Dr harold Gunatillake




 

Osteoporosis is a silent disease-By Dr Harold Gunatillake

Your bones in the body,especially those that are weight bearing such as the spine, and hips should be strong to carry out everyday functions. When you are young, they are strong, engaging in activities such as sports and being active, keeps the bones strong.

Age being a risk factor, leading a less active life, and especially among women when they reach their menopause with low sex hormone, tend to soften their bones being more porous and the density and the quality of the bones weaken and become more fragile due to accelerated bone loss, that occurs after menopause.

This condition is called osteoporosis of the bones which is a silent process without early warning symptoms. In the US. there are over 10 million suffering from osteoporosis and another 44 million suffering from low  bone mass called osteopenia, according to the National
Osteoporosis Foundation.

Our bones are constantly changing, developing and strengthening and are most dense, in our twenties. As we age some of the mineral contents gets depleted and the bone cells begin to dissolve the matrix of the bone, called resorption while new bone cells are formed to
replace them. This process is called remodelling.

In youth there is a balance between resorption and bone formation, but with age the bones become porous, brittle and prone to fractures.

Asians, including Sri Lankan men and women being of smaller stature and leading sedentary lives have a very high incidence of hip fractures-meaning fractures of the neck of the femurs with the slightest fall. They also have less bone to lose than people with larger frames and more body weight.

Also common among Asians including Sri Lankans, are the spine and wrist fractures.

We are born with about 300 soft bones and with age the cartilage attached to them gets replaced by hard bone. Some of these bones later fuse together, so that an adult skeleton has 206 bones.

The structure of our bones consists of a hard-outer layer  called the cortical which is strong and tough, and an inner spongy layer called the cancellous bone.

Bone forming cells are called osteoblasts and the bone resorbing cells are called osteoclasts. Osteoblasts seem to work most efficiently to form bone around the age 30 for both sexes. When you are about 35 years bones breakdown faster than new ones being replaced. In
short, osteoclastic activity takes over from the efficient osteoblastic activity, causing a gradual loss of bone mass.

Women seems to undergo more rapid osteoclastic activity -that is bone loss in the first few years after menopause, as less oestrogen is secreted in the ovaries that enhances the bone formation.

Nutrition-wise, low calcium intake and low vitamin D levels in the body can lead to bone loss. Vitamin D helps to absorb calcium from your food and participate in the structure of the bone.

To prevent osteoporosis, you need to consume adequate amounts of food rich in calcium and vitamin D throughout life.Foods such as seeds, cheese, yogurt, sardines and canned Salmon, beans lentils, leafy veggies provide enough calcium and vitamin D.

You could boost your increase of vitamin D levels by spending time in the sun, consuming fatty fish and seafood, eating more mushrooms, egg yolk and supplements.

There are certain dietetic risk factors to think of, if you have osteoporosis. Eating salty foods, drinking too much soda, and spending most of your time indoors are among habits that should be avoided. A healthy diet as described earlier with exercise, among other things, can
help to prevent the risk of osteoporosis.

Daily exercise is important to keep your bones strong. Walking 10,000 steps a day would be enough. For some regular workouts that include weight-bearing aerobic activity and strength training in a Gym workout is recommended.

There are certain drugs usage long term can lead to osteoporotic bones, such as corticosteroids. Heparin, blood thinners, antidepressants, aromatic inhibitors used to treat breast cancer.

Alcohol abuse and smoking are also cause for osteoporosis. You could get osteoporosis of the bones, after being bedridden for a few weeks after any debilitating illness

There are no symptoms during the early stages of osteoporosis. Loss of height and a curve in the upper back may be early signs.

Your doctor will do a bone mineral density test (BMD) if he suspects you have osteoporosis. The test uses special X-ray machine to measure the mineral content at three different bone sites.

This test is recommended to women over the age of 50
years. The drug of choice for osteoporosis is Bisphosphonates.The others include alendronate (Fosamax), risedronate (Actonel) and ibandronate (Boniva). Studies have shown that alendronate can reduce the risk of spine and hip fractures by up to 50%.

