In the nutshell,&nbsp;prevention is always better than cure. Embrace a healthy lifestyle and forego the bad habits like smoking and excessive alcohol intake. Manage stress by having a positive attitude and with techniques like yoga and meditation. Regular health checks help you to keep a tab on any abnormality in the body.If you or anyone you known have been diagnosed with cancer, get the complete information on the disease and its possible treatment options. Cancer is not the end!<hr>References1 <a href="https://www.google.com/url?q=http://cancerindia.org.in/know-about-cancer/&amp;sa=D&amp;ust=1553427585364000">http://cancerindia.org.in/know-about-cancer/</a>2 Stewart BW, Kleihues P. World Cancer Report. Lyon, France: IARC Press; 20033 <a href="https://www.google.com/url?q=https://www.who.int/features/qa/30/en/&amp;sa=D&amp;ust=1553427585365000">https://www.who.int/features/qa/30/en/</a>4 <a href="https://www.google.com/url?q=https://www.tandfonline.com/doi/abs/10.1080/09553000500091097&amp;sa=D&amp;ust=1553427585366000">https://www.tandfonline.com/doi/abs/10.1080/09553000500091097</a>5 <a href="https://www.google.com/url?q=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5394516/&amp;sa=D&amp;ust=1553427585366000">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5394516/</a>6 <a href="https://www.google.com/url?q=https://onlinelibrary.wiley.com/doi/full/10.1111/ijcp.12703&amp;sa=D&amp;ust=1553427585367000">https://onlinelibrary.wiley.com/doi/full/10.1111/ijcp.12703</a>7<a href="https://www.google.com/url?q=https://journals.lww.com/psychosomaticmedicine/Citation/1991/03000/Immunological_changes_in_young_and_old_adults.2.aspx&amp;sa=D&amp;ust=1553427585368000">https://journals.lww.com/psychosomaticmedicine/Citation/1991/03000/Immunological_changes_in_young_and_old_adults.2.aspx</a>8 <a href="https://www.google.com/url?q=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5876785/&amp;sa=D&amp;ust=1553427585368000">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5876785/</a>9 <a href="https://www.google.com/url?q=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3202271/%23&amp;sa=D&amp;ust=1553427585369000">Ayu</a>. 2010 Oct-Dec; 31(4): 417–423.

The treatment options depend on the type of cancer, its location and which stage it is in. &nbsp;For some people, just one form of treatment is required while for others combination of treatment has to be given like a combination of surgery and radiation therapy. There are three modes of treatment -<ol><li>Surgery</li><li>Radiation therapy</li><li>chemotherapy</li></ol><h4>Surgery</h4>Surgery is a good option for localised hard tumours that are contained in one area. &nbsp;Sometimes surgery is the only required treatment to get rid of the tumour. &nbsp;Some surgeries remove the whole tumour while some remove a part to ease the pain or to prevent damage to other organs.Side effects<ul><li>There could be pain in the area where surgery was performed</li><li>Other risk could include infections/bleeding/reaction to anaesthesia.</li></ul><h4>Radiation therapy</h4>This therapy uses high dose of radiation to kill the cancer cells or to shrink them. It works by damaging the DNA of cells. Once the cell die, they stop dividing and are eventually removed by the body.Radiation therapy is sometimes combined with surgery to treat cancer. &nbsp;<ul><li>Before surgery to shrink the size of the tumour so that it is easier to remove by surgery</li><li>During surgery so that the radiation is aimed directly at the tumour and not through the skin, making it more effective to work on the cancer cell</li><li>After surgery, to remove any traces of cancer cells remaining.</li></ul>Side effects - apart from the cancer cells, this treatment also destroys the healthy cells. Depending on the area where the radiation has been given, the side effects differ. &nbsp;However fatigue, hair loss, loss of appetite are one of the common side effects seen from this treatment.<h4>Chemotherapy</h4>Chemotherapy refers to the use of drugs to treat cancer that can help to improve the quality of life or even improve the survival rate of a cancer patient. &nbsp;These drugs can also stop or slow down the growth of cancer cells. &nbsp;These drugs are either used as the only treatment option or in combination with surgery.Side effects - Since chemotherapy causes death of healthy cells also, it can cause many side effects. The cells of mouth, intestine and those that stimulate hair growth are the ones more commonly affected. This can lead to mouth ulcers, nausea, hair loss and fatigue.<h4>Management of Cancer</h4>In case, the cancer is in advanced stages, then steps should be taken by the family members and by the health care providers to try and improve the quality of life of the cancer patient.After active treatment for cancer, a plan can be developed to monitor for cancer recurrence or spread, follow-up for and management of health problems related to cancer treatment.People with cancer may experience psycho social distress at any point from diagnosis through treatment.&nbsp;Psycho social distress is defined as an unpleasant emotional experience that may be psychological, social, or spiritual in nature. These feelings may become severe and disabling, and may result eventually in a diagnosis of major depression. Proper counselings and support enables not only the patients but also the family members to cope with the disease.Nutritional food with supplements, some amount of physical activity, yoga, music therapy and meditation plays an important role and compliment the ongoing cancer treatment.

As per the research done and published in the international research journal of ayurveda, called ‘Ayu’ 9, the efficacy of an Ayurvedic formulation, Rasayana Avaleha, has been evaluated as an adjuvant medication to modern radiotherapy and chemotherapy. it was observed that Rasayana Avaleha&nbsp;gave better results in controlling the adverse effect of chemotherapy and radiotherapy.The herbs that were a part of this Rasayana included, Amalaki, Ashwagandha, Guduchi, Yashtimadhu, Pippali, Tulasi,&nbsp;sugar and ghee. Many of these herbs have high antioxidant activity, stimulates immune system, anti-tumour and anti-ulcer properties and have the ability to regenerate new healthy cells.

Our body has an excellent mechanism to heal itself and prevent any disease. However continuous exposure to the external stressors can lower the defences after a period of time and can act as a trigger for the proliferation of cancer cells.We can follow certain Do’s and Don’ts that can help to prevent cancer.<figure class="image image-style-align-left"><img src="https://lh5.googleusercontent.com/zXSKpjon2MBSAVdyt1ARLlU3WI5M1n4FtV3kkpUEtBYEsTx6uwkD54PF-MX0R8Unu0b8Q6NvffX_sB_Hj8b9i8AFroAfq3OVYDfthP36Q7I6wy6FgxnHrpXOIOZGvem3ph28MKjX"><figcaption>Ways to prevent cancer</figcaption></figure><h4>Do’s</h4>Following a healthy lifestyle<ul><li>Include colored vegetables and fruits5&nbsp;(4-5 servings daily)</li><li>Include whole grain cereals, pulses, millets and avoid refined foods and sugar</li><li>Purchase organic produce as far as possible or from a reliable source</li><li>Exercise daily</li><li>Get enough good quality sleep</li><li>Limit the usage of electronic gadgets especially those that emit radiations.</li><li>Opt for natural products, be it for cosmetics or for other household cleaning agents</li></ul>Maintain a healthy weight<ul><li>Fluctuations in the body weight or excess weight can be an added stress to the body. Maintain a healthy weight with proper diet and exercise.</li><li>Avoid crash diets and follow a healthy lifestyle</li></ul>Manage stress<ul><li>Relaxation techniques, yoga, meditation help to manage stress</li><li>Setting up realistic goals and not being too critical of yourself</li><li>Being socially active - interaction with friends and family</li><li>Indulging in a hobby - art, music, dance, cooking or learning a new skill</li><li>Taking a break once in a while to recharge.</li></ul>Have a positive attitude toward lifeRegular health checkup post 40 years.<h4>Don’ts</h4><ul><li>Avoid tobacco in any form - either smoking or chewing</li><li>Avoid the smoking areas</li><li>Drink alcohol in moderation</li><li>Limit eating out, try to eat home cooked meals as much as possible</li><li>Avoid having sex with multiple partners</li><li>Avoid sedentary lifestyle</li><li>Avoid over exposure to sunlight</li><li>Avoid non-stick cookware or those with teflon coating</li></ul>

In Ayurvedic concept, according to ‘Charaka’ and ‘Sushruta Samhitas’ cancer is described as inflammatory or non-inflammatory swelling and mentioned either as ‘Granthi’ (minor neoplasm) or ‘Arbuda‘ (major neoplasm). Cancer is the result of ‘tridoshas’ (imbalance of Vata, Pitta and Kapha).<h4>Treatment as per ayurveda - Rasayana therapy</h4>Rasayana therapy is one of the eight specialities of the ayurveda. Rasayana Therapy aims towards restoration of health, strengthening of body tissues, increasing life span, preventing diseases and improving quality of life. Rasayana plays a major role in cancer treatment and prevention.How does this therapy work?Rasayana makes each and every cell of the body healthy and thus reduces the risk of cancer progression. Rasayana has no cytotoxic effect on cancer cells, rather it strengthens normal cells and induces programmed cell death in cancerous cells.In the advanced stages of cancer, this therapy helps to prevent further spread of cancer and reduce the burden of tumour.<ul><li>Taken as an adjuvant along with chemotherapy/radiotherapy, Rasayana helps to tolerate/reduce the side effects of these therapies.</li><li>Rasayana also helps to reduce the number of chemo/radiotherapy cycles required to reach the required stage of treatment.</li><li>Rasayana therapy improves the quality of the patient’s life and increases the life span by many folds</li><li>It also helps a lot in reducing the chances of relapse or metastasis especially in patients who have undergone surgery for tumour removal.</li></ul>Benefits of taking rasayana therapy<ul><li>Improve the quality of life without any side effects or toxicity`</li><li>Reduces the side effects of other conventional treatments like chemo/radiotherapy</li><li>Can be taken as an adjuvant along with other conventional treatments</li><li>Rasayana can be taken at home which does not require hospitalisation</li><li>It is considered very beneficial especially in advanced stage cancer patients in which curative goal is not feasible.</li></ul>More details regarding the therapy can be found from the link<a href="https://www.google.com/url?q=http://rasayucancerclinic.com/index.php/cantype&amp;sa=D&amp;ust=1553427585350000">http://rasayucancerclinic.com/index.php/cantype</a>

<figure class="image image-style-align-left"><img src="https://lh3.googleusercontent.com/TSsqSRz3wqJHCIH3F9jUFwxBxU01ZDOT3fEFTokbzQGMLxnmXCcoGvuB6aytv1hD3cKJKMWJkaMcZFzCuBpKwJRNDjiNakLGQfP60pjBT9OQGDjYrTNECY_a9eriWbpyAbKDu9eX"><figcaption>Symptoms of Cancer</figcaption></figure>Cancers that are diagnosed early are easier to treat.

<figure class="table"><table><tbody><tr><td>Cancer is the most feared word among the population.One in 5 men and one in 6 women develop cancer during their lifetime.Most common cancer - breast, cervical, oral, lung and colorectalWhat can cause cancer - tobacco, h.pylori infection, obesity, family history, exposure to environmental chemicals, hormones, chronic inflammation, alcohol, lifestyle, UV raysIdentifying the signs and symptoms, diagnosing the exact stage of cancer and exploring the treatment options available can help to manage cancer and treat it completely at an early stage.</td><td>Signs and symptoms -&nbsp;<ul><li>Unusual bleeding or discharge from any opening in the body</li><li>Hoarseness in voice, difficulty swallowing</li><li>Sore that does not heal</li><li>Change of bowel or bladder habits</li><li>Unexplained weight and appetite loss</li><li>Lumps in any part of the body</li></ul>Treatment options -&nbsp;<ul><li>Chemotherapy</li><li>radiation therapy</li><li>surgery</li><li>ayurvedic rasayana therapy</li></ul>Prevention -<ul><li>Maintain healthy weight</li><li>Regular health check up post 40 years</li><li>Manage stress and stay positive</li><li>Avoid excessive alcohol, smoking</li><li>Proper diet and lifestyle</li></ul></td></tr></tbody></table></figure>With the rise in the incidence of cancer there has been a rise in the efforts to create an awareness towards it. &nbsp;If you meet any person, he would know somebody who is suffering from cancer. &nbsp;The disease has become very common and the need of the hour is to be informed of the disease and the steps taken to prevent or manage cancer.<h3>Statistics1</h3>GloballyThe global cancer burden is estimated to have risen to 18.1 million new cases and 9.6 million deaths in 2018. One in 5 men and one in 6 women worldwide develop cancer during their lifetime, and one in 8 men and one in 11 women die from the disease.Incidence in India<ul><li>Estimated number of people living with the disease: around 2.25 million</li><li>Every year, new cancer patients registered: Over 11,57,294 lakhs</li><li>Cancer-related deaths: 7,84,821</li></ul>Total deaths due to cancer in 2018<ul><li>Total: 7,84,821</li><li>Men: 4,13,519</li><li>Women: 3,71,302</li></ul>Cancer Facts<ul><li>There are more than 100 types of cancers worldwide.</li><li>The five most common types of cancer both in men and women in India include breast, cervical, oral, lung and colorectal cancer.</li><li>One woman dies of cervical cancer every 8 minutes in India.</li><li>As many as 2,500 people die every day due to tobacco-related diseases in India. Use of tobacco products (e.g. smoking cigarettes) are the single most preventable cause of death worldwide.</li><li>Among the occupational cancer, asbestos cancer or cancer caused by long term exposure to asbestos micro fibre has been commonly reported</li><li>Tobacco (smoked and smokeless) use accounted for 3,17,928 deaths (approx) in men and women in 2018.</li><li>4th February is celebrated as world cancer day.</li></ul>

Diagnosis of the cancer cells is done in the following ways:ImagingImaging includes X-rays, ultrasonography, CT (computerised tomography) scan, PET (positron emission tomography) and MRI (magnetic resonance imaging). These scans help to study the tumour and their locationLaboratory testsInclude tests on blood, urine, fluids and other tissues to assess the status of cancer by checking the tumour markers (chemical compounds which increase when cancer is present)Pathological examinationIn most cases, doctors need to do a <a href="https://www.google.com/url?q=https://www.cancer.gov/Common/PopUps/popDefinition.aspx?id%3DCDR0000045164%26version%3DPatient%26language%3DEnglish&amp;sa=D&amp;ust=1553427585339000">biopsy</a>&nbsp;to make a diagnosis of cancer. A biopsy is a procedure in which the doctor removes a sample of tissue. Microscopic evaluation of the tissue is carried out to determine the size of the tumour, its growth into other tissues and organs, the type of cancer cells, and the grade of the tumour (how closely the cancer cells resemble normal tissue).Additional information about cancers is found during surgery. Surgical reports describe the size and appearance of tumours and may include observations about lymph nodes and nearby organs.<h4>Stages of cancer</h4>Knowing the stage of cancer is important since it helps the doctor to decide the best treatment options available. To diagnose the stage, different tests, x-rays, scans and other lab procedures are carried out.<figure class="image"><img src="https://lh6.googleusercontent.com/_0aG5fWcz4N_W_yILcFZHtQ1KIfrq--RduvnSv3cerq9SNpRFnNlPs9FTyEvxcd_a715GnNeEVpYI4SRiW5jy0NahSgyXc2pVW8kJWHIWnGIj5JubsrlmoK4lb1EFvnbnqtEj9x0"><figcaption>Stages of Cancer</figcaption></figure>stage 0 – indicates that the cancer is where it started (in situ) and hasn't spreadstage I – the cancer is small and hasn't spread anywhere elsestage II – the cancer has grown, but hasn't spreadstage III – the cancer is larger and may have spread to the surrounding tissues and/or the lymph nodes (part of the lymphatic system)&nbsp;stage IV – the cancer has spread from where it started to at least one other body organ; also known as "secondary" or "metastatic" cancer

