually involve manual rupture of the amniotic sac using a sterile plastic hook inserted into the pregnant woman’s vagina. This hook is used to pull on the amniotic sac until it ruptures. This is thought to speed up the contractions and labour. However, some studies suggest that this may not necessarily speed up labour so that some schools of thought prefer to rupture the amniotic sac only if the baby’s head has descended low enough to cover the mouth of the womb. You will be guided by your doctor.

In some rare cases, the baby may actually be born with some portion of the amniotic sac attached to them or born completely inside the sac. Both situations can be addressed by the attending medical team

Have a great evening y’all J