Author Archives: Mukul

Few Health Quarries & Answers


Q : I feel that my face is asymmetrical and I am very self-conscious about it.

Ans: People do have asymmetrical faces. In some, it may be more pronounced. It can be present from birth, when one side of the face develops less than the other. It may come on later as a result of a viral infection (herpes), facial palsy or injury. It can occur because of sleeping regularly only on one side. It can also be due to bad teeth, as a result of which you tend to chew on any one side. It is possible to correct some of the acquired conditions. Sometimes surgery may be required.

Bamboo spine:

Q :  I have a severe backache, and the doctor has diagnosed ankylosing spondylitis. Will it become worse?

Ans:  Ankylosing spondylitis is a condition when the bones of the spine become stiff and rigid, leading to limited flexibility and eventually a “bamboo spine”. It is more common in people who carry the HLA B27 gene and can run in families. Its symptoms are controlled with medication and regular physiotherapy, but it cannot be cured.

Caregiver woes:

Q : I am a 52-year-old woman. I work in an office and also care for my teenage children as well as my mother-in-law who has mild dementia. I find it all rather overwhelming.

Ans: Many women are caught in the never-ending spiral of caring. Remember, you also have to care for yourself. The important thing is to realise that you do the job out of love and not a sense of obligation. Look after yourself, and try to get in 30 minutes of aerobic activity, five minutes of meditation and 10 minutes of stretching every day. Unless you are healthy, you will not be able to care for others.

Medical kit:

Q:  My son as he is starting college and I need to send a medical kit with him to the hostel.

Ans: It is more important that you son’s immunisations against typhoid, hepatitis A, chickenpox and flu are up to date so that he does not go to college and immediately fall sick.

Other than this, paracetamol for fever, levocetirizine and a few ORS sachets for diarrhoea are probably enough.

Sources: The Telegraph (Kolkata, India)


Few Health Quarries & Answers

Q :   I have been given the idea that eggs are bad for you. Is this true?

Ans:   An egg contains about 200mg of cholesterol, mostly in the yolk, leading to the erroneous assumption that eggs are bad for you.

Each egg has 60-70 calories, with essential vitamins, minerals, choline carotenoids like lutein and zeaxanthin, and 60gm of protein. All this reduces the risk of macular degeneration of the eye (blindness) and enhances brain development, while the choline content may improve memory. So eggs are actually good for you.

Shoulder pain: 

Q:   The back of my right shoulder pains and I am unable to move my arm above my head. I sit in front of a computer all day.

Ans:  This happens quite often in people with desk jobs, those who are sitting at a computer for 6-8 hours a day. The natural alignment of the neck bones become affected because of posture. These vertebrae start to impinge on the nerves going to the arms as these emerge from between them. This can cause muscle pain, muscle spasm, headache, joint pain and referred pain. You will probably recover with intensive physiotherapy. Please check your vitamin D3 levels to see if it is low. This “sunshine vitamin” is required for healthy bones.

Warm up, cool down:

Q.   I run for 30 minutes a day, and of late, my knees as well as the inside of my leg and calf muscles have started to pain.

Ans:  It is essential to warm up your muscles before you start to exercise. If you suddenly start a vigorous run, your unprepared muscles get a jolt. Exercise also makes muscles contract and shorten. Once the activity is over, stretch the muscles you have used with cool down exercises. This prevents damage and pain.

Milder forms of exercise such as brisk walking are less damaging to joints and offer equal benefits.


Stress buster :

Q  : I have stress at work and home. Things that happen in both places reverberate in my thoughts all day and at night when I am trying to sleep. My blood pressure is rising, and I have a rapid heart rate.

Ans: Stress is bad for health. it precipitates all kinds of lifestyle diseases such as diabetes, hypertension, heart attacks and stroke. You cannot change your situation either in the workplace or at home. To cope better, go out in the fresh air and walk, run or swim for 40 minutes. Follow this up with yoga and meditation for 20 minutes.

Antibiotic overdose?

Q : My four-year-old son gets watery diarrhoea frequently. Antibiotics are always prescribed for him. I wondered if this excessive antibiotic use will have a negative impact on his health.

Ans: Watery diarrhoea is likely to be infectious. It requires antibiotics only if it has persisted for more than three days and there is a fever. Recurrent diarrhoea can be due to food (particularly milk) allergy.

Diarrhoea is best treated with rehydration using ORS (oral rehydration solution) reconstituted precisely as directed on the packet. A tastier option is watery, lightly salted, mashed khichdi, made with equal quantities of pressure cooked rice and moong dal, alternated with bananas.

Smoker’s tongue:

Q :    I smoke 20 cigarettes a day and have done so for more than 20 years. I stopped last week because of the nagging from my wife and doctor. Now, I have a painless, slightly ulcerated lump in the centre of my tongue.

