Digestion, health and nutrition: Dr. Anil Minocha, a gastroenterologist and nutritionist

Digestion, upper GI health

2008-08-11T05:47:00-05:00

Preventative life style measures for healthy digestive system or gut

Patients may be advised to follow some life-style modifications as well care using medications including over-the counter medicines.

Avoidance of NSAIDs as much as possible should not be restricted to prescription formulations only. For example, NSAIDs in the form of BC powder is taken people in the south for pain on the assumption that it is risk free. candy. Health care providers should try using acetaminophen as much as possible for pain instead of NSAIDs. If NSAIDs are needed, use the lowest possible dose and avoid multiple NSAIDs.
Smoking increases gastric acidity and affects the gastroprotective mechanisms predisposing the patients to ulceration as well as GERD. Smoking cessation in addition to other systemic health benefits like reduction of cancer risk, may reduce dyspeptic symptoms as well as potentially prevent ulcers in some patients.
Alcohol has direct toxic effects on the gastric mucosa and may lead to gastritis and even gastrointestinal bleeding in some cases. Excessive drinking also increases gastroesophageal reflux. Mixed drinks like bloody Mary, screw driver have components (tomato juice and orange juice etc) that have additional injurious effect on esophageal mucosa. Many after dinner drinks have in addition to alcohol sweetened cream etc leading to slower gastric emptying and more gastroesophageal reflux. Avoiding excess alcohol may help reduce dyspeptic symptoms as well as ulcers in otherwise predisposed individuals.
Routine life style measures for GERD in addition to the above include avoiding large fatty, spicy meals especially at dinner, not going to bed for atleast 3 hours after supper, weigh reduction if overweight.
Role of diet is frequently patient specific and may play a role in symptoms in some individuals with dyspepsia. Thus dietary modifications need to be individualized based on patient’s symptom triggers. Patients usually know the foods that trigger their symptoms and they should be asked to avoid them instead of looking for a treatment. Pharmaceutical therapy is not a good substitute for any particular food just because they “like that food” and “cannot give it up”.Patients suffering from recurrent peptic ulcer disease may benefit from eating complex carbohydrates, fresh fruit, vegetables and avoiding red and fried meats.

Prebiotics, FOS, GOS, health benefits

2008-08-04T05:55:00-05:00

Prebiotic is a selectively fermented ingredient that allows specific changes, both in the composition and/or activity in the gut bacteria leading to benefits for the host well being and health. Synbiotic is a combination of prebiotic and probiotic.

Bifidobacteria and lactobacilli have been shown to have potent antipathogenic properties for potentially providing health benefits.

A successful prebiotic has the following properties:

Is not destroyed or absorbed in the gut on its journey from mouth to the colon.
Undergoes bacterial fermentation in the gut.
Selectively promotes the number and/or activity of the indigenous beneficial bacteria like bifidobacteria and lactobacilli

While dietary fiber may act as prebiotic, the most promising however are fructo-oligosaccharides (FOS) because of their selective fermentation towards the more healthy gut bacteria.Galacto- oligosaccharides (GOS) are used in infant formula foods. Both FOS and GOS meet the criteria for prebiotics as outlined above. Inulin type fructans have positive prebiotic effects. Other products with possible prebiotic potential include soybean oligosaccharides from soybean whey. Isomalto- oligosaccharides may be regarded as a quasi-prebiotic since it is partially metabolized in human gut.

Possible health benefits of prebiotics include:

Improved lactose tolerance
Improved resistance to pathogens resulting in decrease in gastrointestinal infections and respiratory infections
Decrease in cholesterol
Increased bacterial synthesis of vitamins
Protection against allergies by reducing gut inflammation
Improved absorption of calcium and magnesium

Dose of prebiotic: 5-8 g per day

Products on the market that may be fortified with prebiotics include diary products, health drinks, infant formula, cereal, dried instant as well as canned foods, and pet foods etc.

Do you or someone you know takes probiotics or prebiotics? If yes, in what form do you take and do you think it makes a difference? Please share your thoughts.

Sex intercourse elderly age

2008-07-28T05:55:00-05:00

Sex is not discussed much as age progresses especially past middle-age. Does that mean older folks are not engaging in sex? Are older folks happy with their sex lives or have they given up on sex.? Baby-boomers, smile and read on!

Beckman and colleagues recently (British Medical Journal 2008) reported on the secular trends in self reported sexual activity and satisfaction in Swedish 70 year olds over a 30 year period

The authors found that from 1971 to 2001, sexual intercourse/activity increased among all groups of the 70 year olds : married men (52% to 68%), married females 38% to 56%), unmarried men (30% to 54%), and unmarried women(0.8% to 12%). Both sexes felt higher sexual satisfaction and more subjects displayed positive attitudes to sexuality.