<figure class="image"><img src="https://lh6.googleusercontent.com/7NMX2S56VTrarC-HH38LiTxNMWZmDwnso6uLcLAywMxAHYHrw2fnfa4JiBPJdagV8ko_5m9XsOa4v9g--4uwkI4TkmqF4u9_CHGcW52Qxh9nb6L2n0Nmjrc6cdYNaTpZursgm1c3"><figcaption>Cancer statistics in India</figcaption></figure><figure class="image"><img src="https://lh5.googleusercontent.com/gNZcrhvCQiZunhnG-ALqVg4LW5xBJiWRrKWGnt0d278u6r287EIOcXnUzUL34fJ-0j7QC-eBUq65c0ZK5aiLU1B3VhnERtK9pBjPsHveP7k3kxW4fE1fqj0denvgio0EBRAR9cJ1"><figcaption>Risk factors for cancer</figcaption></figure>It is difficult to point out why cancer develops in some people&nbsp;and spares others, however there are a few risk factors that have been shown to increase the susceptibility of developing cancers. Not everyone with the below mentioned risk factors are susceptible to cancer. &nbsp;The occurrence of cancer depends on the immunity, duration of exposure to the carcinogens, genetic predisposition and so on.<h4>Tobacco</h4>It is the leading cause of cancer or death due to cancer worldwide. People who smoke and those who are exposed to passive smoking are both at a high risk for cancer. &nbsp;<ul><li>Tobacco smoke is made up of more than 7,000 chemicals, including over 70 known to cause cancer (carcinogens). Some of these substances cause heart and lung diseases, too, and all of them can be deadly.</li><li>Tobacco smoke also contains tar and the poison gases&nbsp;carbon monoxide and nitrogen oxide which are carcinogenic in nature.</li><li>Nicotine, a chemical which gives a ‘kick’ to the smoker is highly addictive and one of the potent cause of cancer.</li><li>The tobacco leaves used to make cigarettes and cigars contain radioactive materials; These radioactive particles build up in the lungs, and over time can mean a big dose of radiation. This may be another key factor in smokers getting lung cancer.</li><li>Smoking tobacco reduces the immunity and also causes damage to DNA.</li><li>People using smokeless tobacco, like snuf or chewing tobacco have increased risk of cancers of mouth, esophagus and pancreas.</li></ul><h4>Infections</h4><ol><li>HPV&nbsp;- The human papilloma virus basically infects the skin and the mucous membrane. For many people infected with the virus, there is no sign or symptom and generally the infection goes away on its own. HPV is the most common sexually transmitted disease which is spread by close contact with the infected person. The main type of cancer linked to HPV is cervical cancer.</li></ol><figure class="image"><img src="https://lh4.googleusercontent.com/ekOkIyFrfnJjsKEqb_eLKwIML4AM7d-l4Sbw9QtqufZQcOlrexe7riN1OZASHqfyVOlvNgVvm5yvs7bNXXNu1ljQiTGkFul_ftyZsuOYsXSuDII7V42lK4AQd61UMAomJ35JJOXF"><figcaption>Cancer caused by HPV</figcaption></figure><ol><li>H.Pylori - is a bacteria that can survive in the stomach lining and cause infection of stomach and duodenum. &nbsp;Once infected, the person stays infected for life unless antibiotics are given to treat them. &nbsp;They can cause inflammation in the stomach, ulcers and is said to be one of the risk factors for developing stomach cancer in people with lower immunity levels.</li><li>Hepatitis&nbsp;- Hepatitis B and C virus have been known to cause cancer. This virus spreads through blood contact, for example usage of infected needles, blood transfusions, toothbrushes, razors and through unprotected sex. These viruses can cause liver cancer and non-hodgkin's lymphoma.</li></ol>The above infections are the most common cause of cancers. &nbsp;Apart from them, there have been few incidences of cancer<ul><li>From people suffering from AIDS, HIV&nbsp;lowers the immunity and makes the cells of the body susceptible to cancer formations.</li><li>EBV, or Epstein-Barr virus, is a very common virus – more than 9 in 10 people are infected worldwide. It spreads through saliva. The virus infects a type of cell called ‘B-cells’ that form part of our immune system – the body’s defence against disease. This is another factor for developing cancer.</li></ul><h4>Family History</h4>An increased risk of developing certain cancers can be inherited in the genetic material passed from generation to generation, accounting for up to 4 percent of all cancers world wide2.<ul><li>Some faulty genes that increase the risk of cancer can be passed on from parent to child. These are called inherited cancer genes.</li><li>However for the gene to manifest in the form of cancer, some environmental factors like tobacco/certain chemicals can act as a trigger.</li></ul><h4>Obesity and Insulin resistance</h4><figure class="image"><img src="https://lh6.googleusercontent.com/XPnrxLrNVXElwh9fU0U6gZXY69u2b9cQj5fZXlaaFkGidJbqMnY1I_0AvEDhiX0JJxPOGXXgRaLcFKg1ZvejGY57yNPoaiejgvmFXWO2qUfaI0I6u9llWBmFRajggQyWRjvNBqpx"><figcaption>Obesity and cancer</figcaption></figure>Obesity also leads to insulin resistance where the body is unable to utilise insulin effectively to absorb glucose from the blood. &nbsp;The cancers of colon, pancreas and liver are associated with insulin resistance.<h4>Other likely causes for developing cancer</h4><ol><li>Age&nbsp;- the cancer risk increases with the age. The risk is higher when there is a family history of some relative who had cancer.</li><li>Alcohol - excessive drinking causes 7 types of cancer, including breast, mouth and bowel cancer.</li><li>Pollution&nbsp;- Pollution of the air (indoor and outdoor), water, and soil causes an estimated 1 to 4 percent of all cancers worldwide. Smoke from car or from burning coal/wood are potential carcinogens. Overuse of chemical fertilisers and pesticides and poor water quality add to the risk.</li><li>Ultraviolet radiation&nbsp;- Natural UV radiation from the sun have been known to cause skin cancer, however the incidence is very low.</li><li>Cancer risk in workplace&nbsp;- occupational risks include those working in mines due to exposure to coal products, silica and other chemicals, those working in the chemical industry, exposure to solvents and paints etc.</li><li>Hormones&nbsp;- Hormone replacement therapy, oral contraceptive or exposure to synthetic hormones either in milk or other products can be a trigger.</li><li>Lifestyle&nbsp;- a diet low in cancer preventing fruits and vegetables, whole grains plus low levels of physical activity have been known to be a risk factor in developing cancer.</li><li>Chronic inflammation&nbsp;- Chronic inflammation can be caused by viral or bacterial infections, autoimmune diseases and inflammatory conditions of unknown origins. They have been known to increase the risk of cancer.</li></ol>

<h4>Bursting Myths&nbsp;on Cancer</h4>You will not get cancer if no one in your family has cancer - MythThere is no guarantee that you will not have cancer if there is no family history of cancer. Only 5-10% are familial or hereditary. The rest are caused due to changes in the genetic material owing to environmental factors, lifestyle factors, age and so on.Cancer is a death sentence - MythDiagnosis of cancer does not mean a person will die in a short period of time. With the advancement in medical field, there has been an increase in the survival rates. Again, the earlier the diagnosis, better are the survival rates.Cell phones cause cancer - MythTo date there has been no convincing evidence of use mobile phones or mobile towers leading to cancer. Studies to date provide no indication that environmental exposure to RF (radiofrequency fields, such as from base stations, increases the risk of cancer or any other disease3Animal studies also does not give any conclusive evidence of the same4Cancer can be very painful - MythCancer in the initial stages will not cause pain. However if the cancer cells continue to divide and expand, it may become painful. There are medications and other pain management techniques to deal with the pain sufficiently.Cancer is contagious - MythCancer is not contagious. However certain cancers are caused by viruses which can spread on contact from one person to another leading to infections. Having said that, a person with the virus can develop cancer but another person with the same virus may not develop cancer. It all depends on the genetic susceptibility and the immune response of that person.People with cancer cannot perform the regular activities and are bound to bed for life - MythMany people need to stay in hospital for cancer treatment for a short duration only. They can do their regular activities, take care of family, do part time or full time job, pursue their hobby and so on even with the ongoing cancer treatment.Person’s attitude determines the recovery from cancer - Myth<a href="#cmnt1">[a]</a>There is no convincing data or evidence that links a person’s attitude to cure of the cancer. It is normal to feel sad, angry, hopelessness for a person diagnosed with cancer. However there are research papers which showed lowered immunity in people with high psychological stress7The psychological well-being could improve the human body immune responses, enhance resistance towards diseases (including infectious diseases), and create a spiritually and physically more prosperous life8.Cancer is caused by food colours and artificial sweeteners - MythAgain, there is no scientific backing supporting the same. Certain reports do suggest that a person can be susceptible to cancer on a long term and heavy intake of such food additives6, but more research needs to be done in this area to get a conclusive evidence.

Cancer 

Since the cause of IBS is not due to a single factor, the treatment approach also is multifactorial. The major role of any intervention is to address the root cause and improve the quality of life.<figure class="table"><table><tbody><tr><td>To get symptomatic relief and improve quality of life</td><td>&nbsp;</td></tr><tr><td>Avoid/Restrict</td><td>include</td></tr><tr><td><ul><li>Wheat</li><li>Dairy</li><li>Whole legumes like kidney beans, garbanzo beans</li><li>Artificial sweeteners, caffeine, chocolates, alcohol</li><li>Very spicy and fried food</li><li>Highly processed and commercial food</li><li>Certain fruits with high fructose content</li><li>Certain vegetables like garlic, onion, leek</li></ul></td><td>Foods with soluble fibre -<ul><li>Oats, barley</li><li>Citrus fruits, banana, avocado</li><li>Some vegetables like carrots, sweet potato</li><li>Nuts</li></ul>Other lifestyle measures -<ul><li>Fluids - 2 liters of water, herbal tea, green tea</li><li>Probiotics</li><li>Exercise everyday</li><li>Fixed timings for eating and sleeping</li><li>Stress management</li><li>Ayurvedic and alternative therapies</li></ul></td></tr></tbody></table></figure>It is better to find the cause that is triggering IBS and treat the same than treating the symptoms alone.The treatment options are based on addressing the cause of IBS and they include -<ol><li>Medicines</li><li>Dietary changes</li><li>Lifestyle changes</li><li>Stress management</li><li>Alternate therapies</li></ol><h3>Medication4</h3>A number of different medications can be used to help treat IBS, including:<ul><li>antispasmodics&nbsp;– which help reduce abdominal (stomach) pain and cramping by relaxing the muscles of the digestive tract. Commonly used is peppermint oil capsule</li><li>laxatives&nbsp;– which can help relieve constipation by softening the stools and allowing smooth passage.</li><li>antimotility medicines&nbsp;– which can help relieve diarrhoea. This works by slowing down the passage of stools through the digestive tract thereby hardening the stools.</li><li>Low-dose antidepressants&nbsp;– which were originally designed to treat depression, but can also help reduce stomach pain and cramping independent of any antidepressant effect. They work by preventing signals being sent to and from the nerves in your digestive system.</li></ul><h3>Lifestyle modification to manage IBS</h3>Here are a few lifestyle modifications that can help in dealing with IBS.Exercise regularlyStudies were done to examine the relationship between the physical activity and bowel movements. It was found that there exist a positive association between increasing physical activity and mean bowel movements.Physical activity could improve gastric motility and prevent stomach cancer. Not only IBS, there is also consistent improvement in general health on including at least 30 min of moderate to high intensity exercise 5 days a week.Stress ManagementAlthough it has not been proven that stress leads to IBS, it is seen that inability to manage stress exacerbates the IBS condition.<ul><li>Practice yoga and meditation to relieve stress</li><li>Involving in a hobby or any activity that helps you to de-stress</li><li>Certain relaxation techniques under the guidance of a psychologist can help to manage stress.</li></ul>Adequate sleepDisturbed sleep i.e.waking up couple of times after the sleep onset can lead to aggravation of IBS11. &nbsp;Research suggests that sleep disturbances lead to greater abdominal and somatic pain reporting in IBS patients12.Sleeping and waking up at the same time everyday helps to set our body clock giving good quality sleep.&nbsp;

There are no specific tests for detecting IBS. Doctors generally rely on the<ul><li>patient’s medical history,</li><li>signs and symptoms and the duration of time that the symptoms were present.</li><li>stool test in case of infection</li><li>certain blood tests to rule out other conditions like celiac disease that have similar symptoms.</li><li>Further testing like colonoscopy (procedure to see inside of the large intestine) may be recommended if there is a family history of stomach or colon cancer.</li></ul>

In the nutshell, Irritable bowel syndrome has no cure. However with many medications, ayurvedic applications, yoga and alternative therapies, it is possible to manage the disease and improve the quality of life.No matter what course of treatment one opts for, it is better to keep your doctor into the loop who would be the best judge to decide the type of treatment required to manage the disease.<hr>References<ol><li><a href="https://www.google.com/url?q=https://www.sciencedirect.com/science/article/pii/002239999290025W&amp;sa=D&amp;ust=1558076375180000">https://www.sciencedirect.com/science/article/pii/002239999290025W</a></li><li><a href="https://www.google.com/url?q=https://bmcgastroenterol.biomedcentral.com/articles/10.1186/1471-230X-10-23&amp;sa=D&amp;ust=1558076375180000">https://bmcgastroenterol.biomedcentral.com/articles/10.1186/1471-230X-10-23</a></li><li><a href="https://www.google.com/url?q=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3468846/&amp;sa=D&amp;ust=1558076375181000">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3468846/</a></li><li><a href="https://www.google.com/url?q=https://www.nhsinform.scot/illnesses-and-conditions/stomach-liver-and-gastrointestinal-tract/irritable-bowel-syndrome-ibs%23treating-ibs&amp;sa=D&amp;ust=1558076375181000">https://www.nhsinform.scot/illnesses-and-conditions/stomach-liver-and-gastrointestinal-tract/irritable-bowel-syndrome-ibs#treating-ibs</a></li><li><a href="https://www.google.com/url?q=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3468846/&amp;sa=D&amp;ust=1558076375182000">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3468846/</a></li><li><a href="https://www.google.com/url?q=https://www.jillcarnahan.com/2011/09/18/fodmaps-the-diet-that-may-eliminate-your-ibs-symptoms/&amp;sa=D&amp;ust=1558076375182000">https://www.jillcarnahan.com/2011/09/18/fodmaps-the-diet-that-may-eliminate-your-ibs-symptoms/</a></li><li><a href="https://www.google.com/url?q=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4918736/&amp;sa=D&amp;ust=1558076375182000">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4918736/</a></li><li><a href="https://www.google.com/url?q=https://www.ncbi.nlm.nih.gov/books/NBK51960/&amp;sa=D&amp;ust=1558076375183000">https://www.ncbi.nlm.nih.gov/books/NBK51960/</a></li><li><a href="https://www.google.com/url?q=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2886445/&amp;sa=D&amp;ust=1558076375183000">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2886445/</a></li><li><a href="https://www.google.com/url?q=https://onlinelibrary.wiley.com/doi/full/10.1111/apt.13677&amp;sa=D&amp;ust=1558076375183000">https://onlinelibrary.wiley.com/doi/full/10.1111/apt.13677</a></li><li><a href="https://www.google.com/url?q=https://link.springer.com/article/10.1007/BF01296103&amp;sa=D&amp;ust=1558076375184000">https://link.springer.com/article/10.1007/BF01296103</a></li><li><a href="https://www.google.com/url?q=https://onlinelibrary.wiley.com/doi/full/10.1111/apt.13677&amp;sa=D&amp;ust=1558076375184000">https://onlinelibrary.wiley.com/doi/full/10.1111/apt.13677</a></li><li><a href="https://www.google.com/url?q=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3923011/&amp;sa=D&amp;ust=1558076375184000">https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3923011/</a></li><li><a href="https://www.google.com/url?q=https://onlinelibrary.wiley.com/doi/full/10.1111/j.1365-2036.2006.02776.x&amp;sa=D&amp;ust=1558076375185000">https://onlinelibrary.wiley.com/doi/full/10.1111/j.1365-2036.2006.02776.x</a></li></ol>

According to ayurveda, IBS is a disease which manifests mainly due to imbalance in agni and doshas, specifically Vata dosha. Ayurveda involves a three tier treatment for IBS -Medicines<ul><li>Rasayan treatment helps in treating inflammation and improving peristalsis.</li><li>Medicines like praval panchamruta, kamdudha, shankhavati are extremely beneficial in helping treat inflammation but one has to take it under medical guidance.</li></ul>Lifestyle management<ul><li>Avoiding oily, spicy food, non veg, heavy to digest food like chole, rajma or legumes etc especially in evening meals.</li><li>Sleeping in time and having early dinners helps a long way in treating the disease.</li><li>Junk food, processed food, stale food, refrigerated food, cold drinks, food with refined flour ( maida ) etc should be completely avoided.</li><li>The meals should be in regulated amounts , overeating has to be avoided. Sleeping immediately after meals or sitting for long hours needs to be avoided to improve digestion.</li></ul>Exercise &amp; yoga<ul><li>Daily pranayama , meditation helps in relieving stress and mild to moderate exercise is helpful in reducing the symptoms to a great extent.</li></ul><h3>Complementary and alternative&nbsp;medicine (CAM)</h3>Mind-body therapies have been evaluated for their potential application as CAM in IBS. Clinical evidence supporting the use of yoga, relaxation, acupuncture, hypnotherapy, and cognitive behavior therapy is indicating that these CAM interventions show improvement in IBS symptoms and overall quality of life13.Acupuncture&nbsp;- has been one of the CAM that has been researched and found to be effective in reducing the symptoms of IBS.It has been shown that application of acupuncture in IBS patients reduces cortisol levels (stress&nbsp;hormone)13Hypnotherapy&nbsp;- A total of 14 published studies were reviewed on the efficacy of hypnosis in treating IBS (eight with no control group and six with a control group).They concluded that hypnosis consistently produces significant results and improves the cardinal symptoms of IBS in the majority of patients.However it is best to consult a medical professional before starting on any of the alternative therapies.

<figure class="table"><table><tbody><tr><td>What causes IBS?<ul><li>Food passing quickly through intestine causing diarrhoea</li><li>Food passing slowly through the intestine causing constipation</li><li>Emotional stress</li><li>Viral or bacterial infection</li><li>Family history</li><li>Excessive growth of bacteria in intestine</li><li>Deficiency of zinc</li></ul></td></tr></tbody></table></figure>The exact cause of IBS is not known. It is believed that IBS can be caused due to digestion related issues or can be a result of any emotional stress.Causes include -<ul><li>Digestion issues/motility changes</li></ul>Food either passes too quickly through the intestines causing diarrhoea or it passes too slowly causing constipation. The reason can be a disruption in the signal between the brain and the gut.<ul><li>Psychological factors</li></ul>Research shows the association between the gut and the brain. The nerves in the stomach is sensitive to the psychological changes.Any type of emotional stress/tragic incidence/stressful situations/abuse can cause changes in the digestive function triggering IBS.Also people suffering from IBS have been known to show traits like anxiety, depression and so on making this a vicious&nbsp;cycle of IBS-mental disorder-IBS1.Getting a professional help to deal with the emotional stress and including yoga/meditation can help in managing this condition.<ul><li>Infections</li></ul>Any bacterial/viral infection causing inflammation in the stomach lining can trigger off IBS. One of the symptoms include itching in the rectum area. Taking proper medications (antifungal or antibiotics) plus supplementing the diet with probiotics, the disease can be controlled and managed.<ul><li>Excessive bacteria in the small intestine -</li></ul>Small intestinal bacterial overgrowth (SIBO) is a condition in which excessive levels of bacteria are present in the small intestine. Recent data suggest that SIBO may contribute to the pathophysiology of Irritable bowel syndrome2.SIBO can be diagnosed with a breath test (that measures gas produced by bacteria) and a urine test (analyses the byproducts produced by bacteria)Treatment with antibiotics and dietary changes help to reduce the bacterial overgrowth.<ul><li>Genetic susceptibility&nbsp;-</li></ul>Studies published to date suggest that there is evidence of genetic susceptibility to IBS. One&nbsp;study showed that patients with IBS were more likely to present a family history of IBS than controls (33.9% and 12.6%, respectively)3.<ul><li>Nutrient deficiency -</li></ul>Deficiency of zinc has been known to cause infectious and persistent diarrhoea. It can be one of the causes for IBS-D. The reason being, low levels of zinc inturn lowers the immune system making the body susceptible to infections.<h3>Who are at risk for developing IBS</h3><figure class="table"><table><tbody><tr><td>What triggers IBS in susceptible people?<ul><li>Women are more prone to IBS than Men</li><li>Food with gluten, lactose, highly processed and fried food.</li><li>Antibiotics or medicines that interfere with gut bacteria</li><li>Personality traits - those with anxiety/depression</li></ul></td></tr></tbody></table></figure>It is not possible to pinpoint at a particular risk factor but a few conditions make people more susceptible to IBS than others. They include -<ul><li>Gender&nbsp;- women are twice more prone to IBS than men. Changing hormonal levels can be one of the triggers for IBS.</li><li>Age&nbsp;- IBS is more common in the young age group of 20-40 years than in people over 50 years.</li><li>Food&nbsp;- certain food act like IBS triggers. These triggers vary from person to person but common ones include - dairy, wheat, high caffeine drinks, fried foods, processed foods like cookies or chips, chocolates, alcohol</li><li>Personality traits - &nbsp;Personality traits and emotional patterns play key roles in affecting autonomic, immune, inflammatory, and endocrine functions, thus contributing to disease physiopathology.</li><li>Medicines&nbsp;- some antibiotics can affect the gut microbes and can trigger IBS.</li></ul>

