Many of us may have taken ibuprofen, sometimes two pills at once, especially when we are struggling with menstrual cramps. Well, as good these pills may be in treating the pain, they are not recommended for your health, especially if you are someone who consumes it on a daily basis or frequently. Gastroenterologist Trisha Pasricha, MD, writes in The Washington Post about why should you avoid taking nonsteroidal anti-inflammatory drugs, or NSAIDs, such as ibuprofen, naproxen and aspirin.

What happens when you consume pain killers?

She writes that NSAIDs are great in treating short term pain. They comprise of a group of drugs that inhibit the production of prostaglandins, which serve as a variety of purposes in the body. Some of which also includes contracting the uterus during menses and regulating blood flow in our vessels.

While one to two doses every now and then is okay, following a regular dosage routine, which could range from several times a month, or twice in an hour or so could lead to health risk. NSAIDs are well known to increase intestinal permeability. This means, these painkillers could damage the lining of your gut.

A 2018 review by Ingvar Bjarnason et. al., also writes about how NSAIDs can reduce the blood flow in the tiny vessels that feeds our guts. It can also disrupt the intestinal cells forming a barrier between the outside world and your insides.

What can be done?

While people with conditions like migraines, chronic back pain or bad period cramps can find NSAIDs to be helpful. It is always advisable to have a chat with your physicians to explore NSAID alternatives.

Pasricha suggests acetaminophen.

However, if someone is in dire need of NSAID, her tip is to take the pill right at the start of your symptoms. She says that the drug can do a far better job at stopping things at the source than chasing after all prostaglandins.

Why is it a concern?

NSAIDs are available as over the counter drug, which means people do not need a prescription for it and can make medical decision about them without the guidance of a physician.

A 2018 study published in the Official Journal of the International Society for Pharmacoepidemiology by David W Kaufman, et.al., found that 15% of adult ibuprofen users in the US have exceeded the maximum recommended daily dose. The study also mentions that more than a third of ibuprofen users were taking other NSAIDs, like aspirin and naproxen, while consuming ibuprofen at the same time. Out of these, 61% did not realise that they were using NSAIDs.

Pasricha talks about how it ruptures the gut wall, as she herself has rushed to the hospital in the middle of the night "far more times than" she can count "to perform an emergency endoscopy on someone who was bleeding profusely from an ulcer caused by NSAID".

Another 2009 study published in the American Journal of Gastroenterology states that as many as 1 in 4 chronic NSAID users will get an ulcer and about 4% will bleed or rupture through the gut wall.

An older study from 2005 titled A quantitative analysis of NSAID-induced small bowel pathology by capsule enteroscopy, found that as 75 percent of people regularly using NSAIDs develop low-grade inflammation in their small bowels. NSAIDs can also lead to development of fatty liver disease. This happens because your gut lining becomes more permeable, more toxins and bacteria from the outside world enters your liver and leads to inflammation.

A 2011 study titled Haemoglobin decreases in NSAID users over time: an analysis of two large outcome trials, states that as many as 6% of people taking NSAIDs regularly have found their blood count dropping within a few months of starting the medicines, this suggests that this is due to the small, slow amount of bleeding in the gut overtime.

Work, school, competition—stress appears to be inevitable these days. Across age groups, many are dealing with it in some form or the other, but unfortunately stress never stops at just headaches or fatigue. It has direct effects on an individual's health through causing disease (such as cardiovascular problems); it also has indirect effects on health by negatively influencing other health behaviors such as physical activity and sleep. It is also vital to note that stress is one of the leading health risks for people in the work environment. Healthcare professionals are advised to consider both major stressors and those that occur regularly. Further discussion about stress reduction strategies is provided.

Dr Anshuman Kaushal, Director of Robotic GI, Minimal Access & Bariatric Surgery at CK Birla Hospital, Gurugram, in an interview with Health and Me, spoke about the long-term effects of chronic stress and why it can be termed a lifestyle disorder.

