lifestyle

Endometriosis occurs when non-cancerous tissues that resemble the ones lining your uterus , begin to grow outside of the uterus in places like the ovaries, the fallopian tube, pelvis and bowel. 

It is a hormone dependent type of condition (especially steroid based hormone estrogen).

The tissues in the uterus becomes  thicker than normal, breaks down and leave the body during menstruation, but these tissues that grow outside of the uterus also thicken and break down but cant leave the body thereby leading to pain, inflammation, formation of scar tissue and most likely, potential fertility problems. 

According to a study, about 70 million women all over the world  are affected by endometriosis. Surprisingly, the disease is even more common than breast cancer and diabetes.

Endometriosis usually occurs during active menstruation when there is still much release of estrogen (i.e it is hormone dependent), it rarely occurs after menstruation. 

WHAT ARE THE SYMPTOMS? 

Symptoms always vary from one woman to another, might come in as mild or moderate or severe.

The degree of pain doesn’t always equate the severity of the condition; you might have very excruciating pains and it’s a mild condition. 

Symptoms involved in endometriosis include: 

• excruciating pains during period
• pain experienced in the lower abdomen and back either before or during menstruation 
• cramps around menstruation week
• heavy bleeding 
• infertility problems 
• pain after sexual intercourse
• Diarrhea or constipation 
• Bloating 

WHAT EXACTLY CAUSES ENDOMETRIOSIS? 

The etiology behind endometriosis is not known yet, but according to some theories put forward, these suggested causes might be linked to the condition: 

• Genetics: the condition most likely runs in families and affects people of some ethnic groups more
• Retrograde menstruation: this happens when some of the womb lining flows up back through the fallopian tubes and hangs on to some organs of the pelvis instead of leaving the body as period.
• When the immune system is malfunctioning 

These suggested theories don’t fully explain the causes of endometriosis; it is a condition caused by many factors put together.  

RISK FACTORS 

Some other factors include: 

• AGE: usually affects women from the ages of 25-40, symptoms can be seen from puberty though. 
• FAMILY HISTORY
• PREGNANCY HISTORY: pregnancy might have the tendency of decreasing the risk of endometriosis, those who haven’t had children might have higher risks of endometriosis.
• MENSTRUATION HISTORY:  issues associated with this can include shorter cycles, heavier and longer periods and might place the individual at higher risks. 

HOW CAN I PREVENT ENDOMETRIOSIS?

Sadly, there is no known way to prevent endometriosis. The possible ways are to create awareness, ensure early diagnosis and management to help slow down or halt the natural progression of the disease. 

HOW IS IT DIAGNOSED? 

Endometriosis can be suspected from history; tender masses might be visible on the vagina and cervix during pelvic examination. 

TREATMENT OPTIONS 

Even though there is no known treatment option for endometriosis, it can be managed to help reduce symptoms. Possible ways to help manage endometriosis includes: 

• nutritional therapy
• exercise
• pain medication
• hormone therapy
• surgery

These options totally depend on the severity of the condition. 

HOW ENDOMETRIOSIS MAY BE LINKED TO DIET 

Diet may have a potential role in the cause of endometriosis through its influence on hormones derived from cholesterol. Hormones like oestrogen which are cholesterol based are the major culprit in endometriosis. So, studies have shown that a plant-based and high fibre diet increase oestrogen secretion and reduce the availability of oestrogen, and this might help reduce endometriosis progression. This diet would help to modify the risk of endometriosis by altering the metabolism of cholesterol based hormones. 

FOODS THAT MAY NEGATIVELY AFFECT ENDOMETRIOSIS 

Endometriosis can be influenced by your lifestyle, and this determines the severity of the condition and the pain experienced. 

The following factors might negatively influence the condition: 

• High intake of transfat : research has it that women who consumed high amounts of transfat especially from fried and processed foods had a higher rate of diagnoses. 
• Red meat consumption
• Gluten: A study showed that most women experienced a decreased pain while they went on a gluten free diet
• High FODMAP diet: low FODMAP diets are majorly prescribed to people who has irritable bowel syndrome (IBS). A research found out that those with IBS and endometriosis that followed a low FODMAP diet had reduced symptoms

Alcohol, caffeine, gluten, red meat, saturated and trans fat can negatively affect hormone regulation in people with endometriosis as they lead to progression of the disorder. So, they should be totally avoided 

FOODS THAT MAY POSITIVELY AFFECT ENDOMETRIOSIS 

A nutrient dense and well adequate diet can help to reduce symptoms from endometriosis. you should consider: 

• A high fibre diet: a diet high in fibre helps reduce the production of oestrogen which is implicated in the mechanism of endometriosis, and also helps to reduce insulin production, which relates to the progression of endometriosis. foods high in fibre includes green leafy vegetables, legumes and whole grains. 
• iron-rich foods, such as dark leafy greens, broccoli, beans, fortified grains, nuts, and seeds
• foods rich in essential fatty acids, such as salmon, sardines, walnuts, chia, and flax seeds
• antioxidant-rich foods found in colorful fruits and vegetables, such as oranges, berries, dark chocolate, spinach, and beets. Studies has linked oxidative stress to the progression of the disease, so its important to also consider these antioxidant rich food sources. 

