Acid reflux or GERD is a major health issue. It can affect both women and mens health. In this condition, there is reflux of stomach content high in acid into the esophagus. Reflux is prevented by the lower esophageal sphincter (LES) which remains tightly closed and opens when peristaltic waves herald the imminent arrival of swallowed food. When the LES becomes faulty acid reflux will result. This is called GERD or gastro-esophageal reflux disease.

Is it possible to cure your acid reflux? If it is due to true LES incompetence, then there is no cure. In LES incompetence, you need maintenance acid suppressant treatment such as omeprazole, or if very severe or you develop secondary problems then surgical treatment such as fundoplication will relieve your symptoms.

However, the effeciency of the LES can be affected by several factors. Consider eliminating these factors that may impact on acid reflux before seeing your doctor or taking over the counter acid suppressants. Sometimes all you need is a change of lifestyle.

Obesity can cause or contribute to acid reflux. This is especially so in the apple type distribution of weight. The increased bulk in the abdomen makes it difficult for the esophagus to discharge food effectively into the stomach. In addition obese individuals are prone to developing hiatus hernias. The LES can be weakened by a hiatus hernia. An important aspect of acid reflux treatment is losing weight.

Acid reflux can be caused by wearing tight fitting clothes especially if it is two sizes too small. The increased pressure on the stomach may force acid back up into the gullet. Wear loose clothes and your reflux symptoms may go away.

Large volume of food in the stomach will increase the pressure on the LES and can trigger acid reflux. We all experience this at some time or other. Gastric clearance time is also increased by large volume allowing more opportunity for reflux. To counter this problem, eat smaller portions.

Acid Reflux can be affected by certain foods. Allergic Eosinophilic Esophagitis is an inflammation caused by cow’s milk intolerance. This is controlled by removing cow’s milk protein from the diet. Other foods that can affect the LES include fats, coffee, tea, alcohol, and some spices.

Some drugs can affect the LES and cause acid reflux. These drugs include broncho-dilators such as theophylline, non-steroidal anti-inflammatory drugs (NSAID), tri-cyclic antidepressants ie amitryptilline and drugs for Parkinson’s disease.

Female hormones can affect GERD symptoms. In a Scandinavian Study, women on hormones had increased risk of GERD. These drugs include the hormone replacement therapy (HRT) and the contraceptive pill. Sedatives and tranquillisers can slow down peristaltic waves in the esophagus affecting proper discharge of food from the esophagus.

If you are on medication and you have GERD, opt for liquid medication. Tetracycline and certain other drugs are corrosive to the esophageal lining. Tablets and capsules (gelcaps) can get stuck in the esophagus. Always drink a glass of water to wash the medication down. Avoid taking medication while lying down. GERD patients should always take medication sitting up or standing and avoid lying down immediately after.

Smoking relaxes the LES and nicotine is corrosive to esophageal lining. Stop smoking and your GERD might improve.

GERD risk is increased by certain exercises. This is the case in competitive weightlifting and cycling. Joggers can develop acid reflux symptoms.

If by eliminating all the risk factors, your symptoms disappear, then you have actually cured your acid reflux. However, if the symptoms persist, the next step is a visit to your doctor.

There is not much confirmation for proving the benefits of dietary supplements but current ongoing research has shown good results. You can add supplements if your food is not providing you enough nutrients. These dietary health supplements also contains vitamins, minerals and other essential nutrients. Vanadium type of supplement is a solution for increasing body’s response towards insulin. You can control blood sugar levels through chromium. Diabetic people are known to have low magnesium levels and thus magnesium helps manage the problem.

Dietary supplements should not be the only matter that one should depend on. A person suffering from diabetes needs to follow a  balanced diabetic diet that aims to control the blood sugar levels. Supplements should be taken only if the diet is not providing sufficient nutrients or under certain circumstances. Although these health supplements provide vitamins and essential minerals and nutrients, one should not take them without consultation. These supplements are best taken under medical guide. Always take care while taking health supplements because improper use of these can be fatal for you.

A doctor’s permission is needed while combining health supplements along with medicines. However, combination of few supplements and medicines can lead to a brutal damage. When undergoing any other health problem, it is best to let your doctor know about the medicines being taken. The best way to curb diabetes is by following a healthy and balanced diet. There is nothing special diet for the diabetes food. Any type of food groups gives a good health when eaten in sufficient amounts.

