Medications and conditions that can cause constipation

Medications and disorders that can cause Constipation

There are many causes of constipation, including some types of medications. Those that already have problems with constipation before starting medications might want to discuss a change in medications if they’ve started one that has that as a side effect.

Medications that can cause or worsen constipation:

Antidepressants including many of the tricyclic antidepressants like Elavil, some of the SSRIs like Prozac, some of the SNRIs

Antipsychotic agents

Calcium carbonate and calcium or aluminum-based antacids

Iron (some are worse than others in this respect)

Antihistamines that are sedating (diphenhydramine for example)

Urge incontinence medications

Calcium channel blockers (an antihypertensive and heart medication)

Disorders the diseases that can cause or worsen constipation:

Dehydration

Irritable bowel syndrome (IBS)

Hypothyroidism

Diverticulosis

Excess stimulant laxative use

Some cancers

Anorexia

Neuromuscular diseases like MS and Parkinson’s disease

Pregnancy

Hypercalcemia

References:  Alison Bardsley, Assessment and treatment options for patients with Constipation in British Journal of Nursing, 2017, Vol. 26, #6

Harvard Health letter, August, 2017, page 7. This is not meant to replace the care of your health care provider.

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Adopting good habits and giving up bad ones

Help for making changes to lose weight

Knowing what causes weight gain and weight loss does not lead to permanent weight loss. That is the sad fact that leaves many hopeless about losing weight. In “Improving Cardiovascular health with Motivational Interviewing” (M. Van Nes and J. Sawatzky, Journal of the American Academy of Nurse Practitioners, 2010, 654-659), it is noted that the traditional method of giving advice to change behavior rarely leads to sustained behavior change. In fact, such advising may actually decrease the changes of behavior changes. This article taps into the wisdom of the Transtheoretical Model for Health Promotion (J. Prochasky and C. DiClemente), in which individuals that need to make behavior changes are classified on a continuum with one end being not even appreciating the need for change, then listening, all the way through wanting to change, doing it and then maintaining the change for good. The article authors note statistics that some two-thirds of people that need to make a behavioral change are in one of the first two stages and often stay there.

In Big Fat Crisis, by Deborah Cohen, M.D. MPH (Philadelphia, PA:  Nation Books, 2014), the barrage of processed foods available at grocery stores, fast food restaurants and numerous other places, overwhelms our self-control. The advertising that promotes these foods is meant to lure us, and avoiding those is also smart. Dr. Robert Lustig, author of Fat Chance (New York, NY:  Penguin Group, 2012) writes about changing one’s food environment to stop the hormonal abnormalities that drive overeating. He encourages a high fiber diet to increase fullness and satiety, eating breakfast and include protein if possible, avoiding processed foods and especially sugar, and exercising. But, as he wisely notes, don’t look to exercise to lose pounds but to improve your health (and that is hopefully what you are primarily after, right?).

So, this is the what is needed:  decide to make the change (I assume most of the readers of this blog article are at least approaching this point to even be reading this article). Next, plan what you’ll need to do to make the changes such as avoiding restaurant meals, cutting out soft drinks, eating lots of fiber, staying away from processed foods, going to the Farmer’s market for locally grown fruits and vegetables, etc. YOU CAN DO IT. Set a date for starting, and if you trip and fall off your diet/new lifestyle, start back on your healthy diet the next day. One mistake does not equal failure by any means.

If it is easier to make the changes more gradually, do so! And remember that increasing fiber too quickly can create some gastrointestinal problems so introduce it slowly. I recommend oatmeal with ground flax, bran, and berries. Also, vegetables throughout the day. Avoid juice because they have carbohydrates without the essential fiber. And please, please, dear reader, do what you can to decrease stress because this nasty response can lead to high cortisol levels. As Dr. Lustig notes, exercise, even 15 minutes a day of walking, can lower cortisol levels.

All of this is hard work but these changes including regular exercise can go very far in losing weight, keeping it off and avoiding many chronic diseases. And it is worth it, isn’t it? This is not meant to replace the care of your primary health care provider.

