Over the past several years, the prevalence of GERD (Gastro-oesophageal reflux disease) has increased in our communities due to unhealthy lifestyle and that can potentially lead to serious medical complications if left untreated. 

GERD is characterized by symptoms and/or tissue damage that results from repeated or prolonged exposure of the lining of the esophagus to acidic contents from the stomach and occurs when the lower esophageal sphincter (LES) does not seal off the esophagus from the stomach.

The two most frequently reported symptoms of GERD are heartburn, which can be described as a burning discomfort that begins behind the breastbone and radiates to the neck and throat, and acid regurgitation, which is characterized as a bitter, sour tasting fluid. One out of five people experience heartburn or acid regurgitation on a weekly basis and two out of five people experience heartburn or acid regurgitation at least once a month.

However, some patients may present with atypical symptoms such as a cough, asthma, laryngitis, or chest pain, and other patients with GERD experience no symptoms at all. 

Causes

1) Eating food while not feeling hungry
2) Eating in haste and in indigestion
3) Eating stale food
4) Eating spicy, hot  & tangy, fermented, stale food on a regular basis.
5) Excess consumption of tea, coffee
6) Sleeping immediately after meals
7) Drinking alcohol & smoking in excess
8) Mental stress
9) Staying awake at night, disturbed
sleep
10) Eating late at night.

Signs and symptoms:

Difficulty in swallowing
Regurgitation of food
Belching
Bitter taste in mouth
Discomfort or pain in upper abdomen
Dry cough
Anorexia ( loss of appetite )
Excessive thirst
Heartburn especially after meals and at night
Loss of taste
Nausea & vomitting
Bloating
Giddiness
Treatment in Ayurveda focuses on:

1) Improving appetite
2) Help nourishment of body
3) Regulating the acid metabolism in the body
4) Improve the ability of digestion & absorption
5) Treat inflammation and cause healing of the digestive tracts
6) Protecting the intestinal layers from ill effects of acid 

Do's & Don'ts for GERD:

Do's

1) Eat light to digest food
2) Eat only when one is hungry
3) Gap between two meals should not be more than 6 hrs
4) Eat fruits  daily 
5) Food good for GERD - Old caged rice, Jowar roti, Moongdal, Bittergourd, pumpkin, dates, pomegranate, Indian gooseberry,  Lemon, mint, mangosteen, turmeric, coriander, cumin, asafoetida, coconut, cowghee, cow milk, fresh buttermilk .
6) Drink lukewarm water half hour after meals
7) Walk after every meal
8) Daily exercise for atleast 45 min

Dont's
1) Very spicy & hot, excessive consumption of chillies & curd
2) Excess tea, coffee & fermented food
3) Excess stress & negative thinking
4) Sedentary lifestyle
5) Excess smoking & drinking
6) Drinking excessive water 
7) Sleeping immediately after meals
8) Sleeping in the afternoon
9) Staying awake late night

Symptoms of GERD are very commonly found in the population. If it is not taken care of, it can lead to complications like Barrett's oesophagus, oesophagitis, ulcers, Ca oesophagus, bleeding, scarring and difficulty in swallowing. Ayurveda has a complete holistic approach in treating GERD. Treating on time helps in avoiding complications in future.

Gastroesophageal Reflux Disease And Ayurveda!

6 face washing mistakes that are damaging your skin, everyday!

Face-washing may be a simple everyday task that requires no great effort on your part. But when it?s not done right, it causes significant harm to your skin, each day. The mistakes that you may make while washing your face could lead to issues like irritation, dryness and even wrinkles. Read on to find out how you can avoid making these common errors, and save your skin from blemishes, ageing and lustreless look.

1. Using the wrong cleanser

The use of the wrong cleanser can throw your ph levels out of balance. The optimal ph balance of your skin is 5.5ph. This is the ideal level at which the thin protective layer on the surface of the skin (called acid mantle) can function to keep germs, toxins and bacteria at bay. You should therefore be picking your cleanser based on your skin type as it would come with the right ph balance. 

2. Not cleaning your hands before touching the face

Always clean the germs and dirt of your hands first before moving onto your face. Ignoring this crucial first step can cause you to transfer all the bacteria and dirt of your hands on your face, giving rise to common skin problems such as acne, pimples and blackheads.

3. Using a pre-used washcloth

To avoid the filth from clogging your pores, always clean the washcloth that you use with an antiseptic to keep germs and bacteria at bay. Once you're done washing your face, don't rub the cloth all over your face but pat dry it.

4. Washing face using with hot water

When it comes to the water that you splash on your face, you should always use lukewarm or room temperature water. This is because hot water leaves your skin dry as it washes away the skin's essential oils; and cold water can break the capillaries (fine blood vessels) of your skin. In contrast, mildly lukewarm water will keep your skin hydrated and healthy.

