1. What Is the Ideal Diet for Summer?
In summer, we need a lot of water for our daily routine life. Most of the time, we forget this and start as usual. Hence, we face a lot of problems during summer. You should drink at least two and half to three litres of water. Juicy fruits and liquids should be encouraged as a.part of daily diet; and a lot of green leafy vegetables will help in preventing constipation.
2. Hard Stools Are Very Common from Children to Elders – How to Overcome Their Problems?
Hard stools happen when we are not taking enough fibre in our diet. Nowadays, we are living in a fast-food era where we consume a lot of food that is precooked. Many times, the fibre in our diet is missing. Many people do not have the time to cook vegetables and prefer a non-vegetarian rich diet for protein intake. Hence, fibre is very much reduced in the diet. This leads to a lot of constipation in our day-to-day life.
3. What is cause of itching in the anal region?
Usually, itching is caused because of worm infestation. So, we routinely advise the patients to take deworming tablets (once in six months). Make sure these tablets are taken in the months of January and – so that the second dose after six months is easily remembered.
4. What is the cause of pain in the anal region?
Pain in the anal region can be due to constipation, during constipation the hard stools are like sharp edges; they cut the mucosal layer in the anal region,and create some minor injury, which slowly progresses to pain. When we develop constipation repeatedly, the anal mucosa stretches more and more while passing motion. This causes more pain and the pain may be present even after passing motion. This is an initial sign of constipation. Hence, patients should avail medical help and get themselves treated as early as possible
5. Is It True That Non-Vegetarian Food in Summer Causes Constipation?
Yes, of course, non-vegetarian food contains more proteins and less fibre. Hence, it may lead to constipation during summer. We are supposed to take more water and more fibre in the diet to prevent constipation.
6. Is Ready-made Curd Good for Gut Health?
Ready-made curds is made by mixing probiotics with milk to convert milk to curd, and it is kept for some amount of shelf time. Hence, preservatives are added in it to prevent it from getting spoiled. But when we make curd in our homes, it is safer.if it not possible to make curds at home, then we can have the ready-made curd.
7. What Is Your Advice on Probiotic Drinks?
When we have semi-solid stools about 3 to 4 times a day, or when we have loose stools, the probiotic drinks may help in maintaining gut health since during loose stools or any diarrhoeal episode, normal bacteria are lost. Hence, this leads to absorption defects and more semisolid motion. This can be prevented by taking probiotics drinks which help in increasing the normal commensals in the intestine. The probiotic also aids in digestion. So, when we have a digestive problem, we can take probiotic drinks. Otherwise, they are not routinely advised.
8. Is Blood in Stools in an Alarming Symptom?
Yes, blood in stools in is always an alarming symptom and when it happens more in summer, we should find out whether the patient is having constipation. The patient may have a painless bleed so many a times it is missed and goes unnoticed because of our Western toilet system and they may present later with haemorrhoids and pain. If there is blood in stools but no pain, it may be due to haemorrhoids bleed or sometimes a polyp which is bleeding from the inside. Whereas, when they have a painful bleed, it may be either due to constipation or due to a fissure in the anus or sometimes having an intercurrent bacterial infection can lead to bloody stools. Going to a hospital to
have the condition treated is the best option.
9. How Often Should We Get a Medical Gastroenterologist Opinion if there is a Gut issue?
When there is blood in stools, we should not ignore it until it becomes painful. We should consult a doctor who will guide us properly. Whenever there is blood in stools, the patient should go to a hospital to find out whether it is due to constipationor due to any other problem. If it is due to constipation, then they can take a lot of water and dietary fibre which may help resolve the condition. However, if the condition becomes severe, then a gastro opinion has to be sought and if needed colonoscopy has to be done to find out the cause to rectify the condition.
10. Is Endoscopy/Colonoscopy a Safe Procedure?
Endoscopy is a procedure in which a doctor uses an endoscope, a flexible tube with a camera, to see the lining of the upper gastrointestinal tract. The endoscopy helps us to find the cause of unexplained symptoms like persistent heartburn, bleeding in the upper GI tract, nausea and vomiting, pain in the upper belly, pain in the chest that is not heart-related, any problem in swallowing and unexplained weight loss. The procedure may be done with or without sedation based on the requirement. The scope is carefully guided inside the mouth, slowly into the esophagus and stomach to find the problem. Upper GI endoscopy can help identify the problem to treat the condition and can also be used for.
Colonoscopy is also an endoscopic procedure that is done to detect the changes or abnormalities in the large intestine. It’s a long, thin, flexible tube having the thickness of a finger with a tiny camera. Colonoscopy is generally a safe procedure. It is usually done to identify irritation or swelling, ulcers or extra tissue in the inner lining of the large intestine. Colonoscopy can help identify polyps or any mucosal abnormalities or malignancy. Both endoscopy and colonoscopy are safe procedures.
11. Frequency of Stools Is Seen in People with a Diabetic Condition – Is It Due to Diabetes or IBS?
We come across a lot of people with a diabetic condition presenting with semisolid stools immediately after taking food (like irritable bowel syndrome). So, in case of diabetes, we have to rule out two things. Initially, it may be irritable bowel syndrome or due to the small intestinal bacterial overgrowth SIBO Because of diabetes where lot of sugars are not absorbed in to the large intestine passing through the large intestine, where the Bacteria multiply which also leads to semisolid stools. Sometimes,certain drugs like metformin may cause increase in the frequently of loose stools because when we take metformin to prevent diabetes, what happens is it prevents glucose absorption from the duodenum to enter into the small intestine which causes more of solute load also lead to loose stools. Therefore, when patients with a diabetic condition present with semisolid stools for 3 to 4 episodes daily, they should consult a diabetologist to change metformin to control semisolid stools. If this does not help, then they have to consult a gastroenterologist to check for any other symptoms to rule out small intestinal bacterial over-growth. If this too is negative, then the patient may have to take a contrast CT scan to rule out malignancies, and if needed, endoscopy and colonoscopy too may be done.
12. We Generally Have a Balanced Diet, but Recently, to Get Good Glycaemic Control and to Control Weight Gain, Various Diets like Millets, Keto Diet, etc. Are All Recommended. Will This Affect Our Gut Health?
We have a lot of diet patterns for weigh loss , but simple things are always simple. Getting up at a proper time and having a good diet with a good sleep routine will help with weight control but we neglect all this and go for diets.
When we go for a millet diet or keto diet, the possibility of constipation is more because millets take a long time to digest and to come out of our body. In case of keto diet, it has a lot of proteins and fats but no fibre which will lead to constipation. Before taking up a particular diet plan, please discuss it with your dietician and gastroenterologist. This is because many patients may not tolerate millets and may end up with irritable bowel syndrome. The keto diet may also cause other problems. Hence, discussing the diet with your gastroenterologist and your dietician will help avoid problems.
Dr Kavitha Sampath Kumar, MBBS., DNB., DM Gastro ESEGH (UK),
Senior Consultant – Medical Interventional Gastroenterologist & Hepatologist
Kauvery Hospital Chennai
