chatwithketch

Q: Hello good day Dr. Please I have ulcer for years now and have been taking deferent types of drugs still no improvement and currently am using cimetidine please help me is there a permanent cure and also is there foods I need to be avoiding if I drink garri or eat beans I will be having so much pain especially on my chest and painful bowel movement each time I go to toilet is usually watering please help me

A: There are two conditions that may often be confused, one for the other: Peptic ulcer and Gastro-Esophageal Reflux Disease (GERD).

Gastric acid is secreted normally in the stomach to help the process of digestion. 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. Infection with an organism, Helicobacter pylori (H. pylori) has been found to be a cause of peptic ulcer.

GERD, on the other hand occurs when stomach acid backtracks into the esophagus causing heart burn.

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 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. 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. Cimetidine which blocks the production of acid by acid-producing cells is clearly useful here. 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

For GERD, there are also conditions like pregnancy and obesity that make this condition worse and there are also foods that encourage this. Examples of these ‘foods’ are fatty foods, alcohol, orange juice, chocolate and coffee, onions, tomatoes, peppermint and spicy foods.

So for the person in the question, I suggest you keep a food diary over a period of time and try to figure out the trigger foods. If you suspect garri or beans, try to confirm this by having a ‘beans meal’ or drinking garri, and watching for heartburn and an unpleasant taste at the back of the mouth. If this is not the issue, perhaps it’s a weight issue or even over-eating.

Treatment is targeted at the acid and healing the esophagus. Remember that occasional heartburn is not regarded a problem but if it happens frequently, like two or more times every week, then it becomes a problem and is now referred to as Gastro-Esophageal Reflux Disease (GERD). So, drugs used can stop acid production (like Cimetidine), reduce acid production and cause healing of the esophagus or neutralize the effect of the acid.

Prevention involves trying to avoid your trigger foods (quite a number are actually healthy maintaining a healthy weight, avoiding heavy meals just before bedtime, try eating smaller meals and avoid tight clothes that may also put pressure on your abdomen.

So, see a doctor first to confirm the diagnosis….peptic ulcer or GERD and then he’ll advice on treatment.

Good news is, these ulcers can heal and so you may not have to take meds forever.

Have a fabulous evening and remember…no heavy meals before bedtime 

Q: Good day Doc. recently, babies are dying in the womb of their mothers with her knowing. Please Doc what can I do to keep my wife & unborn baby alive & healthy & at what stage of pregnancy can she take routine drugs?

A: Here’s an excerpt from my book, Just For The Health Of It, that speaks to a variant of this question. If this is your wife’s first pregnancy, then you’re probably more worried than most. But the practical truth is that she should register for Antenatal care as soon as she realizes she is pregnant.To prepare for that visit, she should remember the date of her last menstrual period, family history of birth of child with abnormality, sickle cell disease etc. She needs to be generous with information about any and everything that may affect the baby’s health such as lifestyle habits like smoking and alcohol drinking etc.Ultrasound scan and other screening tests will also be carried out on urine, blood, blood pressure etc to confirm genotype, rhesus group, Diabetes, presence or absence of anaemia, high blood pressure, abnormalities etc. HIV screening will also be done after voluntary counselling.

You both should choose a center that you feel confident with as regards the quality of the medical personnel and you should freely discuss the birth plan with them.In the first instance, antenatal care will be scheduled once every 4 weeks until the pregnancy is 28 weeks. Thereafter, the appointments are scheduled every 2 weeks until 36 weeks and thereafter, every week till delivery. This is the normal schedule, but your wife’s care giver may decide to give her shorter appointments if there are other factors to be considered like the presence of hypertension in pregnancy or indeed to review results of tests you had been sent to do.Then, those drugs that she is given? If she’s like me and hates to take meds, then this is a big deal! 😀 But she does have to take them. The folic acid ensures that the baby does not end up with abnormalities of the spine and also helps build up her red blood cells in combination with the other meds given. She has got to be religiously committed to taking these drugs to give her pregnancy the greatest chance of a good outcome.

So, has she taken today’s dose? Encourage her to go do it now

For nutrition, here are 5 tips for a pregnant woman:

• Eat a balanced diet with a variety of foods from different food groups.

• Be sure to include a lot of high fibre foods like vegetables, whole grain cereals etc to deal with the constipation associated with pregnancy.

• Ensure you take your antenatal medications (prenatal vitamins) in addition to eating well.

• Be sure to also take foods rich in iron eg and foods rich in folic acid eg green leafy veggies and beans. Folate prevents deformities of the spine.

• Drink at least 4 servings of milk, other dairy products or calcium rich foods. If you don’t eat enough, your baby will start drawing on your own stock from your bones. So, drink up your milk!Pregnancy provides an opportunity for a mother to adequately prepare her baby for life in 9 months. Make sure that you get all the nutrients that give your child a great health boost.