5. Not washing the face twice a day

Just as you shouldn't ignore this important skin care habit that keeps your skin clean, you also shouldn't go overboard with it. Excessive face-washing can hamper the natural oil production of your skin, giving rise to dryness and irritation as a result. Your skin requires the natural oil it produces to keep it smooth and supple. Ideally, you should wash your face twice daily - once in the morning for removing the bacteria and dirt that clogged your pores, and again at night before going to bed.

6. Rushing through the routine

Lastly, don't rush through your cleansing routine. Make sure to properly rinse your face of cleanser completely, otherwise the residues would cause your skin to dry up later on, leading to skin irritation.

It is therefore very important to pay attention to all the little details that make up your face-washing routine. By doing it right, you get to achieve the clear and blemish-free skin that you always wanted.

If you would like to consult with me privately, please click on consult.


6 Face Washing Mistakes that are Damaging Your Skin, Everyday!

Gastroesophageal reflux disease (GERD) is also called as acid reflux. It is a long-term digestive disorder that affects the lower esophageal sphincter, the ring of muscle between the esophagus and stomach which causes the stomach contents to come back up into the esophagus resulting in either symptoms or complications. Gastroesophageal reflux disease is mild acid reflux that occurs at least twice a week or moderate-to-severe acid reflux which occurs at least once a week.

Epidemiology

In western populations, GERD affects approximately 10% to 20% of the population and 0.4% newly develop the condition. In developed nations, the prevalence rate of GERD is associated with age; with adults aged 60 to 70 being the most commonly affected.

Signs and Symptoms

Esophageal symptoms include:

Heartburn
Regurgitation of food or sour liquid
Dysphagia
Sensation of a lump in the throat
Extraesophageal symptoms include:

Coughing and/or wheezing
Hoarseness, sore throat, or 
Otitis media
Noncardiac chest pain
Enamel erosion or other dental manifestations
New or worsening asthma
Disrupted sleep
Risk Factors

Obesity
Pregnancy
Hiatus hernia
Scleroderma and systemic sclerosis
The use of medicines such as prednisolone 
Delayed stomach emptying Zollinger-Ellison syndrome which can show an increase in gastric acidity because of gastrin production
A high blood calcium level which can increase gastrin production, leading to increased acidity
Visceroptosis or Gl nard syndrome, in which the stomach has sunk in the abdomen upsetting the motility and acid secretion of the stomach.
Factors that can increase acid reflux involve:

Smoking habit
Eating heavy meals or eating late at night
Eating fatty or fried foods
Drinking certain beverages, such as alcohol or coffee
Medications, such as aspirin
Tight clothes
Increased intra-abdominal pressure
Differential Diagnosis

Heart disease causing chest pain
Laryngopharyngeal reflux OR extraesophageal reflux disease
Infection
Peptic ulcer
Esophageal spasm
Complications

Narrowing of the esophagus (esophageal stricture): Stomach acid causes the formation of a scar tissue which narrows the food pathway.
An open sore in the esophagus (esophageal ulcer): Acid causes an open sore which bleeds, causes pain, and makes swallowing difficult.
Precancerous changes in the esophagus (Barrett's esophagus): Damage from acid can cause changes in the tissue lining the lower esophagus
Anemia
How to arrive at the diagnosis?

Upper gastrointestinal endoscopy/esophagogastroduodenoscopy
Esophageal manometry
Ambulatory 24-hour pH monitoring
Treatment

The goals of treatment are controlling symptoms, healing esophagitis, and prevention of recurrent esophagitis or other complications. Lifestyle modifications include the following:

Losing weight (if overweight)
Eating small and frequent meals instead of large meals
Waiting 3 hours after a meal to lie down
Elevating the head end of the bed by 8 inches
Avoiding bending or stooping positions
Medications

H2 receptor antagonists (ranitidine, cimetidine)
Proton pump inhibitors (omeprazole, pantoprazole)
Prokinetic agents (aluminum hydroxide)
Antacids (magnesium hydroxide)
Surgery

Transthoracic and transabdominal fundoplication
Placement of a device to augment the lower esophageal sphincter

Gastroesophageal Reflux Disease - What Causes It?

Bariatric surgery is unlike other surgeries, as its effects are not instant but gradual and are seen over the months. Like any other surgery, it is not without complication. But again unlike all other surgeries, the complication rate can be negligible if a strict protocol is followed. Moreover, the factors like technology advancements, development in the field of advanced laparoscopy, enhanced skillset of the bariatric surgeon, dedicated management of bariatric and metabolic surgeries by bariatric surgeons, play a vital role in the reduction of complication rate which eventually results in safe surgery.

