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The Power of Probiotics “Good” bacteria? by Dr.D. Ramarao

The Power of Probiotics

“Good” bacteria?

by

Dr.D. Ramarao

Deep inside our intestines, there’s a complex microbial ecosystem, known as the “gut flora” which we now know it contains nearly a thousand species of bacteria which may affect our overall health in unimaginable ways!
 
It has long been recognized that our gastrointestinal system relies heavily on these gut flora or “good bacteria”.  They exert a pronounced effect on the nutrients and energy that get pulled out of food. In fact, these bacteria are thought to play a big role in a slew of health conditions, including combating obesity, diabetes, infections, lactose intolerance, irritable bowel syndrome, high cholesterol, and even colon cancer. There are many theories as to how these bacteria confer their positive benefits such as an anti-inflammatory effect for the body, increased immunity and therefore healing power after an infection, and even the power to fight off potential cancer cells in a microenvironment by competing for the same nutrients.
 
Probiotics:
At first glance, this concept may seem counter-intuitive and perhaps even downright strange. After all, from a very young age, we are trained to think of bacteria as creepy, crawly invisible things which can and will make us sick. Nevertheless, after the discovery of  the phenomenon of “good bacteria” in the gastrointestinal system in the beginning of the 20th century, scientists began to explore the idea of harvesting these bacteria, manufacturing them as pharmaceuticals and actually introducing them into our body’s system in the form of pills, capsules, and powders entitled “probiotics” with very promising results. Today, the World Health Organization defines probiotics as “Live microorganisms which, when administered in adequate amounts, confer a health benefit on the host”.
 
Future Research
Our gut microbes have recently drawn the interest of heavy hitters like the National Institutes of Health, which launched the Human Microbiome Project in 2008. The bacterial cells in or on the average person outnumber human cells 10 to 1! This presents us with a huge target base for medical intervention which may yield infinite positive results if used correctly. The question now becomes if it’s possible to change your gut ecosystem to improve your health through probiotics, and what interaction exists between genetics, the gut flora and diet which may be manipulated to enhance overall health.
So What’s In It For Me?
Of course, now we know that many probiotic foods are actually produced by the action of lactic acid bacteria, yeasts or a combination of both. These invisible microorganisms break down sugars and carbohydrates in the foods and make them more digestible and more nutritious for us.
 
Is there sufficient data to recommend the addition of probiotics to one’s normal regimen (as is done with vitamins for example)? Although there is little downside except for the cost issue, at this point there is not enough data to insist on the routine use of probiotics for otherwise healthy individuals. People who suffer from chronic gastrointestinal diseases, have undergone recent surgery, or are in need of chronic antibiotics use, may certainly benefit from a probiotic regimen and should discuss the matter with their physicians.
The specific type of probiotics used has not been shown to make a major difference. It’s also interesting to note that some elements of our normal diet such as many yogurts, pickled vegetables, sauerkraut and soy sauce contain a significant amount of probiotics which may be sufficient in most cases.
 
Since the lactobacillus bacteria found in each probiotic food are not the same, plus the fact that every bacterium plays a different role in the body, it’s a good idea to include a variety of naturally fermented foods in our diet.

Why Am I So Constipated? Potential Causes and Solutions by Dr.D. Ramarao

 Why Am I So Constipated?

Potential Causes and Solutions

 by

Dr.D. Ramarao

 

1. Do patients often come to you asking about constipation?
This is a very frequent complaint. On average one in four adults suffers from some degree of constipation in the India. I hear this complaint very frequently, with about a third of my patients inquiring about what to do to help with constipation.



2. What are the five most common causes of constipation? 

·         Lifestyle (not enough fiber, liquids and exercise)

·         Side effects of medications

·         Gastrointestinal disorders: irritable bowel syndrome and functional constipation

·         Manifestations of endocrine disorders (diabetes or hypothyroidism) or neurological disorders    
          (parkinson’s, stroke)

·         More worrisome causes (i.e. tumors ) usually present with other accompanying signs and symptoms.



3. What are the standard treatments for each?
First my staff and I review your medical history, including other medications used. Then depending on symptoms I will either recommend a diet modification plan, or do some routine blood work. Rectal exam with possible radiologic or endoscopic imaging is undertaken based on a detailed discussion with the individual person. Treatment regimen may consist of change of medications that the patient is on or addition of various laxatives medications.