For advanced osteoporosis your doctor may prescribe injections, includes teriparatide (Forteo), abaloparatide
(Tymlos) and romosozumab (Evinity). In addition to above medication you may have to take 1,200 milligrams of calcium per day from food or supplements.
Bottomline:

Being active, and participating in sport activities during you school days, exercising daily and eating the right foods will prevent this disabling disease.
Ref: Article by Carl Nierenberg -Live Science Contributor

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What should be the normal Blood Pressure for a Sri Lankan By Dr Harold Gunatillake

The blood pressure that is considered normal for men and women seems to be changing
from time and again. When we were medical students in the fifties, we were told that the
upper pressure should be less than your age plus 100:
meaning, if you are 50 years, your normal systolic pressure should be 150mm.Hg or less.
With time, studies revealed that the incidence and the risk of heart disease and stroke was
quite high with such blood pressure readings.

Blood Pressure

Then, it was realised that the strain on the Heart muscles with this respective BP considered
normal, was too severe, resulting in high incidence of heart problems, including failure.        

The blood pressure of an individual depends on the force of blood ejected from the left lower chamber (ventricle) of the heart against the resistance of the peripheral arteries and the rate of pumping (pulse rate).          

The medications prescribed for hypertension by the doctors, consider all these three factors in your blood pressure management.

If the systolic pressure is too high a peripheral Vasodilator alone may bring down the
BP in the early stages.
How this works is that lowering the peripheral resistance, you reduce the force of
the ejection of blood from your heart, referred to as the ‘systolic pressure’
The more popular drugs used to bring down the pressure is the Angiotensinconverting enzymes (ACE) inhibitors, help relax blood vessels and also prevents anenzyme in your body from producing angiotensin 11.

The other drug is angiotensin receptor Blockers (ARB) As said earlier these drugs widen or dilate your blood vessels and releases the pressure on the heart.

Then, doctors prescribe calcium channel Blockers. They work by slowing the movement of calcium into the cells of the heart and blood vessel walls. Heart muscles need calcium to contract.

If the heart rate is rapid, in addition to high blood pressure, your doctor will prescribe a beta blocker that lowers the BP in part by decreasing the rate and force at which the heart pumps blood.

This explains the modern methods of bringing down the high blood pressure and the doctors modulate them as required.

It was considered for a few decades that the systolic BP of a Sri Lankan person should be maintained below 120mmHg and the diastolic pressure at 70-80mmHg.

The European Society of cardiology has changed the baseline to 140/90 from the existing 130/80mmHg. This baseline BP applies to people over the age of 60, and those below the baseline is considered as 130/80 Sri Lankans are smaller in stature and strength compared to the Western men and
women, and it is reasonable to maintain the pressure for men as 120/70-80mgHg and for women- systolic as 110mmHg and diastolic as 70mmHg. This should apply to all ages- young and the old.

Such lower pressures maintain the cardiovascular system in prime condition, lowering the risk of heart attacks and stroke.
It is very important that diabetics with chronic kidney disease should adhere to such low pressures.

Bottomline
Sri Lankans should maintain systolic and diastolic blood pressures much lower than those recommend by the European Society of Cardiology which applies to the Europeans.

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Colon Issues By Dr. harold Gunatillake

Script
Let’s talk today on Large Bowel Issues, focussing more on dreaded colon cancer.
Your alimentary canal includes pharynx, oesophagus, stomach, small intestine, large
intestine, and anus.
Today, we are discussing on the debilitating medical
conditions in your large gut only.
This last part of your digestive system functions to absorb water from the remaining indigestible food matter, and to pass the waste material from the alimentary canal, through the anal canal.

It is the segment of the alimentary canal where the beneficial microbes dwell producing chemicals to protect the inner lining of the large gut through a process of fermentation of prebiotics like fibre.
The large intestine consists of the cecum, colon, rectum, and anal canal.
If you ever experience frequent bloating of the abdomen, colic’s, discomfort in your tummy, alteration in bowel movements, tiredness at the end of the day, losing weight. depressed with lethargy, you need to take the symptoms seriously, and see your doctor, soon.

