Hemorrhoids, also known as piles, are a normal part of our bodies. They are clusters of veins located beneath the mucous membranes lining the rectum and anus. When these veins become swollen and enlarged, similar to varicose veins in the legs, it results in the condition we commonly refer to as hemorrhoids. This may be due to the constant challenge of gravity as our bodies strive to pump blood back up to the heart. Therefore, haemorrhoids are often considered a possible consequence of our upright posture as humans.

How common are hemorrhoids in Kenya?

As per the study done at Kenyatta National Hospital (KNH ,the incidence of asymptomatic was found to be 21% all being first degree haemorrhoids, while in the age group 50 years and over, 29% had asymptomatic haemorrhoids. Males had a greater incidence of asymptomatic haemorrhoids than females

What are the factors that contribute to the development of hemorrhoids?

Hemorrhoids are commonly caused by certain factors. One main factor is chronic constipation, where difficulty in passing stools puts strain on the blood vessels in the rectal area, leading to the development of hemorrhoids. Prolonged periods of sitting on the toilet can also contribute to this condition by disrupting the blood flow and causing the veins to enlarge.

During pregnancy, the growing uterus can press on the veins, increasing the likelihood of developing hemorrhoids. Recent studies have found that individuals with hemorrhoids often have naturally tighter muscles in the anal canal, even without straining. When constipation occurs, the act of straining puts extra pressure on the anal canal, pushing the hemorrhoids against the muscle. Also connective tissues which support the hemorrhoids can weaken with age, causing them to bulge and prolapse.

While symptomatic hemorrhoids can affect individuals of any age, including teenagers, they are relatively uncommon in children due to the time it takes for hemorrhoids to develop. However, certain factors can increase the risk of developing hemorrhoids.

You are at higher risk if:

• Being overweight or obese.
• Pregnancy
• Following a low-fiber diet.
• Having chronic constipation or diarrhoea.
• Regularly engaging in heavy lifting.
• Spending prolonged periods of time sitting on the toilet.
• Straining during bowel movements.

Types of hemorrhoids

Hemorrhoids can occur either internally or externally, depending on the location of the swollen veins. The type of hemorrhoids is determined by where the enlarged vein develops.

There are two main types:

• Internal Hemorrhoids: Develop inside the rectum and are not visible or felt from the outside. Internal Hemorrhoids are normally painless but can cause bleeding during bowel movements.
• External Hemorrhoids: These form under the skin around the anus and are visible and often felt as small, painful lumps. External hemorrhoids can cause discomfort, itching, and irritation

Symptoms of hemorrhoids?

Internal hemorrhoids are often painless and may go unnoticed unless they prolapse or protrude. Many individuals with internal hemorrhoids are unaware of their presence as they do not experience any symptoms.

However, if symptoms do occur with internal hemorrhoids, one common sign is rectal bleeding. This can manifest as blood on toilet paper, in the stool, or in the toilet bowl after a bowel movement. It is essential to recognize rectal bleeding as a potential indication of internal hemorrhoids and seek appropriate medical attention for proper diagnosis and management.

Whereas external hemorrhoids can exhibit several characteristic signs, including:

• Persistent Itching: An itchy sensation in and around the anus is a common symptom associated with external hemorrhoids.
• Tender or Painful Lumps: Hard, swollen lumps near the anus can develop, causing discomfort or tenderness when touched or pressed.
• Anal Pain or Discomfort: Individuals with external hemorrhoids may experience aching or pain in the anal area, particularly when sitting or engaging in activities that exert pressure on the affected region.
• Rectal Bleeding: External hemorrhoids can lead to rectal bleeding, which may be visible on toilet paper, in the stool, or in the toilet bowl after bowel movements

Difference between hemorrhoids and anal fissures?