Ans:  As painless lump, unless it is a blood clot, is more sinister than a painful one. Given your smoking history, you need to consult an ENT specialist urgently. If he or she feels you need a biopsy, please do not hesitate.

Source: The Telegraph (Kolkata, India)

Smoking and the Digestive System

Smoking has direct effect on Digestive System:
Smoking can harm your digestive system in a number of ways. Smokers tend to get heartburn and peptic ulcers more often than nonsmokers. Smoking makes those conditions harder to treat. Smoking increases the risk for Crohn’s disease and gallstones. It also increases the risk of more damage in liver disease. Smoking can also make pancreatitis worse. In addition, smoking is associated with cancer of the digestive organs, including the head and neck, stomach, pancreas, and colon.

Smoking affects the entire body, increasing the risk of many life-threatening diseases—including lung cancer, emphysema, and heart disease. Smoking also contributes to many cancers and diseases of the digestive system. Estimates show that about one-fifth of all adults smoke,1 and each year at least 443,000 Americans die from diseases caused by cigarette smoking.

Smoking contributes to many common disorders of the digestive system, such as heartburn and gastroesophageal reflux disease (GERD), peptic ulcers, and some liver diseases. Smoking increases the risk of Crohn’s disease, colon polyps, and pancreatitis, and it may increase the risk of gallstones.

Quitting smoking can improve the digestive system:
Quitting smoking can reverse some of the effects of smoking on the digestive system. For example, the balance between factors that harm and protect the stomach and duodenum lining returns to normal within a few hours of a person quitting smoking. The effects of smoking on how the liver handles medications also disappear when a person stops smoking. However, people who stop smoking continue to have a higher risk of some digestive diseases, such as colon polyps and pancreatitis, than people who have never smoked.12, 13

Quitting smoking can improve the symptoms of some digestive diseases or keep them from getting worse. For example, people with Crohn’s disease who quit smoking have less severe symptoms than smokers with the disease.

Points to Remember:
*Smoking has been found to increase the risk of cancers of the mouth, esophagus, stomach, and pancreas. Research suggests that smoking may also increase the risk of cancers of the liver, colon, and rectum.

*Smoking increases the risk of heartburn and gastroesophageal reflux disease (GERD).

*Smoking increases the risk of peptic ulcers.

*Smoking may worsen some liver diseases, including primary biliary cirrhosis and nonalcoholic fatty liver disease (NAFLD).

*Current and former smokers have a higher risk of developing Crohn’s disease than people who have never smoked.
People who smoke are more likely to develop colon polyps.

*Smoking increases the risk of developing pancreatitis.

*Some studies have shown that smoking may increase the risk of developing gallstones. However, research results are not consistent and more study is needed.

*Quitting smoking can reverse some of the effects of smoking on the digestive system.






Proctitis is an inflammation of the anus and the lining of the rectum, affecting only the last 6 inches of the rectum. Proctitis may be acute or chronic. Anal sex, inflammatory bowel disease, or radiation therapy to your pelvic area or abdomen may cause proctitis. If not treated, proctitis may have complications.

Proctitis can cause rectal pain, diarrhea, bleeding and discharge, as well as the continuous feeling that you need to have a bowel movement. Proctitis symptoms can be short-lived, or they can become chronic.


Proctitis is common in people who have inflammatory bowel disease (Crohn’s disease or ulcerative colitis).

A common symptom is a continual urge to have a bowel movement—the rectum could feel full or have constipation. Another is tenderness and mild irritation in the rectum and anal region. A serious symptom is pus and blood in the discharge, accompanied by cramps and pain during the bowel movement. If there is severe bleeding, anemia can result, showing symptoms such as pale skin, irritability, weakness, dizziness, brittle nails, and shortness of breath.

Symptoms are ineffectual straining to empty the bowels, diarrhea, rectal bleeding and possible discharge, a feeling of not having adequately emptied the bowels, involuntary spasms and cramping during bowel movements, left-sided abdominal pain, passage of mucus through the rectum, and anorectal pain.

Proctitis has many possible causes. It may occur idiopathically (idiopathic proctitis, that is, arising spontaneously or from an unknown cause). Other causes include damage by irradiation (for example in radiation therapy for cervical cancer and prostate cancer) or as a sexually transmitted infection, as in lymphogranuloma venereum and herpes proctitis. Studies suggest a celiac disease-associated “proctitis” can result from an intolerance to gluten.

A common cause is engaging in anal sex with partner(s) infected with sexual transmitted diseases in men who have sex with men. Shared enema usage has been shown to facilitate the spread of Lymphogranuloma venereum proctitis.
Sexually transmitted infections are another frequent cause. Proctitis also can be a side effect of radiation therapy for certain cancers.

