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Irritable Bowel Syndrome (IBS)

Irritable Bowel Syndrome (IBS)

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You’re going about your day as usual but all of a sudden you get abdominal cramping! You brush it off as nothing too serious and chalk it up to maybe being constipated. But you swear you’ve been eating enough veggies and hitting that fiber intake.  And then you remember, “Wasn’t I just having diarrhea a few days ago” ? Maybe it’s that delicious koththu takeout you had that’s giving you stomach discomfort. But you’ve been experiencing these symptoms in and out for quite a few months now. What if I said all these symptoms of stomach discomfort and irregular bowel movements point to a larger underlying illness at hand?

What Is IBS?

IBS, short for irritable bowel syndrome, is rather a common disorder that targets the large intestine which affects 10-15% of the global population. Common signs and symptoms include stomach cramps, bloating, gas, nausea, abdominal pain and diarrhea or constipation, or both. These tend to come and go over time, and can last for days, weeks or months at a time. Unfortunately, IBS is a chronic condition, so you need to manage it long term. It can be frustrating to live with and may impact your day-to-day life but there are IBS treatments that can alleviate and control your symptoms!

You must be wondering how exactly one gets IBS, however, the exact cause is unknown – it has been linked to food passing through your gut too quickly or too slowly, oversensitive nerves in your gut, stress and a family history of IBS. IBS triggers don’t follow any hard and fast rules. Different people have different triggers, such as certain foods, poor mental health, poor sleep, infections, hormonal changes and changes in gut bacteria.

IBS is a functional disorder which means tests would prove inconclusive as there aren’t structural changes in the large intestine or bowel tissue to identify. This means that it can only be diagnosed by your doctor, who is conveniently only three taps away from being consulted on oDoc!

But try not to stress too much about it because stress can worsen or trigger symptoms because of the brain-gut connection, which we covered in our previous blog. Only a small number of IBS sufferers have severe symptoms and pain.

How IBS Affects The Body

  1. Abdominal cramping. Lower abdominal pain which tends to decrease after a bowel movement. Whilst there are certain medications that ease the pain, you can also try modifying your diet to include less FODMAPs. FODMAPs are small carbs that many people with IBS cannot digest well which may cause hydrogen gas build up leading to bloating and cramps. If you find yourself being sensitive to FODMAP rich foods like legumes, dairy products and high fructose foods (including honey and processed foods with high fructose corn syrup), try cutting them down and see if your symptoms alleviate. Since your sensitivity to FODMAPs may differ to others it’s always best to speak to a gastroenterologist to seek the best course of action. 

2. Changes in bowel movements. Around 1/3 of patients experience diarrhea but others experience  constipation-predominant IBS.. However, unlike diarrhea, if you have constipation the abdominal pain usually eases after the bowel movement and often leaves you with a sensation of an incomplete bowel movement. Having both alternating diarrhea and constipation is one type of IBS that affects about 20% of IBS sufferers. 

3. Gas and Bloating. One of the more frustrating symptoms is bloating. If you have IBS your gut has an altered digestion process, which results in more gas being produced leaving your stomach in an uncomfortable state of fullness and tightness.

Stress Influences IBS

The gut is often referred to as the ‘second brain’ so it’s not surprising that IBS is a stress-sensitive disorder. Clinical studies show that the amount of stress you are under is an important factor for the development of IBS symptoms. Your anxiety and stress induces several hormonal changes which affect your gut and cause that diarrhea and stomach churning that you sadly know all too well!

Try to identify the stressors in your life and develop healthy habits to cope with it like mentioned below! You can also check out our blog on how to reduce anxiety as well!

  1. Deep breathing exercises such as in meditation or yoga send messages to your brain to calm down and relax.
  2. You can also seek mental health services to learn better coping mechanisms and other cognitive-behavioral techniques to identify and combat your stress. Whilst mental health may be a stigmatized topic in Sri Lanka, oDoc offers you a private, quick and easy way to consult qualified mental health professionals from the comfort of your own home who are simply three taps away!

3. You need to make sure you get adequate sleep. At least seven to eight hours per night. Getting plenty of sleep will reassure your body it’s not in a state of distress!

4. Exercise the stress away! Exercise releases feel-good chemicals in the brain called endorphins. These are natural painkillers which elevate your mood. This probably explains why going to the gym even on days you don’t feel like dragging yourself there, is bound to lift your spirits!

When To See A Doctor

Since symptoms differ from person to person it’s important to consult either your GP or a gastroenterologist so they can provide you with a proper diagnosis and rule out other diseases.  However, if you notice a change in the pattern of your symptoms or new symptoms (such as changes in bowel movement or a different type of pain that significantly interferes with your daily activities) consult with your doctor straight away on oDoc.