Alteration or changes in bowel habits means that you are not regular as before, or may be passing scanty stools, or may be constipated or having loose motions.

Let’s discuss what issues can cause the problem

There are many diseases specific to large bowel and others occurring in combination with the other parts of the body.
The chronic diseases pertaining to the large bowel are
mainly inflammatory and are:
• Ulcerative colitis
• Crohn’s disease
• Spastic colon (Irritable bowel syndrome)- IBS
• Diverticular disease
• Colon Cancer
Both Ulcerative colitis and Crohn’s diseases, the inner
lining of the large gut can undergo a process called
‘dysplasia’ which is prone to cancer.
Even having Irritable Bowel Syndrome can increase your
risk of colon cancer.
Let’s now talk about UlLet’s now talk about Ulcerative colitis.

It is an inflammatory disease which affects the innermost lining of your large intestine.
It is a disease which debilitates you with life-threatening issues like turning into cancer.
The inner lining of the large gut is seen red or inflamed with ulcers scattered or localised to one region.

Exact cause of this condition is unknown, although it’s thought to be the result of a problem with the immune system, that is the defence system.
Genetics- Inherited genes are a factor in the development of ulcerative colitis.
And of course, there are environmental factors, too Radiological examination, that is through barium enema X rays- demonstrates haustral folds in the entire descending colon with small ulcerations.

There is no specific treatment for ulcerative colitis, only temporising measures to relieve symptoms.
Studies have shown probiotics may improve intestinal mucosa barrier function and immune system function
and promote secretion of anti-inflammatory factors,thereby inhibiting the growth of harmful bacteria in the intestine.

Crohn’s disease is also an inflammatory disease like ulcerative colitis, that can affect any part of the gastroesophageal tract from the mouth to the anus. Symptoms of both ulcerative colitis and Crohn’s disease are similar and there is no cure, but only temporizing
measures.
Diverticular disease
In this condition small bulges called diverticula- like little sacks pouch out from the wall of the large gut. They are most common in the sigmoid colon- part of the gut above the rectum.

The most common cause attributed to the condition idietary- a low in fibre and high in fat diet results in the formation of hard stools and consequently the pressure within the bowel rises and results in the pouches. These sacs remain dormant for a long time and gives no
problems.
The condition is diagnosed through barium meal enema x rays and through colonoscopy.
Common symptoms are abdominal distension and pain in association with diarrhoea or constipation.
They can get inflamed and abscesses may form around
the diverticula and antibiotics seem to settle temporarily. Perforation or with failure of medical therapy, segmental resection surgery may be indicated.
Cancer of the large bowel
Risk of Cancer of the large bowel is prevalent among Sri Lankan population.Colorectal cancer is the fourth leading cancer among men and sixth leading cancer
among women in Sri Lanka, according to authors Yasara Samarakoon, Nalika Gunawardena, Aloka Pathirana.
They further said that the high prevalence of being ‘at risk’ of colorectal cancer indicates the necessity of screening for colorectal cancer as a programme in Sri Lanka. Considering the logistic difficulties in offering follow-up diagnostic colonoscopy examinations for all,
the study recommends that those found as ‘high-risk’ be eferred for colonoscopy.

Furthermore, the high incidence occurs under the age of
50 years Why such a high incidence of colon cancer among Sri Lankans, when only a very small amount is linked to inherited genes. The most inherited syndromes that increase colon cancer risk is the high incidence of polyps in the large bowel. 

