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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.