Mechanisms of Chronic Stress

Exposure to certain stressors activates the HPA axis, and as a result, adrenaline and cortisol are released. While these hormones play a crucial role in survival during emergencies, they can result in serious health problems when continuously present in the body. Some of the most common consequences of stress are low immunity, insulin resistance, or inflammation. It can over time result in hypertension or heart disease.

Lifestyle as the Main Cause

With growing rates of urbanisation, competitive workplaces, financial issues, and the development of technology leading to a permanently accessible Internet, the boundaries between working time and time for rest have been blurred entirely. Moreover, an insufficient amount of sleep, poor sleeping habits, and a sedentary lifestyle cause stress as well. The young generation in India has become victims of stress-related disorders the most.

Identification of the Symptoms

One of the major challenges when identifying chronic stress cases lies in the subtlety of the condition. The list of symptoms includes constant fatigue, irritability, concentration issues, headaches, tight muscles, and insomnia. Other symptoms of the condition include gastrointestinal disorders such as acid reflux, bloating, and loss of appetite that are hardly ever associated with stress.

Long-term effects of stress

Chronic stress may appear harmless, but the truth is quite contrary. When an individual is stressed for too long without controlling it, it may result in anxiety disorders like depression. Physiological side effects of stress are:

1. Poor immunity
2. Inflammation
3. Obesity
4. Diabetes
5. Weakened memory
6. Mood swings

What makes chronic stress a lifestyle disease?

While most lifestyle disorders are caused by environmental factors and behavioural alterations, it can be termed a lifestyle disease. These disorders are progressive and require constant intervention in the form of medication or meditation.

Managing chronic stress

Doctors say that it takes a comprehensive strategy to reduce cortisol levels in the body and uplift mood. For instance, workouts like weight training or yoga are known to increase levels of happy hormones, thereby reducing stress. Breathing exercises and meditation, too, have a positive impact on mental health. Experts recommend combining them with nutrition, proper sleep, and socialising.

Early diagnosis matters

Chronic stress is not just a symptom of modern life but also a key health problem. Recognising it as a health issue and addressing it helps combat the long-term consequences well in time. And with continued changes in lifestyle habits and patterns, a lifestyle disease like chronic stress can also be brought under control for the better.

Asha Bhosle, India's veteran singer, died of cardiac arrest on Sunday. On Saturday evening, the 92-year-old was admitted to Mumbai's Breach Candy Hospital. Initially, she was admitted due to a chest infection but was later moved to the ICU the same night. The news of her hospitalisation was confirmed by her singer granddaughter Zanai Bhosle, citing 'extreme exhaustion and chest infection'.

"My grandmother, Asha Bhosle, due to extreme exhaustion and suffering a chest infection, has been admitted to hospital and we request you to value our privacy. Treatment is ongoing and hopefully everything will be well and we shall update you positively," Zanai wrote.

What is cardiac arrest?

A cardiac arrest is a medical emergency that requires immediate attention. It is characterised by a sudden halt in heart function – it stops beating and blood circulation to the brain and organs is consequently cut off. It is characterised by unresponsiveness, sudden collapse, and lack of breathing. As opposed to a heart attack, a cardiac arrest is an electrical failure caused by conditions like arrhythmia. The symptoms can include palpitations, dizziness, shortness of breath, and sudden collapse. For treatment, or as a life-saving measure, CPR must be performed.

What is CPR?

Cardiopulmonary Resuscitation (CPR) is an emergency procedure for patients who suffer a cardiac arrest. It combines chest compressions and rescue breathing to ensure oxygen flow to the organs. It is an effort to resuscitate a patient, and performing it immediately can double or even triple the chances of survival.

How to perform CPR?

To perform CPR on an adult, follow the given steps:

1. Begin by checking if the collapsed patient is responsive
2. Check if the patient is breathing or not, even if he or she is only gasping
3. Lay the patient on the ground with their back on a firm, flat surface
4. Place the heel of one of your hands on the centre of the chest and place the other hand on top of it
5. Start delivering chest compressions – hard and fast
6. Push at a rate of 100 to 120 compressions per minute and allow the chest to return to normal
7. You may combine 30 compressions with two rescue breaths until an ambulance arrives, or till the patient wakes up

Simply performing this can double the odds of survival, which is why CPR training is a must for all. However, doctors say that if not trained in CPR, then only perform compressions.

