Category Archives: Gastrointestinal

Straight, No Chaser: Travelers’ Diarrhea

diarrheaemergency

This is the time of year in the U.S. when you wished you were somewhere else. (Hawaii, Africa, Australia or Mexico for a nice cruise, anyone?) Unfortunately, sometimes when you travel, you get more than you hoped.

“Montezuma’s Revenge” is often the punchline of a joke in the U.S., but travelers’ diarrhea (TD) is a serious concern. It is the most common illness contracted by travelers, affecting approximately 10 million people per year. Individuals visiting the U.S. can suffer from it as well. That’s a clue as to what’s actually occurring with TD.

TD is typically a response to an infection by a strain of bacteria known as E. coli, specifically, a strain that produces a toxin that affects the intestines. This is the case approximately 80% of the time. Parasites sometimes figure prominently in the illness. The risk and primary source of this infection is food or water that is contaminated with feces. Note that most any disturbance in the bacterial balance of the intestines can cause disruptions in the digestive system, leading to diarrhea.

travelers-diarrhea-risk-map

Although anyone can contract TD, destinations and personal characteristics can markedly increase that risk.

  • Higher risk destinations include developing countries in Africa, Asia, Latin America and the Middle East.
  • Those individuals at higher risk include the immunocompromised, diabetics, young adults, those with inflammatory bowel disease and those taking antacids or medicines known as H-2 blockers.

TD is straightforward. Symptoms include watery diarrhea and cramps. A mild fever may or may not be present.

So, what are you supposed to do to prevent TD? This stuff is miserable! Here are a few tips and pointers for you:

  • Avoid street vendors.
  • Avoid raw or undercooked foods (especially meats and seafood).
  • Avoid raw fruits and vegetables (unless you peel them).
  • Wash your hands!
  • Taking antibiotics in advance (prophylactically) is not recommended, because they can increase your susceptibility to resistant organisms and side effects.
  • Bismuth subsalicylate (two ounces or two tablespoons four times daily) reduces the incidence of TD. Speak to your physician or SMA expert consultant about the risks and indications of taking bismuth subsalicylate. By the way, you know bismuth subsalicylate as pepto-bismol or kaopectate.

And now, a few words about treatment. Here are a few considerations about which you should be aware.

  • TD is usually mild and will run its course without medication. In other words, you’re likely to be just fine.
  • The most important consideration is to ensure adequate hydration. Clear fluids are key.
  • You may need antibiotics if symptoms progress to include fever, bloody stools, nausea, vomiting and severe cramps. Drugs typically include ciprofloxacin and norfloxacin. Previously used drugs such as trimethoprim-sulfamethoxazole and doxycycline aren’t recommended anymore because of the high resistance rate.
  • Bismuth subsalicylate may also be used as treatment (in addition to its role in prevention).
  • A  special word about anti-motility (anti-diarrhea) medications: There are some benefits to using these agents, but there are also significant risks. You should not take these medications without understanding the risks and how they may affect you based on your existing health profile. This topic is discussed in greater detail at www.sterlingmedicaladvice.com, and you certainly can discuss this further with your SMA personal healthcare consultant.

Feel free to ask your SMA expert consultant any questions you may have on this topic.

Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!

Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!

Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.

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Filed under Gastrointestinal, General Health and Wellness, Health Prevention, Infectious Disease, Public Health

Straight, No Chaser: Irritable Bowel Syndrome

irritable_bowel11

The irony of the name “irritable bowel syndrome” (IBS) is found in the connection between stress (in some cases, irritability) and symptoms. This can become a vicious cycle. You care about this condition because once you or your loved ones become afflicted, the symptoms involved present an uncomfortable mix of physical and mental discomfort. As you read this Straight, No Chaser, do so with a mind toward overcoming the anxiety associated with and possibly causing symptoms.

What is irritable bowel syndrome (IBS)? 

IBS is a gastrointestinal (digestive tract) disorder. The gastrointestinal (GI) tract isn’t damaged but symptoms are caused by changes in how the GI tract works. It is important to note that IBS is a group of symptoms that occur together, not a disease. At different points in the past, IBS was called colitis, mucous colitis, spastic colon, nervous colon, and spastic bowel.