One reason why the incidence among Sri Lankans is the consumption of red meat from cattle seems to be high. Cattle red meat is much cheaper that goat meat, and
the average person can well afford to purchase cattle red meat. In most beef stalls in the main cities like Colombo and Kandy, the beef seems to sell fast, and you need to sometimes stand in a queue when the carcasses are brought with the health approved seal
from the health authorities, about 10 o’clock in the morning.
The incidence of consumption of pork is high among the population in the coastal regions of Sri Lanka.
Processed meats, like sausages, hot dogs, bacon are freely available in the supermarkets today, and they
seem to sell fast.
Processed foods that are high in sugar and low in fibre and nutrients have been linked to a higher cancer risk in the colon.
Researchers have found that a diet that causes blood sugar levels to spike is associated with an increased incidence and risk of large bowel cancer. Diets that include lots of vegetables, fruits and whole grain have been linked with a decreased risk of colon
cancer.
In Sri Lankan markets, leafy veggies are cheap, but not all veggies like beetroot, tomatoes, potatoes and many others are out of the reach of the average wage earner.
Obesity also seem to increase the risk of large bowel cancer. Excess body weight contributes to insulin resistance and eating more carbs and foods with added sugars seem to be the cause for obesity, in such situations.
There are certain superfoods that fight and prevents cancer such as most veggies containing cancer-fighting antioxidants and phytochemicals. For example, cruciferous vegetables, including broccoli, cauliflower and cabbage, contain sulforaphane, a substance that has been shown to reduce tumour size in mice by more than 50%
Vegetarians including vegans who consume plant-based foods have a reduced risk of developing or dying from colon cancer.
Ketogenic diet lowers blood sugar and insulin levels seem to reduce the risk of colon cancer.
Bottomline
All inflammatory diseases and cancer of the large bowel are incurable conditions. Cancer can be cured if detected early. It is reasonable to say that you should see your doctor
for an annual screening for cancer, if there is such risk and a family history.
Chronic inflammatory diseases must be diagnosed early for better palliative care and longevity.
Hope this talk was useful. Please be aware of these
tummy issues and get investigated early for better
health and wellbeing
With blessings, thank you
Dr Harold Gunatillake

 

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Lacto-Fermentation Foods & Health-By Dr Harold Gunatillake

 

Fermented Foods are a hot topic, today
Let’s talk about it.
We wonder why our mothers always kept a bottle of onion pickle and lime pickle(lunu-dehi) on the dining table, and we used to nickname them, as ‘rice pullers’What are Lacto-fermented foods, also called lactic acid fermentation foods?

Lacto does not refer here to milk, but refers to lactic acid, produced by lacto-bacillus bacteria. These bacilli are present in yogurt, cheese and the skin of most veggies and fruits among others.

It is starches and sugars in your veggies and fruits that is converted into lactic acid by friendly bacteria -lactobacilli during fermentation Fermentation was used in the ancient times to preserve food, and making alcohol, Cheese, salami and more.

Fermentation is a common practice which was performed from thousands of years ago. fermentation was generally performed to produce alcohol and wine. this fermentation process was then modified and now it is being used for the making of several cultured beneficial products for our wellbeing and health.

Our ancestors knew that pickled supplementary foods aids digestion, but today we know how they help digestive processes and wellbeing.6
The microorganisms that live in our guts are more important than many of us think.
They need to be focussed & cared for daily, for better health and wellbeing, by understanding more about the fermented foods, sometimes called probiotics.
This discussion is all about such food and awareness of their presence in our gut,playing a great role in our health, and newly understanding their diversity to manage ‘antibiotic resistance’ threatening all human- kin

Fermentation of any food promotes the growth of beneficial bacteria, known as probiotics. They support the microbes in your gut to boost the immune system and these bugs supports approximately 60 to 80 % of our immune system.
In short if not for our gut microbes we wouldn’t be living today.
Probiotics are live microbial feed supplements, which benefit the host by improving intestinal microbial balance
There are many other beneficial functions of our gut friends and shall discuss as we go on.
They assist in digestion of the food, heart health and communicate with the brain to keep our body and soul in harmony. The communication between the gut and the brain is though wires-mainly the vagus nerve. The gut is referred to as our second brain.

Lactic acid fermentation (Lacto-fermentation)

It is a natural process through which micro-organisms like yeast and bacteria convert sugars into alcohol and lactic acid when preserved in a tightly closed container. This process of fermentation occurs in an anaerobic environment, and hence in the preparation of these foods like Sauerkraut and Kimchi from cabbage gratings, you need to pack them tight in the jar and keep the lid tightly closed for fermentation and lactic acid formation. The beneficial bacteria that are spontaneously grown in the preserved fermented food are called ‘Probiotics’.Sauerkraut and kimchi are fermented foods rich in beneficial probiotics that provide a wide range of health benefits.