This study suggests that elderly although perhaps still quiet about sex, are becoming more open-minded about enjoying the pleasures of healthy sexual life including sex outside the domain of marriage.

What do you think about the emerging trends noted above? Do you think that grandma and grandpa should be quiet and just give up on sex in case of physical inabilities of sexual dysfunction or should they talk to their physician about it. Should the health insurance companies pay for prescription drugs like Viagra for erectile dysfunction (ED) irrespective of age or should there be a age related restrictions? Please share your thoughts.

Growth hormone HGH, muscle building, exercise performance

2008-07-21T05:50:00-05:00

Sports enthusiasts and athletes believe that human growth hormone (HGH) builds muscles and increases athletic performance. However, the safety and efficacy for increasing muscles, exercise stamina and exercise performance by growth hormone have been mired in debate due to conflicting literature.

Dr. Liu and colleagues from Stanford in California, examined the evidence thus far about the effects of human growth hormone (HGH) on muscle building, athletic stamina and performance in physically fit subjects. Their study titled, “Systematic review: the effects of growth hormone on athletic performance” was published in the journal Annals of Internal Medicine (2008).

The authors reviewed trials examining effect of HGH on muscles and exercise stamina and performance. The data from the combined studies yielded 44 articles and 303 participants receiving human growth hormone. This represented 13.3 person-years of HGH treatment. The average dose of growth hormone used was 36 mcg/kg per day while average duration was 20 days.

The authors found that lean body mass increased in subjects getting growth hormone as compared to those who did not. However, this was not accompanied by an improvement in muscle strength or exercise stamina and performance. Subjects receiving HGH also suffered from more soft tissue swelling and fatigue.

The authors concluded that HGH does not improve athletic stamina and performance. To the contrary, the data suggested that HGH may actually worsen exercise capacity with deleterious side effects.

Caveats: The HGH dose/frequency of HGH used by the athletes is probably much greater in real world than used in the clinical trials and thus the trials do not mimic real world situations. In addition, many athletes and power muscle-builders actually use HGH along with other products like steroids and insulin. Even more importantly, many athletes take use HGH because of healing powers of human growth hormone by “hastening recovery from injury”; this issue was not addressed in the study.

Do you or someone near you uses HGH for building muscles and enhancing athletic performance? Do you think people should use it for this purpose? Please share your thoughts.

Turmeric, curcumin in ulcerative colitis

2008-07-14T05:45:00-05:00

Curcumin is a biologically active phytochemical component in turmeric or yellow curry powder and has been found to be effective in numerous diseases including cancer. Ulcerative colitis (one form of inflammatory bowel disease) may be one of those conditions with poven benefit.

The study below was discussed at one of the sessions at the annual Digestive Diseases week (2008) which is the largest gathering of the gastroenterologists in the world. The two panelists (Dr. Koratz from UCLA and Dr. Mullen from Johns Hopkins) gave two thumbs up to this study of turmeric and endorsed its used in ulcerative colitis.

Hanai and colleagues studied the effect of turmeric (curcumin) as a maintenance therapy for ulcerative colitis in a randomized controlled fashion. They reported their findings in the journal Clinical Gastroenterology & Hepatology (2006) in a study titled, "Curcumin maintenance therapy for ulcerative colitis: randomized, multicenter, double-blind, placebo-controlled trial."89 with ulcerative colitis in remisssion participated in the study. Patients received curcumin (1g twice a day) or placebo in addition to the standard treatment (sulfasalazine or mesalamine) for 6 months.Of the patients receiving curcumin, 5% relapsed as compared to 21% in the placebo group.

The investigators concluded that curcumin seems to be a promising and safe medication for maintaining remission in ulcerative colitis.

What are your thoughts on the above study and the action of a "natural remedy" being endorsed at a prominent medical scientific meeting? Please share your thoughts.

Coffee, multiple sclerosis MS

2008-07-08T21:35:36-05:00

Coffee now good for another disease? The jolt may be beneficial against multiple sclerosis! Based on a studies done in mice, it appears that coffee may protect against MS.

Before you jump and drink coffee for multiple sclerosis, bear in mind that a recent epidemiological study from Belgrade found that coffee consumption is higher among MS patients.

Another similar Italian study had found an association between MS and high consumption of coffee and tea in the period from infancy to adolescence.

Bottomline, mice are not humans and lot more work needs to be done on the issue of coffee and MS before any definitive conclusions can be drawn.