How frequent is IBS?

In most studies, estimates of the frequency of IBS range from 10-15 percent. IBS affects about twice as many women as men, and it is most often found in people younger than age 45.

ibs sx

What are the symptoms of IBS?

The most common symptoms of IBS are abdominal pain, often described as cramping. This is typically accompanied with changes in bowel habits. Other symptoms of IBS may include bloating, constipation or diarrhea, passing mucus or feeling that a bowel movement is incomplete.

To specifically meet the criteria for a diagnosis of IBS, the pain or discomfort will be associated with at least two of the following three symptoms:

  • bowel movements that occur more or less often than usual
  • stool that appears less solid and more watery, or harder and more lumpy, than usual
  • bowel movements that improve the discomfort

What causes IBS?

The causes of IBS are not well understood. Current medical evidence points to a combination of physical and mental health problems.

ibs

How is IBS diagnosed?

There is no test to diagnose IBS; it’s not a disease. Your physician will make the diagnosis based on a complete history, a physical exam and exclusion of other diseases. Although some symptoms will have been present for at least six months, IBS is diagnosed when abdominal pain or discomfort has been present at least three times a month for three consecutive months without other disease or injury that could explain the pain.

IBS-STRESS-management

How is IBS treated?

Though IBS does not have a cure, the symptoms can be treated with changes in eating, diet, and nutrition, medications, probiotics and therapies for any mental health issues. Details on management of IBS can be obtained at www.sterlingmedicaladvice.com.

Feel free to ask your SMA expert consultant any questions you may have on this topic.

Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!

Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!

Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.

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Filed under Gastrointestinal

Straight, No Chaser: The Medical Complications and Medication Treatment of Alcoholism

liver-cirrhosis

 

There are interesting commonalities of certain drugs like alcohol and cigarettes. One is users that really enjoy them are able to do so for a long time while being oblivious to the growing danger those activities pose. Another commonality is even more so than mentally, when things go wrong physiologically, they really go very wrong.

Possible Complications

Alcoholism and alcohol abuse pose threats to many aspects of your health, including the following.

Symptoms in alcoholic liver disease copy

  • Birth defects (fetal alcohol syndrome)
  • Bleeding throughout your digestive tract, including the esophagus (up to and including rupture), gastritis (inflammation of the stomach) and ulcer disease.
  • Brain cell damage
  • Brain disorder called Wernicke-Korsakoff syndrome (includes dementia, mental status changes)
  • Cancer of the esophagus, liver, colon, and other areas
  • Changes in the menstrual cycle (period)
  • Delirium tremens (DT’s)
  • Dementia and memory loss
  • Depression and suicide

Liver-Damage

  • Erectile dysfunction
  • Heart damage
  • High blood pressure
  • Increased risks for behavioral disorders including depression and suicide
  • Increased risks for sexually transmitted infections (STIs)
  • Increased risks for trauma, including motor vehicle collisions, violence and head injuries with intracranial bleeding
  • Inflammation of the pancreas (pancreatitis)
  • Insomnia
  • Liver disease, including alcoholic hepatitis, cirrhosis and cancer
  • Nerve damage
  • Nutritional deficiencies

Treatment

alcoholism_treatment

Medical goals and patient goals are often different and seem to depend on the extent of perceptible injury that has occurred at the time of the decision to quit drinking. Often, patients will want to reduce drinking instead of stopping completely. Continued drinking in moderation is only as viable an option as the patient’s level of alcohol-related level of disease and the patient’s ability to stay limited in consumption and focused toward that goal.

Ideally, abstinence (the complete stopping of alcohol intake) is the goal, and it needs to be the goal if and when the desire to stop drinking is coupled with the presence of significant alcohol-related disease.

As everyone knows, the management of alcoholism requires multiple simultaneous approaches, including family and social networks.  It is often the family network that helps the alcoholic come to the understanding that alcohol intake has disrupted his or her ability to function normally. It is a most unfortunate occurrence when this has not occurred prior to the development of significant medical disease. Individuals with alcohol problems are more likely to take the steps necessary to successfully withdraw from alcohol use.