SUPPLEMENTS ALSO HAVE A ROLE TO PLAY

Apart from an adequate diet, nutritional supplements also have unique roles to play while managing endometriosis. 

For example, supplementing with 1200 IU of vitamin E and 1000 IU of vitamin C was shown to reduce pelvic pain in some women with endometriosis after a clinical trial. 

Also, curcumin, vitamins A and D proved to help in the management of endometriosis

EXERCISE AND OTHER ALTERNATIVES 

 Exercise could help to manage endometriosis as it reduces the production of estrogen and helps in the release of serotonin “the feel good hormone”. Some relaxation techniques can be explored

• meditation
• yoga
• accupunture
• massage

SUMMARY 

Lifestyle changes and dietary patterns could help to reduce the symptoms associated with endometriosis, you can speak to a dietitian and a doctor to help you through this condition as everyone’s body’s are different and should be handled individually.

 

SOURCES

1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3941414/
2. https://nutritionguide.pcrm.org/nutritionguide/view/Nutrition_Guide_for_Clinicians/1342065/all/Endometriosis
3. Zondervan KT, Becker CM, Missmer SA. Endometriosis. N Engl J Med 2020; 382:1244-56.
4. Agarwal SK, Chapron C, Giudice LC, et al. Clinical diagnosis of endometriosis: a call to action. Am J Obstet Gynecol 2019(4):354-64.
5. https://www.researchgate.net/publication/247770015_Diet_-_A_New_Approach_To_Treating_Endometriosis_-_What_Is_The_Evidence
6. Harris, H. R., Chavarro, J. E., Malspeis, S., Willett, W. C., & Missmer, S. A. (2013). Dairy-food, calcium, magnesium, and vitamin D intake and endometriosis: a prospective cohort study. American Journal Of Epidemiology, 177(5), 420-430.
7. Missmer, S. A., Chavarro, J. E., Malspeis, S., Bertone-Johnson, E. R., Hornstein, M. D., Spiegelman, D.,  Hankinson, S. E. (2010). 
8. A prospective study of dietary fat consumption and endometriosis risk. Hum Reprod, 25(6), 1528-1535.

 

OVERVIEW
Ever felt a reddish and tender pain on your big toe or even both?
If yes, then you should go through this article.
Gout is a type of arthritis that forms as a result of formation of crystals in and around the joint.
It is actually the most common type of inflammatory arthritis. It affects one join at a time (especially the joint at the big toe).
Gout is actually an ancient disease; the Egyptians actually noticed it first.
Gout mostly occurs when there are excess amounts of uric acid deposited in the urine and kidneys.
There is no cure for gout, but it can be managed effectively with the right approaches.
It is most common in the big toe, and is also common in the mid foot, ankle, and knee

WHAT SYMPTOMS SHOULD I LOOK OUT FOR?
Acute gout flare mostly come as a rapid onset of pain at the site of the affected joint followed by warmth, swelling, reddish discoloration, and marked tenderness.
Sometimes most people, the pain is so intense that even if a paper touches it, you feel so much paper.
Symptoms in the affected joint(s) may include:
• Pain, usually intense
• Swelling
• Redness
• Heat

CAUSES
the accumulation of uric acid known usually as hyperuricemia is the cause of gout. When this happens, uric acid crystals are formed then they build up in joints, fluids and tissues.
What increases your chances for gout?
You’re more likely to develop gout If the following is present:
• Being male
• Being obese
• Having certain health conditions, including:
• Congestive heart failure
• Hypertension (high blood pressure)
• Insulin resistance
• Metabolic syndrome
• Diabetes
• Poor kidney function
• Using certain medications, such as diuretics (water pills).
• Drinking alcohol. The risk of gout is greater as alcohol intake goes up.
• Eating or drinking food and drinks high in fructose (a type of sugar).
• Having a diet high in purines, which the body breaks down into uric acid. Purine-rich foods include red meat, organ meat, and some kinds of seafood, such as anchovies, sardines, mussels, scallops, trout, and tuna.

ARE THERE POSSIBLE TRIGGERS?
Sometimes these crystals might not go into your joint cavities, and sometimes they might. Possible reasons why they would include:
• a knock or injury to the joint
• an illness that may make you feverish
• having an operation
• having an unusually large meal, especially a fatty meal
• drinking too much alcohol
• dehydration
• starting urate lowering therapy, especially at a high dose, or not taking your treatment regularly each day.

