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.

Ahead of World Diabetes Day observed on November 14, singer Nick Jonas recently opened up about living with type 1 diabetes for almost 21 years. Diagnosed at the age of 13, Jonas spoke about his daily decision-making that revolves around managing the condition. From monitoring blood glucose levels to adjusting insulin doses around meals and physical activity, Jonas expressed the emotional challenges of living with the disease.

In an open letter written for Dexcom's A Letter to Diabetes campaign, Jonas described the condition as an ongoing part of his everyday life. “Twenty-one years, and you haven’t changed a bit,” he wrote, addressing diabetes.

He also explained how frequently he has to monitor his glucose levels and make treatment decisions. “Staring at my phone to see where my glucose is. Reaching for my pump to bolus because I’m about to eat something with 17 carbs. Those are just a couple of the hundreds of little decisions I make every week,” Jonas wrote.

He described diabetes as “an ongoing conversation between your body, your mind, and your devices.”

The singer also recalled the emotional challenges of living with a chronic condition. However, he said that speaking openly about diabetes helped him find a sense of community and connect with others experiencing similar challenges.

What Is Type 1 Diabetes?

Also read: Can Ozempic, Mounjaro Drugs Protect The Brain? What A New Review Found

Type 1 diabetes is a chronic autoimmune condition in which the body's immune system mistakenly attacks and destroys beta cells that produce insulin in the pancreas.

Insulin is a hormone that helps move glucose from the bloodstream into cells, where it is used for energy. When the body produces little or no insulin, glucose builds up in the blood, resulting in high blood sugar levels.

Type 1 diabetes is different from type 2 diabetes as the latter occurs due to insulin resistance and can be a result of genetic and lifestyle factors. In short, type 1 diabetes is not caused by eating excessive carbohydrates and sugar, obesity or leading an inactive lifestyle.

Type 1 diabetes can also develop at any age, although it is frequently diagnosed during childhood or adolescence.

Symptoms Of Type 1 Diabetes

Also read: High-Fibre Diet Outperforms Metformin In Blood Sugar Control And Weight Loss, Study Finds

Symptoms can develop quickly, sometimes over a few weeks. Common warning signs include:

• Excessive thirst: Constantly feeling thirsty even after drinking water.
• Frequent urination: One may feel the urge to urinate frequently as the kidneys attempt to remove excess glucose through urine.
• Unexplained weight loss: The body starts breaking down fat and muscle for energy when it cannot use glucose properly.
• Increased hunger: Cells are unable to access enough glucose for energy.
• Extreme fatigue: High blood glucose and reduced energy availability can cause chronic tiredness.
• Blurred vision: Changes in blood glucose can affect the fluid balance in the eyes.

If type 1 diabetes is not diagnosed and treated on time, it can lead to diabetic ketoacidosis (DKA), a life-threatening complication.

Warning signs including nausea, vomiting, abdominal pain, deep or rapid breathing, fruity-smelling breath and confusion need immediate medical attention.

Management Of Type 1 Diabetes

Managing type 1 diabetes involves maintaining blood glucose levels within a specific target range to reduce the risk of both high and low blood sugar. Treatment includes:

1. Insulin Therapy

People with type 1 diabetes need insulin throughout their lives. It may be administered through multiple daily injections or an insulin pump which delivers insulin continuously.

2. Regular Glucose Monitoring

Blood glucose can be monitored using instant finger-prick tests or continuous glucose monitoring (CGM) devices. CGM systems use a sensor to track glucose levels throughout the day and night.

3. Dietary Management

People with type 1 diabetes need to understand how carbohydrates affect blood glucose levels so they can adjust insulin doses accordingly.

4. Physical Activity

Exercise is encouraged, but physical activity can affect glucose levels depending on its intensity, duration, timing and the amount of insulin in the body. People may need to adjust their food intake or insulin doses to reduce the risk of hypoglycaemia.

5. Regular Medical Follow-ups

Routine assessments help monitor glucose control and identify complications affecting the eyes, kidneys, nerves and cardiovascular system.

Type 1 diabetes diagnosis does not mean a person has to give up their career, travel, exercise or other ambitions. But living with this condition involves planning and attention to blood glucose levels, food, medication and physical activity.