For some people, the symptoms are generally bad immediately after eating. For others, symptoms flare up and stay for a few days before subsiding.Many of the symptoms of IBS generally overlaps with the symptoms of other diseases. Hence IBS is generally not diagnosed at the right time.Symptoms of IBS include,<ul><li>Change in the appearance and/or structure of the stools</li><li>Abdominal pain or bloating</li><li>Diarrhoea/constipation or incomplete bowel movements</li><li>Flatulence</li><li>Passing of mucus in the stools</li><li>Discomfort in the stomach which is relieved after passing the stool</li></ul><h3>Consequence of IBS in the long term</h3>Although IBS is not life threatening, it can greatly lower the quality of life. The symptoms can vary both with respect to type and degree. It can be severe enough to require hospitalisation.Hence certain steps should be taken to keep the disease in control and avoid flare ups.IBS if left untreated can lead to the following -<ul><li>Dehydration&nbsp;- if diarrhoea is present and for a long period of time it may lead to dehydration if proper fluids and electrolytes are not provided on time.</li><li>Nutritional deficiency&nbsp;- since intestine is the place where the nutrients are absorbed, diarrhoea could lead to malabsorption of nutrients causing deficiency disorders.</li><li>IBS can cause undue stress&nbsp;to manage the disease leading to anxiety and depression.</li></ul>

IBS is classified into four types based on the stool consistency. It is important to know the type of IBS to decide the course of treatment that needs to be taken to manage the disease.<figure class="image"><img src="https://lh6.googleusercontent.com/2RM-oyl8pF7gdoswYOyY2K8mQ26m1ufT84aTV8PWstydcXShDuNpLTfYZzZlPWn5my3ejTt1z7aeGzkrWKdMTHOCc0PXf_mJhZJdrn9ptrZfpvTIcUxWA9m_83v1Y32hB5Pt9i9t"><figcaption>Types of IBS</figcaption></figure><h4>BS - C (IBS with constipation)</h4>In this case, more than 25% of the stools are hard and painful to pass especially during IBS flare ups. In certain cases less than 25% of the time people experience watery stools and diarrhoea.There is bloating followed by abdominal pain during constipation. Increasing fibre and fluid intake helps to get rid of constipation and manage IBS.<h4>IBS - D (IBS with diarrhoea)</h4>It is the complete opposite of IBS- C. In this condition, more than 25% of the stools are watery while less than 25% of the stool is hard and lumpy. Bloating and abdominal pain are other symptoms. There is no bowel controlPsychological stress and certain foods are triggers for this type of IBS. Proper counseling/therapy coupled with antidiarrheal medication and food restriction is required to bring the condition under control<h4>IBS - M (Mixed IBS)</h4>Those with IBS will suffer alternating bouts of constipation and diarrhoea. This means diarrhoea and constipation are experienced during the same flare-up. In this case, triggers will need to be identified in order to balance treatmentsIBS - U (Unsubtyped IBS)People with this type of IBS do not experience any irregularities with respect to their stools. The symptoms experienced by patients with IBS-U includes -<ul><li style="text-align:justify;">Gas</li><li style="text-align:justify;">Cramping</li><li style="text-align:justify;">Bloating</li><li style="text-align:justify;">Mucus in the stool</li><li style="text-align:justify;">Abdominal pain and discomfort</li></ul>

&nbsp;Food intolerances or allergies are strong contributors to the exacerbation of IBS symptoms. Individuals with IBS often discover that certain foods aggravate symptoms while others have found relief from IBS symptoms by modifying their daily diet.Foods to be included in the dietThe standard procedure is to increase the amount of dietary fibre to manage the symptoms of IBS since a diet low in fibre is believed to be one of the reasons for the onset of IBS5.Including the food in the given list that are rich in fibre helps with IBS-C.<ul><li>Oats and oatmeal</li><li>Barley</li><li>Legumes like peas, beans etc</li><li>Fruits like apple, citrus fruits, bananas, avocados, figs, guava, pear</li><li>Vegetables like carrots, sweet potatoes, broccoli,</li><li>Nuts like flax seeds, sunflower seeds, hazel nuts</li><li>Sufficient fluid intake to support the fibre intake</li></ul>Foods to be restrictedInsoluble fibre (which does not get digested in the stomach) present in certain food can lead to bloating and gas.Apart from the fibre, lactose, gluten and some forms of carbs present in the food can aggravate IBS. Given below are the food items that can trigger IBS and need to be restricted - &nbsp;<ul><li>Wheat and wheat products, rye, garlic, onion, legumes like kidney beans, dry peas and whole gram, leek</li><li>Dairy and products like curd, yoghurt, cream, cheese, milk powder, condensed milk and desserts made with milk/milk products</li><li>Fruits like mango, watermelon, pears, cherries, plums can lead to bloating in susceptible people</li><li>Artificial sweeteners especially those containing mannitols or xylitols.</li><li>Ready to eat and commercially processed items containing refined flour and additives.</li></ul>Once the restriction has brought about symptomatic relief, the next step would be to reintroduce the foods listed under restricted section, one by one. This will give an idea of the foods that exacerbate the IBS symptoms.After the triggers have been identified, it is better to maintain a food diary to keep an account of the foods that trigger IBS and avoid them in the future while returning to the normal diet.<h3>Dietary tips</h3>Since IBS cannot be completely cured, certain modifications in our day to day life can help to improve the quality of life &nbsp;and manage IBS.<ul><li>Have regular meals and take time to eat.</li><li>Avoid missing meals or leaving long gaps between eating.</li><li>Drink at least eight cups of fluid per day, especially water or other non-caffeinated drinks, for example herbal teas.</li><li>Restrict tea and coffee to three cups per day.</li><li>Reduce intake of alcohol and fizzy drinks.</li><li>It may be helpful to limit intake of high-fibre food (such as wholemeal or high-fibre flour and breads, cereals high in bran, and whole grains such as brown rice).</li><li>Reduce intake of ‘resistant starch’ (starch that resists digestion in the small intestine and reaches the colon intact), which is often found in processed or re-cooked foods.</li><li>People with wind and <a href="https://www.google.com/url?q=https://www.ncbi.nlm.nih.gov/books/n/nicecg61/glossary/def-item/glossary.gl1-d15/&amp;sa=D&amp;ust=1558076375173000">bloating</a>&nbsp;may find it helpful to eat oats (such as oat-based breakfast cereal or porridge)</li></ul>Use of probiotics for IBSThere is some evidence that certain probiotics may help improve irritable bowel syndrome (IBS) symptoms. Probiotics are the good bacteria that regulate the gut microbiome.Changing the gut microflora using probiotics have been helpful in giving symptomatic relief from gas and bloating in people with IBS9. Probiotics can regulate bowel function including motility, sensation, and immune function.The type and duration of the probiotic course would depend on the severity of IBS and hence must be taken after consultation with a professional healthcare practitioner.

<figure class="table"><table><tbody><tr><td>The incidence of IBS is increasing with 10-20% of the population affected globallyIBS has symptoms like abdominal pain, diarrhoea/constipation/bloating which interferes in the day to day activitiesThe cause of IBS is multifactorial which include age, genetics, diet, environmental and lifestyle triggers.Understanding the root cause and complimenting the medicines with alternative therapies can help to improve the quality of life and manage IBS symptoms.</td><td><h4>Treatment options</h4><ul><li>Diet&nbsp;- inclusion of fibre and probiotics, avoidance of food with gluten, lactose and other triggers.</li><li>Lifestyle modification&nbsp;- exercise daily, good quality sleep, yoga and meditation</li><li>Ayurvedic treatment - three tier approach of diet, lifestyle changes and herbal medication.</li><li>Alternative therapies&nbsp;- acupuncture, hypnotherapy</li></ul></td></tr></tbody></table></figure><h4>What is IBS</h4>IBS is irritable bowel syndrome. This is a condition characterised by increased abdominal pain, bloating and discomfort associated with a change in bowel habits (constipation or diarrhoea or both).These symptoms occur without any visible change or damage to the digestive system.<h4>Prevalence</h4><ul><li>This condition affects the large intestine.</li><li>About 10-20% of the population globally are affected by IBS</li><li>This disorder is more common in women than men and develops between the age of 20-30 years.</li><li>This disease is lifelong but can be managed with proper diet and lifestyle changes</li><li>IBS is also known by the names spastic colon, mucous colitis, nervous colon and spastic bowel</li></ul>&nbsp;

Irritable bowel syndrome (IBS)

Including Vitamin D rich food and exposing to the sunlight are some of the ways to prevent or manage the deficiency.SunlightThirty minutes of exposure of the skin over the arms and face to sunlight, without application of sunscreen, preferably between 10 am to 2 pm (as maximum ultraviolet B rays are transmitted during this time) daily is required for adequate synthesis of vitamin D.Diet - the dietary sources are both from vegetarian and nonvegetarian sources:<ul><li>Fatty fish, like tuna, mackerel, and salmon</li><li>Foods fortified with vitamin D, like some dairy products, orange juice, soy milk, and cereals</li><li>Beef liver</li><li>Cheese</li><li>Egg yolks</li></ul>Supplements - many supplements with a combination of calcium and vitamin D3 are available and can be taken in chronic deficiency.

<figure class="image"><img src="https://lh3.googleusercontent.com/Wd7A5zcUuMhRo9yLD-ujyU5V6HIeuop6eKTqYjgimNgdGm4K5PI1Ab4gLwJ6jP9BUbVe8CzxOWNip6G8nxwF6yGTqOIVe17DQaUN163yD1t6bT2URuM59zTa1jVzIttwMKObZA0z"><figcaption>Levels of Vitamin D in blood</figcaption></figure>Since many of the symptoms of VDD is often similar to those seen in other diseases, its prevalence is sometimes overlooked and the deficiency goes undetected. &nbsp;Some of the common symptoms seen are:<ul><li>Low immunity&nbsp;- cold, flu, respiratory infections occur more often.</li><li>Fatigue&nbsp;- severe low levels of Vitamin D in blood can lead to tiredness and a negative effect on the energy levels.</li><li>Back pain&nbsp;and pain in the legs, ribs, joints - since Vitamin D is responsible for calcium absorption and bone health, its deficiency can lead to low calcium levels leading to back pain.</li><li>Poor wound healing - its been found that people with VDD have poor wound healing with high susceptibility of having inflammation and infection.</li><li>Rickets&nbsp;characterised by soft bones in children with VDD.</li><li>Hairfall&nbsp;- severe hair fall is very common among women with VDD.</li></ul><h4>Complications of VDD</h4><ul><li>Osteomalacia - Softening of bones making a person prone to fractures. &nbsp;If the deficiency is not corrected then in the long run, it can cause osteoporosis where bone density decreases leading to fractures especially those of hip and wrist.</li><li>Diabetes - VDD has been linked to retinopathy in type 2 diabetics. (<a href="https://www.google.com/url?q=https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5372970/%23&amp;sa=D&amp;ust=1553237143034000">Nutrients</a>. 2017 Mar; 9(3): 307)</li><li>Cardiovascular diseases&nbsp;- studies have shown the association between VDD and inflammation in the body which can lead to cardiovascular diseases.</li><li>Chronic Kidney disease (CKD)&nbsp;- VDD is especially seen in patients with CKD. &nbsp;It has been characterised by the presence of low grade inflammation which has been an important factor in progression of CKD. (<a href="https://www.google.com/url?q=https://www.ncbi.nlm.nih.gov/pubmed/23239393%23&amp;sa=D&amp;ust=1553237143035000">Pediatr Nephrol.</a>&nbsp;2013 Apr;28(4):605-10)</li><li>Neurocognitive degeneration&nbsp;- recent studies have found an association between dementia, cognitive impairment and VDD.</li></ul>

<ul><li>Geographic location - People living at high latitude and away from the equator will have less exposure to the sun all year around. &nbsp;They are prone to VDD.</li><li>Skin tone -&nbsp;dark skin tone has more melanin pigment in them which acts as a natural sunscreen inhibiting the synthesis of Vitamin D in the skin. &nbsp;This is the reason why more percentage of African americans have VDD.</li><li>Age&nbsp;- The ability to make Vitamin D decreases with age and hence elderly population have low Vitamin D levels.</li><li>Obesity&nbsp;- the bioavailability of Vitamin D decreases in obese people making them susceptible to VDD (The American Journal of Clinical Nutrition, Volume 72, Issue 3, 1 September 2000, Pages 690–693)</li><li>Lifestyle&nbsp;- Spending less time outdoors, covering up completely with clothing while going out and judicious application of sunscreen even while going out for a short duration prevents the synthesis of Vitamin D by the skin.</li><li>Diet&nbsp;- eating food restricted in dairy, fish, fortified milk and cereals can lead to deficiency.</li></ul>

The bottom line is, say no to processed foods and yes to home cooked food. &nbsp;Including fresh produce with whole grains with the required exposure to the sunlight, keeps the nutritional deficiencies at bay and helps you to lead a happy and healthy life!&nbsp;

&nbsp;&nbsp;<figure class="table"><table><tbody><tr><td>Vitamin D functions -&nbsp;For musculo-skeletal health, to make calcium more bio available to the body,&nbsp;hormonal health, for immunity and for cancer prevention.What leads to deficiency? Lifestyle factors, inadequate exposure to sunlight and age.Complications of deficiency - can affect the heart, kidney, nerves and bones, can also lead to diabetes mellitusIdeal dose - 10 mg for children, pregnant and lactating women, 5 mg for normal adults</td><td>Symptoms -&nbsp;<ul><li>Hairfall</li><li>Rickets</li><li>Poor wound healing</li><li>Back pain</li><li>Fatigue</li><li>Low immunity</li></ul>Sources -&nbsp;<ul><li>supplements in case of severe deficiency</li><li>diet - mushrooms, egg yolk, cheese, fatty fish, liver, fortified foods</li><li>30 minutes of sunlight exposure daily,</li></ul></td></tr></tbody></table></figure>While the world is talking about obesity, diabetes and other chronic problems, there has been a silent rise of nutritional deficiencies in the overall population. &nbsp;Malnutrition has two faces. &nbsp;One side resulting from over nutrition like obesity due to excess calories and low physical activity. &nbsp;The other side is under-nutrition especially micro-nutrient deficiency triggering other health problems.Earlier malnutrition was equated with lack of food availability and poverty. &nbsp;Of late malnutrition is more due to lack of quality than quantity. &nbsp;Food is readily available but the quality has dwindled of late which may be due to the following factors:<ul><li>Substandard quality of fruits and vegetables available</li><li>Improper food choices leading to imbalance of macro and micro nutrition</li><li>Lack of nutritional knowledge</li></ul><h4>Deficiency of Vitamin D</h4>Vitamin D, also called as the Sunshine vitamin since body synthesises it in presence of sunlight, is a fat soluble vitamin which is required for a number of functions in the body.Deficiency of Vitamin D (VDD) has become quite common now with more than 75% population of varied age group suffering from it. &nbsp;<figure class="image"><img src="https://lh6.googleusercontent.com/g74cHiuk3rg4aHNLuC-2IEPq-WZg7RZ_FFR1gjGD09ILQ4HurwuVpQPfdcZE9zHvll0E26BBNjvRFLPL47jf_dGwIg1tDEnw0DcqktKcxa-Pb9_LwggdttIsPiW-i9eVcskf4jFq"></figure><h4>Function of Vitamin D</h4><ul><li>Help in skeletal development and bone health</li><li>Required for absorption of calcium in the body</li><li>Required for neuro-muscular development.</li><li>For hormonal health</li><li>Help in building immunity of the body (<a href="https://www.google.com/url?q=https://www.ncbi.nlm.nih.gov/pubmed/20824663%23&amp;sa=D&amp;ust=1553237143028000">Mol Nutr Food Res.</a>&nbsp;2011 Jan;55(1):96-108.)</li><li>Cancer prevention - Studies suggest the protective effect of Vitamin D and lower incidence of cancer. (<a href="https://www.google.com/url?q=https://ajph.aphapublications.org/loi/ajph&amp;sa=D&amp;ust=1553237143029000">American Journal of Public Health (AJPH)</a>&nbsp; <a href="https://www.google.com/url?q=https://ajph.aphapublications.org/toc/ajph/96/2&amp;sa=D&amp;ust=1553237143029000">February 2006)</a></li></ul>

Vitamin D deficiency

<ul><li>Thyroid nodules: are abnormal overgrowth of tissue in the thyroid gland that are most often benign—but may be cancerous in some people. &nbsp;The tissue in the nodule makes too much of T3 and T4 hormones leading to overactive thyroid.</li><li>Thyroiditis: is inflammation of your thyroid that causes stored thyroid hormone to leak out of your thyroid gland. The hyperthyroidism may last for up to 3 months, after which your thyroid may become under active leading to hypothyroidism.</li><li>Excess iodine&nbsp;intake can lead to overactive thyroid. &nbsp;Excess iodine can be through high intake of seaweed supplements, some medicines or cough syrup that has high amount of iodine.</li><li>Excess thyroid hormone medication:&nbsp;if you are taking medication on a regular basis then it needs to be checked periodically at least once in a year to regulate the dosage. &nbsp;Excess can lead to hyperthyroidism.</li><li>Grave’s disease:&nbsp;It is an autoimmune disorder that causes hyperthyroidism, or overactive thyroid. With this disease, your immune system attacks the thyroid and causes it to make more thyroid hormone than your body needs.</li></ul><h4>Risk Factors</h4><ul><li>Women are more prone than men to develop hyperthyroidism</li><li>If you have a family history of thyroid disease</li><li>If you are older than 60 years</li><li>If you have other health problems like pernicious anemia (Vit B12 deficiency) or type 1 diabetes.</li><li>Primary adrenal insufficiency, a hormonal disorder also called addison's diease. Here the adrenal gland does not make sufficient cortisol and aldosterole which can affect the thyroid gland.</li></ul>

Do’s<ul><li>Include non-iodised salt&nbsp;- excess of iodine can worsen hyperthyroidism. &nbsp;Also include foods low in iodine like oats, unfortified cereals and drinks</li><li>Include cruciferous vegetables - help to reduce the amount of hormones produced by the thyroid gland. &nbsp;Cruciferous foods include broccoli, cauliflower, cabbage, kale etc</li><li>Include Calcium and Vitamin D rich food&nbsp;- hyperthyroid interferes with calcium absorption eventually leading to osteoporosis. &nbsp;Include food rich in calcium like dairy products, dark green leafy vegetables, unsalted nuts, salmon, fatty fish, fortified cereals</li><li>Zinc and selenium&nbsp;- are required for good immune system and maintain healthy thyroid. &nbsp;Available from foods such as cocoa powder, pumpkin seeds, dry fruits, mushrooms, chickpeas, beef, tea and so on.</li><li>Omega 3-fatty acids&nbsp;- help to reduce inflammation and balance the thyroid hormones e.g. olive oil, flax seeds</li><li>High protein diet&nbsp;- since weight loss is a common symptom in hyperthyroid, eat enough proteins to maintain the muscle mass and weight. &nbsp;Include dairy, nuts, pulses and whole grain cereals and millets.</li><li>Exercise regularly&nbsp;- help in maintaining bone density, muscle mass and cardiovascular health.</li><li>Yoga and meditation&nbsp;- help in relieving stress which has been a contributing factor in the Grave’s disease.</li></ul>Don’ts<ul><li>Include supplements which are rich in iodine, read the labels before purchasing any ready to eat foods.</li><li>Include medications and cough syrup with iodine</li><li>Nitrates cause the thyroid gland to absorb more iodine. &nbsp;Some foods have naturally occurring nitrates like processed meats, turnips, fennel, leeks, beets, dill, pumpkin. &nbsp;Restrict the use of these foods.</li><li>Avoid smoking</li></ul>

With the increase in the incidence of thyroid related problems, there is a need to find out the root cause of thyroid issues, address them at an early stage with proper lifestyle management and complimentary ayurvedic treatment options. By taking the right preventive/corrective measures it is possible to prevent the disease or manage it effectively.