Regarding the medical aspects of alcohol cessation, withdrawal is a very important consideration and is best done in a controlled manner. Components of effective withdrawal address the various medical and mental health considerations reviewed earlier and medical avoidance treatment.

Medical avoidance treatment includes medicine that prevent relapse via various methods, and they include the following:

  • Antabuse (generic name: disulfiram) is a well-known and commonly used medicine that works by producing very unpleasant side effects with virtually any alcohol intake within two weeks of taking the medicine.
  • Naltrexone (brand name: Vivitrol) is an injectable medicine that works to decrease alcohol cravings.
  • Acamprosate is a drug that has been shown to lower relapse rates in those who are dependent on alcohol.

Feel free to ask your SMA expert consultant any questions you may have on this topic.

Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!

Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!

Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.

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Filed under Gastrointestinal, Toxicology/Drugs

Straight No Chaser: Gluten, Wheat and Celiac Disease

Gluten free signal

One of the reasons I enjoy writing this blog is it brings me closer to understanding you. As you respond to posts or query me, I get to better appreciate the breadth of your concerns. I realize that much of what physicians do in clinical practice is talk AT you. Sometimes physicians assume that you know better because we do. Your issues often involves uncertainty about the nature of your symptoms, and, in real-time, you tend not to appreciate that symptoms are incredibly non-specific, meaning the same set of symptoms show up in multiple diseases and conditions (as you’ll noted from the picture below featuring possible symptoms of celiac disease). Many times, you’ll be researching a topic on the Internet, see symptoms you have and say, “That sounds like me! That must be what I have.” The relationship of symptoms to disease really isn’t anywhere near that linear.

Weight loss is an example of something patients think about differently than physicians. When a patient wants to lose weight, s/he may think of everything under the sun from the latest diet craze, surgery or other potential “quick-fixes.” On the other hand, a physician will parrot something about calorie controlhealthy eating and exercise, assuming you know better than to entertain miscellaneous information aimed to strike fear into your hearts or give you false expectations. (If you need a refresher on that consideration, check here.) In many of these instances, physicians may never even address your questions, because we’re so busy promoting the standard of care.

This month, we’ve been discussing nutrition with probably a dozen different blogs posted on various topics. Do you think the most common questions I’ve received have involved application of the healthy eating plate or simple tips to healthier eating? Nope. They’ve been more along the lines of esoteric concerns – or at least concerns that only affect rare segments of the population – so much so that physicians typically wouldn’t even think to discuss them with patients.

Two such discussions involve the consumption of gluten and wheat. Let’s answer those questions and clear up any confusion you may have. Thank you for your willingness to engage in straight talk. Indeed, your concerns are real, and our mission at Straight, No Chaser and www.sterlingmedicaladvice.com is to get you the information and advice you need.

What is gluten?

Gluten an important protein found in all forms of wheat, barley and rye. It is also found in other foods such as deli meats, soy sauce, vitamins, some chocolate, some toothpaste and imitation crab. For the purpose of this blog, let’s relegate your wheat concerns to gluten.

celiac1

Why do I care about gluten?

You probably don’t and probably shouldn’t, unless you have a specific disease called celiac disease, which is related to the adverse effects of an extreme sensitivity to gluten. Some humans (only some and not many at all) have difficulty digesting gluten. In fact, the ingestion of gluten in those with celiac disease can cause damage to the intestinal lining, causing chronic (ongoing, continuous) diarrhea and abdominal pain. This can result in potentially life-threatening concerns, but it only occurs in less than 1% of the population.

The other reason you may have heard about gluten is the existence of a diet craze based on avoiding gluten (having to do partially with limiting carbohydrates).

Why is this an issue?

As societies have moved to diets with higher consumption of refined wheat flour, the sensitivity to gluten has expressed itself more often. As is often the case, when you over consume or are overexposed to substances, danger ensues. That is not the same as saying you need to avoid any and everything on earth that could potentially cause you harm.

celiac-disease-symptoms

Do I need to give up wheat and gluten completely?