As the procedure is done laparoscopically, the pain is just for a day and is minimally managed by analgesics.

The fear of increasing incidence of incisional hernias while operating an obese patient is so negligible or nil, as the procedure is performed through tiny key holes and all precautions are taken to suture the sheath through which the ports are put to perform the surgery.

Reduced hospital stay and early resuming to work is one of the biggest benefits of this laparoscopic bariatric procedure.

Sometimes, problems that may be faced are:- 

Post-operative bleeding: Normally, this a nearly bloodless surgery involving 5 to 10ml loss of blood. However bleeding from the staple edges is known, but this can be managed well by the surgeon, by choosing the right size of the cartridge as well the right technique of application of the cartridge.

Dehydration: We are normally accustomed to drinking water at long intervals (a few hours) as we can consume nearly 200 to 400ml at one go. Following bariatric surgery, gulping or drinking water in one go is not possible in the first 2 to 4 weeks, due to reduced capacity of the gastric pouch. Hence, care needs to be taken to drink small quantities of water at frequent intervals to avoid dehydration. This is possible only if the patient is counselled about this prior to surgery and is fully aware of this. Also, the patient needs to be given good and clear post operative instructions regarding the quantity and frequency of liquid consumption, not forgetting the type of liquids. Coffee taken frequently could be another cause for dehydration. Family members and colleagues and friends at work play a major role in reminding tthe patient about consuming water frequently. Special care needs to be taken in people who are not accustomed to consuming adequate quantities of water prior to surgery as a general habit.

Vomiting/Fullness/ Discomfort/Indigestion: Following bariatric surgery, soft food is introduced in the diet in the third week, after the first 2 weeks of taking liquids. Due to the reduced capacity of the gastric pouch, the morsel size is significantly reduced and one has to chew the morsel well and eat slowly, giving a gap of 40 to 50 seconds between the morsels. This prevents distension or overdistension of the gastric pouch and thus avoids vomiting. This again requires good counselling prior to the surgery and on the follow up visit too before stating soft food. There is a subjective difference when we say small morsels and we cannot reach a standardization as the morsels size of each individual varies prior to the surgery itself. The best way to avoid this confusion is to make the person have the first soft food meal before you where in you can physically show the way food is expected to be eaten. However, by mistake, there is a chance that one can have a regular sized morsel as over years one is used to eating in that manner. If this happens, the person will vomit , and this will be a reminder to gauge the morsel size the next time the person eats. Following the vomiting, there could be a burning sensation in the stomach which will subside afer taking an antacid. If one follows the instructions of small morsel size, chewing properly and eating slowly, there is no chance that there will be vomiting. Another reason for vomiting could be keeping the stomach empty for a longer duration or having sicy food on an empty stomach. Avoid nuts, seeds, fried foods and processed foods. Very rarely vomiting could be due to reduced size of the joint between the gastric pouch and the small intestine. This could require an Endoscopy and necessary treatment.

Vitamin and mineral deficiency: It is seen that many of the obese patients are seen to have vitamin B12, vitamin D, iron and protein deficiencies in their blood tests that are done prior to surgery. With the significant reduction in the amount of food consumed after bariatric surgery, the existing deficiencies are bound to increase. Hence, it is necessary to do these tests, before surgery and rectify the deficit prior to the surgery.  

Gall bladder stones: Significant weight loss which is consistant over a short duration could lead to the formation of gall bladder stones, be it with or with out surgery in a small percentage of patients. To avoid this there are two schools of thought, one is have a prophylactic removal of the gall bladder along with the bariatric surgery and another is to put the patient on ursodeoxycholic acid (a tablet) for the first few months after surgery during which there is significant weight loss.

Skin sagging: In the morbidly obese, when the skin is overstretched beyond a certain point, it tends to sag once significant weight is lost. This sagging is influenced by a number of factors like age of the patient, the BMI, pre existing sagging, pre-existing muscle tone and protein supplements taken during weight loss and exercises done during the weight loss period. Skin sagging is less if the age is less than 45, BMI less than 45, good protein intake during weight loss and good toning exercises done during the weight loss period.

Hairfall: Significant weight loss either by diet and exercise, aerobics, bariatric surgery, will entail hair loss. But this can be minimised to a greater extent by ensuring good protein intake during the weight loss period and adequate supplements in terms of vitamins and minerals.

Dumping syndrome: With a reduced size of the stomach, the food moves from the stomach into the smaller intestine much faster. This causes the pancreas to release excessive amount of insulin, leading to very low blood sugar levels , producing various symptoms like abdominal cramps, bloating, diarrhoea, sweating, dizziness, nausea, weakness, and anxiety. This is managed by eating less amount of sugars and fats and spacing out the meals through the day, having four to five small meals compared to  2 to 3 large meals. Having a high protein diet and avoiding liquids during meals is also an option.