Symptoms of hyperthyroidism can vary from person to person and may include:<ul><li>nervousness or irritability</li><li>fatigue or muscle weakness</li><li>trouble tolerating heat</li><li>trouble sleeping</li><li>shaky hands</li><li>rapid and irregular heartbeat</li><li>frequent bowel movements or diarrhoea</li><li>weight loss</li><li>mood swings</li><li>Sensitivity to heat</li><li>Changes in menstrual cycle</li><li>Goitre (enlarged thyroid gland)</li></ul>Grave’s disease, a common form of hyperthyroidism can affect eyes and vision leading to :<ul><li>Bulging of the eyes</li><li>Sensitivity to light</li><li>Double vision</li><li>Pain or pressure in the eyes</li><li>Redness or inflammation in and around the eyes</li></ul>

Untreated hyperthyroid can lead to a condition called thyroid storm. During thyroid storm, an individual's heart rate, blood pressure, and body temperature can soar to dangerously high levels. Treatment options - depends on the cause and the severity of the disease<ul><li>Anti-thyroid medications</li></ul>These medications gradually reduce symptoms of hyperthyroidism by preventing your thyroid gland from producing excess amounts of hormones.<ul><li>Radio iodine therapy</li></ul>In radio iodine therapy, you take radioactive iodine-131 by mouth as a capsule or liquid. The radioactive iodine slowly destroys the cells of the thyroid gland that produce thyroid hormone without affecting other body tissues<ul><li>Thyroid surgery</li></ul>Only used to treat people with large goiters or pregnant women who cannot take anti thyroid medicines.<ul><li>Diet and lifestyle management</li></ul>

Diagnosis is done using:Medical history and physical examination - Based on the symptoms and on the physical examination of pulse or tremors in handBlood testsBlood tests to measure the levels of thyroxine and TSH. &nbsp;If the TSH is low or non-existent and there are high levels of thyroxine, it indicates an overactive thyroid. &nbsp;The tests are important in the cases where there are no classic signs or symptoms seen.Radio iodine uptake testFor this test, you take a small, oral dose of radioactive iodine (radio iodine) to see how much will collect in your thyroid gland. A high uptake of radio iodine indicates your thyroid gland is producing too much thyroxine. The most likely cause is either Graves' disease or hyper functioning thyroid nodules.&nbsp;If you have hyperthyroidism and your radio iodine uptake is low, this indicates that the thyroxine stored in the gland is leaking into the bloodstream, which may mean you have thyroiditis.Thyroid scanDuring this test, you'll have a radioactive isotope injected into the vein on the inside of your elbow or sometimes into a vein in your hand and observe the image of your thyroid gland on a computer screen. This test shows how iodine collects in your thyroid.Thyroid ultrasoundThis test uses high-frequency sound waves to produce images of the thyroid. Ultrasound may be better at detecting thyroid nodules than other tests, and there's no exposure to any radiation.

<figure class="table"><table><tbody><tr><td>Hyperthyroid - multifactorial cause -&nbsp;<ul><li>Inflammation of the thyroid gland</li><li>Autoimmune disease</li><li>Thyroid cancer</li><li>Infection</li><li>Excessive thyroid medications</li></ul>Hyperthyroid can cause irregular heart beat, fatigue, irritability, muscle weakness, irregular periods, weight loss, mood swingsIt is diagnosed by blood tests, radioiodine uptake, thyroid scan and ultrasoundUntreated hyperthyroid can lead to thyroid storm</td><td> Treating hyperthyroid involves -&nbsp;Diet and lifestyle changesRadioiodine therapyMedications and surgeryYoga - bhramari pranayamAyurvedic therapy to treat the gland to make right quantity of hormones</td></tr></tbody></table></figure>Thyroid diseases are, arguably, among the commonest endocrine disorders worldwide. India too, is no exception. According to a projection from various studies on thyroid disease, it has been estimated that about 42 million people in India suffer from thyroid diseases.<h4>A bit about our thyroid gland</h4><figure class="image image-style-align-left"><img src="https://lh6.googleusercontent.com/91gGVGeixhEXwSAhRcEUdE2w9nozxALWaLPsxu9zZqyJmULSQ6FszwYM_8wc-sMavScmu4mePg3W6j9rX0sJWoZ8fYhde2iDDtOzcJZR0l7NleoGLnPHm3QAb3Oymxp-klFWsEy9"></figure><ol><li>Thyroid gland, being a part of the endocrine system, is the only gland that absorbs iodine from food that we eat and uses it to make two hormones (T3 and T4).</li><li>The crucial function of &nbsp;T3 (Triiodothyronine) and T4 (Thyroxine) is to break down calories, produce energy and boosts metabolism when released into the bloodstream.</li><li>And it is important, two of the above shouldn’t be either too low or either too high.Above all, two glands in our brain -the hypothalamus and pituitary&nbsp;works a major role in maintaining the balance of T3 and T4.</li><li>The hypothalamus produces TSH Releasing Hormone (TRH) that signals the pituitary to tell the thyroid gland to produce more or less of T3 and T4 by either increasing or decreasing the release of a hormone called thyroid stimulating hormone (TSH).</li></ol>

Treating the gland so that it starts making its own hormones and regulating them&nbsp;Exercise - Bhramari Pranayama helps in stimulating the thyroid gland.<figure class="image"><img src="https://lh6.googleusercontent.com/fcEn1D_MbNG18ClqYaDm0D98WyrK93ebTyY2rxTSlDVWIzf4CpI3v6Vnf_05cwpt64mzwtdLzlSBn7s-rm-mSb1FR24FWVNx_tYPxzKneRVVrg5KcxUxY8txEh662jdm74kHAsZq"><figcaption>How to perform Bhramari Pranayama</figcaption></figure>

Hyperthyroid

The treatment usually involves stimulating the thyroid gland and removing the toxins by use of various herbs and detoxification plans.<ul><li>Stimulates the gland naturally without any hormones</li><li>Detoxification ( Panchakarma treatment)</li><li>Focuses on physical &amp; mental health and reduces symptoms.</li><li>Numerous herbs like the gokshura, brahmi, jatamansi, ashwagandha and punarvana are used in ayurvedic treatment for hypothyroidism.</li></ul>&nbsp;

&nbsp;<figure class="table"><table><tbody><tr><td>Hypothyroid - more common in women than men.&nbsp;Can be congenital or can be due to an under active thyroid gland, causative factors include -&nbsp;<ul><li>Pregnancy</li><li>Radiation</li><li>Surgery of the gland</li><li>Certain medications can trigger</li><li>Infection</li></ul>&nbsp;Hypothyroid affects skin, hair, menstrual cycle, can lead to infertility, fatigue, depression and weight gainProper lifestyle changes, medications, yoga, meditation and ayurvedic treatments are ways to control hypothyroidism</td><td>Ways to treat hypothyroid -&nbsp;Ayurvedic treatment - aims to treat the glad to balance the hormones through therapies like panchakarma and by the use of various herbs.Lifestyle changes - healthy diet, regular exercise, yoga and meditation to manage stressMedications and surgery as per the condition.Diet - aim is to lose weight and balance the hormones.&nbsp;Include - foods rich in iodine, iron, calcium, complex carbs, minerals like zinc and selenium.Avoid - refined and processed foods, smoking, alcohol, fried foods and sweetsRestrict - goitrogenic foods&nbsp;</td></tr></tbody></table></figure>Thyroid diseases are, arguably, among the commonest endocrine disorders worldwide. India too, is no exception. According to a projection from various studies on thyroid disease, it has been estimated that about 42 million people in India suffer from thyroid diseases.<h4>A bit about our thyroid gland</h4><figure class="image image-style-align-left"><img src="https://lh6.googleusercontent.com/91gGVGeixhEXwSAhRcEUdE2w9nozxALWaLPsxu9zZqyJmULSQ6FszwYM_8wc-sMavScmu4mePg3W6j9rX0sJWoZ8fYhde2iDDtOzcJZR0l7NleoGLnPHm3QAb3Oymxp-klFWsEy9"><figcaption>Pic depicting thyroid hormones&nbsp;</figcaption></figure><ol><li>Thyroid gland, being a part of the endocrine system, is the only gland that absorbs iodine from food that we eat and uses it to make two hormones (T3 and T4).</li><li>The crucial function of &nbsp;T3 (Triiodothyronine) and T4 (Thyroxine) is to break down calories, produce energy and boosts metabolism when released into the bloodstream.</li><li>And it is important, two of the above shouldn’t be either too low or either too high.Above all, two glands in our brain -the hypothalamus and pituitary&nbsp;works a major role in maintaining the balance of T3 and T4.</li><li>The hypothalamus produces TSH Releasing Hormone (TRH) that signals the pituitary to tell the thyroid gland to produce more or less of T3 and T4 by either increasing or decreasing the release of a hormone called thyroid stimulating hormone (TSH).</li></ol><figure class="image"><img src="https://lh6.googleusercontent.com/0V6LHtTmkM30EHmdAL9EEXLT2labRjoOKLG7_3yQYq-dybWyE6IgCTLRhVvVzx_ezyIcm1Qw5YsrYe-rYqm0mDtMkKg402NtnK63NN8mDgSFHMjxgxFDRfRBvwagq7hhyZ9PkCES"><figcaption>Statistics showing thyroid disorders</figcaption></figure>&nbsp;&nbsp;

<h4>Do’s and Don’ts of diet therapy</h4>&nbsp;Do’s<ul><li>Include food rich in omega 3- fatty acids&nbsp;like flax seeds, chia seeds, walnuts, salmon and tuna that act as antioxidant and protect the gland, also help in lowering cholesterol.</li><li>Include food rich in zinc and selenium&nbsp;like dry fruits, nuts, seafood, eggs, sunflower seeds and curd. &nbsp;Zinc and Selenium are required for the thyroxine production plus hypothyroidism can lead to deficiency of zinc and selenium</li><li>Iron&nbsp;rich food like dark green leafy vegetables, dates, figs to manage iron deficiency</li><li>Iodine rich foods like fortified table salt, seaweed, salt water fish, dairy and eggs are good sources.</li><li>Complex carbohydrates&nbsp;- whole grain cereals and pulses, whole fruits instead of juices, help in weight management</li></ul>Don’ts<ul><li>Goitrogens&nbsp;are substances that suppress the functioning of the thyroid gland. &nbsp;They act by interfering and blocking enzymes that allow thyroid to use iodine, leading to enlargement of the gland since it is under pressure to produce more hormones. &nbsp;Restrict the consumption of goitrogens like cauliflower, cabbage, sweet potatoes, strawberry, groundnuts, soy and its products, broccoli, Brussels sprout, kale and so on.</li><li>Include foods that are refined and highly processed. &nbsp;Restrict on chips, bakery products, high sugar and fatty foods.</li></ul>

Hypothyroid symptoms start very gradually with weight gain and fatigue and then can produce a list of signs and symptoms as the condition worsens.<ul><li>Fatigue</li><li>Increased sensitivity to cold</li><li>Constipation</li><li>Dry skin</li><li>Weight gain</li><li>Puffy face</li><li>Hoarseness</li><li>Muscle weakness</li><li>Elevated blood cholesterol level</li><li>Muscle aches, tenderness and stiffness</li><li>Pain, stiffness or swelling in your joints</li><li>Heavier than normal or irregular menstrual periods</li><li>Thinning hair</li><li>Slowed heart rate</li><li>Depression</li><li>Impaired memory</li></ul>

Congenital hypothyroidism&nbsp;- congenital hypothyroidism is insufficient production of thyroid hormone in the newborn infant. &nbsp;It is probably the most important, as it is requires an early diagnosis, which is usually followed by appropriate therapy that can prevent the onset of brain damage. It can occur because of an anatomic defect in the gland, an inborn error of thyroid metabolism, or iodine deficiency. &nbsp;Hence all infants are screened now to determine if they are hypothyroid or not.In adults:&nbsp;One in ten adults in India suffer from Hypothyroidism. &nbsp;A recent survey done by the thyroid society of India depicts that the awareness of the disease ranked ninth as compared to other common ailments like asthma, cholesterol, depression, diabetes, insomnia and heart problems.Hypothyroidism is more prevalent among women who are three times more likely to get the disease than men especially in the age group of 46-54 years. &nbsp;The prevalence seem to be increasing at an alarming rate.<h4>Types of hypothyroidism</h4><figure class="image"><img src="https://lh5.googleusercontent.com/rYPhjXJ8Jf_18XfgrARJ8EZjBH2iBE9kwKXZZMcab-Lgc5TpccMDvVfY41FT9UkfcbNGMIjXV3LZPt1U_wojveOMNgTaigzUCnU4oYD5KAfmOQknbqDa9reNnLno6Cm0dvxZEvUE"></figure>

<ol><li>Thyroid medication&nbsp;generally advised if the TSH levels are too high and the thyroid gland is secreting insufficient thyroxine and to help relieve the symptoms.</li><li>Diet therapy&nbsp;- proper dietary habits goes a long way in managing hypothyroid. Proper dietary habits goes a long way in managing hypothyroid, helps in weight loss and also to alleviate the symptoms of hypothyroid.</li></ol>

Hypothyroidism results when the thyroid gland fails to produce enough hormones. Hypothyroidism may be due to a number of factors, including:<ul><li>Hashimoto's thyroiditis&nbsp;have the most common cause of hypothyroidism. Here body’s own antibodies attack the thyroid gland, causing inflammation and the gland’s ability to produce hormones. &nbsp;Cause can be genetic or any virus/bacterial infection.</li><li>Thyroid surgery&nbsp;- removing a part or whole of the thyroid gland can diminish or stop the production of hormone resulting in hypothyroidism.</li><li>While treating hyperthyroidism&nbsp;- medications or treatment with radioactive iodine to normalise the thyroid function can lead to permanent hypothyroidism</li><li>Radiation therapy. Radiation used to treat cancers of the head and neck can affect your thyroid gland and may lead to hypothyroidism.</li><li>Medications -&nbsp;Several medicines may lower thyroid hormone production. These include ones used to treat psychological conditions, as well as cancer and heart disease. This can lead to hypothyroidism.</li><li>Pituitary disorder. A relatively rare cause of hypothyroidism is the failure of the pituitary gland to produce enough thyroid-stimulating hormone (TSH) — usually because of a benign tumour of the pituitary gland.</li><li>Pregnancy.&nbsp;Some women develop hypothyroidism during or after pregnancy (postpartum hypothyroidism), often because they produce antibodies to their own thyroid gland. Left untreated, hypothyroidism increases the risk of miscarriage, premature delivery and preeclampsia (high blood pressure)</li></ul><h4>Risk Factors</h4>Although anyone can develop hypothyroidism, you're at an increased risk if you:<ul><li>Are a woman older than age 60</li><li>Have a family history of thyroid disease</li><li>Have other autoimmune diseases, such as rheumatoid arthritis or lupus, a chronic inflammatory condition</li><li>Have been treated with radioactive iodine or anti-thyroid medications</li><li>Received radiation to your neck or upper chest</li><li>Have had thyroid surgery (partial thyroidectomy)</li><li>Have been pregnant or delivered a baby within the past six months</li></ul>

<figure class="image image-style-align-left"><img src="https://lh5.googleusercontent.com/8O4NExDPtNC0743QdmZEQioWLkxqKPfbEP_jbzmVJon7H9bxpLChZBIC41ZP0nUvPHbLbqjt2IXUrDZ18wmeG4qFv-N8YEe8JM4Tz02bxaYhP2A9B-d0EJabU0kTv8y8tvPBPx7h"></figure>Based on the symptoms and on the blood tests. &nbsp;Measuring the levels of t4 hormones and TSH (thyroid stimulating hormones) help in diagnosis. &nbsp;If you have low levels of free T4 and high levels of TSH, you are hypothyroid.Testing for autoimmune thyroid disease - Thyroid peroxidase (TPO) antibodies are a marker for the presence of autoimmune thyroid disease. Blood test results for TPO antibodies are positive in 95% of patients with Hashimoto's disease, and in 50% to 80% of patients with Graves' disease.

