chatwithketch

Q: I was having stomach problem even to the extent of losing weight, so I went to hospital, did some tests and found out that I’m H. pylori positive. They gave me some drugs. After taking all these drugs, nothing has changed. I am still feeling hungry and thirsty even after eating and drinking. I haven’t even added 1 pound since then. It has been 2months now. Please what could be the problem. Always feeling as if my tummy is burning

A: Infection with Helicobacter pylori (H. pylori) has been found to be a cause of peptic ulcer. Peptic ulcer is a sore in the stomach, esophagus or duodenum and occurs when there is either over-production of this gastric acid in the stomach or reduction in the quantity of mucous that protects the stomach from the acid.

In the past, it was thought that spicy foods caused peptic ulcers. However, there’s no evidence to support this, though spicy foods can certainly make the symptoms of ulcer worse. Smoking, stress and drinking alcohol are also likely to worsen the symptoms of peptic ulcer. Caffeinated and carbonated beverages may also be culprit. Ulcers are also common in people who take certain pain relieving drugs known as Non- Steroidal Anti-Inflammatory Drugs (NSAIDs) like Ibuprofen.

People with peptic ulcer usually complain of burning abdominal pain or even sometimes, chest pain as the pain can be anywhere from the breast bone to the navel…giving room for a wide range of descriptions, typically burning. The pain is usually worse at night or when the stomach is empty.

People with ulcers may vomit blood or pass out fresh or altered blood in stool. For the latter, the stool looks tarry black. Complications of peptic ulcers include internal bleeding, leakage of the acid into the abdominal cavity etc

Treatment is targeted at reduction in acid production, neutralization of acid, treatment of Helicobacter infection, promotion of healing or protection of stomach lining. Your doctor will determine the best option or combination(s) with your active participation, of course

Thus, prevention is targeted at switching pain relieving drugs (if you have an ulcer, please stay away from NSAIDs), reducing your level of stress, stopping smoking and reducing your alcohol intake. Maintaining a healthy diet filled with loads of fruits and veggies, which provide sufficient vitamins to aid healing, is also a good way to go. It is still not very clear how H. pylori infections spread but it is thought to be probably from person to person or from food and water. So, judicious and very frequent, hand washing will certainly help

Does milk help? Well, temporarily but it quickly makes it worse. Milk coats the surface of the stomach, reducing the pain but then stimulates more acid production. Sounds like you can’t win, aye?! ;D

So, see a doctor first to confirm whether the H. pylori infection is still active and also to understand your new symptoms and then s/he’ll advice on treatment.

Q: Good evening Dr. Ketch. please can women with PCOS who can only menstruate, ovulate by taking medication, conceive and put to birth without miscarriage?

A: 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 (PCOS) 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.

So, is it possible to become pregnant with PCOS? It is not impossible. To help improve your chances, maintain a healthy weight, eat healthy, exercise, monitor your ovulation and time sexual intercourse to coincide with this time.

Treatment depends on your particular situation. Your doctor could order serial scans to continually observe the size of the cysts and see if they reduce in size. Another treatment option is the use of birth control pills to prevent the development of more cysts in future menstrual cycles. The final option is surgery.

Risks associated with pregnancy in a patient with PCOS include miscarriage, high blood pressure, premature birth and diabetes mellitus. The risk of these can be reduced by monitoring PCOS symptoms and taking extra care during pregnancy. Your doctor will advise on the best course of action based on your history.

All the best!

Q: Hi Dr. Ketch, I appreciate the good work you are doing in here. Please, I want to know the condition that causes boils to grow in every part of my body – in my nose, eyes, arm pit, vaina, back chest and even my laps. This usually happens two weeks to my monthly cycle and these boils are usually painful but goes after some days. Could this be infection or what? Please help me with answers. I am not on any preventive pregnancy drug, I do natural family planning

A: A boil, also called a skin abscess, is an infection of a hair follicle deep in the skin. Boils can occur in any part of the body, but most frequently in the armpits, groin, around the vagina/anus areas, around a tooth and at the back. They are often swollen, painful, and after a few days collect as a head of pus and debris (this explains what you noticed) which can rupture on their own when soft or ‘ripe’ or may require a health expert to cut it open and drain it (if it’s quite large).

The more common causes/triggers of painful lumps (which could be boils) in the armpits, include:
• Deodorants: These can cause skin irritation which can lead to boils. The delicate and sensitive skin of the underarms and the sweat that can accumulate there making it a rich culture medium for germs are factors that have been implicated. Solution: You may have to try another one…find one without fragrance or perhaps, formulated for sensitive skin. Reading the labels will provide this information J

• Shaving: A lot of people can identify with this…bumps in the underarm after shaving. This can happen if you do not shave properly. Try shaving after taking a bath when the hair is moist and the skin hydrated. If this does not suffice, you may have to find alternative means of removing underarm hair eg depilatory cream.
• Infection of the hair follicles from cuts or injuries to the underarm, or from friction caused by wearing tight clothing. So, be careful while shaving and try to wear clothes that are more loose fitting (especially under the arms) and/or focus on fabrics that can ‘breathe’ like cotton
• Dirt or debris from excessive sweating can clog up hair follicles leading to painful lumps. Personal hygiene is key. Don’t be miserly with bathing and be sure to ‘take care’ of the underarms and other areas like the groin that tend to accumulate sweat and raise a stink J
• Infections due to viruses or bacteria.
• Cancer of the breast may also present like this.