Jonas has spoken about the importance of not allowing the condition to define his life. In an earlier interview with NIH's MedlinePlus Magazine, he shared a message for others living with type 1 diabetes, “Know that you can still do anything you want to do with your life.”

There is no cure for type 1 diabetes currently but advances in insulin delivery, glucose monitoring and research into therapies that preserve or replace insulin-producing cells are expanding treatment possibilities.

Pregnancy is often something women prepare for months in advance. They discuss nutrition, exercise, supplements, medical check-ups and what to expect as their bodies change. Menopause, however, rarely receives the same attention. It is often treated as a stage that women will simply reach one day and somehow manage along the way.

But menopause is also a major transition in a woman’s life, and being prepared for it can help make the experience easier to understand and manage.

Menopause itself is defined as the point when a woman has gone 12 consecutive months without a menstrual period. However, the transition usually begins earlier, during perimenopause, when changing hormone levels can lead to irregular periods, hot flashes, night sweats, sleep problems, mood changes and other symptoms. These changes can begin several years before menopause itself.

Preparation does not mean trying to prevent menopause or “balance” hormones before it happens. Most healthy women do not need supplements or hormones simply because menopause is approaching. Instead, preparation is about understanding what is happening and building a strong foundation for health.

What can women do before menopause?

Also read: At 58, She Mistook Memory Lapses For Menopause Brain Fog, But Tests Revealed Alzheimer’s Risk

Regular physical activity is one of the most useful habits to establish. Weight-bearing and resistance exercises can help maintain bone strength and muscle mass, which become increasingly important in midlife and beyond. Exercises that improve balance, coordination and proprioception, or the body’s awareness of its position and movement, can also support mobility and help reduce the risk of falls as women age.

Nutrition is equally important. A well-balanced diet should provide adequate protein along with essential vitamins and minerals. Calcium and vitamin D are particularly important for bone health, while a varied diet rich in vegetables, fruits, whole grains, pulses, nuts and other nutrient-dense foods can support overall health. Maintaining a healthy weight is also beneficial during this transition.

It is equally important to pay attention to cardiovascular and metabolic health. Regular checks of blood pressure, cholesterol and blood sugar can help identify common non-communicable diseases early. Avoiding smoking, staying physically active and maintaining healthy lifestyle habits can also support long-term health.

Preventive healthcare should not be overlooked either. As women enter midlife, keeping up with age-appropriate cancer screenings and routine health check-ups becomes an important part of looking after their health. The appropriate screening schedule can vary depending on age, family history, personal risk factors and local guidelines, so these should be discussed with a healthcare provider.

Just as importantly, women should become familiar with their own symptoms. Changes in periods, sleep, mood, body temperature, sexual health or concentration should not automatically be dismissed as “just ageing.” Keeping track of symptoms can help women recognise patterns and have more productive conversations with their healthcare provider.

Medical support is also an important part of preparation. Not every woman will experience menopause in the same way, and treatment is not automatically necessary. However, when symptoms begin to interfere with sleep, work, relationships or everyday life, hormonal and non-hormonal treatment options can be discussed with a doctor.

Perhaps the biggest change we need is in how we talk about menopause. It is not an illness, nor is it something women should simply suffer through in silence. It is a natural stage of life, but that does not mean its symptoms or its wider effects on health should be ignored.

Preparing for menopause is ultimately less about predicting exactly what will happen and more about entering this stage with knowledge, healthy habits and access to the right medical support. Women spend years preparing for major changes in their bodies. Menopause deserves that same attention.

By Dr Ponny M S, Consultant - Gynaecologist & Laparoscopic Surgeon, Apollo Adlux Hospital, Keralam

Delhi's air quality deteriorated sharply after Diwali celebrations, with several monitoring stations recording 'Severe' pollution levels on Monday, November 9. As firecracker emissions added to the city's existing pollution burden, concerns are mounting over the impact of toxic air on children's respiratory health.

For children, prolonged exposure to polluted air can be particularly concerning. What may initially appear to be a seasonal cough or minor throat irritation could become more serious if coughing persists or is accompanied by wheezing and breathlessness. Children with asthma or other respiratory conditions may be especially vulnerable, as poor air quality can aggravate their existing symptoms.