Hypothyroid

<figure class="table"><table><tbody><tr><td>A common symptom&nbsp;of various digestion related diseases - acidity.Excessive burning sensation, loss of appetite, inability to eat food, headache, stomach pain, weight loss are some of the common symptoms.Just taking antacids is not a solution to long term chronic acidity. Finding out the root cause and treating the same brings relief and improves the quality of life.</td><td>What causes acidity?<ul><li>Improper diet and lifestyle</li><li>GERD</li><li>H.Pylori infection</li><li>Hiatus hernia</li></ul>Other triggers<ul><li>Certain medications</li><li>Pregnancy</li><li>Stress</li><li>Obesity</li></ul>Treatment options -<ul><li>Alkaline foods</li><li>Avoiding junk food</li><li>Low to moderate exercise</li><li>Ayurvedic therapy</li><li>Stress management</li><li>Medications</li></ul></td></tr></tbody></table></figure><h3>Overview</h3>Chronic acidity or heartburn has become a very common phenomenon among the population these days. &nbsp;Acidity or heartburn involves burning sensation in the upper abdomen or lower chest area just behind the breast bone.Gastric acid, gastric&nbsp;juice, or stomach acid, is a digestive fluid formed in the stomach&nbsp;and is composed of hydrochloric acid&nbsp;(HCl), potassium chloride (KCl), and sodium chloride (NaCl).Stomach acid (hydrochloric acid) is basically required for three reasons -<ul><li>digestion of food</li><li>to kill the disease causing pathogens</li><li>Maintain the optimal pH for the digestive enzymes</li></ul>While the acid is restricted to the stomach, for some people stomach acid and food flow back into the esophagus or food pipe causing discomfort and burning in the throat and chest area.<figure class="image"><img src="https://lh3.googleusercontent.com/m8M9ZZMO5_5-Tall3E-rGtHRzYIs90piJAGXceO8SalDHSU_fzSVjQdeaJ9yM5YnnUlz3OiMD_k8O5y0rHj95_b6X1Lavl4w_q5eA4YYNop7mzZ_Gats-vuSJimf6KCvE-2H0-qx"><figcaption>Image to show back flow of contents into esophagus</figcaption></figure><h3>Signs and Symptoms of acidity</h3>Chronic acidity is actually a symptom of an underlying disease. &nbsp;Acidity can manifest in the following ways -<ul><li>Stomach pain</li><li>Headache which may be due to acid reflux or bloating</li><li>Sore throat and hoarseness</li><li>Bitter or acidic taste in the mouth</li><li>Burning sensation in the chest after eating</li><li>Worsening of heartburn while lying down or bending over.</li></ul><h4>When to see a doctor?</h4><figure class="image"><img src="https://lh5.googleusercontent.com/y4j_clIz1XxE1sHdsdu7q7mBwP9mBjZW-Ftxg6jo_JDBbUc6HgPhkFA1wVQFb36EW6OHlPgGCSOsOO6ncdDK1OORjHclqyunYQfP22gtz95pMd9kSKJHpiiNrp5_NKvA-InvLO1k"><figcaption>list of conditions which requires for you to see a doctor</figcaption></figure>It is better to check with your medical practitioner if you have the following symptoms -<ul><li>Persistent heartburn</li><li>Recurrence of the heartburn even after taking over the counter medications</li><li>Nausea or vomiting</li><li>Weight loss due to inability to eat/loss of appetite</li></ul><h3>What causes acidity/heartburn</h3>There are a number of causes leading to acidity. It is better to find out the root cause and treat the issue accordingly -<h4>Diet</h4>Food is one of the most important causative factors in heartburn. Triggers are different for different people. The most common triggers include -<ul><li>Fried food</li><li>Spicy food</li><li>Citrus foods, tomatoes and its products like ketchup</li><li>Commercial foods like cakes/puffs etc</li><li>Carbonated beverages</li><li>Chocolates</li><li>Salads, garlic, raw onion</li><li>Caffeine and alcohol</li></ul>Eliminating the above food from the diet and then adding them one at a time, can help to identify the specific foods that lead to acidity and heartburn.Other factors include&nbsp;-<ul><li>Large quantity in one meal</li><li>Eating late night dinners</li><li>Having heavy or large meals</li><li>Sleeping immediately after eating</li></ul><h4>Medications</h4>Several medications also can trigger heartburn or aggravate acidity. Before taking any medications it is better to check with the doctor to find out if the medicine can cause acidity. Following medications have been known to exacerbate the problem -<ul><li>Regular use of aspirin</li><li>Certain drugs used to treat asthma</li><li>Painkillers called non-steroidal anti-inflammatory drugs (NSAIDs) can irritate the esophagus.</li><li>Sedatives</li><li>Certain supplements like iron and potassium</li><li>Chemotherapy drugs</li></ul><h3>Risk factors for chronic acidity</h3>Other common risk factors leading to acidity are -<ul><li>Obesity&nbsp;- weight loss can help reverse acidity and heartburn.</li><li>Physical activity&nbsp;- exercise can either help or hurt the acid reflux. A healthy diet and exercise can help to lose weight and help to manage the symptoms. However intense exercise can worsen the already existing problem. These movements include hanging upside down and bending for extended periods. Always check with an expert before starting off on an exercise regimen.</li><li>GERD&nbsp;- Gastroesophageal reflux or GERD, is the presence of stomach contents in the esophagus or food pipe. A weakened valve between the esophagus and stomach allows gastric contents to irritate the esophagus. GERD affects many people, and usually presents itself as heartburn.</li><li>Hiatus Hernia - Hiatal hernia is diagnosed when the stomach moves up into the chest through an opening in the diaphragm. (The diaphragm is the boundary that separates the abdominal contents from the chest cavity) GERD can be one of the symptoms of hiatus hernia .</li><li>Infection&nbsp;- H. pylori&nbsp;is a common type of bacteria that grows in the digestive tract&nbsp;and has a tendency to attack the stomach lining. These bacteria can survive the harsh acidic environment of the stomach. These bacterial infections can lead to symptoms of chronic acidity and diseases like peptic ulcer and inflammatory condition in the stomach called gastritis.</li><li>Stress - Stress on its own may not be the cause of acidity. However, people who have chronic acidity can feel their symptoms worsening when under high stress levels4. Stress&nbsp;can also deplete the production of substances called prostaglandins, which normally protect the stomach from the effects of acid. This could increase the perception of discomfort in some individuals.</li><li>Pregnancy - Hormonal changes and the growing fetus puts pressure on the diaphragm leading to heartburn which generally goes away after delivery.</li><li>Other lifestyle factors include - smoking, skipping meals, erratic meal timings, sleeping immediately after meals.</li></ul><h3>Diagnosis</h3>Diagnosis2&nbsp;is usually based on the symptoms and following diagnostic tools are employed if the symptoms do not become better with medication and lifestyle changes.<ul><li>endoscopy: camera imaging</li><li>biopsy: taking a tissue sample for laboratory analysis</li><li>barium X-ray: imaging the esophagus, stomach, and upper duodenum after swallowing a chalky liquid that helps provide contrast on images</li><li>esophageal manometry: pressure measurement of the esophagus</li><li>impedance monitoring: measuring rate of fluid movement along the esophagus</li><li>pH monitoring: acidity testing</li></ul><h2>Treatment</h2>Treatment is based on the causative factor of the acidity -<h4>Medicines for acidity</h4><figure class="image"><img src="https://lh4.googleusercontent.com/kJpOuBxIufJXo0oi-eWBZZm0hM6dcDEp8q7F9LyblmRugZGlVLHFbxAvXkaw4ya7WZTlBXtv6Icp6t8IKXNO84OrxDfGWqVMzVIVyxp-22GE9ICxHvYIrLaoP1vxNZJgZpOhDKVK"><figcaption>Medicines to suppress acid&nbsp;</figcaption></figure><h4>Antacids</h4>Many people with heartburn or acidity find it easier to take over the counter medicines than to address the root cause of heartburn.Antacids do work for a short duration of time but it is completely useless in certain gastrointestinal diseases like<ul><li>Esophagitis - inflammation of the food pipe causing pain and difficulty swallowing, chest pain.</li><li>Hiatus hernia - part of the stomach enters or pushes into the diaphragm.</li><li>Other complications of reflux disease.</li></ul>It is always better to get yourself checked if heartburn or acidity stays for a long period of time.<figure class="table"><table><tbody><tr><td colspan="1" rowspan="1">What happens on long term use of antacids1?Continuous high doses of antacids can cause<ul><li>acid rebound or excessive acid production.</li><li>milk-alkali syndrome - high level of calcium in the body disrupting acid-base balance in the body</li><li>Congestive heart failure if the sodium content is high.</li><li>Antacids can also adversely affect lower gastrointestinal tract function</li><li>Magnesium-containing antacids may cause diarrhoea, while aluminium-containing antacids may cause constipation.</li><li>Also taking antacids can mask any serious gastro-intestinal disease which can later exacerbate into more serious problems.</li><li>Long duration use of antacids can lead to erectile dysfunction.</li></ul></td></tr></tbody></table></figure>The main allopathic treatment options for acid reflux are:PPIs and H2 blockers decrease acid production&nbsp;and reduce the potential for damage caused by acid reflux.Alginate drugs&nbsp;containing alginic acid&nbsp;works by creating a mechanical barrier against the stomach acid, forming a foamy gel that sits at the top of the gastric contents itself. Any reflux is then relatively harmless as it consists of alginic acid and not damaging stomach acid.<h4>Diet and Lifestyle to manage acidity</h4>Changing the diet works for many people to manage acidity or heartburn. Include the following foods which are low in acid levels and will not aggravate the existing condition -Foods that reduce acidity -<ul><li>Non-citrus fruits&nbsp;- banana is a great option for a problem of acidity. Naturally occurring potassium in bananas help to reduce neutralize the acid content in the stomach. Other recommended fruits include sweet melon, papaya, water melon.</li><li>Vegetables&nbsp;- high moisture vegetables like ash gourd, cucumber should be included. Others low acid vegetables include cauliflower, broccoli, green beans and leafy vegetables.</li><li>Lean meat like chicken, turkey and seafood. Better to go for stir fried, broiled, baked or poached than deep fried versions.</li><li>Oatmeal&nbsp;is a good option to manage acidity. It is a good source of soluble fibre and help to prevent acid reflux.</li><li>Fluids&nbsp;- consumption of water from earthen pot than RO purified water since RO water is more acidic in nature. Preference of buttermilk over curd can help to manage acidity.</li></ul><h4>Home remedies to reduce acidity -</h4>There are a number of herbs and spices present in our kitchen that can provide relief from the acidity and heartburn. In case the symptoms are mild then a few of these home remedies can be tried before popping a pill.<ul><li>Ginger - anti-inflammatory and antibacterial in nature. Ginger both in fresh and dry form helps to improve appetite and digestion. Ginger tea helps to stimulate digestion and improve the digestive fire.</li></ul>Ginger mixed with jaggery is helpful in case of indigestion and constipation. Chewing on fresh ginger mixed with salt just in the beginning of a meal helps in stimulating digestion.<ul><li>Fenugreek - has anti heartburn properties. In a pilot study of subjects with frequent heartburn, 2 week intake of fenugreek fiber product, taken 30 min before two meals/day, diminished heartburn severity3,5.</li><li>Fennel - chewing fennel seeds post a meal is known for its digestive properties and also help to neutralize stomach acids. Fennel tea twice a day helps to improve digestion and prevent bloating.</li><li>Cumin seeds&nbsp;- prevents indigestion and bloating. Drinking cumin water (adding a tsp of cumin seeds in water, soaking overnight and drinking in the morning on an empty stomach) helps to deal with acidity.</li></ul><h4>Ayurvedic treatment for acidity</h4>The main principle behind ayurvedic treatment is to treat the acidity and improve the appetite and digestion. The following treatment options are employed -&nbsp;<ol><li>Panchakarma - detox treatment which balances all the doshas by getting rid of accumulated toxins in the body.</li><li>Vamana/Virechana - treatment mainly advised once a year preferably in the month of February for vamana, october/april for virechana as a process of detoxification.</li><li>Herbal formulations - madiphal rasayan, avipattikar, sootshekhar, kamdudha on the advice of an ayurvedic practitioner.</li><li>Herbs such as yashtimadhu and shatavari water to overcome acidity.</li><li>Intake of 1 teaspoon pure cow ghee on an empty stomach.</li><li>Warm castor oil - 5 ml at night either mixed with milk or water.</li><li>Sheetali pranayama - helps to calm the body and mind, a simple technique to manage stress.</li><li>Ayurveda also advocates taking alkaline food and avoiding any junk/commercially available food.</li></ol><h3>Lifestyle practices to prevent acidity</h3><ul><li>Smaller meals: spaced throughout the day rather than three large meals helps to prevent indigestion and acidity.</li><li>Light Dinner: Avoid eating large meals at dinner.&nbsp;</li><li>Gap between meals and sleep: Sleeping immediately after eating should be strictly avoided. There should be at least 2-3 hours gap between eating and sleeping.</li><li>Exercise: Include mild to moderate exercises like walking daily. Avoid strenuous exercises that involve bending or pressing the abdomen.</li><li>Sleeping Posture: Sleep in an inclined position. Ideally, the head should be 6 to 8 inches higher than your feet.</li><li>Relax: Include relaxation techniques like pranayama to manage stress.</li><li>Lose Weight: If you are obese, losing weight helps to manage the acidity better.</li><li>Review your medications with your doctor in case it could be one of the triggers for the acidity problem.</li></ul>Acidity left untreated makes a conducive environment for other diseases to occur and increase.<hr>References:<ol><li><a href="https://www.google.com/url?q=https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/210441&amp;sa=D&amp;ust=1561358246601000">https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/210441</a></li><li><a href="https://www.google.com/url?q=https://www.medicalnewstoday.com/articles/146619.php&amp;sa=D&amp;ust=1561358246601000">https://www.medicalnewstoday.com/articles/146619.php</a></li><li><a href="https://www.google.com/url?q=https://onlinelibrary.wiley.com/doi/pdf/10.1002/ptr.3229&amp;sa=D&amp;ust=1561358246601000">https://onlinelibrary.wiley.com/doi/pdf/10.1002/ptr.3229</a></li><li><a href="https://www.google.com/url?q=https://www.ncbi.nlm.nih.gov/pubmed/15184707&amp;sa=D&amp;ust=1561358246602000">https://www.ncbi.nlm.nih.gov/pubmed/15184707</a></li><li><a href="https://www.google.com/url?q=https://www.nutraingredients-usa.com/Article/2011/02/02/Fenugreek-extract-may-ease-heart-burn-Frutarom-study&amp;sa=D&amp;ust=1561358246602000">https://www.nutraingredients-usa.com/Article/2011/02/02/Fenugreek-extract-may-ease-heart-burn-Frutarom-study</a></li></ol>&nbsp;

Dealing with Chronic acidity

प्रागार्तव सिंड्रोम (प्री मेंस्ट्रुअल सिंड्रोम - पीएमएस) के कई लक्षण व संकेत होते हैं जिनमें मनःस्थिति में अस्थिरता (मूड स्विंग्स), स्तन मृदुता (टेंडर ब्रेस्ट्स), खाने की लालायितता (फूड क्रेविंग्स), थकान (फे़टीग़), चिड़चिड़ापन (इरिटेबलिटी), अवसाद व निराशा (डीप्रेशन) की भावनआएं शामिल हैं। ऐसा अनुमानित है कि हर ४ &nbsp;में से ३ महिलाओं ने प्रागार्तव सिंड्रोम (पीएमएस) को किसी ना किसी रूप में ज़रूर अनुभव किया है।&nbsp;<figure class="image"><img src="http://nebula.wsimg.com/d30009ed8d9862366a260450c69463b9?AccessKeyId=8AD9CE52374771B1CF38&amp;disposition=0&amp;alloworigin=1" alt="Image result for pms"></figure> पीएम्एस के लक्षण प्रायः माहवारी शुरू होने है ५ से ११ दिन पूर्व ही दिखने लगते हैं और आमतौर पर माहवारी शुरू होने पर समाप्त हो जाते हैं। हालांकि पीएमएस का कोई ठोस कारण ज्ञात नहीं है, कई शोधकर्ताओं का ऐसा मानना ​​है कि यह मुख्यतः माहवारी की शुरुआत में होने वाले लैंगिक हा‌ॅर्मोन (सेक्स हा‌ॅर्मोन) और सेरोटोनिन (मनोदशा प्रभावित करने वाला हा‌ॅर्मोन) के स्तरों में परिवर्तन से संबंधित है। आमतौर पर पीएम्एस के लक्षण हल्के या मध्यम होते हैं। लगभग २० से ३२ प्रतिशत महिलाओं ने ऐसे मध्यम से गंभीर लक्षणों को महसूस किया है जो कि उनके जीवन के किसी ना किसी पहलू को प्रभावित करते हैं। किन्तु पीएमएस सिंड्रोम से ग्रस्त महिलाओं कि एक छोटी संख्या ऐसी भी है जिन्हे हर माह अक्षम करने वाले लक्षणों (डिसेब्लिंग सिम्पटम्स) को सहन करना पड़ता है। पीएमएस के इस रूप को प्री मेंस्ट्रुअल डाइस्फ़ोरिक डिसऑर्डर (पीएमडीडी) कहा जाता है। अवसाद (डिप्रेशन), मनःस्थिति में अस्थिरता (मूड स्विंग), क्रोध(एंगर), व्यग्रता (एंग्ज़ाइटी), अभिभूत महसूस करना (ओवरव्हेल्म्ड), एकाग्रता में कमी होना, चिड़चिड़ापन और तनाव (टेंशन) पीएमडीडी के कुछ मुख्य लक्षण हैं। &nbsp;<h4>भावनात्मक एवं व्यावहारिक लक्षण</h4><ul><li>तनाव (टेंशन) य व्यग्रता (एंग्ज़ाइटी)</li><li>अवसाद (डिप्रेशन)</li><li>मनःस्थिति में अस्थिरता (मूड स्विंग) व चिड़चिड़ापन अथवा क्रोध (एंगर)</li><li>भोजनेच्छा में बदलाव (एॅपेटाइट चेंजेज़) तथा खाने की लालायितता (फूड क्रेविंग्स)</li><li>अनिद्रा (इंसोम्निया)</li><li>सामाजिक प्रत्याहरण (सोशियल विदॖड्राॅल)</li><li>लघु एकाग्रता (पुअर काॅन्सन्ट्रेशन)</li><li>कामेच्छा (यौन क्रिया) में परिवर्तन</li></ul><h4>शारीरिक लक्षण</h4><ul><li>जोड़ों एवं मांसपेशियों में दर्द</li><li>सिरदर्द</li><li>थकावट</li><li>द्रव प्रतिधारण (फ्लूइड रिटेंशन) के कारण वजन में वृद्धि</li><li>उदरीय (एब्डॉमिनल) सूजन</li><li>स्तन मृदुता (ब्रेस्ट्स टेंडरनेस)</li><li>मुँहासों में अतिशय बढ़ोत्री (एक्ने फ्लेयर अप)</li><li>कब्ज़ तथा दस्त</li><li>मद्य असहिष्णुता (एल्कोहोल इंटोलेरेंस)</li></ul><h4>मद्धम से औसत पीएमएस व माहवारी के दौरान क्या करें और क्या नहीं</h4> क्या करें<ul><li>आहार विषयक परिवर्तन - आवश्यक सूक्ष्म पोषक तत्व और फाइबर प्रदान करने वाले साबुत धान्य अनाज व दाल, ताज़े फल और सब्जियों को भोजन में शामिल करें।</li><li>सहजता से पचने वाले आहारों को लघु मात्रा में ग्रहण करें|</li><li>तनाव प्रबंधन करने हेतु प्रतिदिन 30 मिनट टहलें, योग और ध्यान करें।</li><li>माहवारी के दौरान विशेष रूप से पर्याप्त आराम&nbsp;करें व न्यूनतम ७ घंटे की नींद पूरी करें|</li><li>जल युक्त फल और सब्जियां लें व समुचित जलयोजन (हाइड्रेशन) बनाए रखें|</li><li>माहवारी&nbsp;शुचिता&nbsp;- प्रवाह के आधार पर सुनियोजित अंतराल पर पैड बदलें| 15-20 ग्राम त्रिफला चूर्ण को आधा लीटर पानी में रंग परिवर्तित होने तक उबालें और ठंडा होने के पश्चात छान कर प्रतिदिन एक बार योनिक क्षेत्र को साफ करने के लिए उपयोग करें|</li></ul>क्या न करें<ul><li>अधिक नमक, शराब, अधिक चीनी / वसा (फैट), अत्यधिक परिष्कृत (रिफाइंड) खाद्य पदार्थ और कैफीन का उपभोग ना करें|</li><li>कोई भी अत्यधिक प्रगाढ़ता (हाई इंटेंसिटी) वाला व्यायाम या कार्य या जिमखाने में कसरत अथवा कोई आनंदप्रद गतिविधियां जैसे ट्रेकिंग / मैराथन दौड़ इत्यादि ना करें।</li><li>औदरिक (एब्डॉमिनल) तनाव के दौरान विशेष रूप से तैलीय भोजन (जंक फ़ूड) का सेवन ना करेंI</li></ul><h4>पीएमएस के दौरान आहार संबंधी सहायक संघटक</h4><ul><li>कोको (काकाओ) बीन्स - इनमे प्रचुर मात्रा में आयरन, कैल्शियम, मैग्नीशियम, जस्ता और ट्रिप्टोफैन (जो मनोदशा वर्धक सेरोटोनिन का प्रणेता) होता है| कच्चे कोको पाउडर का एक बड़ा चम्मच दूध/पानी में मिलाकर सेवन करने से पीएमएस के लक्षणों से निपटने में अत्यंत लाभकारी होता है|</li><li>कद्दू के बीज - जो कि ओमेगा-३ और ओमेगा-६ फैटी एसिड, फाइबर और जिंक से भरपूर होते हैं|</li><li>हरे पत्ते वाली सब्जियां - ये आयरन, कैल्शियम और मैग्नीशियम का समृद्ध स्रोत होती हैं|</li></ul><h4>आयुर्वेदिक परिप्रेक्ष्य व उपचार</h4><ul><li>गर्म अरंडी के तेल (कैस्टर ऑयल) का उदर (पेट) पर लेप|</li><li>5 मिलीलीटर गर्म अरंडी के तेल का आंतरिक रूप से सेवन करें।</li><li>१/८ चम्मच सूखी अदरक + १/४ चम्मच अजवायन को ४५ मिलीलीटर पानी में रंग परिवर्तन होने तक उबालें और छानने के पश्चात ग्रहण करें।</li><li>प्राणायाम तथा गहरी श्वसन क्रिया भी पीएमएस के लक्षणों से निज़ात पाने में अत्यंत लाभकारी सिद्ध होते हैं|</li></ul>&nbsp;