Sauerkraut is fermented cabbage. If you buy sauerkraut at the store, purchase the unpasteurized variety. Pasteurization destroys beneficial bacteria.When you make your own fermented foods how long should you keep them to ferment. This depends on various factors such as hot weather, cold weather salt and so on. Generally, you keep with the lid tight for a few weeks.To make sauerkraut, salt is used as a preservative in vegetable lacto- fermentation,working alongside the good bacteria present on the food being preserved.

Obese people

We are coming to understand that obese people lack a bacterium called Akkermansia muciniphila in their gut.
When these bacteria were given to obese people, they lost weight. So, it has been observed that these bacteria are less abundant in the guts of people who are obese or have type 2 diabetes.
Yogurt is a well-known food source of probiotics, having beneficial bacteria that promote health.
Certain strain of bacteria in yogurt have B-D-galactosidease, an enzyme that helps break down lactose in dairy products into the sugar glucose and galactose. Lack of this enzyme causes lactose malabsorption.
People who eat fresh yogurt containing live and active cultures digest lactose better than those who eat pasteurized yogurt. Yogurt is also rich in minerals like magnesium, phosphorous, potassium, and calcium, which are important for building and maintaining healthy bones Probiotics in kimchi inhibit the growth of H pylori. Which causes stomach ulcers They
may also help prevent cancer, obesity, inflammatory bowel disease (IBD), dermatitis, food allergies, and obesity. Probiotics in kimchi produce valuable B vitamins, riboflavin and folic acid. These foods contain vitamins that boost immunity and help ward off infection.
Kimchi a staple in Korean cuisine, is a famous traditional side dish of salted and
fermented vegetables, made with cut cabbage, radish and scallions and a seasoned
paste of red pepper, garlic, ginger, sugar and fish sauce, salted shrimps and so on….

Here is a list of 11 probiotic foods that are super healthy.

*Yogurt. Yogurt is one of the best sources of probiotics, which are friendly bacteria that can improve your health. Probiotic Yogurt is high in many important nutrients, including calcium, potassium, phosphorus, riboflavin and vitamin B12*Kefir. Kefir is a fermented milk and shown to improve the digestion of lactose in lactose intolerance
*Sauerkraut. Is produced by fermenting cabbage into lactic acid and bacteria. It
contains Lutein and Zeaxanthin antioxidants promoting eye health.
The antioxidant content in sauerkraut may also have promising effects on cancer prevention.
*Tempeh- produced from cooked whole soybeans and fermented. It is a traditional Indonesian soy product
*Kimchi-made from cabbage and other veggies like radishes. Reduces cholesterol and reduces insulin resistance, blood pressure and body weight
*Miso produced by fermenting soya bean with salt and koji. It stimulates digestion and energise the body
*Kombucha. – is fermented black or green tea that is fizzy, tart and flavourful. It helps liver toxicity due to exposure to chemicals. Also has anti-cancer properties
*Pickles- Sour salty pickled cucumber might help weight loss, diabetes and even cancer prevention. Sri Lankans love pickled onions as a ‘rice puller’.
Lifestyles and diet seem to affect the diversity of the human gut microbiome.
Probiotics are ‘live microorganisms which when administered in adequate amounts confer a health benefit on the host’. In other words, these friendly bacteria work hard to improve your health. They have strength in numbers – you need to consume a large enough dose of probiotics in order to see their benefits.
Regular consumption of probiotics might help mitigate the rise of antibiotic resistance. A recent review of multiple studies showed that infants and children who consumed probiotics to reduce the appearance and duration of acute respiratory and digestive tract infections have a lower risk of being prescribed antibiotics.
You will observe that Lactobacilli and Bifido-bacteria are two gut microbes that are involved in the process of fermented foods, we call probiotics.
Probiotics can impact our gut microbiota indirectly as well, for example by influencing our immune system which in turn influences our gut microbiota.
Though there are only a few probiotics we are aware of, probiotics can grow, metabolize and interact with our friendly gut bacteria. They are live microorganisms formed in fermented foods that provide health benefits