Boils in the pubic region, can be caused by an ingrown hair (the hair instead of growing upwards, grows inwards into the skin, this may occur following shaving), blocked hair follicles (from sweat, or a damp unclean environment), a sexually transmitted infection (herpes, when it’s just starting) a sign of some other disease like diabetes, or problems with the immune system, poor hygiene (especially during menses for women) and poor nutrition.

As much as you may want to, avoid squeezing or scratching it, allow it rupture on its own. This would help prevent further infection of deeper structures and skin, and also prevent spread to other areas. Apply warm water with a cloth on the boil for about 10-15 minutes, 2-3 times a day. Avoid sharing towels and washcloths with other people and keep the area clean and dry as much as you can. An antibiotic cream or mupirocin cream can also be applied (ask for this in a pharmacy shop). You may require antibiotics, which would be prescribed by your doctor, if he thinks you need them.

Further evaluation may be necessary if you have boils in multiple areas (as could be the case here), recurrent boils over several months, a very large boil, or boils on your face (including the nose that appears to be affected here) and anus.

I hope this helps.

Have a good night, y’all 😀

Stress causes the release of a hormone called Cortisol which, amongst other things, causes fat to be deposited around our tummy. 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…it 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. 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.

Here’s what Harvard Health thinks. https://www.health.harvard.edu/blog/stress-eating-five-strategies-to-slow-down-2019082617620

Q: Hi I need some advice Dr, Please, I am a female and I have hair growing around my nipples, in my anus, in my vagina (bikini line ,under the vagina lips and in towards the back) also under my chin, I am ashamed of it and wanted to know why is it I have hair in places like these. I also noticed the hair under the vagina lips is causing lumps I don’t know what to do for these lumps. Please advise me. Blessings

A: Hi dear. Thanks for writing in.

What you’ve described sounds like hirsutism which is a situation in which there is excessive hairiness in a woman in places like the face, chest and back. Funny enough, growing up, very hairy ladies were considered pretty special…In a good way 😀

This situation can be caused by any situation that increases the male sex hormones (androgens) or increases the response of hair follicles to androgens. Some conditions that can cause this include Poly Cystic Ovarian Syndrome (PCOS), some drugs, obesity etc It is more likely in people who have a family history of this and in people of Asian, Mediterranean and Middle Eastern origin. This can also be found in women with no risk factors and women where no specific cause can be found.

If specific causes are found eg obesity or PCOS, these should be addressed.

As you may have found out, permanent methods of getting rid of the facial and other unwanted hair like laser treatment (which does not destroy the hair follicles) and electrolysis (which destroys hair follicles but may leave small scars on face) are expensive with laser being more popular and more expensive.

Mild cases of hirsutism can be dealt with by shaving, waxing, plucking or using depilatory creams…much as you would take care of underarm hair.

Birth control pills used over a period of 6 to 12 months may improve this condition by helping reduce the effects of androgens and reducing the production of more sex hormones. Anti-androgen drugs can also be used.

So, make out time to go find a gynaecologist as soon as you can and discuss this. He will carry out a detailed investigation and then confirm treatment options that would work best for you depending on his findings eg whether the contraceptive pills are an option for you etc.

Until you’re able to do that, you may have to keep plucking, waxing or using depilatory creams. As soon as you can afford it, laser treatment should be considered.

Shaving is also an option but it could lead to razor bumps in the groin/vagina like what you have observed. The reason for this is because in Africans, the hair in the groin area is very curly and so it is pretty easy for the hair to curl and grow down instead of growing up and out. These lead to red, raised spots/bumps which could get infected and become pus-filled.

More often than not, an ingrown hair does not require special treatment. They just leave quietly on their own…much like how they came. This of course, presupposes that there is no shaving done during this period to aggravate the situation. In the meantime, do not squeeze the bumps as this may push the bacteria further inside. You could use a soft bristled brush to loosen the hair before shaving or use a sterile needle or tweezers to tease out the ingrown hair(s) if it lies close to the surface.

How to prevent ingrown hairs? Simple! Stop shaving…at least for a while. That’s always an option. There’s always a huge debate about whether things should be kept natural down there! 😀 However, if you choose to shave, try using a scissors to trim, before using a single blade shave stick to shave. Make the hair as wet as possible using shave foam and then shave in the direction of the growth of the hair. And while you may think it’s fun to be completely clean shaven there, try not to shave too close to the skin and rinse the shaver after each stroke 😀 Pat the area gently afterwards…don’t rub vigorously. Remember that re-using razors you have used on the infected parts may lead to further re-infection with bacteria that are on the surface of the razor.

Your doctor will make a definitive diagnosis. He/she may prescribe some anti-biotic ointment or oral antibiotics (taken by mouth) and some other ointments to stop the inflammation. Remember that antibiotics should be taken for the full period prescribed by the doctor and not stopped as soon as you feel better.