Absolutely not, unless you have celiac disease or demonstrated allergies to these substances. This is simply another example of your needing to understand the issue. As with most overstated concerns, solutions are to be found in the same principles of healthy eating described throughout Straight, No Chaser. (Feel free to research our many topics by typing your topic of interest into the search engine over on the right side of the page.)

In this instance and others, what happens all too often is folks create new problems running from other, perceived ones. Substituting high-calorie, high-fat products for wheat and other products containing gluten is not a healthy decision and has been shown to increase weight gain and the risk of diabetes. The principles of any successful efforts to diet remain the same. Your best bet is to learn principles of healthy eating and incorporate calorie control and exercise into your regimen. Embrace moderation across the board, and enjoy learning to make healthy eating an adventure by adding variety to your meals.

One final caveat: There’s nothing wrong with, and potentially much to gain from, asking your physician about your individual risks for celiac disease. Just understand that unless you have the symptoms (e.g., diarrhea, abdominal pain, bloating, fatigue, headaches and joint pains to name a few), you likely will cause your physician to scratch her or his head.

Feel free to ask your SMA expert consultant any questions you may have on this topic.

Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!

Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!

Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.

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Filed under Diet and Nutrition, Gastrointestinal, General Health and Wellness

Straight, No Chaser: When Eating Goes Wrong, Part II – Bulimia

Bulimia…-nerviosa-1

If you read Part I of this conversation on eating disorders (anorexia nervosa), you will recall that eating disorders are a mix of an abnormal body image combined with abnormal behaviors that lead to medical consequences. Today’s Straight, No Chaser is on bulimia, yet another dangerous eating disorder.

The ‘Bizz-Buzz’ of bulimia nervosa is ‘binge-purge.’ What that means is bulimics engage in frequent episodes of eating excessive amounts of food (bingeing) followed by one of several methods of eliminating what was just ingested (purging). This methods include forced vomiting (most common), use of diuretics or laxatives, fasting or excessive exercise. It is important to note that the bulimic feels a lack of control over these episodes.

bulimia_nervosa_1

Bulimia is an especially dangerous disease because it usually occurs in secret, and victims are able to hide it. This means symptoms will typically be further along when discovered. Bulimics usually manage to maintain a normal or healthy weight despite their behavior and may appear to be the person who ‘never gains weight’ despite ‘eating like a horse.’ This is a key differentiator between bulimia and anorexia. Otherwise, the two diseases do share some of the same psychological pathology, including the fear of weight gain and the unhappiness with physical appearance.

Treatment considerations for bulimia are similar to those for other eating disorders. A combination of psychotherapy, reestablishment of normal nutritional intake and medications usually leads to marked improvement. Again, the particular challenge with bulimics is discovering the condition in the first place. As with anorexia nervosa, treatment for bulimia nervosa often involves a combination of options and depends upon the needs of the individual. Medications may include antidepressants, such as fluoxetine (Prozac), if the patient also has depression or anxiety.

Let’s recap by revisiting where we started with our conversation on anorexia. Our society doesn’t do the job it should in promoting a normal image of health. The typically promoted American ideal of beauty sets standards that lead many to pursue unrealistic means of meeting that ideal. In the setting of an actual American population that is obese by medical standards, this becomes even more of a problem. The levels of stress, anxiety and depression resulting from this reality sometimes leads to eating disorders. Remember, eating disorders aren’t just habits. They are life-threatening conditions. If you or a loved one is suffering, please seek help immediately.

bulimia

Post-script: If you’re wondering about the above picture of the teeth, you’re viewing the effects of all that regurgitated acid on the enamel layer of your teeth.  I know. It’s not your best look.

Feel free to ask your SMA expert consultant any questions you may have on this topic.

Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!

Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!

Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.