What to avoid if you want to lose weight and be healthier

What to avoid if you want to lose weight and be healthier

     Adding positive habits and good foods to one’s life takes work but is relatively easier than giving up practices and foods that have a hold on us. This is the real work of watching what goes in and building a foundation for good health. Following are some of the key things that need to be avoided if living longer and living a fuller, unimpeded life.

     Sugar

It isn’t needed and often leads to fat storage. It is also addictive, so the more of it you eat, the more you crave it. High fructose corn syrup is the worse of the worst, promoting fatty liver and potentially leading to liver failure. It also increases uric acid production and thus gout can develop or worsen.

Fruit juices

These are bad since they have sugar but no fiber. Many have as much sugar as soft drinks.

Artificial sweeteners

Although they don’t have any calories, they can cause hunger. Research studies have linked daily use to weight gain, as well as increased stroke and dementia risk.

Saturated fat

It’s found in beef, lamb, pork, chicken skin, and dairy products made from whole milk. They have a lot of calories, easily leading to weight gain. It also increases the bad type of cholesterol.

Trans fats

It deserves it title as the unhealthiest food. It increases bad cholesterol, decreases the good form of cholesterol, cause a heart attack, stroke, or Alzheimer’s disease. It is found in fried foods, fast foods like French fries, peanut butter, salad dressings, potato chips, crackers, cookies, doughnuts, pies and cake.

Processed meats

Meats like salami, as well as bacon, sausage, and hot dogs are high in saturated fat and thus a concentrated source of calories. They are also high in salt. Some have a lot of nitrate compounds. These chemicals are converted to carcinogens in the body.

Late night snacking

Will power often dwindles by the end of the day. Heading to bed with calories on board when they are least needed, can support weight loss. There is a lot to be said for fasting twelve hours each day. If you wake up in the middle of the night with stomach pain that is relieved with food, it could be the sign of an ulcer and warrants medical evaluation. Treating yourself with an over-the-counter acid reducer could result in inadequate treatment, especially for ulcers caused by a bacterial infection.

 

 

10 habits and choices that can help you achieve permanent weight loss

10 habits and choices that can help you achieve permanent weight loss

When most people want to lose weight, they usually go on a diet that restricts calories. These may work, but only temporarily because a return to the person’s normal patterns causes the weight to return. That is frustrating because people try to lose weight with the goal of keeping it off. The key to permanent weight loss is a change in habits. Adopting healthy eating habits and getting rid of bad habits can not only help with lasting weight loss, it can lead to an improvement in health. These are wonderful benefits!

  1. Drink 8 to 10 cups of water each day. Cold water is especially helpful because calories are spent when the body warms it. Tea can aid abdominal fat loss, but it can cause insomnia if consumed after 12:00 p.m. It can also cause some people to urinate too much.
  2. Lift weights at a gym. This helps increase muscle cell size and increase the calories burned even when you are at rest. Muscle burns fifteen times as many calories as fat.
  3. Include some monounsaturated fats in your daily diet. These include walnuts and other nuts, seeds, olives and olive oil, plus avocados. These fats decrease hunger, lower cholesterol, and can help decrease cravings. But they are high in calories so limit them to a small amount daily.
  4. Try to exercise every day, even if it is only for fifteen minutes. This burns some calories, and improves mood.
  5. Eat a rainbow of fruits and vegetables, or, to put it another way, eat a variety of colors of fruits and vegetables. Each color is made of different nutrients and when you eat a variety, you are most likely to get all those you need to burn fat and stay healthy. During winter, choose frozen produce, not canned. Some fruits and many vegetables have fiber that helps you feel full and is good for the intestines. Cabbage, broccoli and cauliflower are especially good at preventing weight gain.
  6. Eggs are an excellent source of protein and have nutrients to help decrease hunger.
  7. Oatmeal is one of the best grains you can eat! It too helps you to feel full, decreases the cholesterol level, is high in fiber but low in calories, and has many important minerals needed for health. It is easy to add other nutrients to oatmeal such as ground flax, wheat germ and wheat bran, ground nuts and berries.
  8. Beans are excellent sources of protein, as well as fiber to help you stay full. They also have many other nutrients.
  9. Another important type of fat to consume each day is omega-3 fatty acids. This is a type of polyunsaturated fat, fats that are essential fatty acids needed for good health. It is most abundant in fatty fish like sardines and salmon. Flaxseeds and walnuts are other sources. They help burn fat, decrease harmful chronic inflammation, and build muscle.
  10. It is important to get at least seven hours of sleep each night. Sleeping less than that increases the hormone ghrelin and that increases hunger feelings. Rest and relaxation also help decrease stress hormones like cortisol that increase the blood sugar level and weight gain.