There should be fresh vegetables and fruits in a healthy diabetic diet. Including complex carbohydrates and unsaturated fats in your diabetic diet plan is good. Trash and fried foods should always be avoided. Foods that are baked or low fried is exceptionally better than a deep fried food item.  Diabetic food need not be boring and tasteless. You can definitely cook healthy yet relishing food. Add a bowl bowl full of brown cooked rice or whole grain pasta in your diabetic diet it is healthy enough. Fish, eggs, skimmed milk, yoghurt, sour cream, nuts, beans, vegetables, and fruits, lean meats are also proved to be healthy and must be a part of diabetic diets.

Consulting a doctor or an experienced dietitian will help you plan your healthy diet. By understanding various food groups you can sketch your own diet to meet your body’s requirements. Diabetes diet health supplements can prove useful to fight diabetes; however, there is no guarantee of the same.

An Excellent Healthy Drink for Diabetics

Did you know that flavored carbonated water has no calories, sugar, body, sweetener, color or preservatives?

The taste is incredible, extremely refreshing and gives diabetics the best drink without any carbohydrates. A large and affordable assortment of flavored carbonated water concentrate is available for free delivery world wide from www.allfreightfree.com.

If you have arthritis and you are looking to control pain without drugs, then the first thing you need to do is to  reduce your weight or maintain a normal weight. If you are overweight, weight loss will be the most important thing you can do to improve the level of pain, stiffness and mobility.

A small amount of weight loss can make a significant difference. The best measure of weight in relation to height and general body health is the Body Mass Index (BMI). The normal range is 20-25 and 26-30 is considered overweight and over 31 obese.

Extra weight puts additional stress on weight bearing joints such as knees and hips, and increases the level of pain. It also increases the risk of arthritis. It is not always easy to lose weight if you have arthritis.

If your weight remains constant on a particular diet plan, then you are consuming just the right amount of calories to provide for the needs of the body. If you are gaining weight, then you are taking more than your body needs and the extra calories are stored as fat.

To lose weight you need to consume less than your body requires. This way the extra calories needed is obtained from the breakdown of fats stored in the body. Exercise will help you burn fats. It is not as effective as a specific diet plan but will help. It should be incorporated into the whole weight loss plan.

The heavier you are, the more calories you will burn during exercise. Exercise will keep the joints supple, reduce stiffness and tone up supporting muscles. It also makes you feel healthier and energised.

When exercising, you are moving synovial fluids around the joint. This is beneficial because it improves nutrition to the joint.

To assess your progress, evaluate the level of pain, stiffness and mobility before your diet and exercise plan, then make assessments at intervals.

Dr. Phil Hariram

Arthritis Guide.

Glucosamine is an amino acid sugar produced by the body and present in cartilage. It has been widely promoted as a treatment for osteoarthritis.

There is no conclusive evidence that this drug is effective. It is up to you to make your own mind up on it. There are individuals who swear by it and others who have no benefit.

Promoters of glucosamine claim it repairs damaged cartilage. It is derived from shells of shellfish. It is classified as dietary supplement just like chondroitin and its manufacture is not subjected to regulation. Make sure you purchase from a reputable company and check the ingredients.

There are no serious side effects with glucosamine. It is extracted from shells of shellfish so if you are allergic to shellfish be aware of this. If you are a diabetic, remember that glucosamine is an amino acid sugar and can impact on your blood sugar level.

Your family doctor is not likely to recommend glucosamine or chondroitin as an arthritis treatment because there is no clear evidence that they confer greater benefits over placebo in arthritis treatment.

It is, however, a safe medication. If you are on this drug or you are considering taking it, use it for three months before making your evaluation. If you are convinced there is improvement, continue using it as a treatment of arthritis.

Dr. Phil Hariram,

Arthritis Guide.

Winter poses a few problems for patients with arthritis especially arthritis of the hips and knees. Your driveway, the pavements and the roads are often wet and slippery. Early morning frost or ice on the road is also a problem. There is a risk of slipping and falling.

In addition the cold weather may increase stiffness and pain. I live in England and although it is not that cold here, it is very damp. Many arthritic patients have increased pain and stiffness and a few who go off to warmer climate such as Spain admits that their pains and stiffness are a lot less.

Although there is no concrete evidence that weather has an impact on the symptoms of arthritis, anecdotal evidence is different.