Watermelon, natural aphrodisiac sex stimulant

2008-07-07T05:06:00-05:00

Guys love watermelon, atleast that's the trend in recent days. The same men who hated produce now filling their plates. Wonder why?

Quoting scientists from Texas, there has been a surge in media reports that watermelon may have effects similar to Viagra. If true, this would give us a natural aphrodisiac, cheap and without prescription.

How can watermelon help enhance the men's lives? Turns out, it has high concentrations of citrulline, which is then converted to arginine in the body, Arginine leads to higher levels of nitric oxide which is a vasodilator improving the blood supply to tissues.

However, the reports that watermelon is similar to Viagra may be grossly exaggerated. Watermelon ingesstion does improve blood supply everywhere in the body, however without focussing on "where it is needed". As such, you would need to eat lots of watermelon to match the effects of Viagra. Before you try that, don't forget the potential diuretic effects of watermelon!

Coffee death risk

2008-06-17T05:39:00-05:00

The relationship between coffee consumption and health and various diseases has frequently been conflicting. Literature suggests that coffee may have positive effect in diabetes mellitus, heart disease and cancer.

A recent study examined data on over 41,00 men and 84,000 women. The issues studied included coffee drinking, diet and smoking. The investigators founded that subjects who consumed coffee were less likely to die during the study period. They attributed this to reduction in heart-related deaths while there was no effect of coffee on cancer deaths.

It is interesting that the association with coffee was positive irrespective of whether the subjects drank regular or decaffeinated coffee. This suggests that caffeine may not be the only positive factor in coffee.

Coffee has numerous other substances besides caffeine that may contribute to beneficial effects. These include phenolic compounds with antioxidant activity, magnesium, trigonelline and quinides. The effects of such substances may be mediated via their effects on inflammation, blood vessels, and diabetes.

Authors concluded that drinking large amounts of coffee may be protective against early death. This is consistent with another recent study in elderly Finnish population.

Do you drink coffee, lots of it? or decaffienated? What are your thoughts on this report and if it will affect your coffee habits? Please share your thoughts.

Constipation, dolichocolon and colonic kinks

2008-06-17T05:34:00-05:00

Dolichocolon causes constipation-really? What is dolichocolon anyway and what is the evidence to support its role in constipation.

The Dolichocolon concept was the brainchild of Arbuthnot Lane and is based on the the theory that kinking of colon leads to constipation. While colon is like a country road with its own twists and turns (and of course each "colonic country road" is different), the Lane theory suggests that gravity leads to unnatural "kinking" or twisting initially in the fixed parts of colon on the left side. It gradually progresses upward and proximally causing elongation and further kinking.

In fact, Lane was a proponent of colonic resection or a byepass. While initially colonic resection became very popular, it came into disrepute in the early 20th century and now is performed in rare selected cases only.

Lets face it-the concept of dolichocolon or kinking causing a partial obstruction appears simple, straightforward, appealing and plausible (perhaps too simple and straightforward). Furthermore, theoretically speaking, the kinking along with elongation of colon has potential for increased fecal stasis in colon leading to increased water absorption from the fecal contents resulting in "drier" stool and constipation. However, scientific data to support these theoretical concepts is lacking. At the same time, constipation does not appear to be correlated with colonic length and surgery is not beneficial in cases of colonic "kinks" unless a volvulus is present.

Do you or someone close to you have constipation? What is the cause of constipation in your opinion? Does the Lane's theory of dolichocolon make sense and sound believable to you? Please share your thoughts.

Stool stasis, autointoxication due to fecal matter

2008-06-09T05:14:00-05:00

Undigested food staying in gut too long, creating toxins leading to disease--have you heard of this?

The phenomenon is known as autointoxication and has its origins in ancient Egyptian civilization as far back as 16th century BC. Sir William Lane in the early 20th century in his treatise published in the Proceedings of the Royal Society of Medicine (1913) asserted that "autointoxication is the cause of all the chronic diseases of civilization".

Is this concept of autointoxication a fact or a myth? The proponents argue that slowed gut transit or increased stasis of fecal matter in the colon results in greater putrefaction and production of toxins. These toxins get absorbed and cause chronic illnesses with or without low grade inflammation.

It is difficult to demonstrate such a toxin experimentally especially since such a toxin(s) may not be universally present. It is entirely possible that a multitude of toxins is involved and the disease results from individual susceptibility. Furthermore, there may not be a special toxin, but the disease may be a consequence of some normal product of bacterial putrefaction that is not necessarily absorbed but has a direct action on colonic wall affecting the gut immune cells, endocrine-neuro-immune system and ultimately the entire body system. In addition to all the above unknowns, we cannot exclude the possibility of yet unknown toxin being involved.