Hemorrhoids and anal fissures can produce similar symptoms, including itching, pain, and bleeding. However, the underlying causes differ: hemorrhoids result from swollen veins, while anal fissures stem from a tear in the lining of the anus

Effective Strategies for preventing hemorrhoids

As we age, the likelihood of developing hemorrhoids increases. However, there are steps you can take to prevent the occurrence of hard stools and constipation, which are common culprits behind hemorrhoids. Implementing the following measures can help you maintain optimal rectal health

• Avoid prolonged sitting and excessive straining on the toilet
• Respond promptly to bowel urges, avoiding delay
• Drinks plenty of water to stay well-hydrated by
• Eat high-fiber foods or consider fiber supplements
• Stay physically active to keep your bowels moving

Ref. :

• Harvard Health Publishing, Harvard Medical School (https://www.health.harvard.edu/ )
• A study of haemorrhoids as seen at the Kenyatta National Hospital with special reference to asymptomatic haemorrhoids ( East Afr Med J. 1991 May;68(5):340-7)
• Cleveland Clinic ( https://my.clevelandclinic.org/ )

Chlamydia, often referred to as the “silent” STI, is a common sexually transmitted infection that affects millions of people worldwide. Despite its prevalence, many individuals are unaware of the risks, symptoms, and necessary preventive measures associated with Chlamydia. In this comprehensive fact sheet, we aim to bridge the knowledge gap and empower readers to take informed action against this silent but significant health concern.

What is chlamydia?

Chlamydia, a prevalent sexually transmitted infection (STI), can affect individuals of all genders. If left untreated, it can lead to long-term consequences, particularly for women, including irreversible harm to the reproductive system. This damage can result in challenges or even infertility when attempting to conceive in the future. Additionally, Chlamydia carries the risk of potentially life-threatening ectopic pregnancy, where the fertilized egg implants outside the uterus.

How it is spread?

Chlamydia can be contracted through engaging in vaginal, anal, or oral sex with a person who is infected with the bacteria. It’s important to note that the transmission can occur even if there is no ejaculation during sexual activity. Additionally, it’s crucial to be aware that a pregnant individual who has chlamydia can pass the infection to their baby during the childbirth process.

Recognizing the Risks

Certain factors increase the risk of Chlamydia, including unprotected sex, multiple sexual partners, and a history of previous STIs.

Abstaining from vaginal, anal, or oral sex is the only sure-fire way to entirely avoid contracting sexually transmitted infections (STIs), including chlamydia. Below are the measures you can take to reduce the risk of acquiring chlamydia:

• Being in a committed and exclusive relationship with a partner who has tested negative for chlamydia.
• Consistently and correctly using condoms every time you engage in sexual intercourse.

These precautions can help lower the chances of contracting chlamydia and other STIs. However, it’s important to note that no method is fool proof, and regular testing for STIs is still advisable, especially if there is a change in sexual partners or any potential exposure to infection.

Common Symptoms:

Chlamydia is often asymptomatic, meaning it can be present in the body without causing noticeable symptoms. However, even in the absence of symptoms, it can lead to severe health complications. If symptoms do occur, they may not manifest until several weeks after engaging in sexual activity with an infected partner

In women, untreated chlamydia can cause damage to the reproductive system, even in the absence of symptoms. Common symptoms experienced by women with chlamydia may include:

• Abnormal vaginal discharge.
• A burning sensation during urination.

In men, symptoms of chlamydia can include:

• Discharge from the penis.
• A burning sensation during urination.
• Swelling & pain in one or both testicles (less common)

Chlamydia can also infect the rectum. This typically occurs through receptive anal sex or spread from another infected site, such as the vagina. While rectal chlamydia infections often do not manifest noticeable symptoms, they can cause:

• Rectal pain
• Discharge from the rectum
• Rectal bleeding

It is important to seek medical attention from a healthcare provider if you experiencing any of these symptoms,. Additionally, it is advisable to see a healthcare provider if your sexual partner has been diagnosed with an STD or displays symptoms of one. These symptoms may include:

• Unusual sores
• Foul-smelling discharge
• Burning sensation during urination
• Bleeding between periods

The Complications of Untreated Chlamydia:

Although the initial damage caused by chlamydia may go unnoticed, it can lead to significant health complications if left untreated. In women, untreated chlamydia can progress to pelvic inflammatory disease (PID), which can result in various complications, including:

• Formation of scar tissue that blocks the fallopian tubes, leading to infertility.
• Ectopic pregnancy, where the fertilized egg implants outside the womb.
• Long-term pelvic or abdominal pain.
• Increased risk of chronic PID (Pelvic Inflammatory Disease).

