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Suffering from 'Piku' syndrome? Don't sit on it

Although there are several ayurvedic medicines and home remedies that claim to ease bowel movements, constipation is a painful reality one has to live with - sometimes for years

 

If you ask about the one thing that Amitabh Bachchan-starrer and now a Rs.100-crore-club member 'Piku' has done to the Indian masses, apart from entertaining them, is bringing into the public domain a topic that is taboo in social conversations but that almost everyone experiences or has been a chronic sufferer: constipation.
 
The "Motion Se Hi Emotion" tagline has become such a talking point and has touched an empathetic chord in people that the unpretentious, low-budget film, that also has Deepika Padukone and Irrfan is stellar roles, has not only become a runaway hit but has brought out the 'bowel problem' of people out in the open.
 
Although there are several ayurvedic medicines and home remedies that claim to ease bowel movements, constipation is a painful reality one has to live with - sometimes for years.
 
According to Deepak Lahoti, senior consultant (gastroenterology) at Max Super Speciality Hospital in New Delhi, the Indian squat position is the best to beat the morning blues (which, in fact, actor Irrfan Khan suggests to Big B in 'Piku' too). "It is more effective than the western chair position to maintain a healthier bowel movement, especially if you raise your knees towards your chest," Lahoti told IANS.
 
Yogesh Batra, director and senior consultant (gastroenterology) at BLK Super Specialty Hospital in the capital, agrees.
 
"The squat position is definitely more physiological for passing stools. It has been used by Indians for ages," Batra said.
 
The reason behind this is simple.
 
The acute angle present between the rectum and the anal canal gets straightened and there is external pressure applied over the anterior abdominal wall for the smooth release of the stool.
 
One disadvantage is that it is difficult for old people with knee problems to sit for long.
 
"An option is to convert the western commode to semi-squat position by keeping a stool under the feet," Batra said.
 
In fact, a new book titled "Charming Bowels" by Giulia Enders, who is studying in Germany for her medical doctorate in microbiology, has buttressed the claim that humans should be squatting, not sitting, on a toilet bowl.
 
This is because the closure mechanism of the gut is not designed to "open the hatch completely" when we are sitting down or standing up: it is like a kinked hose.
 
Squatting is far more natural and puts less pressure on our bottoms.
 
"Nearly 1.2 billion people around the world who squat have almost no incidence of diverticulosis and fewer problems with piles. We in the west, on the other hand, we squeeze our gut tissue until it comes out of our bottoms," she writes.
 
Another tool in your armory to tackle constipation is to change your diet.
 
"Oats and high-fibre diet helps in tackling mild-to-moderate constipation. However, in case of severe constipation, you need to seek expert advice," said Manish Kak, consultant gastroenterology at Ghaziabad's Columbia Asia Hospital.
 
A fibre-rich diet is important.
 
"The reason for this is that fibre increases the bulk of the stool and thus facilitates its passage through the intestinal passage," Batra added.
 
Fibre does not get absorbed and travels easily triggering reflexes which make it easier for a person to pass motion.
 
Other than this, drinking two to three litres of water every day, maintaining an exercise regime with yoga or jogging or a walk in the morning helps. Alcohol, stress and fried foods need to be avoided.
 
"Try home remedies like Isabgol husk, black currants, mint, bael (wood apple) powder or juice. These are free of side effects of using laxatives," Batra says.
 
The key to defeat constipation is to maintain a healthy lifestyle. "Sitting for long hours and not moving - in office or at home - can result in constipation," Lahoti noted.
 
Some experts suggested that acupressure over the perineal area (the genital area between the vulva and anus in a woman and between the scrotum and anus in a man) can theoretically trigger a defecation reflex and passage of stool.
 
Doctors however do not recommend this since it is not backed by sufficient studies.
 
Finally, do not be obsessed with constipation as whatever is inside will eventually come out.
 
"If you ease yourself, you will be relieved faster. Do remember that in the western world (among predominantly meat eaters), people may not pass stool up to a week without any discomfort," Batra points out.
 
So, set aside unhurried and regular time for defecation and always respond to a defecatory urge.
 
Increase fluid intake and avoid stress for that elusive, but relieving, "Piku" moment daily.
 

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Need to step up fight against smokeless killer

The prestigious scientific journal Lancet has placed India at the second position -next to China - in terms of those consuming smokeless tobacco

 

Wrapped inside betel leaves and placed in the corner of the mouth, chewing tobacco has been a practice in India for centuries.
 
While there is certainly an increased awareness in terms of the harmful effects this could have on health, the medical fraternity is very much concerned about the growing number of cancerous lesions in the mouth.
 
The prestigious scientific journal Lancet has placed India at the second position -next to China - in terms of those consuming smokeless tobacco.
 
Various forms of loose-leaf chewed tobacco are commonly consumed in the Indian subcontinent. Smokeless tobacco use is particularly prevalent in India, Bangladesh and among women in Thailand.
 
What is less known to most people in India is that more than 4,000 different chemicals have been found in tobacco and over 60 of these chemicals are known carcinogens.
 
Almost 30 percent of the Indian population older than age 15 use some form of tobacco. Men use more smoked tobacco while women are more likely to use the chewed variety.
 
In case of paan with tobacco, the main ingredients of paan are the betel leaf, areca nut (supari), slaked lime (chuna), and catechu (katha).
 
Sweets and other condiments are also added for flavour. The varieties of paan are named for the different strengths of tobacco in it. It is a myth that chewing tobacco with betel leaf is not harmful.
 
The International Agency for Research on Cancer (IARC) has rightly established that people who chew both the betel leaf and the areca nut along with tobacco have a higher risk of damaging their gums and having cancers of the mouth, pharynx, esophagus and stomach.
 
Khaini is yet another common chewing tobacco seen mostly among the women folk. Dried tobacco leaves are crushed and mixed with slaked lime and chewed as a quid. The practice of keeping the quid in the mouth between the cheeks and gums causes most cancers of the gums - the most common form of mouth cancer in India.
 
Let us pause and take a look at a case study here.
 
Raghav Sharma (name changed) was diagnosed with stage IV mouth cancer. A road-side vendor in Delhi, he earned his living out of selling vegetables.
 
Sharma underwent surgery and had to get the central portion of his lower jaw removed. For this, he gave away all that he had to save himself.
 
Now, the same man has knocked the door of the hospital again with two marble-sized yellowish lumps in his gums.
 
The ugly dreadful cancer is back again with a vengeance and the doctors have no other option but to go for a second surgery.
 
There is an urgent need for increasing awareness on the ill effects of chewing tobacco. Interestingly, there are misconceptions that tobacco has germicidal compositions that could cleanse the teeth.
 
Mishri is one of the kind which is applied on the teeth like a tooth powder. In due course, the individual gets addicted to the usage and becomes totally dependent on the product. The user also ends up damaging his teeth and gums.
 
Gudakhu, again used commonly by women, is a paste of tobacco and sugar molasses and involves direct application of tobacco to the gums, thus increasing the risk of cancer of the gums.
 
A campaign that empowers cancer survivors to tell their stories to influence policymakers and raise awareness among other tobacco users about the damaging effects of tobacco on health is the need of the hour.
 
Besides cancer of mouth, use of tobacco, in the smoke or smokeless form, may lead to other serious diseases including heart, lung, circulatory diseases and stroke.
 
Once diagnosed with cancer, the genetic damage is irreversible.
 

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