4. When should a patient talk to you about constipation?

·         Blood in toilet

·         Change from your normal habits

·         Pain

·         Abdominal distention

·         Nausea or Vomiting

·         Fever

·         Weight Loss

·         Feeling Week

·         Interferes with daily activities

·         Symptoms come and go and persist for more than 3 weeks



5. Is it okay to take laxatives, or can they have serious side effects?

·         It depends on the type of the laxative (mechanism of action) and the amount used, 
          as well as whether  you have any other medical conditions, especially kidney or heart or may  be      

          pregnant.

·         Majority can be taken as pills or as enemas. Enemas generally work quicker.

·         In general are safe if used in small doses. Consult your doctor for frequent use.



6. What can patients do at home to help prevent constipation?

·         Drink plenty of water

·         Eat fruits and vegetables high in fiber: beans and berries

·         Eat natural laxatives:  prune juice, cantaloupe, figs and dried apricots

·         If you feel the need to go – don’t hold it in

·         Eat small frequent meals

Fear of Birth – How Do We Reduce the Fear by Dr D. Padmavathi

Fear of Birth

by

Dr.D.Padmavathi

Every day I listen to women about their fear of childbirth. There is a rising Cesarean section rate, which is major surgery. Many women end up exhausted, some traumatized and they talk to other pregnant women and share their stories. This can only add to the fear.

Childbirth is a natural normal life changing experience. Sometimes intervention might be necessary for a safe outcome for you and your baby, birth is not automatically a medical event the moment you become pregnant.

Fear of childbirth has become a modern day epidemic amongst pregnant women, they are worried about what might go wrong! They are afraid they will not be able to cope!

I often wonder why women are scared, and wonder is it the fear of forceps deliveries or caesarean sections which appear to be increasing. Maybe we are not preparing women and their partners adequately for labour, delivery and breastfeeding. Perhaps it is a combination of both. However I cannot emphasise the importance of good antenatal education for couples in preparation for labour, birth and caring for their baby.

Here I am going to cover some of the fears I hear from women, with some advice and reassurance to help deal with them.

Episiotomy (cut to the perineum)

An episiotomy is only carried out if necessary for example if baby is becoming distressed and needs to be delivered, an episiotomy will help speed the delivery up. If a forceps or vacuum delivery is required there is a high chance of an episiotomy. Routine episiotomy is now very rare in any hospital. The midwife or doctor will explain the procedure to you first.

A Caesarean Section

Unfortunately this is always a fear for every woman, especially with the high rate of caesarean sections it is no wonder women worry about it. Discuss your birth preferences with your partner, midwife and doctor is excellent preparation for labour and birth. Being well informed, knowledge is power, practice breathing and relaxation every day and having confidence in your ability to do it is essential.

Something happening to baby

Throughout your pregnancy it is normal to worry about something going wrong or something happening to baby, I hear lots of dreams from women. Some can be very upsetting. It is good to talk over dreams with your partner and your midwife or doctor as it helps to deal with all possibilities. Really don’t think too much about the negatives, you need to go into labour with a positive mind-set.

Forceps Delivery

If your doctor is concerned about your baby for example baby is distressed, or you are distressed sometimes intervention is necessary. Remember go into labour prepared having discussed all your fears with your midwife or doctor so you are prepared for every scenario. Knowledge is power and when you have this knowledge you can make informed decisions.

Accidental bowel movement

If this happens during the delivery of your baby, the chances are you will never know, midwives are very discreet about these things. If it does happen it is completely normal. Don’t hold back keep pushing with the urge to push and deliver your baby. Many girls have diarrhoea before labour starts and this is nature’s way of emptying your bowel in preparation for birth.

Meconium

If your baby’s bowels move before birth there will be meconium in the amniotic fluid. When your waters break the fluid should be clear and if it isn’t you must contact you midwife or labour suite immediately. The midwife and doctor will want to monitor your baby’s heartbeat, and check on your progress in labour. If they are concerned they may want to deliver baby straight away.

Cord around baby’s neck

A large percentage of babies a born with the cord around the neck and it rarely causes a problem. As soon as your baby’s head is out the first thing the midwife will do is check for neck cord, and if it is loose she can slip it over baby’s head and if it is a little tight she will clamp and cut it. There are occasions when the neck cord is too tight and can cause baby to become distressed if this happens your doctor will make a decision with you on the best plan for delivery.

Premature Delivery

If you develop contractions or have vaginal bleeding it is very important that you speak to the midwife or doctor. Some conditions can cause premature labour for example urinary tract infections and if caught early, labour can be stopped. However, sometimes labour starts early for no reason but be reassured premature babies do very well today with the advancement in neonatal care. If you are concerned please call your midwife or labour suite.