Men, on the other hand, generally experience fewer health problems from chlamydia. However, in some cases, the infection can lead to epididymitis, causing fever and pain in the tubes attached to the testicles. This rare condition can potentially result in infertility.

Furthermore, untreated chlamydia can increase the risk of acquiring or transmitting HIV, the virus that causes AIDS.

Treatment and Partner Notification:

Chlamydia infection can be effectively treated with antibiotics, typically within a week or two. However, it is crucial not to discontinue medication solely based on symptom improvement. It is recommended to consult your healthcare provider regarding the necessary follow-up steps to ensure the complete eradication of the infection even after finishing the prescribed course of antibiotics. This is important because chlamydia infection can recur.

As part of your treatment, it is crucial to take steps to prevent re-infection and ensure that any sexual partners who may be infected also receive appropriate treatment. Below are some important measures one should take:

Complete your medication: Take all prescribed medication as directed by your healthcare provider. Do not stop medication even if your symptoms have improved. Finish the full course of treatment to ensure the eradication of the infection.

Notify sexual partners: Contact any sexual partners you have had within the last three months and inform them about your chlamydia infection. Encourage them to seek medical testing and treatment promptly.

Undergo comprehensive STI testing: It is recommended to get tested for other sexually transmitted infections (STIs) such as HIV/AIDS, syphilis, herpes, and gonorrhoea. It is common to have multiple STIs, and it is crucial to receive tailored treatment for each infection. Discuss with your healthcare provider to ensure appropriate testing and treatment for any additional STIs.

Increasing awareness and understanding of Chlamydia is essential in combating this silent STI. By recognizing the risks, understanding the symptoms, and taking proactive steps such as prevention, regular testing, and timely treatment, individuals can protect their sexual health and contribute to reducing the spread of Chlamydia within their communities. Remember, from awareness to action, we all play a crucial role in tackling Chlamydia and promoting overall sexual health

 

Ref.:

Centers for Disease Control and Prevention (https://www.cdc.gov/)

Cleveland clinic (https://my.clevelandclinic.org/)

If you’ve ever experienced the uncomfortable burning sensation and frequent urge to urinate, you’re certainly not alone. Among the common reasons for seeking medical attention from an Obs/Gyn, urinary tract infections (UTIs) rank high on the list. Urinary tract infections (UTIs) affects millions of people worldwide. However, statistics indicate that women are more prone to UTIs compared to men. This disparity has intrigued researchers and medical professionals for years. In this blog, we will delve into the reasons behind this gender-based vulnerability, exploring various factors that contribute to the increased occurrence of UTIs in women.

Anatomy and Physiology:

One of the primary reasons why women are more prone to UTIs lies in their anatomical and physiological differences. The primary factor contributing to the higher susceptibility of UTIs in women is their unique anatomical structure, specifically concerning the urethra. The urethra serves as the passage for urine to exit the bladder and leave the body. The female urethra is shorter compared to that of males, which increases the likelihood of bacteria reaching the bladder. The average female urethra is 1-2 inches long compared to the male urethra which is 6 inches long. These factors are further compounded by the close proximity of the female urethra to the rectum, which carries waste and bacteria, including E. coli. Notably, E. coli is the primary cause of bladder infections, accounting for approximately 51% of cases.
Furthermore, unlike their male counterparts, the external urethral meatus in women is predominantly lined with moist mucosal tissue, which is thinner and more sensitive compared to the skin found elsewhere on the body. This delicate nature of the female urethral tissue makes it more susceptible to trauma and irritation. The irritated skin can create an environment that allows bacteria to potentially thrive and multiply before ascending the short distance up the urethra and reaching the bladder

Hormonal Influences:

Hormonal fluctuations in women can impact the likelihood of developing UTIs. Changes during the menstrual cycle, pregnancy, and menopause can affect the acidity of the vaginal environment and alter the balance of beneficial bacteria. These hormonal shifts can weaken the immune response and create an environment conducive to bacterial growth.

Sexual Activity:

Sexual intercourse can introduce bacteria into the urethra and increase the risk of UTIs. The use of spermicide or a diaphragm for birth control can also increase the frequency of UTIs. Spermicide may lead to vaginal irritation, creating a conducive environment for bacterial growth.