Download oDoc today on the App Store or Play store.

References

  1. What Is IBS?, NHS (2021)
  2. 9 Signs And Symptoms Of IBS, Healthline (2019)
  3. Impact Of Psychological Stress On Irritable Bowel Syndrome, NCBI (2014)
  4. How Stress and Anxiety Can Aggravate IBS Symptoms, Healthline (2017)

  

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Insomnia – Everything You Need To Know

Insomnia - Everything You Need To Know

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female with insomnia struggling to sleep at night

People with Insomnia find it hard to fall asleep, stay asleep or even go back to sleep if woken up. Insomnia may cause someone to feel tired when woken up, drain their energy level, resulting in a low performance at work, mood swings and even some adverse health conditions such as diabetes, hypertension and weight gain.

The amount of sleep needed varies from person to person. However, an average person needs at least six to nine hours of sleep. Quality sleep plays a vital role in overall well-being. Not getting sufficient sleep regularly can significantly impact physical and mental health along with the quality of life. 

What are some insomnia symptoms?

Insomnia is defined as: 

  • Difficulty in falling asleep at night
  • Waking up in the middle of the night
  • Waking up too early

As a result, here are a few other symptoms related to the lack of sleep:

  • Feeling drained out/tired
  • Difficulty in focusing or paying attention 
  • Increase in carelessness
  • Feeling tired and lethargic during the day
  • Feeling anxious or depressed 

Insomnia can be both short-term and long-term. Short term insomnia tends to last for a few days or weeks and is often triggered by stress. Whereas long-term or chronic insomnia is when sleep difficulties occur at least three times a week for three months or longer.

What causes insomnia?

Insomnia may be the primary problem, or it may be associated with other health conditions. However, several things may contribute to insomnia, including environmental, physiological, and psychological factors.

Causes for chronic insomnia include:

  • Stress: Concerns regarding jobs, education, finance, family and health can affect the mind’s activity at night, making it difficult to fall asleep.
  • Schedule: Circadian rhythms are 24-hour cycles that are part of the body’s internal clock running in the background to carry out essential functions and processes. One of the most essential and well-known circadian rhythms is the sleep-wake cycle. When the sleep schedule is disrupted due to working/studying till late at night, travelling across multiple time zones, working a late or early shift, or frequently changing shifts, it makes it difficult to fall asleep.
  • Poor sleep habits: Eating, watching TV till late, using smartphones, playing video games before bed can interfere with the sleep cycle. Similarly, poor sleep habits include an irregular bedtime schedule, naps, an uncomfortable sleep environment, and using the bed for work, eating or watching TV.

Common causes of insomnia include:

  • Mental health: Trauma, anxiety, depression could affect the sleeping patterns, leading to insomnia.
  • Medication: Many prescribed drugs can interfere with sleep, especially severe illnesses.
  • Illnesses: Insomnia is influenced by medical conditions such as cancer, diabetes, asthma, Parkinson’s and heart diseases. 

Additionally, excessively drinking caffeine may also cause irregular sleeping habits, while nicotine in tobacco products is another stimulant that can interfere with sleep. On the other hand, alcohol may help fall asleep, but it prevents deeper stages of sleep and often causes awakening in the middle of the night.

What are the risk factors of insomnia?

Almost everyone has experienced a couple of sleepless nights. However, the risk of insomnia is more significant if someone falls into a specific demographic or experiences certain lifestyle factors:

 

  • Over the age of 60: Changes in sleep patterns and health.
  • Women: During the menstrual cycle and menopause, the hormonal shifts influence sleep patterns. Further, during menopause, night sweats and hot flashes often disrupt sleep. Insomnia is common during pregnancy, especially in the first and third trimesters.
  • Mental or physical health condition. 
  • Constant stress
  • Irregular schedule

How can insomnia be prevented?

Good sleep habits will help improve sleep and prevent insomnia. 

  • Consistent bedtime and wake up time
  • Stay active (regular physical activities)
  • Create a bedtime routine that will help get in the mood to sleep (Taking a warm bath, reading or listening to soft music.)
  • Avoid or minimise caffeine, alcohol, and prevent the use of nicotine.
  • Avoid large meals and beverages before bedtime.
  • Keep the bedroom dark, quiet and cool to make it comfortable.

Insomnia is not a nuisance or a small inconvenience but an actual sleep disorder that can significantly impact one’s physical, mental and emotional health. 