Dr.Hollander did a trial to assess the effect of temperature, humidity and atmospheric pressure on arthritis. He found that there was more joint pain and stiffness in high humidity and lower pressure. Weather only affects the symptoms. It does not have any affect on the disease itself.

Elderly arthritic patients who have moved to Florida will tell you that their arthritis feels better. The facts really is that they are having fewer symptoms.

If you can move to warmer drier climate that is fine. For various reasons not all of us can. I personally prefer to stay where I am. So in winter make sure you are kept warm. You may be inclined to do less in winter. Remember exercise is good for your joints and muscles. Inactivity may increase your pain and stiffness. You do not need to go outdoors to exercise. There are lots of exercises you can do indoors. If you like walking but you are worried about the risk of slipping and falling, get an exercise bike.

Remember that in winter there is less sunshine and your body will not manufacture enough Vitamin D to keep your bone strong. Make sure your consume foods rich in Vitamin D or if necessary take a supplement.

Dr.Phil Hariram.

Arthritis Treatment.

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Patients with Rheumatoid Arthritis should benefit from the new range of drugs called Tumour Necrotic Factor Inhibitors (Anti-TNF).

Tests on three of these new drugs slowed progression and reduced symptoms by up to 50%.

Research at the Medical University of Vienna, Austria, has shown that these three drugs are most effective in combination with the standard treatment, methotrexate.

In their published article, the team said, “The emerging agents show that a new era has started in the treatment of Rheumatoid Arthritis.”  UK expert, Paul Emery said, “They are strikingly effective and they work  on different targets from the existing drugs. That’s the joy of it.”

The three drugs in the trial are MabThera (rituximab), Orenca (abatacept), and tocilizumab.

These drugs are, however, not cheap. It is estimated that it will add around £250 million to the NHS drug bill.

Rheumatoid Arthritis is a debilitating joint disease and develops when the immune system attacks the joints causing destruction, stiffness and pain. It is estimated that there are about 400,000 rheumatoid arthritis patients in the UK.

Orenca was the first drug to target T cell in blood and tissue. Other Anti-TNF drugs are Enbrel (etanercept) and Remicade (inifliximab).

As these drugs affect the immune system, there is a higher risk of infections. They can cause headaches, fevers and increase blood cholesterol.

Ailsa BOSWORTH of the National Rheumatoid Arthritis Society said, “It means that we have some choice, and that’s very important if you are 22 and facing a lifetime of the Disease.”

Dr. Phil Hariram.

Arthritis Treatment.

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Here is food for thought. Eating the correct food can reduce the risk of cancer. According to a report from the World Cancer Research Fund eating red meat or processed meat and drinking alcohol increase the risk of cancer. It is estimated that up to a third of cancers reported in Britain are linked to diet. That is 100,000 cases annually. By knowing the right foods to consume you can limit some foods and increase the consumption of others. This way you can reduce the risk by 35%.

The main foods to increase consumption of are fruit and vegetables. The average consumption in Britain is three pieces a day when the recommended daily consumption should be five portions or more. Scientists have discovered that there are substances in brocolli, sprouts, cauliflower and cabbage that can speed up DNA repair in cells. This gives good cancer protection.

Scientists have found that bowel cancers are caused by nitrosamines found in cured meats such as ham and bacon. Garlic contains substances that protect against this chemical and thereby boost the body’s defences.

Fibre is an important ingredient in any diet. Bowel cancer makes up 13% of all cancers in Britain. Eating more fibre cuts the risk by 50%

In addition to increasing foods that boost defences against cancers, you need to also reduce the consumption of foods known to cause cancers. Red meat is linked to bowel cancer, breast and stomach cancers. You should eat no more than 500 g of red meat a week You should also avoid processed meat and that means no bacon, sausage, salami, ham or burgers.

Instead eat white meat, such as chicken and lots of fish. Soya products like tofu, soya milk may reduce the risk of developing hormone related cancers such as prostate and breast cancers.

Salt is a culprit. Too much salt can cause stomach cancer. Keep to the limit of 6g of salt daily. Regularly eating meals high in saturated fats increases the risk of many cancers especially breast cancer. Use vegetable oil when cooking and avoid deep frying. When barbecueing, avoid cooking the food until it is black. This may produce chemicals that can increase cancer risk.