Structural Abnormalities:

Some women may have structural abnormalities in their urinary tract, such as a urethral diverticulum or a urinary tract obstruction. These conditions can impede the flow of urine, leading to stagnant urine in the bladder and increasing the chances of bacterial growth and infection.

Tips for prevention

The above discussion highlights the inherent vulnerability of women to bladder infections compared to men, despite practicing perfect hygiene. However, there are several hygiene tips that women can follow to help prevent UTIs.

Ensuring an adequate intake of fluids, particularly water

Staying adequately hydrated, particularly by drinking plenty of fluids, is crucial for maintaining hydrated and healthy bladder tissue. Hydration helps dilute urine, reducing the concentration of bacteria in the bladder. Remarkably, some individuals can even resolve mild infections through increased fluid intake alone.
By prioritizing hydration and ensuring sufficient fluid consumption, you can take proactive steps in preventing UTIs.

Empty your bladder often

To prevent bacteria from finding an optimal environment to thrive, it is essential to empty your bladder regularly. Regular bladder emptying minimizes the amount of time urine spends in the bladder, depriving bacteria of a warm and wet environment. By ensuring you empty your bladder frequently, typically around four to eight times per day, you disrupt the conditions that bacteria need to grow. This simple practice can significantly reduce the risk of UTIs and promote bladder health

Urinate after sex

Urinating soon after sexual intercourse is an important preventive measure. During intercourse, bacteria can come into close proximity with or enter the urethra, the small tube that empties the bladder. By urinating shortly after sex, you can expel some of the bacteria from the urethra before it has a chance to cause an infection. This simple act helps to flush out any potentially harmful bacteria, reducing the risk of developing a UTI. Making it a habit to urinate promptly after sexual activity is an effective strategy for maintaining urinary tract health.

Wiping front to back

Practicing proper wiping technique is crucial in preventing the spread of bacteria from the anal region to the vagina and urethra. After urinating or having a bowel movement, it is important to wipe from front to back. This technique ensures that any bacteria present in the anal area are not accidentally transferred to the vaginal or urethral area. By consistently following the front-to-back wiping motion, you can minimize the risk of introducing harmful bacteria and reduce the likelihood of UTIs.

Ref :
J Gend Specif Med.2000 Nov-Dec;3(8):27-34.
Menopause Int. 2013 Dec;19(4):155-62
 https://www.mayoclinichealthsystem.org/

Introduction:

Pregnancy is a time of immense joy and anticipation, and maintaining a healthy diet is crucial for the well-being of both the expectant mother and her growing baby. Proper nutrition during pregnancy supports fetal development, helps prevent complications, and promotes the mother’s overall health. In this comprehensive guide, we will explore the importance of diet and nutrition during pregnancy, providing valuable insights and practical tips for expectant mothers.

The Importance of a Nutritious Diet for a Healthy Pregnancy

A well-balanced and nutritious diet plays a crucial role in maintaining a healthy lifestyle, and it becomes even more significant during pregnancy or when planning to conceive. Consuming a healthy diet during pregnancy is essential for optimal fetal development and growth.
While there is no need to follow a specialized diet, it is important to incorporate a diverse range of foods into your daily meals to ensure you and your baby receive the necessary nutrients. Obtaining essential vitamins and minerals from whole foods is preferable, but during pregnancy, it is advised to take essential vitamins and minerals supplement to ensure adequate intake.
Remember, a healthy pregnancy diet revolves around consuming a variety of nutrient-rich foods daily, which promotes the well-being of both the expectant mother and the developing baby.