So what is the verdict? Is the concept of autointoxication a hard fact or just a myth perpetuated by "quacks" over the centuries. We do not have the perfect answer, atleast not yet. One thing we do know however that having a bowel movement everyday is essential for positive health.

What are your thoughts on autointoxication? Do you or someone you know believe in and practice any methods to counter it? Please share your thoughts.

Gut smells like nose olfaction. Really?

2008-05-20T05:41:00-05:00

Gut has a nose and can smell! You have heard of ”gut reactions” and “my gut tells me”. Can the gut smell? Could these "gut reactions" be mediated via smelling function of the gut?

Braun and colleagues from Germany recently studied whether nasal olfactory (smell) receptors are present in human gut and whether odorants present in spices, fragrances, detergents, and cosmetics can cause release of neurotransmitters like 5HT or serotonin. As you know, serotonin regulates intestinal motility as well as secretions and is involved in pathogenesis of vomiting, diarrhea, and irritable bowel syndrome as well as psychological conditions like depression.

These investigators found 4 olfactory receptors in human gut. Odorant ligands of the these olfactory receptors via cascade of events lead to serotonin release thus have potential to affect gut function.

The authors concluded that odorants present in the gut/intestinal lumen may stimulate 5HT/serotonin release via these olfactory receptors in gut mucosa. Some physicians especially gastroenterologoists do use antidepressants including SSRIs for the treatment of intestinal conditions like irritable bowel syndrome, cyclic vomiting and abdominal migraine.

Now based on this article, could you also legitimately say, “my gut can smell it” in addition to “my gut reaction is” and “my gut tells me”.

Alcohol, bone osteoporosis and bone fracture risk

2008-05-13T05:52:00-05:00

Alcohol and bones? Does alcohol help or hurt bones? Modest drinking helps against osteoporosis as compared to abstainers and heavy drinkers. Don't you love it!

Berg and colleagues examined the literature studying effect of alcohol drinking hip fracture, bone density, non-hip fracture, bone density loss over time, bone response to estrogen replacement, and bone remodeling. They found that as compared to abstainers, subjects imbibing 0.5 to 1.0 drinks per day had lower hip fracture risk. In contrast, the risk was higher in subjects enjoying more than 2 drinks per day. Modest drinking is thus better than no drinking or heavy alcohol drinking.

The investigators also found a positive impact alcohol consumption on bone density.

Now that you know that alcohol tends to prolong life and may build healthy bones, are you more likely to enjoy a drink a day, to keep the doctor away. Please share your thoughts. Cheers!

Fish type, mercury and heart benefits

2008-05-06T05:50:00-05:00

Fish, omega-3 fatty acids and heart: Fish contain high amounts of omega-3 fatty acids (eicosapentaenoic acid and docosahexaenoic acid) which have been proven to be cardioprotective, i.e. good for heart. They prevent heart attacks. Studies suggest that there is 29% reduction in mortality over 2 years inpatients who have had heart attacks.

The evidence is strong enough for the American Heart Association to recommend increased intake of omega 3-fatty acids. The good news is that mercury content of all the fish is not the same. The mercury content of predatory fish is much higher because they eat other fish containing mercury and indirectly attain much higher levels mercury than the fish at the lower end of the food chain.

The beneficial effect if fish intake can be demonstrated with as few as 1 fish per week, and greater intake provides even greater protection.

Fish, mercury and toxicity: The benefits of fish intake are tempered by the concern over mercury intake through fish and the resultant potential for neurotoxicity.

Low versus high mercury fish: The good news is that mercury content of all the fish is not the same. The mercury content of predatory fish is much higher because they eat other fish containing mercury and indirectly attain much higher levels mercury than the fish at the lower end of the food chain.

Identifying low versus high mercury fish: Sardines, salmon, and shrimp have lower mercury content than the predatory sharks, tuna, sword fish and orange roughy.

Farmed fish: Even more importantly, the farmed fish have the lowest mercury content while providing the same benefit.

Limiting the mercury content: The exposure to mercury can be lowered by limiting the amount of fish ingested and eating the fish with lower mercury content.

Recommendations for fish intake: Institute of Medicine provides conservative recommendations regarding fish consumption. Non-pregnant persons may eat 1 predatory fish meal and 2-3 low mercury fish meals per week. Pregnant women should not eat more than 1 predatory fish meal per 2 weeks; however they may eat other fish 2-3 times per week.

Both wild and farmed fish are beneficial.

Above is based on an article in Nature Clin Practice (2008).

Right diet for child's sex: son or daughter?