Have a good night, everyone 😀

Hallos Family!

How is it going? Well, as the rumour mills get to work, keep your peace. Focus on getting the right information and listen to government agencies for the real information on what’s going on. Some practical tips from WHO on how to cope with stress (adults and children) during this time.
Have a great week ahead!

https://www.who.int/docs/default-source/coronaviruse/coping-with-stress.pdf?sfvrsn=9845bc3a_2

https://www.who.int/docs/default-source/coronaviruse/helping-children-cope-with-stress-print.pdf?sfvrsn=f3a063ff_2

Still on hygiene. This time, paying a little more attention to children, I repeat a post from a couple of years back that will also be useful for the fight against the New Corona Virus (COVID-19)
Do you have a child who appears to catch anything that just moves around in the air? They go to school and will catch a cold provided another child has it? They will get measles, just by looking at a child that has one…even from a safe distance (okay…that’s an exaggeration that was meant to make you smile :D). I had one of those; my daughter would pick up any virus that was making the rounds! My constant prayer everyday was, ‘lord, don’t let this child die’
And so I decided to take things personal. When she was in a crèche, I led the campaign to ensure that children who had the sniffles were kept home and not dumped on unsuspecting caregivers in school. It would amaze you how many mothers do this. I am not passing judgement here because a lot of parents have to work and so staying home to look after a sick child may not be an excuse that is readily understood by bosses. But, the child risks having a medical emergency in school that cannot be handled by caregivers and of course poses a threat to other children who were previously uninfected. If the roles were reversed, you certainly don’t want your child going to school and picking up other people’s germs. I worked with the creche to ensure that all hand held toys were disinfected every morning and after use by the children as their use of the hand held toys (at the crèche stage) simply involved dipping the toy into their mouths and sucking for dear life! Flu and other droplet infections are spread by contact with droplets from someone else who has an infection.
At the primary level, anytime I was invited to give talks, I focused on droplet infections and how they are spread. I teach the children how to wash their hands, for at least 20 seconds, preferably under running water and drying.
The steps to effective hand washing in the ‘perfect’ situation are:
Wet hands with clean running water and apply soap.Rub your hands together to make a lather and then scrub between fingers, under the nails and the back of your hands.Continue to scrub for at least 20 seconds.Rinse your hands under running water.Dry off with a clean towel.Okay, not every convenience has running water; if you’ve got one of those toilets, just ensure that you pour the clean water on to sudsy hands and scrub for 20 seconds…the time it takes to sing Happy Birthday twice.
Remember to teach your children that germs hide in every single nook and cranny, especially in shared spaces. They are on the toilet handles, the tap knob, the tissue dispenser etc. Thus, after using the toilet, wash your hands last after you have cleaned yourself up and flushed. Okay, I heard that snigger…’yeah right! Like anyone has to be taught that!’ Well, actually, quite a number of people have to be taught as we have realized that quite a number of children are not taught this early enough and would have come down with some diseases before this is realized.
Buy them hand sanitizers. Alcohol based sanitizers reduce the number of germs on hands. The children can use these even after hand washing and leaving the toilet, in cases where there was insufficient water. In addition, this is a handy tool for all those times they come in contact with ‘eewy eeckies’ and don’t have the luxury of washing their hands; when they have been shaken by someone they just observed sneezing into their hands etc. The small handy packs of sanitizers fit well into most pencil cases. The sanitizer should be applied to the palm of one hand, both hands rubbed together and product rubbed over the surface of hands and fingers until the hands are dry. Sanitizers that contain at least 60% alcohol are most effective, especially when water and soap are not readily available.
Teach them to sneeze into the crooks of their elbows and not into their palms. With this, we will be building the next generation of people who do not go around sneezing (rendering thousands of germs homeless) in people’s faces (finding alternative homes for these germs) or into their hands and then subsequently shaking other people’s hands (ensuring that these germs hit their mark).
Back tracking to toilet training again, teach the children especially the girls, to clean from the front backwards. Many an infection has been caused by faecal matter deposited in places where they have no business being! Girls should also be taught to clean up after urinating as early as possible. This can also aid in prevent infections that thrive in warm and moist places like candida.
So, beyond the books, stationery and inevitable school fees, let’s ensure that our children have the right health and wellness tool kit to survive a new term and come home with those amazing grades we all look forward to!