Bariatric Surgery - Know Problems Of It!

The three primary functions of the kidney are- eliminating waste materials and toxins from the body, producing hormones that help control your body mechanism and regulating blood pressure. Chronic Renal Failure, also known as Chronic Kidney Disease, refers to the condition where your kidney gradually stops functioning properly over time- weeks, months or years. As the condition worsens, wastes and fluids start to build up in your system instead of being filtered out. This leads to an end-stage renal failure/disease.

What causes Chronic Renal Failure?
Chronic renal failure is caused due to a condition or disease that impairs kidney function. The most common causes are- diabetes (Type 1 and Type 2), polycystic kidney disease, glomerulonephritis, interstitial nephritis. Glomerulonephritis occurs when the filtering units of the kidney become, inflamed. Interstitial nephritis refers to an inflammation in the kidney tubules and its surrounding regions. Prolonged obstruction of the urinary tract due to kidney stones or enlarged prostate, also can cause chronic renal failure.

What are the symptoms that you must watch out for?
Symptoms and signs of chronic renal failure develop gradually over time. Therefore, most of the time people suffering from this condition are diagnosed at the later stage when functioning of the kidney is significantly impaired. Nevertheless, if you encounter signs such as unintentional weight loss, weakness and fatigue, vomiting and nausea, swelling of face and legs, cramps and muscle twitches, change in the urinating pattern, easy bruising, blood in the stools etc., then you should see a doctor and have yourself diagnosed. In case the fluids get accumulated in the lining of your heart or lungs, you may experience chest pain and shortness of breath.

Role of homeopathy in curing Chronic Renal Failure-
Unlike conventional treatment methods which focus on the pathological condition, homeopathy takes a holistic approach to treat the individual. Homeopathy remedies and medicines are natural, and try to rectify the underlying causes of this condition. The medications are selected and prescribed after thorough analysis of the patient s medical history and health condition. A particular remedy is chosen keeping in mind the general symptoms of the condition. Among several homeopathic medicines, the frequently used ones are- Belladonna and a solution made from gold and sodium. Homeopathy remedies reduce swelling of the face, cures kidney inflammations, and reduce severe, recurring pain in the lumbar region. They work by stimulating your immune system so that the damaged kidney and other organs start functioning more correctly.

Homeopathy remedies do not provide substitutes for any organ of your body. They simply repair the damaged organs, improve your overall health and thereby prevent the person from suffering a relapse.

Chronic Renal Failure - How Homeopathic Treatment Is Best For You?

6 ways to minimize visible pores on your skin

Pores are openings in the skin through which your body's natural oil, called sebum, is released. They appear larger when they are clogged with dirt or oil, and are home to hair follicles. Dead skin cells and sebum which, put together, form a pimple can stretch out pores. Aging and exposure to the harmful UV rays of the sun also contribute to the appearance of pores on your skin. Pores can be controlled with the right skin care. 

Here's how:
1. Choose your skin care products wisely 
Zinc and magnesium help to maintain your skin's oil balance and clear pores. Products with softening ingredients like rosemary and lavender may soothe your skin and prevent pores from stretching out. You should use products with salicylic acid as an ingredient since it unclogs pores, exfoliating your skin. 

2. Maintain cleanliness
Washing your face temporarily stops your pores from holding extra oil or dirt. Exfoliating two to three times a week can also control the cropping up of pores on your skin. However, these are temporary methods because you will have large pores naturally if your skin is oily.

3. Applying sunscreen
Exposure to the harmful UV rays of the sun for too long can make your pores look bigger. Applying sunscreen on the face and on exposed areas of your skin with SPF 30 can minimize your pores. Also, wear a broad-brimmed hat and withdraw stepping out in the sun between 10 A. M. To 4 P. M.

4. Treating the spot
Oily skin tends to have larger and more noticeable pores. Some areas of your face may be oilier making the pores visible. A clay mask can be used for spot treating if the pores on your nose, cheeks or forehead are large. Apply a thin layer of the mask on your skin and rinse it off with water after a few minutes. The clay extracts the extra oil out of your clogged pores so that the skin looks sleek. Using blotting paper on your oily areas can also be effective. 

5. Maintain a proper diet
Avoid food that is oily and high in fat because unhealthy oil can agitate the skin leading to clogged pores. You should eat low-fat foods like fruits and vegetables instead of munching on chips, cookies and candies. 

6. Remove makeup before going to bed
One of the biggest blunders that you can do is to leave your makeup on and go to bed. Leaving makeup on clogs your pores, stretching them out over time. Even if you forget to wash off your makeup at the sink due to some reasons, make sure that you at least remove it with face wipes. 





6 Ways to Minimize Visible Pores on Your Skin

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