2008-04-28T05:51:00-05:00

Boy? Girl? Would-be mother’s diet, i.e. preconception diet, can help make the choice. This comes from a study titled, You are what your mother ate”, published in the journal Proc Biol Sci in 2008. If son is the choice, the woman before pregnancy should be pigging out!

There is paucity of information about natural and/or environmental factors affecting mechanisms of sex allocation in human evolutionary process. The investigators studied 740 women. The women with the highest energy intake preconception were likely to have sons. While food intake during pregnancy had no impact, women with the top third intake food intake had sons 56% of the times, whereas only 45% from the group from the lower third of energy intake had sons.

Interestingly, women eating cereal everyday prior to conceiving had almost 90% chance of having a son as compared to those eating just one bowl or less of cereal per week. Women having sons ate about 300 more calories than the ones who had girls. Potassium rich diet is also likely to lead to a male child.

Is it because boys tend to be bigger and larger energy investment tilts balance?

Are these results plausible? While more data is needed to confirm these findings, these results are consistent with laboratory data related to fertilitization and survival of male embryos.

“Our results support hypotheses predicting investment in costly male offspring when resources are plentiful”, wrote the authors. These results also have implications for artificial gender selection in fertility clinics.

Do you think diet can or does affect ultimate sex of the would-be baby? Do you know of someone who goes by this theory and practice it? Please share your story.

Nurses smell stool for diarrhea cause: nursing nose makes odiferous diagnosis

2008-04-22T05:23:00-05:00

Can nurses smell the diagnosis better than doctors and tests? Especially by smelling stool for cause of diarrhea?

Nurses have long been contributing to astute observations that have stood the test of time. A shining example is Sister Mary Joseph's nodule.

All diarrheas are not the same and nurses can smell and actually diagnose the cause for diarrhea. An early diagnosis can help early specific treatment.

While rotavirus gastroenteritis appears clinically to be similar to other types of diarrhea, nurses were able to correctly diagnose Rotavirus as the cause in 69% on the bases of the stool smell alone. This was reported by Poulton and colleagues in the Archives of Diseases in Childhood.

Clostridium difficile diarrhea can be devastating and prompt treatment may help attenuate the seriousness pending results of investigations. Johansen and colleagues studied diarrheal stool sample and found that nurses could identify Clostridium difficile toxin positivity in 31 out of 37 cases yielding a sensitivity and specificity of 84 and 77% respectively. The authors concluded that there is a characteristic “Clostridial odor” that helps nurses identify the cause.

These results of the odiferous diagnosis were confirmed in a more recent study by Burdette and Bernstein and published in the journal Clinical Infectious Diseases 2007.

Do you believe the data above that nurses have sharp noses and can actually identify cause of diarrhea? Do you think it is because they tend to be more perceptive as an occupation OR that nurses are predominantly women and that women are more perceptive than men? Please share your thoughts.

Apple a day, keeps colon cancer away

2008-04-07T05:30:00-05:00

Does apple help health or is it a myth? Can it help against cancer? Do apple pectin and juice extract produce anticarcinogens during the fermentation in the colon? The answer seems to be yes.

Dr. Waldecker and colleagues in the journal Nutrition 2008 studied the fermentation supernatants from incubation of human fecal slurry with apple pectin and apple juice extracts. The Inhibition of the enzyme histone deacetylase (HDAC) seems to play a central role in these anticancer effects. The authors found that fecal slurry from fermentations with pectin was rich in butyrate and very active in HDAC inhibition in colon tumor cell lines.

The HDAC-inhibitory potency from pectin-rich fermentations correlated with the butyrate levels. Fecal slurry from fermentations with apple juice extract had lower butyrate yields but similar HDAC inhibition and potentially similar anticarcinogenic effect.

This is how it works: Apple fermentation leads to increase in short chain fatty acids like butyrate. Butyrate is a chemopreventive metabolite that can prevent the occurrence of colorectal cancer. The mechanism is via inhibition of histone deacetylase leading to retarding the carcinogensis, the process of tumor formation.

The authors concluded that apple products exert anticarginogenic effects in the colon.

What are your thoughts about fruit in general and apple in particular? Are you going to go more for fruits or apples in the grocery store? Please share your thoughts.

Organic food heals Crohn’s disease

2008-04-01T05:00:00-05:00

Organic food—expensive! Should we eat this expensive organic food for better health in Crohn’s?

Would organic diet be better for healing Crohn’s?

Gasche and colleagues from Austria tested the hypothesis that organic diet is better for treating Crohn’s disease.

Patients with Crohn’s received organic diet or a control diet (low-fiber, low-fat, and high-carbohydrate). Outcome measures included MRI, endoscopy, Crohn's Disease Activity Index (CDAI), and the Inflammatory Bowel Disease Questionnaire (IBDQ).