पीएमएस

मौसम में बदलाव अपने साथ कई स्वास्थ्य संबंधी समस्याएं लेकर आता है | यह एक प्राकृतिक प्रक्रिया है जिसमें मानव शरीर स्वयं को वायुमंडलीय तापमान और नमी के अनुसार समायोजित करता है| इस बदलाव के दौरान निम्न शारीरिक प्रतिरोधक क्षमता वाले लोग बीमार पड़ जाते हैं | बुखार/ज्वर ऐसे ही रुग्णता का लक्षण है |सर्दी-जुकाम, पेट दर्द या कोई और संक्रमण शरीर में ज्वर के रूप में व्यक्त होता है | ज्वर हमारे शरीर के प्रतिरोधक तंत्र की संक्रमण के खिलाफ प्रतिक्रिया है | इसमें शरीर का तापमान सामान्य से अधिक हो जाता है |<figure class="image"><img src="http://cdn7.dissolve.com/p/D428_109_005/D428_109_005_0004_600.jpg" alt="Image result for thermometer fever"></figure><h4>ज्वर/ बुखार में क्या होता है</h4><ul><li>शरीर का तापमान 98.6 डिग्री फारेनहाइट से अधिक हो जाता है</li><li>शारीरिक चयापचयया मेटाबॉलिज्म बढ़ जाता है</li><li>भूख की कमी</li><li>दर्द की संवेदनशीलता का बढ़ना</li><li>सुस्ती</li><li>संक्रमण के आधार पर कुछ विशेष लक्षण जैसे ज्वर के साथ ठिठुरन/शरीर या सर में दर्द</li></ul><h4>क्या करें</h4><ul><li>आराम करें - क्योंकि बुखार के दौरान शरीर संक्रमण से लड़ रहा होता है, इसलिए आराम करने से शरीर की प्रतिरक्षा प्रणाली को सहायता मिलती है |</li><li>पानी खूब पिएं&nbsp;- बुखार के दौरान चयापचय बढ़ने से शरीर में निर्जलीकरण होना स्वाभाविक है, इसलिए अधिकाधिक मात्रा में पेय पदार्थ, जैसे सादा पानी, जूस, सूप या नारियल पानी ले |</li><li>सादा और सुपाच्य भोजन ग्रहण करें - घर का बना सादा भोजन जैसे चावल या इडली खाएं जिससे शरीर को तुरंत ऊर्जा मिले और पाचन तंत्र पर भार न पड़े |</li><li>हल्के कपड़े पहने - ढीले सूती सूती कपड़े पहने | शरीर को कपड़ों की परतों या स्वेटर से ना ढके | इससे शरीर में ताप कैद रहता है और तापमान को नीचे लाने में कठिनाई होती है |</li><li>घर का वायुसंचार कुशल रखें - ताजा हवा शरीर के तापमान को कम करने में सहायक होती है|</li><li>हाथ या माथे पर ठंडी पट्टी रखें |</li><li>संक्रमण फैलाने से बचें - अपने हाथ नियमितता से धोएं |</li></ul><h4>न करें</h4><ul><li>बिना निर्देश पेरासिटामोल या कोई अन्य दवाई ना ले - यदि तापमान 100 डिग्री फारेनहाइट है तो दवाई ना ले | शरीर की प्रतिरक्षा प्रणाली बैक्टीरिया या वायरस से लड़ने के लिए शरीर के तापमान को बढ़ा देती है | यदि तापमान 102 डिग्री फॉरेनहाइट से अधिक है और साथ में दर्द और थकान है तो डॉक्टर से संपर्क करें |</li><li>यात्रा ना करें - क्योंकि शरीर पहले से ही वातावरण के अनुरूप होने की कोशिश कर रहा है, यात्रा से होने वाले बदलाव या अस्थिरता की वजह से शरीर को वापस संतुलित होने में अधिक समय लगेगा |</li></ul><h4>बच्चों में ज्वर/ बुखार होने पर सुझाव</h4><ul><li>बच्चों में भिन्न प्रकार के लक्षण हो सकते हैं | लक्षण के आधार पर उपचार करें |</li><li>शरीर का तापमान 101 डिग्री फेरनहाइट के ऊपर होने के अलावा सुस्ती, थकान और तंद्रा जैसे लक्षण बच्चों में देखे जाते हैं| बच्चों के चिकित्सक के निर्देश में एंटीपायरेटिक दवाइयां देना शुरू करें |</li><li>जबरदस्ती भोजन ना खिलाए | भूख न लगना शरीर की प्रतिरक्षा प्रणाली का हिस्सा है |</li><li>पानी या अन्य पेय पदार्थ जैसे सूप, रवा या चावल की गंजी, पतली खिचड़ी दे | यह सुपाच्य है, शरीर को ऊर्जा प्रदान करते हैं और जल नियोजित रखते हैं|</li><li>औषधियां और मसाले जैसे सोंठ, अजवाइन और काली मिर्च दे | यह संक्रमण से लड़ते हैं, शरीर से विषाक्त पदार्थों को निकालते हैं और भूख बढ़ाते हैं |</li></ul><h4>आयुर्वेदिक उपचार</h4><ul><li>महासुदर्शन गण वटी - वयस्कों और 3 साल से अधिक बच्चों को एक टैबलेट दिन में 3-4 बार, 2 से 3 साल के बच्चों को आधा टेबलेट दिन में 3-4 बार |</li><li>काढ़ा - 100 ml पानी में 3g सोंठ पाउडर, 5g अजवाइन, 3g काली मिर्च, 2 लौंग और दालचीनी का एक छोटा टुकड़ा डालकर आधा होने तक उबालें | इसे chhanein और गुड़ मिलाकर दिन में एक या दो बार पीयें | यह विषहरण , पाचन क्रिया और भूख बढ़ाने में सहायक है |</li></ul>ज्वर/बुखार लक्षण मात्र है, इसलिए कारण जानने के लिए प्रयास करना आवश्यक है | शरीर की प्रतिरक्षा प्रणाली को कार्य करने का समय दें | कोशिश करें कि शरीर को संक्रमण से लड़ने के लिए सहायता प्रदान करें | आराम करें, पेय पदार्थ लें और शरीर को ऊर्जा प्रदान करें | इससे शरीर की प्रतिरोधक क्षमता बढ़ेगी और दवाइयों के दुष्प्रभाव से बचा जा सकेगा |

ज्वर/बुखार

कब्ज़ पाचन तंत्र की वह स्थिति है जिसमें व्यक्ति का मल कड़ा होने के कारण मलत्याग में कठिनाई होती है | व्यक्ति को ऐसा प्रतीत होता है कि पेट ठीक से साफ़ नहीं हुआ है | ज़्यादातर यह स्थिति इसलिए उत्पन्न होती है क्योंकि अमाशय में मौजूद भोजन में से अमाशय आवश्यकता से अधिक पानी सोख लेता है | मल कड़ा हो जाता है और निष्कासन में तकलीफ होती है | &nbsp; हाल ही में हुए एक सर्वेक्षण के अनुसार, लगभग 22 % वयस्क भारतीय जनता कब्ज़ से ग्रसित है | कलकत्ता में इसकी व्यापकता 28% है, जो सर्वेक्षण के आठ शहरों में सबसे अधिक है | &nbsp; &nbsp;<figure class="image"><img src="https://millioneyes.azureedge.net/1vmo3mg7/image_1548744108923_ad34f21062769d810f82813fb464d09f.png"></figure><h4>कब्ज़ के कारण &nbsp;</h4><ul><li>संसाधित खाद्य पदार्थ जैसे चिप्स, ब्रेड, सफ़ेद चावल का सेवन &nbsp; </li><li>भोजन में साबुत अनाज, फल और सब्ज़ियों की कमी&nbsp; </li><li>दुग्ध पदार्थों का अत्यधिक सेवन &nbsp; </li><li>पानी काम मात्रा में पीना&nbsp; </li><li>चाय/कॉफ़ी/मदिरा का अत्यधिक सेवन &nbsp; </li><li>सुस्त जीवनशैली &nbsp; </li><li>दबाव आने पर शौच न जाना &nbsp; </li><li>हाइपोथायरायडिज्म, मधुमेह, पार्किंसंस रोग, पेट का कैंसर, मल्टीप्ल स्क्लेरोसिस, नैदानिक डिप्रेशन, IBS दवाइयां जैसे, गर्भावस्था, हार्मोनल बदलाव लौह सप्लीमेंट, हाइपरटेंशन की दवाइयां, एंटीडेप्रेस्सेंट&nbsp; </li><li>आयु - वृद्धावस्था में सुस्त चयापचय क्रिया &nbsp; </li><li>यात्रा - दिनचर्या में बदलाव की वजह से अल्पकालिक कब्ज़ &nbsp; </li><li>रेचक औषधियों का अधिक सेवन &nbsp; </li><li>तनाव</li></ul><h4>लक्षण &nbsp;</h4><ul><li>मल निष्काशन में कठिनाई एवं अत्यधिक बल का प्रयोग &nbsp; </li><li>सप्ताह में तीन बार से कम मल निष्काशन &nbsp; </li><li>शुष्क मल के कारण मलद्वार कटना और रक्तस्राव होना &nbsp; </li><li>उदर में फुलाव और दर्द &nbsp; </li><li>जी मिचलाना &nbsp; </li><li>भूख में कमी</li></ul><h4>कब्ज़ की जटिल स्थिति &nbsp;</h4>बवासीर : यदि मल निष्काशन के समय व्यक्ति ज़्यादा बल लगाता है तो मलद्वार के आस-पास की शिराओं में सूजन आ जाती है | जीर्ण कब्ज़ की वजह से पाइल्स होने की भी सम्भावना होती है | &nbsp; मल में खून आना : मल निष्कासन में ज़्यादा बल लगाने से मलद्वार कट जाता है | &nbsp; शुष्क मल - कब्ज़ के कारण कड़ा मल अंतड़ियों में चिपक कर इकठ्ठा होने लगता है | &nbsp; गुदा भ्रंश - मल निष्कासन में लगातार बल लगते रहने से गुदा का एक भाग खिंच कर मलद्वार से बाहर आ जाता है | &nbsp; &nbsp;<h4>उपचार &nbsp;</h4><figure class="image"><img src="https://millioneyes.azureedge.net/1vmo3mg7/image_1548740149632_2590410b4ad2248c9f224d8452937149.png"></figure>उपचार का लक्ष्य मल को आयतन प्रदान करना है | मॉल की शुष्कता कम करना एवं उदर की मांसपेशियों का व्यायाम मॉल निष्कासन में सहायक होते हैं | &nbsp; खान-पान एवं जीवनशैली में बदलाव &nbsp;<ul><li>रेशायुक्त भोजन का अत्यधिक सेवन : 20-25 ग्राम रेशा साबुत अनाज, दाल, बिना छिले हुए फल और सब्ज़ियों से लें | धीरे-धीरे भोजन में फाइबर की मात्रा बढ़ाएं | इससे मल में नमी रहती है और मल आसानी से निष्कासित होता है | &nbsp; </li><li>लसादार रेशायुक्त भोजन लें - भिंडी, अलसी, मेथी, सब्जा, इसबगोल इत्यादि | &nbsp; </li><li>संसाधित भोजन और दुग्ध खाद्य पदार्थों से बचें |</li></ul>व्यायाम&nbsp; लगभग ३०-४० मिनट चलें या योगाभ्यास करें जिसमें उदर की मांसपेशियों का इस्तेमाल हो | &nbsp; सही शौच अभ्यास<ul><li>अख़बार, मोबाइल फ़ोन, टेबलेट अपने साथ शौच में न ले जाएं &nbsp; </li><li>मलत्याग को न रोकें &nbsp; </li></ul><figure class="image"><img src="https://lh4.googleusercontent.com/wFFJU4OzU8O-9ie_ZPlhnbpXgQbb55XclrDyiKpbMMqmGpebBmNPaPeO7RIUtiKzomZ8qvrTbRV2RrTDR8PfYkzR3lSE3FnNTGRoTx5v0z6t6SCsnkxQbtECsvg-vN3iQ4djK___XbshqgsrDQ"></figure><ul><li>उकड़ूँ बैठने से मॉल त्यागने में आसानी होती है | यदि आधुनिक शौचालय है तो एक छोटा स्टूल पैर के नीचे रखें जिससे उकड़ूँ बैठने में मदद मिले|</li></ul><h4>आयुर्वेदिक उपचार &nbsp;</h4><ul><li>रेड़ी का तेल - यह स्निग्धकारी है तथा बच्चों और वृद्धों के लिए सौम्य रेचक का भी कार्य करता है | &nbsp; </li><li>हाइपोथायरायडिज्म &nbsp;और मधुमेह का उपचार &nbsp; </li><li>प्राकृतिक स्निग्धकारियों का इस्तेमाल - गाय का घी, घर का बना मक्खन &nbsp; </li><li>रात को गरिष्ट भोजन न लें और भोजन के तुरंत बाद न सोएं | &nbsp; </li><li>उदार पर रेड़ी का तेल लगाएं &nbsp; </li><li>समय पर सोएं &nbsp; </li></ul>

कब्ज़ 

Diabetes is a disease in which your blood glucose, or blood sugar, levels are too high. Glucose comes from the foods you eat. Insulin is a hormone that helps the glucose get into your cells to give them energy. With type 1 diabetes, your body does not make insulin. With type 2 diabetes, the more common type, your body does not make or use insulin well. Without enough insulin, the glucose stays in your blood. You can also have pre-diabetes. This means that your blood sugar is higher than normal but not high enough to be called diabetes. Having pre-diabetes puts you at a higher risk of getting type 2 diabetes.&nbsp;<figure class="image"><img src="https://www.memorialhealthcare.org/wp-content/uploads/2017/11/diabetes-1024x683.jpg" alt="Image result for diabetes"></figure><h4> Why is it bad? &nbsp;</h4>When the body is unable to efficiently incorporate glucose from the blood into the cells where it is needed, glucose stays in the blood, where it can cause serious problems. It can damage your eyes, kidneys, and nerves. Diabetes can also cause heart disease, stroke and even the need to remove a limb. In addition, the cells don’t receive the energy they need to function properly. Pregnant women can also get diabetes, called gestational diabetes. &nbsp;

An important part of managing diabetes, as well as your overall health — is maintaining a healthy diet, calm mind and staying physically active. Many people are able to manage their diabetes with dietary changes, especially when these changes are made early on in the development of the disease. In fact, when early intervention is made with diet, people with pre-diabetes can prevent development of the disease itself.<h4>Healthy eating</h4>Contrary to popular perception, there's no specific diabetes diet. You'll need to center your diet on whole foods - &nbsp;more fruits, vegetables, lean proteins and whole grains — foods that are high in nutrition and fiber and low in fat and calories — and cut down on saturated fats, refined carbohydrates and sweets.Another important part of healthy eating is to maintain a rhythm around your meals -- both timing and quantity. It is imperative that we don’t eat food when we are not hungry, which otherwise leads to a problem of excess and puts undue strain on nutrition metabolism in our bodies.<h4>Physical activity</h4>Everyone needs regular aerobic exercise, and people who have diabetes are no exception. Exercise lowers your blood sugar level by moving sugar into your cells, where it's used for energy. Exercise also increases your sensitivity to insulin, which means your body needs less insulin to transport sugar to your cells.Increasing physical activity helps reduce excess Kapha dosha. However, vigorous exercise is not always recommended, especially in diabetic individuals who are frail or thin (where obesity does not play as much of a role). Choose activities you enjoy, such as walking, swimming or biking. What's most important is making physical activity part of your daily routine. Aim for at least 30 minutes or more of aerobic exercise most days of the week. Bouts of activity can be as brief as 10 minutes, three times a day. If you haven't been active for a while, start slowly and build up gradually.Yoga can be very helpful in pushing towards the prakriti equilibrium and giving relief, specific Asanas that can help are mentioned in subsequent sections.<h4>Calm Mind</h4>The liver serves as a storehouse for glucose, keeping it in a concentrated form called glycogen. It breaks down small amounts of glycogen all the time, releasing glucose into the bloodstream to nourish the brain, nerves, heart and other “always active” organs. The liver’s release of glucose depends largely on the presence of certain hormones. Of all the hormones in the body, only insulin causes the liver to take sugar out of the bloodstream and store it in the form of glycogen. All the other hormones—including stress hormones, sex hormones, growth hormones and glucagon—cause the liver to secrete glucose back into the bloodstream.Stress can cause a significant and prolonged increase in the blood sugar level, calming our mind through regular practice of meditation can help us regulate the glucose/glycogen metabolism better.<h4>Supporting Yoga and exercises</h4>There are specific yoga postures that offer the greatest benefits with the least amount of stress. Some of these poses include:<ul><li>Surya Namaskar (Sun Salutation series) is an extremely beneficial yoga practice for high blood sugar as it improves the blood circulation of pancreas and enhances utilization of insulin in the body.</li><li>Seated forward bend (paschimottanasana): Tone up the abdominal and pelvic organs. Intestines and gall bladder are smoothly pressed and stimulated.</li><li>Tree pose (vriksasana)</li><li>Warrior I and II (virabhadrasana I and II)</li><li>Extended side angle (utthita parsvakonasana)</li><li>Bridge pose (setu bandha sarvangasana)</li><li>Alligator twist (jathara parivartasana)</li><li>Relaxation pose (savasana)</li></ul>For most people, it’s best to aim for moderate exercise for a total of thirty minutes a day, at least five days a week.&nbsp; &nbsp;