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Filed under Diet and Nutrition, Gastrointestinal, Mental Health

Straight, No Chaser: Treatment of Food Poisoning (Foodborne Illness)

food-poisoning home remedies

The vomiting, diarrhea, fever, abdominal cramps and all around bad feelings you may get with food poisoning is extremely unpleasant. We’ve previously discussed preventative measures you can take to minimize your risks, but you should also want to know what measures to take in the event you actually develop food poisoning. Of course, with over 250 different illnesses related to various forms of food poisoning, there’s a wide variety of treatment, some of which means to treat the specific disease (and its cause) and others that only treat the symptoms.

I always tell patients that although the vomiting and diarrhea are dramatic nuisance symptoms, the real concern is the risk of dehydration from these fluid losses. Given the body is approximately two-thirds water, altering that balance can lead to disturbances of many of the body’s functions and increase the risk of more serious infections. Thus the key to treatment is staying ahead of fluid and electrolyte losses that occur. Perhaps you’re wondering “How can I do that if I’m vomiting?” Here are five very important principles for you to remember.

  • First things first: if you have severe diarrhea, your favorite sports drink is not the cure. The composition of fluids and electrolytes in your stool is different from in your sweat, so these drinks don’t optimally replace your losses.

ORT

  • I want you to become familiar with oral rehydration therapy/solution (ORT). It’s how most of the rest of the world first treats fluid losses from vomiting and diarrhea. You may have heard of Ceralyte, Oralyte or Pedialyte, all of which are examples. ORT represents the best possible fluid for you to take and is readily available without a prescription at your local pharmacy or grocery store.
  • Here’s the deal with staying hydrated: you can’t hold a lot on your stomach. You need to dial back as much as possible so that you can tolerate something. That’s why you sip on chicken soup instead of steak when you’re sick. You’re likely to have more success keeping down teaspoons of fluid at a more frequent interval (say, every few minutes) than trying to chug a lot of fluid all at once. Food-Poison pink
  • Preparations of bismuth subsalicylate (Pepto-Bismol is a common example) can reduce the duration and severity of simple diarrhea.
  • If you have diarrhea and cramps with a fever or bloody stools, you should not take antidiarrheal medication without an evaluation by a physician. Even if they make you feel better, these medicines can make your food poisoning much worse.

Here’s one other point that you should understand as you’re going into your doctor’s office or the emergency room: don’t expect to receive an antibiotic to treat your vomiting and diarrhea. Most of these episodes are caused by viruses, which are self-limited and will resolve within two to three days. Furthermore, viruses don’t respond to antibiotics. In fact, efforts to use antibiotics in many of these cases only contribute to antibiotic resistance later on when you actually need them. Antibiotic resistance is discussed in detail in this Straight, No Chaser post.

Innocent problems

Finally, here are symptoms that should prompt you to see your physician.

  • Bloody stools
  • Diarrhea lasting more than 3 days
  • High fever (oral temperature over 101.4 F)
  • Signs of dehydration, such as a decrease in urination, a dry mouth and throat, and dizziness with standing
  • Vomiting with inability to keep down liquids

Feel free to ask your SMA expert consultant any questions you may have on this topic.

Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!

Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!

Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.

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Filed under Diet and Nutrition, Gastrointestinal, Infectious Disease

Straight, No Chaser: Understanding Food Poisoning (Foodborne Illness)

FoodPoisoning

We make a decision with everything we place into our mouths. We also exhibit a large amount of trust that the food we eat is safe. Most of the time that’s true, but unfortunately sometimes it’s not. Here are some questions and answers to understanding the scope of food poisoning.

How frequent is food poisoning?

According to 2011 data from the U.S. Centers for Disease Control and Prevention (CDC), every year in the U.S. approximately 1 in 6 Americans (almost 50 million people) gets sick, 128,000 are hospitalized, and 3,000 die of foodborne diseases.

food poisoning

What causes food poisoning?

Over 250 different foodborne diseases have been described, most of which are infections. The most common foodborne illnesses are caused by norovirus and by the bacteria SalmonellaClostridium perfringens, and CampylobacterStaph Aureus (yes, that Staph) is another prominent but less common cause of food poisoning. Poisonous chemicals or other harmful substances can cause foodborne diseases if present in food.