Organic food diet showed improvement in their intestinal lesions not seen in patients assigned to a high-carbohydrate diet. The investigators concluded that food as part of the modern Western lifestyle may cause persistence of intestinal Crohn's lesions.

Diet and environmental have been linked to risk for Crohn’s disease. Diet and environment are not mutually exclusive. The increase in incidence of Crohn’s disease in recent decades suggests environmental risk factors associated with a Western lifestyle may contribute to Crohn’s disease.

What kind of diet do you prefer? Would you be willing to spend more for organic food in your diet based on this study?

Placebo pain relievers and price

2008-03-26T05:46:00-05:00

Placebo pain relief, really?

Yes, placebos work for pain, so say Dr. Weber et al. in JAMA…the more the price, the better the placebos work. After all you get what you pay for.

Some doctors probably do use placebos knowingly or unknowingly for chronic painful conditions that they can’t find effective treatments? These may include irritable bowel syndrome, fibromyalgia, chronic fatigue syndrome, interstitial cystitis etc.

The question arises, should the doctors use placebos knowingly? If yes, the more expensive ones?

And where do you draw the line? Should the doctor be allowed to have a shop displaying remedies in his clinic?

Please share your thoughts.

Diet Crohn’s disease risk

2008-03-18T05:45:00-05:00

Diet as risk for Crohn’s disease?

Over the years, some dietary foods predominant in vegetables and fruit have been thought of as protective. In contrast, fatty foods have been thought as increasing the risk for Crohn's disease. The literature however has been inconsistent. As such, the controversy continues as the precise cause of Crohn’s disease remains an enigma.

Dr. D’Souza and colleagues from Canada reported the results of their study in Inflammatory Bowel Diseases 2008. They examined the dietary patterns and risk for Crohn's disease in children in a case-control study fashion. Subjects included newly diagnosed Crohn’s disease compared with population and/or hospital-based controls.

Dietary patterns were assessed using a food frequency questionnaire. The study comprised of 149 cases of Crohn’s disease and 251 controls.

Girls consuming diet consisting of meats, fatty foods, and desserts had an increased risk by 4.7 fold. In contrast, boys and girls enjoying diet consisting of vegetables, fruits, olive oil, fish, grains, and nuts had a the risk decreased substantially.

The authors concluded that specific dietary patterns could be associated with higher or lower risks for Crohn’s disease in children.

Do you or someone you know has Crohn’s disease? What are your thoughts on the relationship of diet and Crohn’s disease or ulcerative colitis?

Aphrodisiac foods as sex stimulants

2008-03-04T05:23:00-06:00

Do sex and aphrodisiac food really mix well? Recommendations for aphrodisiac sex stimulants especially for erectile dysfunction are rooted more in beliefs, mythology than in science.

Chocolate has been known as “nourishment of the Gods” since ancient times. A combo of a passionate fruit like strawberry dipped in chocolate may just be enough to give a big jump start to the mood of just about anyone.

Fruits: Pomegranates, passion fruit, pears, and berries (raspberries and strawberries) take the cake in this category. Other aphrodisiac foods contributing to sexual desire, stimulation and libido include apples, bananas, cherries, figs and grapes.

Vegetables: Asparagus has the reputation passion stimulant both in Ayurvedic medicine as well as Arabic folklore and is invigorating both for men and women. A juicy tomato, or "love apple," a potent source of the antioxidant, lycopene, was once a highly sought-after libido enhancer. Artichoke, avocado, carrots, celery, cucumbers have been bestowed with legendary aphrodisiac reputation for revitalizing sexual system.

Nuts and seeds: Both pine nuts and pumpkin seeds are aphrodisiac adjuvants. Almonds and pistachios are other popular sexual stimulants.

Seafood especially oysters: Legend has it that Casanova use to cherish 50 oysters every morning. It is loaded with zinc, which is needed for many critical biochemical reactions. While just the act of savoring raw oysters can be stimulating by themselves, make sure with your doctor that it okay for you to enjoy this delicacy especially if there is any question about immune system.

Herbs and Spices Mint, cinnamon, cardamom, saffron are frequently associated with sexual stimulations. Others potential aphrodisiacs include basil, rosemary and cloves. Beware however of some sexual herbal stimulants that actually have unapproved drug aphrodisiac substrates.

Alcohol: Another glass of wine please? While planning a romantic meal, do not forget the role of alcohol. Drink in modest amount only if you don’t want to be disappointed later!

Supplements: Keep in mind that our hectic life styles does not frequently allow for a well balanced diet every day. A daily multivitamin/mineral/antioxidant supplement offers extra health insurance. Talk to your doctor about it.