The role of nutrition in supporting fetal development and growth

From the moment of conception, the developing embryo relies on the mother’s nutrient reserves to support its rapid growth. Insufficient nutrient stores, particularly micronutrients like zinc and iron, can hinder fetal growth and impair organ development. In fact, research indicates that nutrition during the preconception period, which spans approximately two to three months before pregnancy, plays a critical role in fetal development. It is now understood that the quality of nutrition prior to pregnancy is as significant as nutrition during pregnancy itself. Therefore, it is vital to enhance nutrient stores before conceiving, as a substantial portion of the nutrients supplied to the growing embryo and fetus originate from established nutritional reserves
Dietary and Caloric recommendations during pregnancy

During pregnancy, it is important to consume approximately 300 additional calories per day to support a healthy pregnancy. These calories should come from a well-balanced diet that includes protein, fruits, vegetables, and whole grains. It is advisable to limit the intake of sweets and fats. Following a healthy and balanced diet can also help alleviate pregnancy symptoms like nausea and constipation
The following foods are beneficial for both maternal health and fetal development during pregnancy:

– Vegetables: Incorporate a variety of vegetables into your diet, such as carrots, sweet potatoes, pumpkin, spinach, cooked greens, tomatoes, and red sweet peppers. These vegetables are abundant in essential nutrients like vitamin A and potassium.

– Fruits: Opt for fruits such as cantaloupe, honeydew, mangoes, prunes, bananas, apricots, oranges, and red or pink grapefruit, as they are excellent sources of potassium.

– Dairy: Choose fat-free or low-fat yogurt, skim or 1% milk, or soymilk to ensure an adequate intake of calcium, potassium, and vitamins A and D.

– Grains: Incorporate ready-to-eat cereals or cooked cereals fortified with iron and folic acid into your meals to support your iron levels and meet your folic acid requirements.

– Proteins: Include beans, peas, nuts, and seeds as plant-based protein sources. Lean meats like beef, lamb, and pork can also be consumed.

Additionally, oily fish such as salmon, trout, herring, and sardines are beneficial due to their omega-3 fatty acids content
Avoid these foods during Pregnancy
-Unpasteurized milk and foods made with unpasteurized milk: These can contain harmful bacteria such as Listeria, which can lead to foodborne illnesses.
-Hot dogs and luncheon meats: Unless they are heated until steaming hot before serving, these products can carry the risk of Listeria contamination.
-Raw and undercooked seafood, eggs, and meat: Consuming these foods increases the risk of bacterial or parasitic infections
-Refrigerated pâté and meat spreads: These products may contain Listeria and should be avoided to minimize the risk of foodborne illnesses.
-Refrigerated smoked seafood: Smoked seafood, such as salmon or trout, that is refrigerated and not canned or shelf-stable may carry the risk of contamination and should be avoided.

Preparing food safely: Essential Steps for a Healthy Pregnancy

-Thoroughly Wash Fruits, Vegetables, and Salads: To eliminate any potential traces of soil that may carry the toxoplasma parasite, which can pose a risk of toxoplasmosis to your unborn baby, it is crucial to wash fruits, vegetables, and salads diligently.
-Clean Surfaces, Utensils, and Hands: After handling raw foods such as poultry, meat, eggs, fish, shellfish, and raw vegetables, it is important to wash all surfaces, utensils, and your hands thoroughly. This practice helps prevent food poisoning and the spread of harmful bacteria.
-Store Raw Foods Separately: Ensure that raw foods are stored separately from ready-to-eat foods to avoid cross-contamination. Mixing raw and ready-to-eat foods can lead to the transfer of harmful bacteria and increase the risk of foodborne illnesses.
-Use Separate Knife and Chopping Board for Raw Meats: To minimize the risk of bacterial contamination, it is advisable to use a separate knife and chopping board specifically designated for handling raw meats. This helps prevent the spread of bacteria to other foods
-Properly heat Ready Meals: When consuming ready meals, especially those containing poultry, it is essential to heat them until they are steaming hot all the way through. This thorough heating process helps eliminate any potential bacteria and ensures food safety.

Conclusion:
A well-planned and balanced diet during pregnancy is vital for the health and development of both the expectant mother and her baby. By prioritizing nutrient-rich foods, making informed choices, and seeking professional guidance when needed, expectant mothers can ensure they are nourishing themselves and their babies in the best possible way. Remember, a healthy pregnancy diet is a journey that supports the growth of a new life and sets the foundation for a lifetime of well-being.

Reference:
https://www.nhs.uk/pregnancy/keeping-well/have-a-healthy-diet/
https://www.hopkinsmedicine.org/health/wellness-and-prevention/nutrition-during-pregnancy