 

This blog article isn’t meant to replace your primary health care provider.

The next article will cover foods, drinks and habits to give up to promote weight loss and good health. The following one will give suggestions on how to make the changes like giving up bad habits and making the good practices part of your everyday routine.

Chromium: The good, the bad, and the not-so-important

Chromium:  The good, the bad, and the not-so-important

Chromium is found and produced in several different forms. The most common forms are metallic, trivalent and hexavalent. The trivalent form occurs naturally and is an essential nutrient. Its needed for fatty acid and cholesterol production and insulin metabolism. It is found in eggs, meat, cheese, whole grains and certain fruits and vegetables. Metallic chromium isn’t pertinent to this article (Pediatric Environmental Health, 3rd edition, Dr. Ruth Etzel, Editor, and Dr. Sophie Balk, Assoc. Editor. Elk Grove Village, IL:  2012).

Hexavalent chromium is the toxic form. The US National Toxicology Program, World Health Organization, EPA, and International Agency for Research on Cancer have all identified hexavalent chromium as a human carcinogen. It comes mostly from industrial emissions and passes into the air, water, and soil. It’s also part of tobacco smoke. Chromium is used in so many ways it isn’t surprising it is found in more than 50% of the National Priorities List superfund hazardous waste sites as well as many landfills. Fossil fuel burning and steel production are major sources of chromium in the air. The movie Erin Brockovich was about The Pacific Gas and Electric Company’s role in the excessive chromium in water and even though it has been out a long time, this is still a real problem.

Absorption of hexavalent chromium from the lungs is high. Gastrointestinal absorption of this form can be as high as 50% but much of it is converted to the trivalent form. Chromium doesn’t stay in the body very long, so antidotes and chelators aren’t in demand. Vitamin C helps convert hexavalent chromium to the trivalent form. Laboratory assessments are not particularly useful, and environmental documentation is more helpful.

Topical chromium is a common cause of allergic contact dermatitis. Swallowing a large amount of hexavalent chromium could cause nausea, vomiting and acute kidney failure.

The biggest concern is with chronic inhalation of the hexavalent form of chromium. Those at highest risk are those working or who have worked in industries where chromium is used. These individuals have an increased chance of developing nasal and lung cancer. The latter risk increases with the duration of an exposure and there’s about a 13 to 30-year latency period. In “Profiling stainless steel welding processes to reduce fume emissions, hexavalent chromium emissions and operating costs in the workplace,” (by M. Keane, et al in Journal of Occupational and Environmental Hygiene, 2016, v. 13#1, pages 1-8) almost half a million Americans do some welding in their work, and that is a potential exposure. Gas metal arc welding was found to create less exposure to toxic gases.

In “Hexavalent Chromium Is Carcinogenic to F344/N Rats and B6C3F1 Mice” (by M. Stout, et al, in Environmental Health Perspectives, v117, #5, for May 2009, pages 716-722), the possibility of an increased risk for oral, stomach and duodenal cancer with chronic consumption of water polluted with excess chromium was raised. The research done involved giving water with various levels of hexavalent chromium in it to the test animals for 2 years. Before you decide that this isn’t relevant to humans, consider the fact that rats and mice are used in research because they share many biological processes and tissue structures with humans.