<ul><li>Gurmar&nbsp;(Gymnema Sylvestre): Known as sugar destroyer, this herb stimulates insulin secretion, increases the effects of circulating insulin, and decreases blood glucose levels. It has also been shown to have a protective effect on the pancreas, which is the organ that produces and secretes insulin. Gymnema sylvestre seems to increase the sensitivity of the tissue to insulin, which helps the body use glucose for energy.</li><li>Fenugreek&nbsp;(Trigonella Foenum-graecum): have a high fiber content, and several components of the seed have been identified as having direct glucose-lowering effects. Studies have shown that daily use of fenugreek seeds can decrease insulin resistance and improve blood sugar control.</li><li>Cinnamon: stimulates insulin receptors on the cells, as well as acting directly on our DNA to “turn off” genes that are responsible for deactivating insulin receptors on our cells. These actions make it much easier for cells to take up glucose, thus reducing blood sugar levels.</li><li>Karela&nbsp;(bitter gourd): works by decreasing absorption of glucose from the intestine, stimulating insulin secretion and increasing uptake of glucose into muscle cells.</li><li>Kanduri&nbsp;(ivy gourd): The juice of this food contains an enzyme that humans naturally produce that breaks down sugars. Extracts of the root and leaf have been shown to lower blood sugar levels</li><li>Ginger: Drinking hot ginger tea with meals helps stimulate slow digestion. Drink 2–3 cups of ginger tea daily. Yes but tea north advisable along with food.</li><li>Almonds: eating almonds with a carbohydrate significantly lowers the release of sugar into the blood, similar to the addition of cinnamon to a meal.</li></ul>

<h4>Glycated hemoglobin (A1C) test.</h4>This blood test, which doesn't require fasting, indicates your average blood sugar level for the past two to three months. It measures the percentage of blood sugar attached to hemoglobin, the oxygen-carrying protein in red blood cells. The higher your blood sugar levels, the more hemoglobin you'll have with sugar attached.<ul><li>An A1C level of 6.5 percent or higher on two separate tests indicates you have diabetes.</li><li>An A1C between 5.7 and 6.4 percent indicates prediabetes.</li><li>Below 5.7 is considered normal.</li></ul><h4>Blood Sugar Test</h4>Random blood sugar test:&nbsp;A blood sample will be taken at a random time. Regardless of when you last ate, a random blood sugar level of 200 milligrams per deciliter (mg/dL) — 11.1 millimoles per liter (mmol/L) — or higher suggests diabetes.Fasting blood sugar test: A blood sample will be taken after an overnight fast. A fasting blood sugar level less than 100 mg/dL (5.6 mmol/L) is normal. A fasting blood sugar level from 100 to 125 mg/dL (5.6 to 6.9 mmol/L) is considered prediabetes. If it's 126 mg/dL (7 mmol/L) or higher on two separate tests, you have diabetes. &nbsp;Incorrect - current WHO parameters differ. Also 126 will still be borderline so one cannot say diabetes immediately. Needs to be evaluated further.Oral glucose tolerance test: You fast overnight, and the fasting blood sugar level is measured. Then you drink a sugary liquid, and blood sugar levels are tested periodically for the next two hours.<ul><li>A blood sugar level less than 140 mg/dL (7.8 mmol/L) is normal.</li><li>A reading of more than 200 mg/dL (11.1 mmol/L) after two hours indicates diabetes.</li><li>A reading between 140 and 199 mg/dL (7.8 mmol/L and 11.0 mmol/L) indicates prediabetes.</li></ul><h2>Urine Tests</h2>Urine tests may be done in people with <a href="https://www.google.com/url?q=https://www.medicinenet.com/diabetes_mellitus/article.htm&amp;sa=D&amp;ust=1547105369393000">diabetes</a>&nbsp;to evaluate severe <a href="https://www.google.com/url?q=https://www.medicinenet.com/hyperglycemia/article.htm&amp;sa=D&amp;ust=1547105369394000">hyperglycemia</a>&nbsp;(severe <a href="https://www.google.com/url?q=https://www.medicinenet.com/hyperglycemia/article.htm&amp;sa=D&amp;ust=1547105369394000">high blood sugar</a>) by looking for ketones in the urine. Ketones are a metabolic product produced when fat is metabolized. Ketones increase when there is insufficient <a href="https://www.google.com/url?q=https://www.medicinenet.com/insulin/article.htm&amp;sa=D&amp;ust=1547105369394000">insulin</a>&nbsp;to use <a href="https://www.google.com/url?q=https://www.medicinenet.com/glucose/article.htm&amp;sa=D&amp;ust=1547105369395000">glucose</a>&nbsp;for energy.Urine tests are also done to look for the presence of <a href="https://www.google.com/url?q=https://www.medicinenet.com/proteinuria_protein_in_the_urine/symptoms.htm&amp;sa=D&amp;ust=1547105369396000">protein in the urine</a>, which is a sign of kidney damage. Urine glucose measurements are less reliable than <a href="https://www.google.com/url?q=https://www.medicinenet.com/type_2_diabetes_pictures_slideshow/article.htm&amp;sa=D&amp;ust=1547105369396000">blood glucose</a>&nbsp;measurements and are not used to diagnose <a href="https://www.google.com/url?q=https://www.medicinenet.com/type_2_diabetes_pictures_slideshow/article.htm&amp;sa=D&amp;ust=1547105369396000">diabetes</a>&nbsp;or evaluate <a href="https://www.google.com/url?q=https://www.medicinenet.com/diabetes_treatment/article.htm&amp;sa=D&amp;ust=1547105369397000">treatment for diabetes</a>. They may be used for screening purposes.

<h4>Type 1 diabetes</h4>Type 1 diabetes is caused by the immune system destroying the cells in the pancreas that make insulin. This causes diabetes by leaving the body without enough insulin to function normally. This is called an autoimmune reaction, or autoimmune cause, because the body is attacking itself.&nbsp; The following triggers may be involved:&nbsp;<ul><li>Viral or bacterial infection&nbsp; </li><li>Chemical toxins within food</li></ul><h4>Type 2 diabetes</h4>Type 2 diabetes is primarily a lifestyle disease, people with certain genetic disposition are more at risk. The factors that increase the chances of developing the condition are.&nbsp;<ol><li>Obesity&nbsp; </li><li>Living a sedentary lifestyle&nbsp; </li><li>Increasing age&nbsp; </li><li>Bad diet</li></ol><h4>Gestational diabetes &nbsp;</h4>The causes of diabetes in pregnancy also known as gestational diabetes, remain unknown. However, there are a number of risk factors that increase the chances of developing this condition:&nbsp;<ul><li>Family history of gestational diabetes&nbsp; </li><li>Overweight or obese&nbsp; </li><li>Suffer from poly cystic ovary syndrome&nbsp; </li><li>Have had a large baby weighing over 9 lb</li><li>Causes of gestational diabetes may also be related to ethnicity - some ethnic groups have a higher risk of gestational diabetes.</li></ul>Some studies have suggested that frequent consumption of processed meats may increase the risk of type 2 diabetes. Meats, especially processed meats, contain many pro-inflammatory chemicals that can contribute to a chronic state of inflammation in the body.&nbsp;<h4>Connection to Mind Body constitution [TBC]&nbsp;</h4>Kapha pradhan prakriti are prone to diabetes. However diet, lifestyle and psychological health have significant relation with manifestation of diabetes, irrespective of prakriti. &nbsp; Type 2 diabetes is primarily an imbalance, or excess, of the Kapha dosha, which consists of the earth and water elements. Kapha governs the physical structure of our body and several metabolic processes, but when it builds to excess, can manifest in weight gain, lethargy, allergies, and resistance to change. Kapha Diabetes is treatable through diet and exercise, it is where diabetes clogs the system and is a disease of excess. It used to be a disease that mainly occurred in older patients, but it is now rising dramatically in children and adolescents, a population that is much more sedentary and overweight than previous generations.&nbsp; Overeating is sometimes provoked by an imbalance in the Vata dosha, which can easily become aggravated. When people with Vata imbalances overeat to soothe themselves, Kapha can in turn become imbalanced and, over time, contribute to the development of type 2 diabetes. However Ayurveda considers type 1 diabetes to be primarily an imbalance of the Vata dosha. Vata and Pitta Diabetes deplete the &nbsp;nervous system, Pitta Diabetes can be controlled with strict management whereas Vata Diabetes is much harder to treat and stabilize.&nbsp; &nbsp;

Since diabetes is mainly an excess of Kapha dosha, a Kapha-pacifying diet is recommended to keep diabetes under control. &nbsp;<figure class="table"><table><tbody><tr><td colspan="1" rowspan="1">Favor</td><td colspan="1" rowspan="1">Reduce/Avoid</td></tr><tr><td colspan="1" rowspan="1">Foods that are bitter, astringent, or pungent in taste</td><td colspan="1" rowspan="1">Foods that are sweet, sour, or salty.</td></tr><tr><td colspan="1" rowspan="1">Foods that are light, dry, or warm</td><td colspan="1" rowspan="1">Foods that are heavy, oily and cold</td></tr><tr><td colspan="1" rowspan="1">Use dairy substitutes, or small amounts of ghee, low-fat milk, and low-fat yogurt</td><td colspan="1" rowspan="1">Dairy tends to increase Kapha, use in moderation</td></tr><tr><td colspan="1" rowspan="1">All beans are good for Kapha types</td><td colspan="1" rowspan="1">Avoid soybeans and tofu, or eat in moderation</td></tr><tr><td colspan="1" rowspan="1">Lighter fruits such as apples, pears, pomegranates, cranberries, and apricots.</td><td colspan="1" rowspan="1">Heavier fruits like bananas, pineapples, and figs.</td></tr><tr><td colspan="1" rowspan="1">Grains like barley, corn, millet, buckwheat, and rye</td><td colspan="1" rowspan="1">Oats, rice, and wheat</td></tr><tr><td colspan="1" rowspan="1">Use pungent spices like pepper, cayenne, mustard seed, and ginger freely</td><td colspan="1" rowspan="1">Use salt in moderation</td></tr></tbody></table></figure>The Ayurvedic perspective on balancing Kapha is consistent with modern western medicine’s current understanding of the proper diet for diabetes, which recommends minimizing simple carbohydrates, fats, and other heavy foods while increasing “lighter” foods such as beans (as the main protein source), whole grains, and lighter fruits and vegetablesA diet high in legumes, fruits, and vegetables is also beneficial in the prevention and management of diabetes. Like whole grains, these foods tend to be high in fiber, and prevent the rapid release of glucose into the blood, thereby preventing rapid release of insulin as well.&nbsp;

Known medicines and how they work<h4>Formulas and their actions</h4>Sulfonylureas: &nbsp;glimepiride, glipizide, glyburide. Among the oldest diabetes drugs still used today. They work by stimulating the pancreas with the help of beta cells. This causes your body to make more insulin.Biguanides: metformin. Decrease how much sugar your <a href="https://www.google.com/url?q=https://www.healthline.com/human-body-maps/liver&amp;sa=D&amp;ust=1547105369401000">liver</a>&nbsp;makes. They decrease how much sugar your intestines absorb, make your body more sensitive to insulin, and help your muscles absorb glucose.Thiazolidinediones&nbsp;(Tzd): pioglitazone, Actosgeneric. &nbsp;Work by decreasing glucose in your liver. They also help your fat cells use insulin better. These drugs come with an increased risk of <a href="https://www.google.com/url?q=https://www.healthline.com/health/heart-disease&amp;sa=D&amp;ust=1547105369402000">heart disease</a>.Alpha-glucosidase inhibitors: Acarbose, Miglitol. These medications help your body break down starchy foods and table sugar. This effect lowers your blood sugar levels. For the best results, you should take these drugs before mealsMeglitinides: nateglinide. These medications help your body release insulin. However, in some cases, they may lower your blood sugar too much.Combination of sulfonylureas&nbsp;plus metformin<h3>Medical Interventions</h3>Interventions may be needed for when diabetes is severe and risk of associated complications are high<h4>Insulin</h4>Insulin injection is used to control blood sugar in people who have type 1 diabetes (condition in which the body does not make insulin and therefore cannot control the amount of sugar in the blood) or in people who have type 2 diabetes that cannot be controlled with oral medications alone.&nbsp;Insulin injection is used to take the place of insulin that is normally produced by the body. It works by helping move sugar from the blood into other body tissues where it is used for energy. It also stops the liver from producing more sugar. All of the types of insulin that are available work in this way. The types of insulin differ only in how quickly they begin to work and how long they continue to control blood sugar.<h4>Insulin Pumps</h4>An <a href="https://www.google.com/url?q=https://www.diabete.qc.ca/en/understand-diabetes/resources/glossary%23insulin&amp;sa=D&amp;ust=1547105369417000">insulin</a>&nbsp;pump is a battery operated portable device about the size of a pager, worn externally to deliver a continuous amount of fast-acting insulin. The wearer can also administer extra (bolus) doses of insulin when needed by pushing a button on the pump. <a href="https://www.google.com/url?q=https://www.diabete.qc.ca/en/understand-diabetes/resources/glossary%23insulin-pump&amp;sa=D&amp;ust=1547105369417000">Insulin pump</a>&nbsp;treatment is a type of intensive <a href="https://www.google.com/url?q=https://www.diabete.qc.ca/en/understand-diabetes/resources/glossary%23insulin-therapy&amp;sa=D&amp;ust=1547105369418000">insulin therapy</a>&nbsp;requiring multiple insulin injections.An insulin pump attempts to mimic the function of a normal <a href="https://www.google.com/url?q=https://www.diabete.qc.ca/en/understand-diabetes/resources/glossary%23pancreas&amp;sa=D&amp;ust=1547105369418000">pancreas</a>&nbsp;by delivering a basal insulin dose, and bolus doses at mealtime when blood <a href="https://www.google.com/url?q=https://www.diabete.qc.ca/en/understand-diabetes/resources/glossary%23glucose&amp;sa=D&amp;ust=1547105369418000">glucose</a>&nbsp;(sugar) levels rise above normal. Unlike the pancreas, insulin pumps don’t automatically deliver the appropriate amount of insulin based on what the user has eaten. Users, with the help of their healthcare team, must program the doses themselvesWhile an insulin pumps gives better control and higher lifestyle freedom to a diabetes patient, it can also lead to occasional infections and is an expensive option.<h4>Transplantation</h4>A transplant of the pancreas is usually reserved for those with type-1 diabetes and serious complications. Typically, part or all of a new pancreas is surgically implanted. The old pancreas is left alone; it still makes digestive enzymes, even though it doesn’t make insulin. Most organs are obtained from someone who has died but has decided to be an organ donor.Pancreas transplant can enable patient to enable normal blood glucose level without the need for taking insulin. This can result in the symptoms of diabetes stabilising, not getting worse and even improving in some cases - especially those with nerve damage. &nbsp;However this is a risky surgery and Transplant patients must take powerful immunosuppressant drugs to prevent rejection of the new pancreas.An alternate option being tried by some of the hospitals is Islet Transplants. &nbsp;Islets are clusters of cells in the pancreas that make insulin. In people with type 1 diabetes, islet cells are destroyed. Only 1-2% of the pancreas is made up of islet cells. In pancreatic islet transplantation, cells are taken from a donor pancreas and transferred into another person. Once implanted, the new islets begin to make and release insulin. Transplanting islet cells has several advantages over transplanting a pancreas. It is a minor surgical procedure, is less expensive, and is probably safer.<h4>Bariatric Surgery</h4>Bariatric surgery includes a variety of procedures performed on people who have obesity. Weight loss is achieved by reducing the size of the stomach with a gastric band or through removal of a portion of the stomach or by resecting and re-routing the small intestine to a small stomach pouch. Gastric bypass surgery often improves the symptoms of type 2 diabetes, even before patients start to lose weight.After gastric bypass, the small intestine spontaneously begins to produce a molecule called GLUT-1 that helps the body use glucose. This happens most likely because the intestine has to work harder to do its job, for example to absorb the nutrients or move the food further down. Also, it may be that the mechanical stress of 'dumping' the food directly to the intestine, since the stomach is bypassed, contributes to these changes.For severe diabetes, the benefits of surgery may far outweigh the complications associated with it.