Last but not the least, don’t “eat” the meal, slowly savor it. Foods may provide sexual substrates, but how you eat (enjoy) it can have an even bigger stimulant effect on the mood.

Bottomline: Do you believe in role of food in romance? Do you think some particular foods or how they are prepared or enjoyed helps setting up the right mood and enjoyable experience? Please share your thoughts.

Glutamine immunity on gut immune system

2008-02-25T05:41:00-06:00

Immune system in the gut? Glutamine for gut immunity?

Lets first discuss immunity especially gut health and immunity.

Did you know that as much as 25-75% of our immune system is located inside our gastrointestinal system? Immune system is spread throughout body in an effort to have immune defenses all around for our protection. In fact, it is one of the largest organ systems in our body and serves to protect us from forces outside as well as within.

In addition to our GI immune system, our non-immune defenses include the gut flora, physical barrier between the luminal contents and inside of our body, chemical barrier as well as gut motility that helps to keep things moving down and out as in good sanitation.

The intestinal wall acts as a barrier to the noxiuos luminal contents. It is also involved in transport of nutrients. At the same time, intestinal wall is also helping with immunological surveillance since the gut is constantly exposed to injurious agents like toxins etc.

Based on above, dietary modifications by altering the intestinal milieu have potential to alter the expression of genes in the epithelium.

What does glutamine have to do with immunity? Additional glutamine may be one way to boost one’s immunity. Studies have documented that feeding additional glutamine can improve immune function, reduce complications and hospital stay and perhaps improve survival in sick patients. The results are best seen when glutamine is combined with other immune-nutrients.

How does glutamine work? It is an energy source for immune cells as well as gut enteroicytes. It is required for synthesis of nucleotides and proteins etc. In addition, it enhances T and B-cell function, facilitates phagocytosis as well as bacterial killing.

Do you believe in nutritional supplements? Do you take glutamine or any other nutritional supplements? Does this article change your mind in any way? Please share your thoughts.

GERD Acupuncture treatment

2008-02-19T05:43:00-06:00

Did you know that acupuncture may be an effective GERD or chronic reflux treatment?

Gastroesophagaeal reflux disease or GERD affects tens of millions of people in the US. Proton pump inhibitors (PPIs) are the most effective medical therapy. Patients on PPI therapy are usually started on once a day dosing. However, many patients require double dose, i.e. twice a day dosing for PPIs for relief of reflux symptoms.

Long term use of PPIs is not without long term side-effects. Many patients choose to employ complementary and alternative medicine therapies instead. Chinese medicine is an ancient system of holistic medicine effective for treatment of variety of gastrointestinal and non-digestive disorders as well as mental conditions and has been used in this context.

Dickman and colleagues examined whether addition of acupuncture rather than another dose of PPI (omeprazole) to the regimen of once a day PPI dose for GERD would be beneficial. Acupuncture was conducted at 5 points selected to calm the stomach system. The investigators found a dramatic difference in relief by addition of acupuncture to the regimen as compared to another dose of omeprazole.

Acupuncture may work better since it treats whole body acting at multiple processes than stomach acid alone.

Do you have chronic heartburn or GERD? What treatment to you take? What are your thoughts on long term use of PPIs versus use of alternative and complimentary therapy like acupuncture. If you are taking medical treatment for GERD, would you be willing to add or even substitute it with some form of CAM? Please share your thoughts.

Sex addiction on internet treated by naltrexone

2008-02-11T05:47:00-06:00

Internet sex addiction is fast becoming one of the newer compulsive behaviors with immense health as well as psychosocial implications. Although triggers and manifestations be variable and unique for different individuals, the final neurochemical pathways are probably similar. Hence, one successful treatment modality against one is likely to be successful against other. One such option is naltrexone is an opiate blocker and is currently approved for alcoholism.

Drs. Bostwick and Bucci from the Mayo Clinic (Mayo Clinic Proc Feb 2008) report naltrexone based successful treatment of compulsive internet use for sexual gratifications, both self and virtual as well as spontaneous off-line sexual encounters with others he had met online.

The patient is a 24 year old male who presented complaining of “sexual addiction” that was affecting his job as well as his marital life. He attributed this habit to his discovery of grandfather’s pornographic material as a child. Prior to online sexual fantasies and encounters, he used to indulge in phone sex on 900-lines. At the same time he felt guilty about his addition since he is a devout Christian.

He had tried multiple treatment modalities including antidepressants, psychotherapy, sexual addicts anonymous, pastoral counseling without any benefit.