Have a great evening, y’all 😀

‘ A study published recently in the American Journal of Clinical Nutrition sparked interest when it reported that red and white meat have a similar effect on low-density lipoprotein (LDL, or “bad”) cholesterol, which is associated with increased heart disease risk. You may conclude, “Well, if chicken is just as bad for my cholesterol as red meat, I may as well order that hamburger.”.

Is this really the fact? Well, don’t just stand there…just read! 😀

Q: Good morning Dr,please I am 34weeks pregnant and discovered I feel pain in my left ear. I did not go to my Dr but I am using Chloramphenicol (due to itching and I used cotton buds but I think I injured myself) will it affect me or my baby,help am scared. Should i go to my DR?

A: Chloramphenicol is an antibiotic which is usually used to treat various infections in the body. It slows down the growth of bacteria by preventing them from producing the proteins that they need to survive and multiply. It can be used in ear and eye infections etc
34 weeks? Wow! Steady on…you’re almost there!

Pregnancy is a very delicate time…a new life is forming within and the mother has to sustain this life by making all the right decisions. This does not include popping pills or taking un-prescribed medications at will. A significant number of drugs are not advised for use in pregnant or lactating mothers. If they are to be used, the focus is always on ensuring the benefits far outweigh the potential risks. Chloramphenicol eardrops may not necessarily be absorbed in sufficient quantities as to cause any problems for the mum or baby, but its use in pregnancy is not advocated because the drug crosses the placenta.

So, what to do? Discontinue this drug and whether pregnant or not, do not self medicate. That’s what doctors are there for!  Go to them for advice and/or treatment.

Have a good night, fab people 

Q: Thank you Doc…  Growing up I had the hernia in my navel too, but now it is no more. It disappeared when I was in secondary school, but now, if I should touch my navel, like trying to remove dirt, I will feel a little stomach upset. Does my case still call for surgery? 

A: First rule of thumb for any condition you have is that where in doubt, please revert to your doctor again or seek a second opinion. If indeed, you have hernia and you are now having pain, as you will see in this post, see your doctor IMMEDIATELY.

Starting from the beginning, hernia is the protrusion of an organ through a defect (like a hole or opening) in the wall of the muscle or cavity which usually holds it in place. There are different types hernias (or herniae) and they include:

Inguinal hernia: The most common type of hernia. It usually happens in situations where the pressure inside the abdomen is increased.

Other hernias include incisional hernia (where a protrusion develops from the site of a previous surgery, especially abdominal surgery), femoral hernia (which has the same risk factors as inguinal), umbilical hernia (common in black children where the umbilicus, aka navel does not form a small ‘button’ on the abdominal wall but protrudes) and hiatal hernia (where the stomach squeezes through a hole meant for the oesophagus (the pipe through which food gets to the stomach).

Typically, all hernias are caused by a weakness in the wall of muscles or containing cavities and an increase in pressure. Examples of activities that increase pressure in the abdomen are long-standing cough or frequent sneezing, carrying heavy loads regularly, straining at stool whether due to constipation or diarrhea etc. The walls of muscles are usually weakened in people who are obese, pregnant women, smokers and malnourished people. It is also more common in men and as people grow older.

What are the symptoms? People with hernia would usually notice a protrusion after a strain eg lifting something heavy or coughing. Sometimes, they are able to push it back. Other times they are not. The worry about hernia and the reason why they have to be treated quickly is that they may strangulate. Yes, just think about the word strangle and you understand what strangulate means J The protrusion may become squeezed by the opening through which it passes blocking off blood supply to the area protruding. Once a part of the body is deprived of blood, it dies. We don’t want that to happen!

The decision as to whether to go for surgery or not depends on where the hernia is located (inguinal and femoral hernias usually need surgery), the contents of the hernia sac and the symptoms. A truss (a supportive device that prevents enlargement of a hernia) may be prescribed by your doctor to help for a short period of time. Typically a doctor will schedule a surgery to repair a hernia. Complaints of pain in a hernia patient may mean strangulation, which needs to be dealt with immediately. Umbilical hernia does not usually require surgery as the protrusions usually ‘return’ on their own. If this persists beyond 5 years, then surgery may be needed.

If you do require surgery, you don’t need to fret about it…really. This is not major surgery…it’s intermediate (sort of like half way between minor and major :D). Your doctor will provide answers to all the questions you have and of course, counseling. There are options for laparoscopic surgery which is surgery done through small incisions guided by a camera.

Preventive measures include having a healthy weight, giving up smoking, treating conditions that may lead to long-standing coughs, eating healthy to prevent straining at stool etc. These are the self-help options available to you now. I am worried though, about the possibility of strangulation. I suggest that you go to a doctor who will give you a proper diagnosis after examining you.

All the best!

‘ What can you do to prevent stroke? Age makes us more susceptible to having a stroke, as does having a mother, father, or other close relative who has had a stroke. ‘ https://www.health.harvard.edu/womens-health/8-things-you-can-do-to-prevent-a-stroke