Hello everyone! I hope you had a good week?
Well, y’all have heard the news about the case of Corona Virus in Nigeria, right? Well, not to panic – good hygiene is the way to go. Please do not spread panic and/or hysteria in the environment by spreading false rumors eg take a deep breath et al 😀
I figured a reminder class on hygiene would be useful. 🙂
How many of us can confidently raise our hands for hygiene these days? When the Ebola scourge was at its highest, people became very hygiene-conscious. People washed their hands often and on, used hand sanitizers when they could not wash their hands and were generally careful about what and who they touched. Alas! A couple of months after we were declared Ebola-free, it was back to business as usual for most people.
How many people still wash their hands after using the toilets now? Some people believe it’s only important to wash hands after passing out faeces but not necessarily when they urinate. How many times do you wash your hands before eating or before cooking or before picking up a new baby? How many times do you cough or sneeze into your hands and then proceed to shake people with the same hands…thereby passing on your germs to them? The ways and means by which we pass on germs by not washing our hands are too numerous to count and so I wonder about how many of us can really raise our hands for hygiene at this time.
Well let’s give you a reminder class on when to wash your hands and how to wash your hands: Mums wash your hands before you make your baby’s/family’s food, after you change baby’s diaper, after you blow your nose, after cleaning etc. You can also use a sanitizer if it is not possible to was your hands at that time.
We should ensure that we teach children and indeed remind ourselves to wash hands after playing or doing stuff outside the house, before eating, after using the toilet, after playing with pets or disposing of their wastes (in fact children should not be encouraged to play too close to their kennels or sheds), before cooking and even after handling dirty laundry!
Sanitizer tips:Remember that sanitizers are only useful for hands that are not visibly dirty. For visibly dirty hands, you’ve got to wash!
Also remember that when choosing the sanitizer, look for products that have up to 60 percent alcohol and ensure that when you use it, you rub until your hands are dry.
Tips for effective hand washing: wet your hands with water, apply soap, then scrub thoroughly paying attention to your nail beds, in between fingers, palms and back of hands. Then rinse thoroughly before drying your hands.
Remember that clean hands, save lives!

Q: Good afternoon doctor. Please what could be responsible for breast milk coming out of my wife’s breast for one week now while she is not yet pregnant?

A: Some women who are not pregnant may have milky fluid come out of their breasts when they are not breastfeeding or even in women who have never been pregnant. This is called galactorrhea. This is not a disease on its own but a symptom of a problem. The hormone, prolactin which is responsible for lactation in nursing mothers, is usually produced in these cases.

This milky fluid can be expressed by pressing or it can spontaneously come out on its own. It can affect one or both breasts and usually there are no blood stains involved.

Sometimes, the cause of this discharge may not be known but some causes could be some medications, some drugs like cocaine, spinal cord injuries, some birth control pills, stress and even excessive stimulation during sexual intercourse.

Galactorrhea can also happen in men and new born babies! In new born babies this can happen if the mother has a high level of estrogen which crosses over into the baby and stimulates the formation of breast tissue and sometimes, some milky white discharge. Please note: this is NOT witchcraft!

If you notice this, please visit your doctor who may try to express this discharge to study. The discharge may also be clear (as in your friend’s case), bloody or even tinged yellow. These need further evaluation and the presence of lumps should also be checked for. The level of prolactin will also be assessed. This may, however, be normal in people who are overly sensitive to prolactin. In this class of people, prolactin level is normal but there is still milky discharge from the nipples.

Treatment is focused on the underlying cause if one can be found. If the problem is medication, please stop or switch to something else under the supervision of your physician (doctor). If there is a tumour producing prolactin, drugs can be taken to shrink it or surgery can be done. If no cause is found, drugs that reduce prolactin level are prescribed. Remember, that your friend could be pregnant and so a pregnancy test may not be out of place.

In the meantime, breast pads can be worn to prevent the embarrassing leaks from staining clothes, limit manipulation of breasts either by self-breast examination or during sexual activity and try not to wear clothes in which there would be friction between the nipples and the material.

All the best!

Q: Hello doc, after how long does morning sickness start in pregnant women? Because I’m a little nervous about my girlfriend ,,,,,, I don’t know if she wanna fix it on me.

A: Morning sickness can actually occur at any time of the day, although the name makes you think otherwise. For most women, the symptoms typically start at around 4 to 6 weeks of pregnancy. To prevent cases like this and worries about girlfriends ‘fixing stuff on their partners’, here are a few tips:

Remember the ABCs. Abstain (which is always the best bet if you’re not married), be faithful to one partner (who is hopefully being faithful to you) or use condoms.

Now, for the rest of you who want to know how to handle morning sickness in pregnancy, below are some tips for you:

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, your wife needs your love and support more than ever. If she can’t stand cooking now, because of this, be supportive. Help out or ensure she has help. Knowing you’re on her side will most certainly help her cope with this.

Have a good night everyone 😀