But how can parents distinguish a routine cough from a warning sign of respiratory distress? When should they seek medical attention, and what precautions can help protect children? HealthandMe spoke to pulmonologists to understand the symptoms parents should watch for and when to worry.

How Should Parents Respond If A Child Develops Coughing Or Wheezing?

Also read: Delhi AQI Crosses 2,000 Mark After Diwali: What Happens To Your Body Within Hours Of Exposure?

If a child develops a cough or wheezing, the first step is to minimise further exposure to polluted air.

Dr Nikhil Rajvanshi, Consultant – Pediatric Pulmonologist, Allergy and Sleep Specialist at Rainbow Children's Hospital, Delhi, advises parents to avoid outdoor play, running and strenuous physical activity when AQI levels are high.

Parents should also keep windows closed during peak pollution periods, use a HEPA air purifier if available, and ensure children wear a well-fitted N95 mask if they are old enough to tolerate it safely.

For children with diagnosed respiratory conditions such as asthma, following their prescribed treatment plan is important.

"If the child has a diagnosed respiratory condition such as asthma, parents should follow the prescribed action plan and administer inhalers or nebulisation only as advised by their doctor. Inhaled medication should never be started or discontinued without medical guidance," Dr Rajvanshi told HealthandMe.

He also cautioned against routinely giving children antibiotics or over-the-counter cough and cold medicines without consulting a paediatrician.

Warning Signs Of Breathing Trouble Parents Should Not Ignore

A cough does not always indicate a serious respiratory problem, but certain symptoms need prompt medical assessment.

Dr Rajvanshi said parents should watch for:

• Rapid or laboured breathing.
• Visible pulling in of the chest or ribs while breathing.
• Flaring of the nostrils.
• Persistent wheezing.
• Difficulty speaking or feeding because of breathlessness.
• Unusual drowsiness.
• Bluish or grey discolouration of the lips or tongue.

A child who is struggling to breathe, has pauses in breathing or develops bluish lips needs emergency medical care. Infants below three months with a temperature of 38°C or higher also require prompt medical assessment.

Read More: Delhi Becomes World's Most Polluted City Ahead Of Diwali, Says Swiss Agency: Experts Recommend Precautions

Coughing Or Wheezing: How Can Parents Tell The Difference?

One important distinction parents should understand is that wheezing is not simply another form of coughing.

Dr Rajvanshi explained that wheezing is a whistling sound, usually heard while breathing out, and may indicate narrowing of the airways.

Recurrent wheezing, night-time coughing or coughing that worsens during physical activity should be evaluated by a paediatrician rather than dismissed as a seasonal cough.

He also emphasised that good nutrition can support a child's general immunity but cannot replace appropriate respiratory treatment. Reducing pollution exposure, recognising symptoms early and seeking timely medical attention remain important.

How Can Families Protect Themselves From Poor Air Quality?

Dr Kuldeep Kumar Grover, Associate Director – Pulmonology and Critical Care at CK Birla Hospital, Gurgaon, said an appropriately fitted N95 or FFP2 respirator offers better protection against fine particulate matter than a cloth or surgical mask.

However, the mask must fit snugly around the nose and mouth, without gaps.

He advised people to avoid outdoor running, brisk walking, cycling and strenuous exercise during periods of high pollution, as increased breathing rates can lead to greater inhalation of pollutants.

Children, older adults, pregnant women and people with asthma, COPD or heart disease should be particularly cautious and minimise prolonged outdoor exposure.

At home, families should keep windows and doors closed when outdoor pollution is high, use a HEPA air purifier where possible, and maintain good indoor ventilation when outdoor air quality improves.

People with asthma or other chronic respiratory conditions should continue their prescribed medication and keep their rescue inhalers accessible.

"Anyone experiencing severe breathing difficulty or chest pain should seek immediate medical attention," Dr Grover told HealthandMe.

He added that air pollution can affect even healthy individuals, so precautions should not be limited to those with pre-existing respiratory conditions.

"The objective is not to stop stepping outdoors altogether, but to make informed decisions about when, where and how long we expose ourselves to polluted air," he said.