Doctors can diagnose proctitis by looking inside the rectum with a proctoscope or a sigmoidoscope. A biopsy is taken, in which the doctor scrapes a tiny piece of tissue from the rectum, and this tissue is then examined by microscopy. The physician may also take a stool sample to test for infections or bacteria. If the physician suspects that the patient has Crohn’s disease or ulcerative colitis, colonoscopy or barium enema X-rays are used to examine areas of the intestine.

Risk factors:

Risk factors for proctitis  are:

* Unsafe sex. Practices that increase your risk of a sexually transmitted infection (STI) can increase your risk of proctitis. Your risk of contracting an STI increases if you have multiple sex partners, don’t use condoms and have sex with a partner who has an STI.

* Inflammatory bowel diseases. Having an inflammatory bowel disease (Crohn’s disease or ulcerative colitis ) increases your risk of proctitis.

* Radiation therapy for cancer. Radiation therapy directed at or near your rectum (such as for rectal, ovarian or prostate cancer) increases your risk of proctitis.


Proctitis that isn’t treated or that doesn’t respond to treatment may lead to complications, including:

* Anemia. Chronic bleeding from your rectum can cause anemia. With anemia, you don’t have enough red blood cells to carry adequate oxygen to your tissues. Anemia causes you to feel tired, and you may also experience dizziness, shortness of breath, headache, pale skin and irritability.

* Ulcers. Chronic inflammation in the rectum can lead to open sores (ulcers) on the inside lining of the rectum.

* Fistulas. Sometimes ulcers extend completely through the intestinal wall, creating a fistula, an abnormal connection that can occur between different parts of your intestine, between your intestine and skin, or between your intestine and other organs, such as the bladder and vagina.


Treatment of proctitis depends on its cause and the severity of your symptoms and often includes medicines. Some causes of proctitis, such as infection or rectal injury, can be prevented. Doctors treat complications of proctitis with medical procedures.

For example, the physician may prescribe antibiotics for proctitis caused by bacterial infection. If the proctitis is caused by Crohn’s disease or ulcerative colitis, the physician may prescribe the drug 5-aminosalicyclic acid (5ASA) or corticosteroids applied directly to the area in enema or suppository form, or taken orally in pill form. Enema and suppository applications are usually more effective, but some patients may require a combination of oral and rectal applications.

Another treatment available is that of fiber supplements such as Metamucil or psyllium husk. Taken daily these may restore regularity and reduce pain associated with proctitis.


To reduce your risk of proctitis, take steps to protect yourself from sexually transmitted infections (STIs). The surest way to prevent an STI is to abstain from sex, especially anal sex. If you choose to have sex, reduce your risk of an STI by:

* Limiting your number of sex partners

* Using a latex condom during each sexual contact

*Not having sex with anyone who has any unusual sores or discharge in the genital area

If you’re diagnosed with a sexually transmitted infection, stop having sex until after you’ve completed treatment. Ask your doctor when it’s safe to have sex again.

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.


Ménétrier’s Disease


Other Name: Hypoproteinemic Hypertrophic Gastropathy

Ménétrier’s disease causes the ridges along the inside of the stomach wall—called rugae—to enlarge, forming giant folds in the stomach lining. The rugae enlarge because of an overgrowth of mucous cells in the stomach wall.

It is a rare, acquired, premalignant disease of the stomach characterized by massive gastric folds, excessive mucous production with resultant protein loss, and little or no acid production. The disorder is associated with excessive secretion of transforming growth factor alpha (TGF-?)

In a normal stomach, mucous cells in the rugae release protein-containing mucus. The mucous cells in enlarged rugae release too much mucus, causing proteins to leak from the blood into the stomach. This shortage of protein in the blood is known as hypoproteinemia. Ménétrier’s disease also reduces the number of acid-producing cells in the stomach, which decreases stomach acid.

The average age of onset is 40 to 60 years, and men are affected more often than women. Adults with Ménétrier disease have a higher risk of developing gastric adenocarcinoma.


Individuals with the disease present with upper abdominal pain (epigastric), at times accompanied by nausea, vomiting, loss of appetite, edema, weakness, and weight loss. A small amount of gastrointestinal bleeding may occur, which is typically due to superficial mucosal erosions; large volume bleeding is rare. 20% to 100% of patients, depending on time of presentation, develop a protein-losing gastropathy accompanied by low blood albumin and edema.

Symptoms and pathological features of Ménétrier disease in children are similar to those in adults, but disease in children is usually self-limited and often follows respiratory infection.

Scientists are unsure about what causes Ménétrier’s disease; however, researchers think that most people acquire, rather than inherit, the disease. In extremely rare cases, siblings have developed Ménétrier’s disease as children, suggesting a genetic link.