What are the most common symptoms of food poisoning?

Even though there are many different foodborne diseases, they share a commonality of entering your system through your gastrointestinal tract. As a result, the first symptoms are caused and expressed from there and typically include nausea, vomiting, diarrhea and abdominal cramps.

foodpoisoning traceback_900px

Why do foodborne diseases seem to occur in outbreaks?

Actually, the overwhelming majority of cases of food poisoning don’t occur in outbreaks, but of course you wouldn’t know that because having diarrhea is not something people typically will tell you… When outbreaks occur, it’s because a group of people happened to eat the same contaminated item. This would explain how instances of groups of friends or strangers could have been involved. Contamination that occur closest to the food supply’s distribution result in the widest outbreaks. Look at the above picture. If contaminated food from the producer makes it all the way through the distribution chain, individuals in multiple states could end up with the same infection.

   foodpoisoningfoodsimage

What foods are most associated with foodborne illness?

  • Foods that mingle the products of many individual animals: Raw milk, pooled raw eggs and ground beef have increased risk because contamination in any one of the multiple animals involved can contaminate the entire mixture.
  • Raw foods of animal origin: Foods such as meat, poultry, shellfish, eggs and unpasteurized milk are the most likely foods to be contaminated.
  • Raw fruits and vegetables: Washing reduces but doesn’t eliminate pre-existing contamination, such as that occurring from the fresh manure that fertilizes vegetables. Furthermore, water itself may be contaminated.
  • Shellfish: Because “filter-feeding” shellfish strain microorganisms from the sea over many months, they are particularly likely to be contaminated if there are any in the seawater.

An additional Straight, No Chaser will discuss treatment options. Refer to this post for preventative tips.

Feel free to ask your SMA expert consultant any questions you may have on this topic.

Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!

Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!

Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.

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Filed under Detoxification, Gastrointestinal

Straight, No Chaser: Me on the Business End of a Colonoscopy, aka Getting Screened for Colorectal Cancer

colonoscopy

The last two posts have highlighted recommended screening examinations for men and women between ages 40-64. In today’s Straight, No Chaser, I want to pay special attention to one examination in particular: the screening colonoscopy, largely because I had the experience of getting it done just yesterday – but more on that later in the post.

Colon cancer is the second most common cause of cancer in the United States after lung cancer (stop smoking!). As previously noted in the post on recommended screenings, everyone should have a screening colonoscopy at least by age 50. Certain groups of individuals, such as African-Americans and those with positive family history for colon cancer should have the test done earlier. Simply put, colonoscopy is definitive in screening and diagnosing colorectal cancer, and it is one of the most successful ways to both prevent and treat early cancer.

Here’s a bit about how a colonoscopy is done.

colonoscopy-icons

First, you have to do a bowel prep. Over a few days, you’ll eliminate certain foods (e.g. corn, nuts) from your diet, then progress to an all liquid diet, followed by taking a few doses of a very strong laxative to completely clean out the contents of your intestines (those of you looking for a good detox should be so lucky). I actually lost 3.5 pounds doing this.

colonoscopy_procedure

The exam involves using a tube (colonoscope) to view your digestive tissue from your rectum all the way up the large intestine (approximately 5 feet). It includes cleaning away and suction stool that blocks the view, direct visualization of the intestines and real-time removal of suspicious tissue (e.g. polyps) that could be cancerous or early signs of cancer. You may or may not choose to be sedated (put to sleep) during this. Of course, my medical curiosity was such that I wanted to see everything on the screen in real time, so I went without any medications, and yes, I lived to tell the story: the level of discomfort never got higher than a 3 on a scale of 1-10.

The point here is simple and straightforward: Most people in whom colon cancer is found and treated early will not only be alive 5 years later, but many will live a normal life span. On the other hand, when it’s not, colorectal cancer is very dangerous because it often doesn’t cause noticeable signs or symptoms until the cancer is advanced and much more difficult to treat. The screening colonoscopy gives you the best chance to know where you stand.