The prevalence of diseases and disorders in the gastrointestinal tract has increased within the last decade due to significant lifestyle modifications. Patients suffering from gastroenterological diseases exhibit high levels of depression, stress, anxiety, and dysfunction in the central nervous system. The name "functional gastrointestinal disorder" refers to numerous diseases manifesting symptoms related to GI problems (for example, pain in the abdomen, difficulty swallowing, indigestion, diarrhea, constipation, and bloating) but lacking detectable physical anomalies during standard diagnostic tests. There are 20 different diseases categorized as FGID in children. FGIDs have an extremely high frequency. Almost every other individual has met the criteria for FGIDs.

Dr. Anukalp Prakash, Director, Gastroenterology, CK Birla Hospital, Gurugram, in an interview with Health and Me, spoke about the rising incidence of

Prevalence Trends of Functional Gastrointestinal Disorders in India

Functional Gastrointestinal Disorders (FGIDs) occur frequently among adolescents, causing significant morbidity. Nevertheless, the actual prevalence rate is not well-defined yet. FGIDs are commonly encountered in school- and college-going adolescents, with most FGIDs being functional abdominal pain disorders.

Lifestyle Issues that Influence the Health of the Gastrointestinal System in Adolescents

1. Diet: Overconsumption of fast foods, junk foods, and sweet drinks leads to disturbances in the gut flora. Frequent consumption of oil-containing foods and spices raises the risk of heartburn and inflammation. Irregular meal times lead to indigestion.
2. Sedentary Lifestyle: Increased periods spent sitting because of online classes and remote working have adverse effects on intestinal motility. Inadequate physical activity leads to obesity and insulin resistance—the main causes of liver diseases.
3. Stress and Sleep Disorders: Educational and occupational stress affect brain-gut interactions. Stress causes irritable bowel syndrome. Sleep deprivation has a negative impact on liver function.
4. Substance Abuse: College alcohol abuse causes liver diseases like fatty liver and hepatitis. Cigarettes and energy drinks are detrimental to the GI tract and the liver.

Youth Lifestyles and Liver Disorders

1. Non-Alcoholic Fatty Liver Disease (NAFLD): NAFLD was uncommon among the youth previously but is becoming more prevalent nowadays. This is highly associated with obesity, insulin resistance, and bad dietary habits. The condition has no symptoms and develops gradually from benign fatty liver to cirrhosis.
2. Liver Injuries due to Alcohol Abuse: Binge drinking is common nowadays among the youth, especially among university students and city dwellers. Consumption of large amounts of alcohol in short periods of time leads to fatty liver or hepatitis. Persistent abuse leads to cirrhosis that develops earlier than usual.
3. Metabolic Disorders among Youths: These include several disorders such as obesity, diabetes, and high blood pressure due to lifestyle changes. These conditions have increased in prevalence in India as well as across the globe and result in NAFLD and heart ailments.

Management and Prevention Techniques

1. Dietary Modifications: Intake of whole grains, fruits, and vegetables along with drinking enough water should be suggested. Refined foods, beverages, and fast food should be reduced.
2. Daily Exercise: Doing moderate exercise for at least 30 – 45 minutes daily is suggested. Spending less time on the screens and opting for more exercise is recommended.
3. Stress Reduction and Sleep Patterns: Yoga and meditation practices enable better connection between the brain and intestines. Eight hours of sleep each night contribute to better regeneration of the liver.
4. Avoidance of Risky Behavior: Not consuming any alcohol, smoking cigarettes, or drinking energy drinks. Instead, recommending stress-reducing physical activities is suggested.
5. Frequent Screening for Illnesses: Liver screenings should be performed for young people who are at risk of health issues.