Pain

It is important to remember childbirth is a normal physical process, and contractions are the muscles working very hard to open up your cervix and push you baby out. Don’t think pain think contractions. They should be welcomed in a positive way bringing you closer to seeing your baby. Birth is not an illness and the contractions are not causing any harm. There are many forms of pain relief for women who want to use them. Discuss your birth preferences with your partner and midwife, be prepared. A calm environment with supporting loving people around you a key to coping.

Delivering baby before getting to the hospital

This is a rare occurrence with your first baby. Second babies can come fast so please be prepared. Remember at all times keep calm.

World Breastfeeding week 2015

Why Breastfeeding & New Discoveries

A lot has been written about breastfeeding in recent years, and if you are the parent of an infant or small child, you have undoubtedly read at least a little on the subject already. You may, in fact, have read so much that you wonder what more could possibly be said on the subject that would be news to you. A great deal, surprisingly. Although medical literature is full of reports of studies concerning breast milk and breastfeeding, very little of the information is actually available to the general reading public. In this article, I will share some of the scientific findings concerning breastfeeding and the mother-child relationship during this special time.

But First...

Before the breasts of a new mother produce milk, they release a thick, yellow substance called colostrum, which has immune properties. Colostrom is actually higher in protein, minerals, vitamin A, and nitrogen than milk is. Colostrum coats the baby's stomach and intestines to help ward off harmful diseases such as polio and pneumonia, and helps the baby pass meconium - a tarry substance that accumulates in the intestines. Also, cells in colostrum called macrophages destroy potentially dangerous bacteria.

The Main Course

When breast milk begins to flow (approximately two to three days after delivery), it, too, provides important vitamins and minerals for your baby, including the brain-cell builder taurine. While taurine is not an essential amino acid, its high concentration in breast milk does seem to indicate a need that cannot be met by the child's own body. But how much taurine is in formula or cow's milk? None! Yet extremely high levels of this "smart" substance are found in the brains of children, indicating that it is an important aid to brain growth. Ninety-six per cent of brain growth occurs by the age of five years. The average age at which a child weans in cultures that practice infant-led weaning is - you guessed it - five years.

Two commonly told stories about breast milk are that (1) it has very little iron and (2) it lacks vitamin D. But the fact is that breast milk does contain sufficient amounts of both nutrients, providing the mother has them to give (she should follow a balanced diet and boost her daily caloric intake to about 3,500). True, cow's milk and formula might contain more iron, but it is in a form that is poorly absorbed by infants. Babies fed these substitutes get anemic around six months of age if they don't receive supplemental iron. This is not true of breastfed infants. For example, a group of babies in Japan were totally breastfed for two years without any difficulties.

In the case of vitamin D, researchers spent a lot of time and money fruitlessly looking for that essential nutrient in the fatty portion of breast milk. But where was it? In the watery part the researchers had been discarding! Now scientists realize that there is no reason to give a nursing child vitamin D supplements ... even if Mom is an Eskimo and doesn't see the sun for six months!

Disease Prevention

Disease resistance is another benefit of breast milk, which contains 37 known immune mechanisms. These are present the entire time a mother breastfeeds her child, and can be divided into the following categories: protective bacteria, enzyme "attackers," protein binders, antiviral agents, and antibody "defenders." It is the job of these "fierce" mechanism groups to find and destroy any viruses or bacteria that may harm the baby, while also making sure he or she gets enough protein and nutrients. However, as soon as the baby is exposed to solid foods - even one bottle of sugar water - 17 of these immune mechanisms are destroyed (by the E. coli bacteria that are introduced) and can never be restored.

Overall, studies have shown that bottle-fed babies are sick more often than breast-fed babies. A research study in India (where breastfeeding is more the norm than the exception) indicated that of 3,684 babies observed, 7 out of the 2,031 breastfed children got pneumonia, whereas 48 out of the 1,653 who were bottle-fed got the disease.

If you become sick with a "bug" while nursing, don't fret about spreading the sickness to your child. Amazingly enough, white blood cells appear in the breast milk on the fourth day after the mother is exposed to the illness - cells her body has created specifically to eat that bacterium or virus! Thus your milk will give your child a specific antidote for the illness you are worried about. (This sickness-healing sequence obviously works better if the mother gets sick first. Fortunately, most times, mothers are "considerate enough" to do so.)