You may have heard the word prebiotic. They are foods for our friendly gut microbes. They are used by the beneficial gut microbes impacting the gut environment, with an overall health benefit. Fermented foods act as medicine

Let’s talk about prebiotics

Prebiotics generally helps to grow the probiotic bacteria in our gut to improve better health. Prebiotics are like fertilizers to make gut bacteria grow and be healthy, like adding fuel to your vehicle. Prebiotics are mainly found in our dietary fibre including
all fruits and veggies, oats and so on.
Prebiotics have been shown to increase levels of beneficial bacteria, playing a role in the promotion of our health.
Inulin is a soluble fibre found in onions, garlic, and some veggies. A new study, led by Dr. Nathalie Delzenne from UC Louvain in Brussels (Belgium), has found that regular consumption of vegetables rich in inulin-type fructans improve food behaviour and are well tolerated overall, through changes in the gut microbiota.

Fibre is a key overlooked nutrient in the diets of many. Some dietary fibres cannot be digested by the human gut and the microbes participates in breaking down for our benefit.

Fibre acts as a prebiotic to the beneficial gut microbes, and most prebiotics are in the form of dietary soluble fibre.
Beyond promoting regular bowel movements, and working as prebiotics to gut microbes, adequate fibre consumption improves blood levels of lipids and glucose, while keeping us fuller for longer.
Hope you enjoyed this 9-minute video.
The bottom line is- please consume foods with plenty of fibre which feeds the beneficial gut bacteria and make it a habit to eat some form of lacto fermented probiotics, for general wellbeing, health including prevention of cancer.

 

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Abdominal bloating – BY Harold Gunatilake

bloatingWe all at some stage or other, frequently or less frequently feel bloated and tight in our abdomens. It is mainly due to build-up of gas in the tummy and the small gut and due to disturbances in the movement of the smooth muscles in the small gut.

On feeling your stomach, it feels distended and most times you may have colicky pains and discomfort.

Some people have more flatulence and bloating than others. They pass more gas, or you could call it breaking wind. Healthy people do it between 14 to 23 times each day.

If you pass wind more than the typical person, you may wonder what’s going on in your gut and whether it’s a symptom of a more serious health condition.

Excess bloating and flatulence could be due to harmless causes such as swallowing air, eating gas producing foods and drinks, anxiety, childbirth and effects of aging. Those who chew chewing gum habitually gets bloating due to swallowing of air. If you keep on talking while you eat, you tend to swallow more air that will cause bloating.

In most situations it is food that causes the bloating, especially over-eating.

Sometimes, drinking milk can cause bloating. Lactose present in milk is a carbohydrate, and intolerance to lactose can cause bloating. People intolerant to lactose are unable to digest lactose due to the absence of lactase enzyme produced by the cells that lines the walls of the small gut, that normally breaks down lactose.

Eating foods made of wheat like bread or gluten can cause food intolerance and cause bloating.

Gluten is a protein found in wheat, semolina, rye, and barley. Gluten helps foods maintain their shape, acting as glue.

Most people tolerate gluten just fine. But people having celiac disease, gluten sensitivity, wheat allergy can cause bloating.

Eating too much of fructose in fruits or fruit sugar can cause bloating or gas. Apples, pears and mangoes are high in fructose and may produce gas.

Berries, citrus fruits like lemons and oranges and bananas have less fructose, so they are less likely to cause gas.

Some healthy foods can cause bloating, especially foods that are loaded with gas such as beans and lentils, broccoli, sprouts, cabbage, onions, cauliflower Beans are extremely good for our health but producing excess gas can cause a problem.

Packaged food can cause bloating.

Carbonated drinks such as sparkling mineral water, champagne, are full of bubbles that can make you bloat.

As you get up in the morning you may feel that you stomach is not bloating. As you eat different kinds of food during the day can cause bloating.

If you often feel bloated after a meal, don’t be too quick to blame high-fibre foods.
The real culprit could be the extra salt in your food.