He was then started on naltrexone resulting in sustained success at avoiding compulsive internet use. The discontinuation of naltrexone resulted in relapse of internet sexual habit which again resolved on restarting naltrexone.

Do you know of anyone around you who has had addiction problems, especially internet addiction and even more specifically internet based sex addiction. I am interested in knowing how the readers feel about internet based sex adiction in general, its impact on life and this report specifically.

Hiccup home remedies, causes and drugs

2008-02-07T05:14:00-06:00

Hiccup or singultus (from singult in Latin meaning catching breath while sobbing.) is an involuntary nuisance bodily action of no functional value. Most hiccups resolve spontaneously without any active intervention. Hiccups may occur even prior to birth.

Hiccup frequency varies with individual (4 to 20 per minute, going as high as 60/minute in some cases). Similarly the duration of hiccups is variable from few minutes to hours, days and even weeks.

An episode of hiccups may last as long as 48 hours. Some patients have persistent hiccups lasting as long as one month. Intractable hiccup episodes may continue beyond 2 months in rare cases.

How hiccups occur?

Hiccups occur due to contraction of muscles of diaphragm and inspiratory respiratory muscles causing sudden inspiration with closure of the glottis. What provokes a bout of hiccups remains an enigma. “Hiccup reflex arc” comprising of connection of intercostal muscles with multiple nervous connections including phrenic and vagus nerves, sympathetic nervous system, central nervous system (probably brain stem especially respiratory centers. has been implicated.

What causes hiccups?

A bout of hiccup is usually instigated by distention of the stomach as a result overeating or excessive air in stomach due to carbonated beverages, swallowing air. Simple things like upper respiratory infection or a hair in ear in contact with ear drum can provoke an episode. Gastroesophageal reflux disease (GERD), and hiatal hernia have also been implicated. More serious causes include tumors and infections throat, ears and brain. AIDS is another possible cause.

Other stimulants include a drugs, toxins, alcoholism, kidney failure, sudden excitement and changes in temperature, alcohol intake, and tobacco use. Stress has also been implicated.

Failure to identify a cause for persistent or intractable hiccups may suggest a psychogenic etiology. Occurrence of hiccups during sleep makes a psychogenic cause less likely.

Investigations: Most episodes of hiccups are brief, self-limiting and don’t require investigations. Work up should be undertaken in cases of persistent and intractable hiccups. This generally includes a thorough history and physical exam, as well as simple labs like complete blood count (CBC), comprehensive metabolic panel., liver and pulmonary function tests, drug and tox screen. The use of x rays, CT or MRI scans, EEG, lumbar puncture, EGD (esophagogastroduodenoscopy or upper GI scope) needs to be individualized. Treatment of hiccups — There is paucity of rigorously tested scientific data on this subject. Of course if an underlying cause is found, treatment can be directed at that the cause.

Drug options:These include chlorpromazine, antireflux or anti GERD heartburn medications like Prilosex, muscle relaxants like Baclofen, prokinetic like metoclopramide (Reglan), antidepressants and antiepileptic agents.

One AIDS patient used marijuana to get rid of his hiccups.

Home or non-drug remedies: These time tested home remedies for hiccups have been passed on through the generations.

My favorite is closing the ears with your fingers/hands while drinking water through a straw.

Other popular home remedies include:

Take a deep breath and hold as long as you can
Gargle with ice water
Pull the tongue
Valsalva
Bite on lemon

There are also reports of successful use of alternative and complementary therapies like hypnosis and acupuncture.

As a last resort, surgery as well as implantation of breathing pacemakers and vagus nerve stimulators have been undertaken.

Do you know of someone with a major hiccup problem? Do you know of a home remedy that works for you. Please share with us.

Nutrient dense or calorie dense foods

2008-02-01T05:30:00-06:00

Foods may be nutrient dense or calorie dense. Nutrient-dense foods are opposite of opposite of calorie-dense.

Nutrient-dense foods provide healthy nutrition while calorie dense foods provide empty calories without any significant additional nutrients. Given a choice, prefer a nutrient dense foods as compared to calorie dense.

Consider the following:

There are 6 nutrient components of food: carbohydrates, fats, proteins, vitamins, minerals, and water.
Nutrient dense foods include whole-grain breads, cereals, rice, beans, pasta, vegetables.
One cup of strawberries contains only 150 calories, but 3.5g fiber, and high in vitamin C and folate.
Empty calories or calorie dense foods include candy bars, donuts, and cookies which contain carbohydrates and fats but only insignificant amounts of vitamins and minerals.

Bottomline about nutrient-dense versus calorie-dense: If you have a choice between snack of fruit like strawberries or apple versus a candy bar or donut, prefer a the fruit.