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So this isn’t that complicated. If you’re older, African-American, have a positive family history for colon cancer or inflammatory intestinal conditions, live a sedentary lifestyle or have a low-fiber, high-fat diet, you are at risk. A word about your diet: you should know that according to the American Institute for Cancer Research, just 1.7 ounces of processed meats consumed daily (equivalent to less than two strips of bacon) roughly increase a person’s risk for colorectal cancer by 21 percent. More definitely, no amount of processed meat is considered safe for consumption.

Thankfully, my colonoscopy was perfectly normal: I keep telling you diet is 75% of health (unless you’re either lucky or unlucky in your genetic makeup)! The actual colonoscopy took just over 10 minutes, and I won’t have to go through this for another 10 years. Isn’t that investment of time worth giving yourself the best chance for a clean bill of colon and rectal health?

Feel free to ask your SMA expert consultant any questions you may have on this topic.

Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!

Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!

Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.

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Comments Off on Straight, No Chaser: Me on the Business End of a Colonoscopy, aka Getting Screened for Colorectal Cancer

Filed under Gastrointestinal, General Health and Wellness, Health Prevention, Hematology & Oncology/Blood Disorders/Cancer

Straight, No Chaser: Treatment of Acid Reflux (Gastroesophageal Reflux Disease)

acid-reflux-400x400

If you experience heartburn two times a week or more, you may have gastroesophageal reflux disease (GERD). Because there are significant differences in the severity of GERD, you should know when varying forms of treatment may be necessary. This Straight, No Chaser focuses on treatment of mild symptoms. For discussion of more severe GERD, visit www.sterlingmedicaladvice.com or discuss the options listed below with your healthcare provider.

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Mild symptoms As is the case for many diseases, simple dietary changes away from foods that increase acid producing and reflux symptoms often can be sufficient. As a reminder, such foods include alcohol, caffeine, chocolate, fatty foods and peppermint. With mild symptoms, over the counter medications such as antacids or antihistamines might be all that’s needed. Additional considerations such as the following have been shown to be helpful in some people with mild reflux and is worth the effort.

  • avoiding large meals
  • avoiding late meals
  • avoiding tight-fitting clothing
  • elevating the head of your bed six to eight inches
  • increasing the chewing of gum or use of oral lozenges (this is related to saliva production, which can neutralize acid)
  • quitting smoking (smoking actually reduces saliva production)
  • weight loss

acid_reflux_treatment

If and when medicines are used for mild symptoms, there are two classes of medicines used.

  • Antacids — Antacids such as Maalox, Myalanta and Tums are commonly used for short-term relief of acid reflux. The frustration you may have experienced in taking them is related to the fact that these medicines only neutralize stomach acid very briefly after each dose.
  • Histamine antagonists (aka antihistamines) — These medicines, including cimetidine (Tagamet), famotidine (Pepcid), nizatidine (Axid) and ranitidine (Zantac), reduce acid production in the stomach and are often helpful as a first line effort.

Moderate to severe symptoms — For patients with moderate, severe or refractory symptoms of acid reflux, or for those with complications of gastroesophageal reflux disease, different treatment options must be used.

  • Proton pump inhibitors (PPIs) — This class of prescription medicine is stronger and more effective than the histamine antagonists listed above. When these are necessary, it typically takes an eight-week course of treatment to optimize dosing and produce the best results that can be achieved.
  • Surgical treatment — When PPIs are ineffective, surgical options such as strengthening the lower esophageal sphincter and repairing any hiatus hernias (conditions in which the stomach partially slips through the diaphragm into the chest, facilitating more escape of acid into the esophagus) may be necessary.

There’s a lot you can do to avoid taking medicines and needing surgery. Make those better choices and live a healthier, happier life!

Feel free to ask your SMA expert consultant any questions you may have on this topic.

Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!

Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!

Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.