This all lends support to having water tested, including well water, before even a sip.

What can harm or help preserve memory

What Harms and what Helps preserve Memory

There’s a plethora of research on things that can harm the brain including memory. Not surprising, many of these are things that also harm other organs and can cause or advance diseases. Some of the top offenders:

  • Stress – especially long-term stress when cortisol production is prominent, interferes with thinking and learning.
  • Obstructive sleep apnea significantly increases the risk for dementia.
  • Obesity – fat cells secrete inflammatory chemicals that damage many tissues
  • A lack of sleep – regularly sleeping less than 5 hours a night is associated with worse cognition (compared with those getting 7 to 8 hours a night).
  • Sedating medications – older antihistamines, strong pain medications, some beta blockers used for high blood pressure and heart problems, to name just a few. Discuss this with your health care provider if you are on a medication that can cause drowsiness or problems with clear thinking.
  • High blood sugar – from diabetes or poor diet. Processed foods, especially high in sugar baked goods, soft drinks and candy can increase the blood sugar and cause harm even if you don’t have diabetes.

What helps preserve and even strengthen memory and thinking ability? This list is also long!

  • Exercise – even a thirty minute walk each day helps with blood circulation and with special memory. Physical activity is also associated with an increase in brain cells and improved long-term memory.
  • Relaxation – just looking out a window for ten minutes a day is helpful.
  • Healthy foods – those high in antioxidants are especially beneficial – for example berries, green vegetables, whole grains, fish, and beans. Turmeric and sage tea are also credited with brain protective effects.
  • Social engagement – talking with others, even if the subject isn’t theoretical physics or other deep topics, aids memory and other brain functions.
  • Music and art (making and appreciating), crafts like knitting, jigsaw puzzles and word games all can help.

This article is not intended to replace your health care provider. The intent is to make important information about medications and other things that can affect your health available.

The best way to prevent an infection

The best way to prevent infections

Since we’re living in an era when there isn’t an antimicrobial drug for every infection, prevention is critical. Although there have been a lot of advances in medicine, proper hand washing is the best way to prevent picking up or spreading an infection. Proper in italics because this is key, and I would venture to say most people don’t do that. That changed after reading Dr. Frederic Saldmann’s Wash Your Hands! (New York: Weinstein Books, 2008).

It’s no secret that hands carry a lot of germs, and not just those that cause skin infections or gastroenteritis. We cough into our hands, touch computers and elevator buttons, shake hands, touch our face, grab onto the handrails of stairs, touch toilet seats and sink faucets, touch our face, pick up fruits and vegetables at the grocery store, touch our face, and then do a split-second wash that may be giving the germs just the chance they need to start a very big family and also get free housing.

Proper hand washing includes washing every part including the space between fingers and cuticles. In the article “Implementing Infection Prevention and Control Precautions in the Community” by Deborah Ward (British Journal of Community Nursing, March 2017, vol. 22, #3) it’s noted that fingernails and fingertips have the highest number of organisms. The author adds that rings and other jewelry can also be a reservoir for germs. She also notes that alcohol-based sanitizers don’t kill the germs that cause the pseudomembranous colitis, a serious lower GI infection.

Drying is just as important because, per Dr. Saldmann’s book, moist hands carry five hundred times as many pathogens as dry hands! Yet another study found that about a third of hand washers don’t dry their hands. And using a damp towel can contaminate washed hands. The most startling news is that using a warm-air dryer actually leads to a significant increase in the number of germs on hands compared with the number before washing them!

After shaking hands with someone that had a recent trip to the bathroom and didn’t wash their hands, there’s a 33% chance you’ll get some of the bacteria from their feces in your mouth within a couple hours. If you think it’s rare for someone to not wash their hands after using the restroom, guess again. In one study, almost half of the research subjects didn’t wash their hands then if they were alone; that’s five times the rate of those who are in the bathroom with other people around. Proper hand washing takes less than a minute – a worthy investment!