Drug Usage While Nursing

In general, it is best to avoid drugs (including the "social" ones) while nursing. Even aspirin must be taken with caution, since approximately one-twelfth of an adult dosage is equivalent to a full dosage for a ten-pound baby. To find out if a particular medicine is safe, please consult your local La Leche League leader. Remember that drugs secreted through the placenta are not necessarily secreted through the breast, since the placenta and the breast are different kinds of transfer organs.

Advantages For Mom

Breastfeeding benefits the mother by stimulating the release of the hormone prolactin, which has been found to induce maternal behavior in laboratory animals. Another "nursing hormone", oxytocin, helps to squeeze the milk into the ducts that lead to the nipple; it also helps to relax the mother. The baby's sucking also helps the mother's uterus contract to normal size, lowering the amount of blood loss.

Of course, the increased opportunity for parent-child bonding offered by breastfeeding is a widely known benefit of nursing, which brings up an interesting sidelight. A baby can have lots of brain cells, but they won't do any good unless they're interconnected. The nerve fibers that connect these cells are called dendrites. And what develops dendrites? You probably said breast milk ... right? Wrong! Touching develops dendrites. Holding, touching, and stroking a baby, as a mother naturally does while nursing ("you can prop a bottle but not a breast"), helps the child develop the way nature intended, both physically and emotionally.

When to Start Foods

If this thin, watery stuff called milk is so good, when do you need to start feeding your baby "real" food? This is a difficult question to answer. Recent studies have shown that hydrochloric acid - used to digest most protein - doesn't even appear in the stomach until the end of the seventh month and doesn't reach a peak until the eighteenth month. Coincidentally, 18 months is approximately when rennin - used to digest the protein in breast milk - has disappeared. Also, it seems that ptyalin, the digestive juice for carbohydrates, doesn't appear until the end of the baby's first year. (The earliest books on baby care always recommended that mothers pre-chew any solid food.)

You may say that your baby was so hungry that he or she was fighting for solid food at five months, but actually this probably isn't what was happening. The fact of the matter is that in your house you have this strange custom. Each day without fail you gather the clan around a square board and all of you stuff strange-looking things in your faces. The baby probably just wanted to be part of the clan ritual. Remember - babies tend to mimic the behavior of those around them.

I leave to you the decision of when to start foods, but let me offer two pieces of advice. First, don't force food on your baby. He or she will let you know when breast milk isn't completely satisfactory by showing an increased interest in nursing sessions (which you will soon discover is not due to a growth spurt). Second, instead of feeding your child, just let the youngster feed him or herself, from food you place on the high chair tray. (As the father of eleven children, I know this can be quite a messy experience!)

This way, not only will your child be less likely to overeat, but the little one will also tend not to eat foods he or she may be allergic to. By the way, honey, nuts, heavily sweetened foods, and spicy or salty foods are definitely not recommended for babies.

When to Wean

As soon as the baby is introduced to anything other than breast milk, the weaning process has begun. It is best to do this slowly, and, as with solid foods, let the baby tell you when he or she is ready, and allow him/her to set the pace. Contrary to popular belief, a child who is weaned at a late age is not any more dependent than a child weaned earlier. In fact, the late nurser may be more independent because the choice to break away from Mom was his or her own. So, don't let yourself be influenced by the behaviour or reactions of other mothers - this is a decision between you and your child.

Breast milk is "species-specific". It has everything in it that the baby needs, in just the right amounts. It fulfils both physical and emotional needs. It is not habit-forming, and all children wean themselves when they have had enough. Try it. You, and yours, will like it.

Put Nursing Fears to Rest

Does the thought of nursing give you butterflies? If so, here are some helpful hints.

The first two or three weeks of breastfeeding can be very difficult for a new mother, but take a deep breath ... and relax! It is very important to get plenty of rest during the nursing period, as this will stimulate the let-down reflex - the squeezing of milk from the alveoli. Fear, anxiety, confusion, or fatigue can hamper this reaction, so find a comfortable, tension-free place to nurse.

Two common misbeliefs are that (1) small-breasted women cannot produce enough milk and that (2) if you do not have enough milk when you begin nursing, you will never satisfy your baby's great need for nourishment. Neither of these beliefs are true! In all pregnant women a physical change occurs in the milk ducts that enlarges the breasts. In addition, the more your baby nurses, the more milk your breasts produce. And a new baby nurses approximately every 1-1½ hours at first.

It may take almost a week for you and your baby to nurse successfully - but don't give up!