“Sodium reduction is an important dietary intervention to reduce bloating symptoms and could be used to enhance compliance with healthful high-fiber diets,” said study researcher Noel Mueller, an assistant professor at the Johns Hopkins Bloomberg School of Public Health in Baltimore.

Eating more salt can promote water retention and make digestion less efficient, which can lead DehydrationDehydration is also considered as a cause of bloating. Drink plenty of water, unsweetened cranberry juice, grapefruit juices, you may add ginger into any of these drinks to help as a cure for bloating.

Avoid artificial sweetenersIf you have any belly pain, flatulence, diarrhea or constipation, and feeling tired,exhausted, depressed and have headaches more frequently, then you must considersuch symptoms needs help from your doctor for further investigations.

Irritable Bowel Syndrome Bloating affects as many as a third of Americans, including more than 90% of those with irritable bowel syndrome. It’s a painful build-up of excess gas created as gut bacteria break down fibre during digestion.

These symptom complex just describes could be irritable bowel syndrome. Doctors  do investigate the disease by performing endoscopy, blood and stool examination and so on, and all tests are negative, the label IBS or irritable bowel syndrome is given.

There is no treatment for permanent cure, but symptoms can be relieved by medication and change of diet.

Gut microbiota related causes of bloating are a new finding. 70% of your immune system is in the gut, so gut bacteria or as we call them microbiota play an important role. So, bloating or interruption of normal digestive function may be due to decreased good bacteria and you may end up with excess gas and a distended tummy.

Eating too fast can cause bloating.

Your stomach is approximately the same size as your fist, and it stretches when you eat. If you eat too much you feel uncomfortable and bloated.

Enjoy meals at the dining room at home and at restaurants, and you tend to eat less due to chit chats with friends whilst eating.

Avoid watching TV while you eat, as it disturbs your enzyme digestion of food and may cause bloating.

Be mindful when you eat, and your body signs will after you when you are full.

Eating salty food can cause increased gas production because of water retention.

Eating junk foods starting from sweets and certain desserts, such as cakes, or donuts, fast foods that are filled with fats such as burgers and pizzas can cause bloating Alcohol, and certain kinds of sodas and carbonated drinks can cause bloating.

According to the Gastroenterology Organization (WGO), tens of millions of people across the globe are affected by digestive disorders to cause bloating and other
symptoms mentioned.

It is possible that IBS is caused due to lack or the presence of certain bacteria in your gut. Very soon the research that is been done will find the microbes that influences gut disorders like IBS, and other causes of bloating.

Constipation cause bloating
If you miss a bowel movement, you may feel bloated. Foods like ice cream, cheese, fast foods that are processed, prepared fried or high in fat can cause constipation
.
To help you avoid excess gas and bloating according to a report published recently
in the American Journal of Gastroenterology, the recommendations are:
• Increase physical activity.
• Limit highly processed foods, such as fast food, frozen meals, junk food and
fried food.
• Increase your fluid intake and make peppermint tea part of it. Avoid
carbonated beverages.
• Eat more foods that are rich in fibre, such as vegetables, legumes and whole grains. Increase these slowly and in small portions and be sure to increase your fluid intake at the same time.
• Have smaller meals.

Rasam

Indians and Sri Lankans drink ‘Rasam’ soup made with tamarind, tomatoes and other spices like mustard, cumin, and pepper.

This ‘My Mother’s Rasam seem to have a carminative effect and prevent bloating,
even after you enjoy a calorie-dense “Biriyani”
Most Sri Lankan restaurants in Colombo and other provincial towns serve rasam soup and do not forget to enjoy this soup when you next visit Sri Lanka.

We had this soup followed by Biriyani, at the Oak-Ray Flower Drum restaurant in Colombo, and it was exquisite, and no bloating or stomach disturbances experienced after.

Tragedy in Sri Lanka

Despite the recent tragedy, Sri Lanka remains an incredible place to visit as
highlighted in ‘Lonely Planet.
The island is peaceful and do visit with no hesitation.
Hope you enjoyed this film

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