<ol><li>Excessive urine formation &amp; Frequent urination.&nbsp; </li><li>Burning of palms and soles.&nbsp; </li><li>Increased hunger&nbsp; </li><li>Excessive Thirst.&nbsp; </li><li>Sweet taste to mouth etc.&nbsp; </li><li>Weight Loss &nbsp; </li><li>Blurry Vision &nbsp; </li><li>Wounds that take time to heal &nbsp; </li><li>Skin Infections&nbsp; </li><li>Unexplained extreme fatigue &nbsp; </li></ol>

Diabetes

Premenstrual syndrome (PMS) has a wide variety of signs and symptoms, including mood swings, tender breasts, food cravings, fatigue, irritability and depression. It's estimated that as many as 3 of every 4 menstruating women have experienced some form of premenstrual syndrome.&nbsp; PMS symptoms start five to 11 days before menstruation and typically go away once menstruation begins. The cause of PMS is unknown. However, many researchers believe that it’s related to a change in both sex hormone and serotonin levels at the beginning of the menstrual cycle.&nbsp; The symptoms of PMS are usually mild or moderate. &nbsp;Twenty to 32 percent of women report moderate to severe symptoms that affect some aspect of life.&nbsp; But a small number of women with premenstrual syndrome have disabling symptoms every month. This form of PMS is called premenstrual dysphoric disorder (PMDD).&nbsp; PMDD signs and symptoms include depression, mood swings, anger, anxiety, feeling overwhelmed, difficulty concentrating, irritability and tension.&nbsp;<h3> Emotional and behavioral signs and symptoms</h3><ol><li>Tension or anxiety</li><li>Depressed mood</li><li>Crying spells</li><li>Mood swings and irritability or anger</li><li>Appetite changes and food cravings</li><li>Trouble falling asleep (insomnia)</li><li>Social withdrawal</li><li>Poor concentration</li><li>Change in libido</li></ol><h3> Physical signs and symptoms&nbsp;</h3><ol><li>Joint or muscle pain</li><li>Headache</li><li>Fatigue</li><li>Weight gain related to fluid retention</li><li>Abdominal bloating</li><li>Breast tenderness</li><li>Acne flare-ups</li><li>Constipation or diarrhea</li><li>Alcohol intolerance</li></ol><h3> Do’s n don’ts of PMS (for mild to moderate cases) and during Menstruation.&nbsp;</h3><h3>Do’s&nbsp;</h3><ol><li>Dietary modifications - Including whole grain cereals and pulses, fresh fruits and vegetables to provide the necessary micronutrients and fibre.</li><li>Taking small meals which are easily digestible</li><li>Going for a 30 min walk daily, yoga and meditation to manage stress.</li><li>Take enough rest especially during the menstrual cycle, including a minimum 7 hours sleep</li><li>Maintain proper hydration and include fruits and vegetables with high water content.</li><li>Menstrual hygiene - changing the pads at frequent intervals depending on the flow. &nbsp;Using triphala powder, 15-20g powder boiled in half a liter water till colour changes, cool, sieve and use to clean the vaginal area once a day.</li></ol><h3>Don’ts&nbsp;</h3><ol><li>High salt, alcohol, high sugar/fat, highly refined foods and caffeine.</li><li>Any high intensity exercise or work or gymming or recreational activities like trekking/running marathons and so on.</li><li>Eat junk especially during abdominal cramps.&nbsp; </li></ol><h3>Dietary constituents that help during PMS&nbsp; &nbsp;</h3><ol><li>Cacao beans - rich in iron, calcium, magnesium, zinc and tryptophan (precursor for mood booster serotonin). &nbsp;A tsp of raw cacao powder to your milk/water helps to deal with the symptoms of PMS</li><li>Pumpkin seeds - rich in omega 3- and omega 6- fatty acids, fibre and zinc.</li><li>Green leafy vegetables - rich source of iron, calcium, magnesium.</li></ol><h3> Ayurvedic perspective/treatments&nbsp;</h3><ol><li>Application of warm castor oil on the abdomen</li><li>5ml of warm castor oil to be taken internally.</li><li>⅛ &nbsp;tsp of dry ginger + ¼ &nbsp;tsp of ajwain in a 45 ml water, boil till the colour changes, strain and drink.</li><li>Pranayam or deep breathing techniques.&nbsp; </li></ol>

Pre Menstrual Syndrome

The change in the seasons brings along a series of health problems to children and adults alike. &nbsp;It is a natural process where the body is trying to adapt to the change in atmospheric temperature/humidity. &nbsp;During this transition, some people with lower immunity fall sick where the body takes more than its normal stipulated time to get used to the change. &nbsp;Fever is one of the symptoms of any such sickness.Any cold/cough or stomach flu or any infection is manifested in the form of fever. &nbsp;Fever is when the temperature of the body is higher than the normal and is a part of our immune system’s natural response to any infection.What happens in fever?<ul><li>Certain symptoms like chills/body ache/headache may be accompanied with fever depending on the type of infection.</li><li>Sleepiness</li><li>Increased sensitivity to pain</li><li>Loss of appetite</li><li>Increase in body’s metabolism</li><li>Body temperature goes beyond the normal temperature of 98.6 degree Fahrenheit.</li></ul><h4>Dealing with Fever</h4>Do’s and Don’ts in a feverDo’s<ul><li>Wash your hands often - you may not want to spread the infections.</li><li>Put cold cloths on the forehead or arm to bring down the temperature.</li><li>Have good ventilation in the house. &nbsp;Proper air circulation helps to get in fresh air and also help to bring down the temperature.</li><li>Wear light clothing - wear loose cotton clothes that ‘breathe’. &nbsp;Do not wear layers of clothes or cover yourself with a sweater or thick blanket since it can trap heat and not bring down your body’s temperature.</li><li>Eat simple and easily digestible food - simple home cooked meals which are easily digestible like rice or idli should be taken, which can give quick energy and not load your digestive system.</li><li>Keep hydrated - since there is an increase in the body’s metabolic rate, dehydration is very common during fever. &nbsp;Drink plenty of liquids like plain water, juices, soups and coconut water.</li><li>Take rest - since body is fighting with the infection during fever, taking lot of rest can support our immune system to do its job.</li></ul>Don’ts<ul><li>Don’t make any travel plans - since your body is already trying to adapt to the changing environment, another change will take a longer time for the body to come back to its equilibrium.</li><li>Popping a pill/paracetamol - don't pop a pill if the temperature is 100 degree F. &nbsp;One of the body’s mechanism to fight with the bacteria/virus is by raising the temperature. If the temperature increases beyond 102 degree F accompanied with body pain or severe fatigue, check with your doctor for the medications.</li></ul>Tips for fever in children<ul><li>In children, the symptoms may vary, treatment should be given as per the symptoms.</li><li>Apart from the fever going beyond 101 degree F, symptoms such as lethargy, fatigue, sleepiness are present, then it is better to get the advice of a paediatrician and start them on antipyretic medicines.</li><li>Include herbs and spices like dry ginger, ajwain and pepper in the preparations which help to fight the infection and removes toxins from the body, also aids in restoring appetite.</li><li>Keep them well hydrated. &nbsp;Soups, rava/rice ganji, thin khichdi/pongal are easily digestible, gives the required energy and keeps the body hydrated.</li><li>Never force feed the child during fever since loss of appetite is a way for body to concentrate on fighting with the infection.</li></ul>&nbsp; Ayurvedic treatment options<ul><li>Kashaya - for 100ml of water, add 3g of dry ginger powder + 5g of ajwain + 3g of pepper powder + 2 cloves + small piece of cinnamon stick, boil it till the colour changes or reduce it till half. &nbsp;Strain and add jaggery, drink kashaya once or twice a day. This helps to detox the body and to improve appetite and digestion.</li><li>Mahasudarshan Gana Vati - for adults and children above 3 years of age, take 1 tablet, 3-4 times a day, for children (2-3yrs) ½ tab 3-4 times a day</li></ul>Since fever is just a symptom, efforts should be taken to find what is causing the fever. &nbsp;Give body some time to deal with the problem. If possible help the body to fight the infection by giving it enough rest, fluids and energy. &nbsp;This will go a long way in building up the immunity and avoid the unnecessary side effects of medications.&nbsp;

Fever

Asthma signs and symptoms include:<ul><li>Coughing or wheezing attacks that are worsened by a respiratory virus, such as a cold or the flu</li><li>A whistling or wheezing sound when exhaling (wheezing is a common sign of asthma in children)</li><li>Trouble sleeping caused by shortness of breath, coughing or wheezing</li><li>Chest tightness or pain</li><li>Shortness of breath</li></ul>Signs that your asthma is probably worsening include:<ul><li>The need to use a quick-relief inhaler more often</li><li>Increasing difficulty breathing (measurable with a peak flow meter, a device used to check how well your lungs are working)</li><li>Asthma signs and symptoms that are more frequent and bothersome</li></ul>For some people, asthma signs and symptoms flare up in certain situations:<ul><li>Allergy-induced asthma: triggered by airborne substances, such as pollen, mold spores, cockroach waste or particles of skin and dried saliva shed by pets (pet dander)</li><li>Occupational asthma: triggered by workplace irritants such as chemical fumes, gases or dust</li><li>Exercise-induced asthma: which may be worse when the air is cold and dry</li></ul>Children with asthma may exhibit symptoms such as:<ul><li>frequent colds that settle into the chest</li><li>rapid breathing that pulls the skin around their ribs or neck tight</li><li>Labored breathing</li><li>coughing, especially at night</li><li>a nagging cough</li><li>panting during activities that shouldn’t leave them winded</li><li>difficulty eating or sucking</li></ul>Antibiotic use early in life has been linked to the development of asthma in childhood; it is thought that antibiotics make one susceptible to development of asthma because they modify gut flora, and thus the immune system.Antibiotics are completely useless in case of viral/fungal infections. Antibiotics only act against bacterial diseases.Among older children, the most common symptoms include:<ul><li>cough</li><li>chest tightness</li><li>feeling winded after physical activities</li><li>wheezing, or a squealing sound, especially when exhaling</li></ul>

With more natural ways of treatment available for asthma, the disease can be easily managed. Following the guidelines given and avoiding the triggers are some of the ways to prevent the exacerbation of the disease.&nbsp; &nbsp;<hr>References&nbsp;<ol><li><a href="https://medlineplus.gov/asthma.html">https://medlineplus.gov/asthma.html</a></li><li><a href="https://www.nhlbi.nih.gov/health-topics/asthma">https://www.nhlbi.nih.gov/health-topics/asthma</a></li><li><a href="http://www.phcogrev.com/article.asp?issn=0973-7847;year=2009;volume=3;issue=6;spage=247;epage=258;aulast=prasad">http://www.phcogrev.com/article.asp?issn=0973-7847;year=2009;volume=3;issue=6;spage=247;epage=258;aulast=prasad</a>&nbsp;</li><li><a href="https://www.aaaai.org/conditions-and-treatments/asthma">https://www.aaaai.org/conditions-and-treatments/asthma</a></li><li><a href="https://kidshealth.org/en/kids/asthma.html">https://kidshealth.org/en/kids/asthma.html</a></li><li><a href="http://www.ccras.nic.in/sites/default/files/viewpdf/faq/Bronchial%20Asthma%20article%20and%20FAQs%20for%20web%20site.pdf">http://www.ccras.nic.in/sites/default/files/viewpdf/faq/Bronchial%20Asthma%20article%20and%20FAQs%20for%20web%20site.pdf</a></li><li><a href="https://www.naturalremediescenter.com/6239/dhumapana-herbal-smoking-cough-ayurvedic-therapy/">https://www.naturalremediescenter.com/6239/dhumapana-herbal-smoking-cough-ayurvedic-therapy/</a></li></ol>

<ul><li>Pay attention to increasing quick-relief inhaler use. If you find yourself relying on your quick-relief inhaler, such as albuterol, your asthma isn't under control. See your doctor about adjusting your treatment.</li><li>Take your medication as prescribed. Just because your asthma seems to be improving, don't change anything without first talking to your doctor. It's a good idea to bring your medications with you to each doctor visit, so your doctor can double-check that you're using your medications correctly and taking the right dose.</li><li>When your peak flow measurements decrease and alert you to an oncoming attack, take your medication as instructed and immediately stop any activity that may have triggered the attack. If your symptoms don't improve, get medical help as directed in your action plan.</li><li>Identify and treat attacks early. If you act quickly, you're less likely to have a severe attack. You also won't need as much medication to control your symptoms.</li><li>Monitor your breathing. You may learn to recognize warning signs of an impending attack, such as slight coughing, wheezing or shortness of breath. But because your lung function may decrease before you notice any signs or symptoms, regularly measure and record your peak airflow with a home peak flow meter.</li><li>Identify and avoid asthma triggers. A number of outdoor allergens and irritants — ranging from pollen and mold to cold air and air pollution — can trigger asthma attacks. Find out what causes or worsens your asthma, and take steps to avoid those triggers.</li><li>Get vaccinated for influenza and pneumonia. Staying current with vaccinations can prevent flu and pneumonia from triggering asthma flare-ups.</li><li>Asthma is an ongoing condition that needs regular monitoring and treatment. Taking control of your treatment can make you feel more in control of your life in general.</li><li>Follow your asthma action plan. With your doctor and health care team, write a detailed plan for taking medications and managing an asthma attack. Then be sure to follow your plan.</li></ul>

<figure class="table"><table><tbody><tr><td>Asthma - common in all the age groupsIt is a disease of the lungs where the airways become narrow, inflamed and produce mucus.Common symptoms - difficulty breathing, coughing, wheezing, shortness of breathExercise, pollution, certain medicines, infection, environmental and workplace triggers asthmatic attack</td><td>There are different types of asthma depending on the age and triggers.Prevention -&nbsp;<ul><li>Pay attention to breathing and identify asthma attacks</li><li>Breathing exercises</li><li>Take vaccination for respiratory diseases</li><li>Avoid triggers</li></ul>Treatment -<ul><li>Building up immunity through diet and exercise.</li><li>Ayurvedic therapies</li><li>Quick relief drugs</li><li>Long acting medicines</li></ul></td></tr></tbody></table></figure>Asthma is a condition in which your airways narrow and swell and produce extra mucus. This can make breathing difficult and trigger coughing, wheezing and shortness of breath.<figure class="image"><img src="https://millioneyes.azureedge.net/6gnzpmwj/image_1544346308655_36086a57b2d78e9f2cffe8a9b713ed52.jpeg"><figcaption>Asthma Illustration</figcaption></figure>

Genetics and environmental factors are the main causes of development of Asthma in adults2.Exposure to various irritants and substances that trigger allergies (allergens) can trigger signs and symptoms of asthma. Asthma triggers are different from person to person and can include:<ul><li>Air pollutants and irritants, such as smoke</li><li>Cold air</li><li>Physical activity (exercise-induced asthma)</li><li>Respiratory infections, such as the common cold</li><li>Airborne substances, such as pollen, dust mites, mold spores, pet dander or particles of cockroach waste</li><li>Certain medications, including beta blockers, aspirin, ibuprofen (Advil, Motrin IB, others) and naproxen (Aleve)&nbsp;</li><li>There is growing evidence that psychological stress is a trigger. It can modulate the immune system, causing an increased inflammatory response to allergens and pollutants&nbsp;</li><li>Sulfites and preservatives added to some types of foods and beverages, including shrimp, dried fruit, processed potatoes, beer and wine&nbsp;</li><li>Gastroesophageal reflux disease (GERD), a condition in which stomach acids back up into your throat.&nbsp;</li><li>Caesarean sections3 have been associated with asthma when compared with vaginal birth; a meta-analysis found a 20% increase in asthma prevalence in children delivered by Caesarean section compared to those who were not2.&nbsp;</li><li>Hormonal changes in adolescent girls and adult women associated with their menstrual cycle can lead to a worsening of asthma2.&nbsp; </li></ul>

Asthma is of various types and the treatment depends on the asthma variant.&nbsp;<ul><li>Allergic asthma - caused due to pollen, dust mites and so on, very common in childhood&nbsp;</li><li>Non - allergic asthma - caused basically due to weather changes. Monsoon or cloudy weather generally triggers such kind of asthma.&nbsp;</li><li>Other causes include cleaning products, strong odors like perfumes.&nbsp;</li><li>Asthma caused due to infection with a certain type of fungus.&nbsp;</li><li>Taking aspirin or other NSAIDs (non-steroidal anti-inflammatory drugs) triggers an asthma attack.&nbsp;</li><li>Exercise induced asthma - generally in athletes when the airways narrow during or after exercise&nbsp;</li><li>Waking up in the middle of the night due to asthma is sometimes called “nighttime asthma” or “nocturnal asthma.”&nbsp; </li></ul>

<ul><li>Controller medications are the most important because they prevent asthma attacks. When you use these drugs, your airways are less inflamed and less likely to react to triggers.&nbsp;</li><li>Quick-relief medications - also called rescue medications - relax the muscles around your airway. If you have to use a rescue medication more than twice a week, your asthma isn’t well-controlled. &nbsp; It is better to keep the medicine dose as low as possible since long term intake of high doses can lead to complications such as cataract and osteoporosis.&nbsp;</li></ul>Inhalers, Nebulizers, and Pills as Asthma Medicine&nbsp; There are a few ways to take asthma medications. Some are inhaled, using a metered dose inhaler, dry powder inhaler, or a nebulizer (which changes medication from a liquid to a mist). Others are taken by mouth, either in pill or liquid form. They can also be given by injection.&nbsp; Some asthma drugs can be taken together. And some inhalers mix two different medications to get the drugs to your airways quicker.&nbsp;<h3>&nbsp;</h3>

When it comes to the treatment it is very well documented by Ayurveda that we should do the treatment in a different pattern, and here it is-<blockquote>&nbsp;स्नेह बस्तिमृते&nbsp; केचिदूर्ध्व चाधश्च शोधनम ! मृदु प्रणयातं श्रेष्ठम श्वासदिनमादिशन्ति हि !!</blockquote>As per the Ayurveda Bronchial Asthma is Vatakaphaja disease, it begins in the stomach, progresses to the lungs and bronchi. Hence the aim of treatment is to move the excess Kapha back to stomach and then eliminate it. &nbsp; For this purpose following methods are adopted. &nbsp; 1. Swedana (Sudation) &nbsp; 2. Vamana (Therapeutic emesis) &nbsp; 3. Virechana (Therapeutic purgation) &nbsp; These procedures will be followed as per the need of the individual patient. &nbsp; &nbsp; For acute cases, medicines involve - &nbsp; Sameer Pannag Ras is an ayurvedic formulation. This formulation is known to be prepared from the mixture of herbs and minerals and available in the form of powder and tablet. &nbsp; For chronic cases, medicines involve - &nbsp;<ul><li>Shwas kuthar ras - ayurvedic medicine in powder/tablet form given in the treatment of asthma&nbsp;</li><li>Shwas kuthar chintamani ras - another ayurvedic medicine which consist of heavy metals and generally used in treating respiratory illness.&nbsp; Both these medicines are to be taken under supervision.&nbsp;</li></ul> Apart from the above medicines, some treatment common to both acute and chronic includes -<ul><li>Dhumapana7 is an Ayurvedic herbal smoking therapy for treating ailments (cough, bronchitis and asthma, etc). In this therapy, the person inhales herbal smoke for treating or preventing the diseases.&nbsp;</li><li>Abhyanga - body massage with herbal oil, local application of kharpuradi oil and making ajwain potli. These treatment methods can be used for kids as well.&nbsp; &nbsp;&nbsp;</li></ul><figure class="table"><table><tbody><tr><td>Ajwain potli&nbsp; Roast 2 tsp of ajwain on a tawa or a heavy bottom pan until the smell emancipates. Put roasted ajwain in a muslin cloth to make a potli or a thick pouch. You can rub this hot ajwain on your chest. It helps to counter congestion in chest and stuffy nose too.</td></tr></tbody></table></figure>Lifestyle measures&nbsp;<ul><li>Aiming for a healthy weight. Obesity can make asthma harder to manage. Even a 5 to 10 percent weight loss can help symptoms.&nbsp;</li><li>Being physically active. Even though exercise is an asthma trigger for some people, you should not avoid it. Physical activity is an important part of a healthy lifestyle. &nbsp;</li><li>Heart-healthy eating. Eating more fruits and vegetables, and getting enough vitamin D, can provide important health benefits that may help you with asthma control.&nbsp;</li><li>Managing stress. Learn breathing and relaxation techniques, which can help symptoms. &nbsp;</li><li>Quiting smoking or avoiding secondhand smoke. Smoking tobacco and secondhand smoke make asthma harder to treat. &nbsp; </li></ul>

Asthma is diagnosed generally by the medical history and using one of the below mentioned tests4,6 - &nbsp;<ul><li>Pulmonary function tests include Spirometry and peak flow which estimate the narrowing of the bronchial tubes and how fast an individual can breathe.</li><li>Chest X-ray is useful in differentiating asthma from other lung diseases. &nbsp;</li><li>Allergy tests helpful in finding the allergen causing the asthma. &nbsp;</li><li>Methacholine challenge test and Nitric oxide tests are confirmatory tests in Bronchial asthma.&nbsp; </li></ul>

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