Copyright © 2017 · Sterling Initiatives, LLC · Powered by WordPress

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Filed under Gastrointestinal, Medical Treatment

Straight, No Chaser: Acid Reflux (Gastroesophageal Reflux Disease)

I’m at the point in life where I rarely eat after 8 pm. That has defined health benefits, but it’s also protective from today’s Straight, No Chaser topic: gastroesophageal reflux, aka GERD, aka acid reflux, aka reflux. You should be surprised and feel fortunate if reflux don’t bother you at some point. Let’s tackle this spicy topic via a question and answer format:

acidreflux

What is reflux? Most simply put, acid reflux occurs whenever stomach contents back up into your food pipe (esophagus) and/or mouth.

Why does this occur? Your feeding tube (esophagus) has a connection to the stomach at its lower end. This connection is made via a circular ring of muscle called the lower esophageal sphincter (LES). The LES relaxes and contracts to allow food to enter and prevent it from forward back up into the esophagus. Unfortunately, there are a number of conditions that cause the sphincter to relax, such as episode overeating, lying flat and the presence of a hiatus hernia (more on that in the next blog).

Is this a disease? Some degree of acid reflux is actually normal, but it does rise to the level of a disease (gastroesophageal reflux disease, aka GERD) when symptoms create difficulties for the patient.

acid-reflux

What are the symptoms? You know them, and you hate them! The most common symptoms include heartburn, difficulty with swallowing (including pain or food getting stuck; this is called dysphagia), regurgitation and vomiting. In fact, heartburn occurs in 10 million adults in the US every day. In severe cases, the acid can cause hoarseness due to the effects on the vocal cords or go back down the air tube (trachea) and into the lungs (this is called aspiration). Here are some additional symptoms you may experience.

  • Asthma “only” at night
  • Chronic cough
  • Chronic sinus infections
  • Non-burning chest pain
  • Painful swallowing
  • Persistent sore throat
  • Persistent laryngitis/hoarseness
  • Recurrent lung infections
  • Sense of a lump in your throat
  • Stomach (upper abdominal pain)
  • Waking up with a choking sensation
  • Worsening dental disease

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Do foods cause heartburn or acid reflux? You already know they do! Here’s a quick list of common food that worsen or trigger symptoms:

  • Alcohol (think red wine)
  • Caffeinated drinks, including coffee, soda and tea
  • Chocolate
  • Citrus fruits and products, including oranges and orange juice
  • Peppermint
  • Spicy foods, such as black pepper, garlic, raw onions and tomatoes.

When should I seek help for reflux? Although you should feel free to contact your healthcare provider for any symptoms, you should be aware that the following signs and symptoms may indicate a more serious problem. The presence of any of these should prompt you to visit and emergency room or otherwise contact your physician immediately. Please do not assume because you’ve had these symptoms previously, that the symptoms represent the same thing they always have.

  • Chest pain
  • Choking
  • Difficulty or pain with swallowing, or a sensation that your food gets stuck
  • Unexplained weight loss
  • Vomiting blood or have Bleeding (vomiting blood or dark-colored stools)

In the next Straight, No Chaser, we’ll review some complications, how GERD is diagnosed and treatment options.

Feel free to ask your SMA expert consultant any questions you may have on this topic.

Take the #72HoursChallenge, and join the community. As a thank you for being a valued subscriber to Straight, No Chaser, we’d like to offer you a complimentary 30-day membership at www.72hourslife.com. Just use the code #NoChaser, and yes, it’s ok if you share!

Order your copy of Dr. Sterling’s new books There are 72 Hours in a Day: Using Efficiency to Better Enjoy Every Part of Your Life and The 72 Hours in a Day Workbook: The Journey to The 72 Hours Life in 72 Days at Amazon or at www.72hourslife.com. Receive introductory pricing with orders!

Thanks for liking and following Straight, No Chaser! This public service provides a sample of what http://www.SterlingMedicalAdvice.com (SMA) and 844-SMA-TALK offers. Please share our page with your friends on WordPress, like us on Facebook SterlingMedicalAdvice.com and follow us on Twitter at @asksterlingmd.

Copyright © 2017 · Sterling Initiatives, LLC · Powered by WordPress

Comments Off on Straight, No Chaser: Acid Reflux (Gastroesophageal Reflux Disease)

Filed under Gastrointestinal