If you think you have insomnia, feel free to reach out to a healthcare professional via the oDoc app as soon as possible. They can assist you in exploring the possible causes and offer help with finding the best treatment for your needs.

References

  1. Insomnia, Cleveland clinic (2020)
  2. Insomnia, Mayo Clinic (2016)
  3. Everything you need to know about Insomnia, Healthline (2022)
  4. Circadian Rhythm, Sleep Foundation (2022)
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How Do You Deal With Grief & Loss?

How Do You Deal With Grief & Loss?

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Grief is an emotional response to loss. Any type of loss could cause grief; loss of a loved one, loss of a pet, loss of a job and financial stability, loss of a relationship, loss of a baby and more.

The pain of loss can sometimes be overwhelming and it can be hard to deal with such intense, overpowering, unexpected emotions. Your physical health can also be affected, making it difficult for you to eat, sleep or think straight. Your whole world can be changed with a loss. Nothing could look quite the same anymore – everything appears lacking, strange or unfamiliar. These are completely normal reactions to have.

how to deal with grief

You might be going through something similar and maybe you’re wondering how you can feel better soon? How can you get to the point where you are not in so much pain anymore?

There are healthy ways to cope with grief & loss that can ease your sadness over time and help you come to terms with what happened and move on with life. There is no ‘’normal’’ way of grieving. Everyone goes through it differently with some feeling better in a few weeks while others take years to fully heal.

Myths about grief & loss

You need to ‘stay strong’

You can feel your feelings. You can feel sad, scared and lonely. You can cry, get angry or stay quiet. None of these reactions are ‘’weak’’. You don’t need to put on a brave front.

Distracting yourself from the pain will make it go away faster

Ignoring the pain or trying to push it down so you don’t feel it will make you feel worse in the long run. While it is extremely hard to do, you need to face what has happened.

If you don’t cry, you didn’t really care about the loss

Crying is one reaction to grief & loss but it’s not the only one. Those who don’t cry can react to loss in different ways. This doesn’t mean they didn’t feel the pain as badly.

After a certain amount of time, you should be over it 

There’s no timeline to grieve. For some, grief will always remain but they are able to manage their grief better over time.

What are the different ways you can cope with grief & loss?

Talk to someone about it

Talking about the loss can be hard because that means you have to think about what has happened and come to terms with it. But sharing your feelings and thoughts with friends and family can be clarifying and cathartic.

Express your feelings in other ways

If you’re not able to talk about the loss, you can journal or write down your thoughts. Scrapbooking or volunteering for a cause can also help you let all your emotions out

Don’t be afraid to find moments of joy

Again, feel your feelings. It’s okay to laugh, be happy, have a good time and joke around if those emotions come naturally to you.

Look after your physical health

Having quality sleep, eating healthy and exercising regularly allows you to better cope with your grief emotionally.

Sometimes, it can be hard to grieve by yourself. How can you make sure you’re dealing with grief& loss in a healthy, non-destructive way? You can always reach out to a mental health professional, possibly one who specializes in grief counseling, who can help you work through your emotions and teach you coping mechanisms.

You can speak to a licensed mental health practitioner on oDoc. Download the app now.

Sources:

  • Coping With Grief & Loss, Help Guide, October 2021
  • How To Cope With Loss: Tips for Healthy Grieving, Everyday Health, October 2021
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The Gut-Brain Connection

The Gut Brain Connection

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gut brain connection

Ever heard of the phrase ‘gut feeling’ or felt the ‘butterflies’ in your stomach? These experiences can be explained by the gut-brain axis, the communication network that connects the brain and gut, physically and biochemically. This may seem like a minor thing, right? That is until you realise it’s essentially like our ‘second brain’. Yup you read that right! Who knew that hidden in our digestive system are two thin layers of over 100 million nerve cells that dutifully line our intestine all the way from gullet to rectum. They make up what is known as the enteric nervous system (ENS).

Let’s see how our ‘second brain’ interacts with the rest of our body!

How Gut Health Affects Our Body

Are you  wondering how on earth your brain directly connects to your gut? The answer is simple (unlike the many complex tasks it carries out)! The Vagus nerve is an important two way connector between the brain and gut. It’s found to play a crucial role in our thoughts, feelings and behaviours.

Stress is noted to inhibit the signals along this nerve causing intestinal distress. You may experience this phenomenon more often if you suffer from pesky IBS (Irritable Bowel Syndrome) as it reduces Vagus nerve function.

Alternatively, do you ever find yourself battling against big emotional shifts like heightened or irrational fear, anxiety and stress? This may be triggered by your ENS.  So if you suffer from IBS or any other functional bowel problems, you have a higher chance of being diagnosed with psychological disorders like depression and anxiety because of this connection resulting in poorer mental health!