Studies suggest that people with Ménétrier’s disease have stomachs that make abnormally high amounts of a protein called transforming growth factor-alpha (TGF-?).

TGF-? binds to and activates a receptor called epidermal growth factor receptor. Growth factors are proteins in the body that tell cells what to do, such as grow larger, change shape, or divide to make more cells. Researchers have not yet found a cause for the overproduction of TGF-?.

Some studies have found cases of people with Ménétrier’s disease who also had Helicobacter pylori (H. pylori) infection. H. pylori is a bacterium that is a cause of peptic ulcers, or sores on the lining of the stomach or the duodenum, the first part of the small intestine. In these cases, treatment for H. pylori reversed and improved the symptoms of Ménétrier’s disease.1

Researchers have linked some cases of Ménétrier’s disease in children to infection with cytomegalovirus (CMV). CMV is one of the herpes viruses. This group of viruses includes the herpes simplex viruses, which cause chickenpox, shingles, and infectious mononucleosis, also known as mono. Most healthy children and adults infected with CMV have no symptoms and may not even know they have an infection. However, in people with a weakened immune system, CMV can cause serious disease, such as retinitis, which can lead to blindness.

Researchers are not sure how H. pylori and CMV infections contribute to the development of Ménétrier’s disease.

The large folds of the stomach, as seen in Ménétrier disease, are easily detected by x-ray imaging following a barium meal or by endoscopic methods. Endoscopy with deep mucosal biopsy (and cytology) is required to establish the diagnosis and exclude other entities that may present similarly. A non-diagnostic biopsy may lead to a surgically obtained full-thickness biopsy to exclude malignancy. CMV and helicobacter pylori serology should be a part of the evaluation.

Twenty-four-hour pH monitoring reveals hypochlorhydria or achlorhydria, and a chromium-labelled albumin test reveals increased GI protein loss.[5] Serum gastrin levels will be within normal limits.

Other possible causes (eg differential diagnosis) of large folds within the stomach include: Zollinger-Ellison syndrome, cancer, infection (cytomegalovirus/CMV, histoplasmosis, syphilis), and infiltrative disorders such as sarcoidosis.

Cetuximab is the first-line therapy for Ménétrier disease. Cetuximab is a monoclonal antibody against epidermal growth factor receptor (EGFR), and has been shown to be effective in treating Ménétrier disease.

Several medications have been used in the treatment of the condition, with variable efficacy. Such medications include: anticholinergic agents, prostaglandins, proton pump inhibitors, prednisone, and H2 receptor antagonists. Anticholinergics decrease protein loss. A high-protein diet should be recommended to replace protein loss in patients with low levels of albumin in the blood (hypoalbuminemia). Any ulcers discovered during the evaluation should be treated in standard fashion.

Severe disease with persistent and substantial protein loss despite cetuximab may require total removal of the stomach. Subtotal gastrectomy is performed by some; it may be associated with higher morbidity and mortality secondary to the difficulty in obtaining a patent and long-lasting anastomosis between normal and hyperplastic tissue. In adults, there is no FDA approved treatment other than gastrectomy and a high-protein diet. Cetuximab is approved for compassionate use in the treatment of the disease.

Pediatric cases are normally treated for symptoms with the disease clearing up in weeks to months.

Intravenous Protein and Blood Transfusions:
A health care provider may recommend an IV treatment of protein and a blood transfusion to a person who is malnourished or anemic because of Ménétrier’s disease. In most cases of children with Ménétrier’s disease who also have had CMV infection, treatment with protein and a blood transfusion led to a full recovery.

If a person has severe Ménétrier’s disease with significant protein loss, a surgeon may need to remove part or all of the stomach in a surgery called gastrectomy.

Surgeons perform gastrectomy in a hospital. The patient will require general anesthesia. Some surgeons perform a gastrectomy through laparoscopic surgery rather than through a wide incision in the abdomen. In laparoscopic surgery, the surgeon uses several smaller incisions and feeds special surgical tools through the incisions to remove the diseased part of the stomach. After gastrectomy, the surgeon may reconstruct the changed portions of the GI tract so that it may continue to function. Usually the surgeon attaches the small intestine to any remaining portion of the stomach or to the esophagus if he or she removed the entire stomach.

Eating, Diet, and Nutrition:
Researchers have not found that eating, diet, and nutrition play a role in causing or preventing Ménétrier’s disease. In some cases, a health care provider may prescribe a high-protein diet to offset the loss of protein due to Ménétrier’s disease. Some people with severe malnutrition may require IV nutrition, which is called total parenteral nutrition (TPN). TPN is a method of providing an IV liquid food mixture through a special tube in the chest.


Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.