As for alcohol, the limit recommended by the government is 14 units a week for women and 21 for men. Cancer Research UK suggest that a pint of beer a day or one glass of wine raises the risk of bowel cancer by 10% and for women a glass of wine daily increases the risk of breast cancer by 6%

Anti-cancer diet is likely to make you lose weight. Obesity is linked with increased cancer risk.

Eat more of fruit and vegetables especially brocolli, cauliflower, sprout and cabbage. Stir fry or steam to retain a high amount of cancer resisting substances. Aim to use about two cloves a week. Fresh and not dried. Use hugh fibre foods like pasta, wholegrain bread, bran. You should consume about 30g a day. Use soya-based foods like tofu.

Eat less red and processed meat. Reduce your intake of pork, lamb and beef. Alcohol consumption should be 7 units for women and 14 for men weekly. Reduce saturated fats from your diet. Instead of butter and lard, use vegetable or olive oil. Cut down on foods high in fats i.e. cakes, biscuits and chocolate. Do not add salt to food and check the ingredients of ready made meals for the salt content.

Dr. Phil Hariram

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A Group led by Professor Irving Kirsch, at the Department of Psychology at the University of Hull, looked at 47 clinical trials using data from Freedom of Information rules by the US Food and Drug Administration. They looked at the most commonly used anti-depressants such as fluoxetine (Prozac), venlafaxine (Efexor) and paroxetine (Seroxat).

They found that these anti-depressants had no greater effect than a placebo for mildly depressed patients and the majority of people suffering severe depression.

This new group of anti-depressants are called selective Serotonin re-uptake inhibitors. If the blood serotonin level is low, you feel depressed. These drugs improve this. The study confirmed that depression improved with these drugs but patients also improved with dummy pills. In other words depression will improve without chemical intervention.

Prof. Irvine Kirsch said, “Given these data, there seem little evidence to support the prescription of anti-depressant medication to any but the most depressed patients unless alternative treatments have failed to provide benefit.”

Nine out of ten GPs admit that they are forced into dishing out prescriptions because of poor access to treatments such as cognitive behavioural therapy. In Chelmsford the waiting time for CBT is very long.

Although there has been numerous side effects linked with these drugs and suicidal tendencies associated with prozac and seroxat, they are an improvement on the older drugs. GPs over prescribe these drugs and this research will change the prescribing habits across the country. It is certainly a step in the right direction if patients are given coping mechanisms to control depression. If and when depression recurs, they will know what to do for themselves rather than expect the magic pill to sort it out.

There are numerous times that I spent over twenty minutes talking to a depressed patient and prescribing the drug they expected from me and when they return for a follow up, they admitted that they did not take their tablets but took on board what I said, changed a few things in their lives, and that felt much better. There are also quite a few elderly patients on these drugs. They get their repeat prescriptions every month and stack them up in their cupboard and show no signs of any change.

This research result will not just save the NHS money in reduced prescriptions, but will change patients expectation. They will know that to get better, they should first heed the statement of two letter words. “If it is to be, it is up to me.”

Dr. Phil Hariram.

Tagamet was introduced when I was a trainee GP or as it is called today, a GP registrar. Before Tagamet and the other anti-ulcer drugs, ulcer patients suffered severely. When antacids were ineffective and a barium meal showed an ulcer, surgery was the next option.

There were procedures such as Vagotomy and pyloroplasty and the scary Bolroth. At the time there was a saying “You are not a successful executive unless you have an ulcer by 35.”

Ranitidine, the second anti-ulcer drug made Glaxo a big player in the Pharmaceutical Industry. Similarly Losec (Omeprazole) , a proton pump inhibitor, changed Astra, the Swedish Drug Company.

These drugs changed the lives of people with dyspepsia. For ulcers and acid reflux surgery became rare. The introduction of fibre optics into medicine meant endoscopies were carries out. Gastroscopies became a routine procedure and biopsies enabled the gastro-enterologists to grade the severily of the condition.

In 1982, the Australian duo and Nobel Prize Winner, Warren and Marshall, discovered a bacteria in the stomach of ulcer patients. The bacteria is Helicobacter pylori. Eradicating this bacteria allowed healing of ulcers. A combination of high dose antibiotics and anti-ulcer drugs for a week or two cured the ulcers.

Today gastric and duodenal ulcers are associated with Helicobacter pylori infection rather than stress, lifestyle or over indulgence.

Dr.Phil Hariram