Neurotransmitters are chemicals that control feelings and emotions. These are mainly produced in the brain but also by our gut cells and the trillions of microbes that live there! For example, a large proportion of the serotonin neurotransmitter associated with happy feelings is produced in the gut. Gut microbes also make the GABA neurotransmitter, which helps control fear and anxiety.

It’s important to note that these chemicals released by gut microbes also affect brain function. So preserving our ‘second brain’ will eventually support our real brain! Poor gut health results in the microbes releasing lipopolysaccharide (LPS), an inflammatory toxin made by certain bacteria that enters the bloodstream and causes inflammation especially in those with higher intestinal permeability. Inflammation and high LPS in the blood have been associated with a number of brain disorders including severe depression, dementia and schizophrenia.

Consequences Of Ignoring Gut Health

Your gut is a giant chemical factory that helps you digest food, regulate hormones and produce healing compounds to keep your entire body healthy.  When the gut starts to break down, it won’t be long before the rest of your body starts to break down too!

Imagine this, you’re building a house and for the foundation you carefully lay bricks and cement it all together to protect its inhabitants from the dangers outside. Now, transferring this analogy, our own intestinal wall has to be intact to prevent the passage of dangerous toxins, pathogens, and other proinflammatory substances into the human body. If it fails to do so and is more ‘naive and friendly’ it will let these enemies permeate our defence lines and wage war on us! This may result in system wide inflammation and cause disease.

The ‘leaky gut hypothesis’ explains that poor intestinal barrier function may induce chronic inflammatory changes in the target organs by virtue of those little microbial products produced in the gut that cross over into the body.

Just like a poor foundation will result in a house that will crumble, poor intestine health and its increased permeability have been found in many diseases like inflammatory bowel disease (IBD), irritable bowel syndrome, type 1 and type 2 diabetes, depression, and more.

Foods That Will Better Your Gut Health

                                          Eating a diverse range of foods will result in, you guessed it, a diverse microbiome!

  1. Up the fibre:  In particular, legumes, whole grains, beans and fresh fruit which contain lots of fibre and can promote the growth of healthy bacteria which then helps digest fibre, produce important chemicals like B vitamins and prevent infections from other bacteria like E. coli. The fibre feeds your gut microbes and helps them do their job, which is to protect you! Remember apart from being fibre rich, these plant-based foods are also great sources of other longevity-supporting nutrients, like antioxidants which are known to prevent chronic inflammation.
  2.  Eat. Fermented. Foods! They contain healthy bacteria and can reduce the number of disease-causing species in the gut. These foods include yoghurt, curd, tofu and miso paste. Who knew such sour foods could be so sweet to our body!
  3. You’ve heard of probiotics but what about prebiotics? They are different from probiotics in that they promote the growth of healthy bacteria in your gut whilst probiotics either consumed as a supplement or found in naturally fermented foods are live bacteria that can help restore the gut to a healthy state after dysbiosis, which happens when gut bacteria become an unbalanced. Prebiotic rich food includes artichokes, bananas, asparagus, oats and apples. 

4. Eat polyphenol rich foods! These plant compounds are found in red wine, green tea, dark chocolate, coffee and whole grains. These foods contain plenty of antioxidants and also help your gut find the good bacteria army!

5. Do you often crave that sugar ‘high’? Do you  ‘inhale’ those delicious sweets  when you’re feeling stressed or when you feel … wait, I mean who needs an excuse to eat sweets anyways! We all just eat sweets because they’re such a treat! These days however pretty much everyone has heard the diet craze of cutting out refined sugar BUT some people often mistranslated this to EAT ARTIFICAL SWEETNERS. Hmmm … raise your hands if you’ve done this! Artificial sweeteners have been linked to increasing the growth of unhealthy bacteria in the gut microbiome.

6. When you think of the word antibiotics, you think it’s a miracle cure to your infections. But think of antibiotics like a hyperactive child. This child will love to play with all the toys in the room, just like your antibiotics  fighting off  bad bacteria in the body, but this kid will play with the room’s furniture even though it’s not meant to be played with. Just like that, antibiotics may also fight off your good bacteria too. So, use it only when necessary!

If you have any concerns regarding your gut health, you can speak to a doctor via the oDoc app from the comfort and privacy of your home. GPs and Specialised doctors like gastroenterologists are also available to consult.

Download oDoc today on the App Store or Play store.