ARE THERE TREATMENT OPTIONS?
Oh sure!
With self-management and medications, gout can be effectively treated. You can achieve this If you:
1. Manage the pain of a flare: Treatment for flares consists of nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen, steroids, and the anti-inflammatory drug colchicine
2. Get physically active: every minute of activity counts. It is at least better than doing nothing. It is recommended that you do at least 15 minutes of physical activities daily.
3. Eat a healthy diet: foods high in purines are most commonly the triggers for gout flares. Avoiding them could totally help to alleviate pains and soreness in gout. Foods that has high levels of purines includes red meat, seafood like shellfish, limit the intake of alcohol or totally give it up.
4. Protect your joints: low impact types of exercises which won’t lead to joint injuries are preferred. Swimming, bicycling and skipping are actually very good options for exercises.

SOURCES: https://www.webmd.com/arthritis/ss/slideshow-gout
https://www.hss.edu/conditions_gout-risk-factors-diagnosis-treatment.asp
https://www.nhs.uk/conditions/gout/
https://www.versusarthritis.org/about-arthritis/conditions/gout/

 

OVERVIEW
Lipedema affects closely 11% of women globally. It occurs when fat distribution is in an irregular/uneven way beneath your skin, usually in the buttocks and legs. It can eventually cause pain and other problems. Most times, lipedema can be mistaken for regular obesity or lymphedema.
Education/awareness about lipedema is rare in the society today and due to this, there is lack of psychosocial support for women with lipedema, causing them to suffer from psychosocial disorders, including depression, anxiety, and eating disorders. Therefore, proper counseling and treatment of these conditions are important.

SYMPTOMS OF LIPEDEMA
The typical symptoms are a large lower half body size (from waist downwards), which are often tender and bruise easily. For example, the top half of your body may be a size 8, but the bottom half may be double.
As time goes on and the condition seems to progress, there is continuous buildup of fat, and your lower body grows heavier. The lipedemic fat can later collect in the arm.
Over time, excess fat cells block the vessels of your lymphatic system, which normally makes sure there is a balance in body fluid levels and protect against infection. This blockage prevents the proper drainage of lymph fluid, leading to a buildup of fluid called lymphedema (oedema in the lymphatic system).
If not treated, lymphedema can lead to problems such as infections, delayed wound healing, development of scar-like tissue called fibrosis, and hardened skin in the legs.
In comparison to obesity and lymphedema, it targets legs, thighs and sometimes arms and starts in the upper legs. It usually affects both legs.

CAUSES OF LIPEDEMA
The cause is not known, but doctors suspect female hormones play a role and also genes as people involved has a family history of it. This theory is based on the fact that it mostly affects women especially at their stages of menopause.

PATHOPYSIOLOGY
From the onset, swelling in lipedema is a result of both an increase in cell number and size in the adipocyte. Apart from the incidence of enlarged adipocytes, there is thickening of the interstitium with the presence of increased interstitial fluid, and this leads to a blockage causing oedema in the lymphatic vessels. Although interstitial fluid is increased, at least in early stages, the lymphatic system seems to be functioning normally.

LIPEDEMA TREATMENTS
Although managing lipedema fat with lifestyle modifications is almost futile, there is evidence to support the positive effects of exercise, particularly aquatic therapy, and lifestyle change on lymphedema, lymph flow, and overall health.
A treatment called complete decongestive therapy can ease painful symptoms. Complete decongestive therapy involves:
Manual lymphatic drainage: “A form of massage that uses gentle, rhythmic pumping movements to stimulate the flow of lymph around blocked areas to healthy vessels, where it can drain into the venous system. This helps relieve pain and prevent fibrosis”.
Compression: “The use of stretch bandages or custom-fitted panty hose, panties, or spandex shorts to increase tissue pressure in the swollen legs and lessen the odds of fluid building up again”.
Exercise: ” Helps to reduce fluid buildup, boost mobility, and maintain or improve how well your legs work”
Thorough skin and nail care: “Helps lower the risk of wounds and infection if you have lipedema associated with swelling”.
Liposuction: “specifically water-assisted liposuction and tumescent liposuction, can remove the lipedema fat. The procedure uses a hollow tube that is placed under the skin to suction the fat tissue. Several sessions may be needed depending on the amount of abnormal fat”.

MISCONCEPTIONS
One of the most common misconceptions about patients with lipedema is that they have excess fat stored up due to lifestyle or diet induced obesity. Although some patients with lipedema may also have obesity, lipedema should be diagnosed exclusively. Likewise, despite an elevated body mass index, the incidence of diabetes is relatively low among women with lipedema.

CONCLUSION
In a society where body shaming individuals with extra pounds’ flies easily, it’s very important to create awareness about this anomaly and make people understand its implications on individuals.
Sine it is also a condition with so many misconceptions, it should be taught about more in medical schools to avoid unnecessary laboratory tests and consultations.

SOURCES: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2653640/
https://www.webmd.com/women/guide/lipedema-symptoms-treatment-causes