References

  1. The Brain-Gut Connection, Johns Hopkins (2022)
  2. Gut Health and Pain – Part 3: Your Gut and Stress, Northern Pain Centre (2021) 
  3. The Gut-Brain Connection: How it Works and The Role of Nutrition, Healthline (2020)
  4. Increased Intestinal Permeability and Decreased Barrier Function: Does It Really Influence the Risk of Inflammation?, NCBI (2016)
  5. Here’s How the Longest-Living People on the Planet Maintain Optimal Gut Health, Well + Good (2022)
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Is this COVID-19 or Dengue?

Is this COVID-19 or Dengue?

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The differentiation between dengue and COVID-19 diagnoses is challenging in tropical regions because of the similarity of symptoms and limited access to specific diagnostic tests for each disease. According to research, most people who get dengue or COVID-19 have mild illnesses and can recover at home and feel better after a week or two. However, some will be at risk of developing severe diseases that could be life-threatening and require hospital-based care that differs between conditions.

Warning signs for COVID-19 and Dengue.

COVID-19: Fever or chills, cough, shortness of breath or difficulty breathing, fatigue, muscle or body aches, headache, the new loss of taste or smell, sore throat, congestion or runny nose, nausea or vomiting and diarrhoea.

Dengue: Nausea, vomiting, rash, aches and pains, gum bleeding, lethargy and restlessness.

Common factors of COVID-19 and Dengue? 

Both COVID-19 and dengue fever are infections caused by viruses. They could both cause fever and body ache in the affected individual. Additionally, both these viruses could cause mild to severe symptoms. In their severe forms, both conditions could damage multiple organ systems and cause death in their severe forms. 

Difference between COVID-19 and Dengue? 

COVID-19 is a respiratory illness caused by the virus SARS-CoV-2. It is most often transmitted from one person to another via respiratory droplets that are spread when an infected person coughs, sneezes, or talks. However, dengue fever is caused by the dengue viruses that spread through the infected Aedes species mosquitoes’ bite. 

Dengue’s incubation period ranges between 3-10 days, typically 5-7 days. On the other hand, COVID-19 is thought to extend to 14 days, with a median of 3-5 days from exposure to symptoms onset.

What are the possible complications of COVID-19 and Dengue? 

Some people, about 1 in 6, may have complications, including life-threatening ones. 

COVID-19 complications may include the following

  • Cardiovascular complications
  • Kidney complications
  • Severe lung disease
  • Blood clots
  • Death

A small percentage of people who have dengue fever can develop a more serious form of the disease.

Its complications may include the following

  • Decrease in blood pressure
  • Bleeding
  • Hemorrhagic fever
  • Breathing difficulties
  • Death

These lists are not exhaustive.

How can you protect yourself from COVID-19 and Dengue?

COVID-19

  • Get vaccinated as soon as it’s available to you and follow local guidance on vaccination.
  • Maintain distance, avoid crowds and close contact.
  • Double mask while going out.
  • Clean your hands frequently with alcohol-based hand rub or soap and water.
  • Cover your mouth and nose with a bent elbow or tissue when you cough or sneeze. Dispose of used tissues immediately and clean hands regularly. 
  • If you develop symptoms or test positive for COVID-19, self-isolate until you recover.

Dengue

  • Use mosquito repellent.
  • Wear long-sleeved clothing.
  • Use mosquito nets/screens at home.
  • Cover and clean water containers of stagnant water regularly.

When should you see a doctor?

It is best to consult a doctor if fever develops with any of the following:

  • Diarrhoea
  • Pain in muscle or bone 
  • Nausea or vomiting
  • Rashes
  • Shortness of breath
  • Cough

It is difficult to differentiate COVID-19 from dengue fever during the early stages of the illness. A PCR or Rapid Antigen Test is the best (and only) way to rule out COVID-19. If you test positive and need to isolate at home, the oDoc Home Care package brings you a dedicated doctor virtually to monitor your symptoms every day while you recover. Tested positive? Start your recovery now!

On the other hand, a complete blood count test and a Nucleic acid amplification test (NAAT) or a Dengue antigen test (NS1) must be done to check for Dengue. Our mobile lab service, oLabs, comes to your door so you don’t need to leave home for blood tests. If you are experiencing any of the severe symptoms mentioned above and need to clarify certain doubts, speak to one of our doctors on oDoc! Download the app today!

References

  1. Symptoms of COVID-19, Centre of Disease Control and Prevention (2021)
  2. How do You Tell COVID-19 and Dengue Apart?, Health plus (2020)
  3. Differentiating Dengue from COVID-19: Comparison of Cases in Colombia, ASTMH (2021)
  4. Advice for the public: Coronavirus disease (COVID-19). World Health Organisation (2021)
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