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.

As many as 23 cases of young women aged below 35 suffering from heart-related problems in only a month (reported by the Indian Medical Association) have left cardiologists concerned. What were earlier considered symptoms of stress, anxiety, and hormonal imbalances such as chest pain, breathing difficulty, palpitations, unexplained fatigue, and giddiness are now not being taken lightly when they occur for a prolonged time or recur. They are being increasingly identified as cardiac-related problems even in young adults.

Lack of physical activity, improper diet, obesity, diabetes, high blood pressure, smoking, and continuous stress have been labeled responsible for these problems. Some women's conditions like PCOD and autoimmune diseases can also put them at a higher cardiovascular risk. Regular check-ups, monitoring of blood pressure, blood sugar, cholesterol levels, and timely check-ups for the heart whenever these conditions occur can help in detecting the problems at the earliest, thus initiating treatment and recovery effectively.

In today's times, management of complicated heart diseases in India has dramatically improved and achieved outcomes at par with global standards. Today, the management of very severe heart valve disease offers much in terms of percutaneous catheter-based solutions, which, alongside conventional surgery (performed according to a person's age, general health, and clinical profile), give improved outcomes. Early detection and management of heart diseases prevent major complications and restore an individual's quality of life.

Increased knowledge about heart health, early identification of symptoms, and immediate medical attention are very important to achieve successful results. The observance of preventive measures such as engaging in regular exercise, a healthy diet, sleep, managing stress, and conducting regular medical checkups helps in the prevention of heart problems. Early diagnosis and adequate treatment form the key factors for achieving the best heart health.

By Dr. Nagendra Singh Chouhan, Interventional Cardiologist at Medanta Hospitals, Gurugram

Feeling breathless after climbing several flights of stairs or a session of strenuous exercise is usually considered normal.

But breathlessness that appears suddenly, happens frequently, or occurs during routine activities should never be dismissed as tiredness or lack of fitness.

When Is Breathlessness Concerning?

Breathlessness, clinically known as dyspnoea, can occur due to many reasons. Asthma, allergies, respiratory infections, chronic lung disease, and heart problems are some of the common possibilities. Anxiety, anaemia and obesity could also be driving factors.

In some cases, persistent or unexplained breathing difficulty may also be linked to more serious conditions, including lung cancer. The important thing is to understand when breathlessness needs medical attention.

HealthandMe spoke to lung disease experts - Dr. Sachin Kumar, Director of Pulmonology & Critical Care Medicine, Sakra World Hospital, Bengaluru, Dr. Sanjeev Kumar, Director & Unit Head of GI & HPB Surgical Oncology & Clinical Administrator, Surgical Oncology, Max Super Specialty Hospital, Dwarka, Dr. Ruchi Singh, HOD & Senior Consultant, Radiation Oncology, Asian Institute of Medical Sciences, and Dr. Ashwin Mallya, Uro-Oncologist and Robotic Surgeon, Sir Ganga Ram Hospital.

Dr. Sanjeev Kumar explains that breathlessness that gets worse during routine activities are major red flags. He also says that other symptoms like chronic cough, coughing up blood, tiredness, and others should not be neglected.

He says, "Pay attention if breathlessness is accompanied by chest pain or pressure, dizziness, fainting, unusual sweating, bluish lips or fingertips, or a feeling that you cannot get enough air. A persistent cough, wheezing, recurring chest infections, coughing up blood, unexplained weight loss or prolonged fatigue along with breathlessness also deserves medical assessment. A cough that does not go away or changes in a long-standing smoker’s cough should not be overlooked. Although these symptoms can have several causes, they can occasionally be associated with lung cancer and need appropriate evaluation."

He also said that changes in usual breathing capacity is also a red flag. He said that if you previously walked comfortably for 20–30 minutes but now have to stop frequently because you are breathless, this change should not simply be attributed to age.

Also read: Lung Nodule on CT Scan? Doctors Explain When You Should Worry

Risks Of Delayed Evaluation & Treatment

Dr. Ruchi Singh points to a worrying trend. She said that the initial symptoms of lung cancer are usually dismissed as routine, which leads to delayed evaluation and treatment.

She says, "One of the most concerning things we are tracking is how late many patients present. Because symptoms like persistent cough or breathlessness are so easily mistaken for pollution-related irritation or a lingering infection, people delay getting scanned."

She explains that earlier detection through low-dose CT screening in high-risk groups remains the best tool for improving survival, and awareness needs to catch up with how the patient's profile itself is changing.

Also read: Can Fitness Hide Lung Cancer? Why Even Active People Shouldn't Ignore Symptoms

Importance Of A Multidisciplinary Approach

Talking about how lung cancer could metastasize, Dr Ashwin Mallya explains that along with early evaluation, it is essential to adopt a treatment strategy

Dr Mallya said, "Although primarily a thoracic malignancy, lung cancer frequently extends beyond the chest. Adrenal metastases are among its most common distant manifestations, while renal metastases, though less frequent, are well recognised."

He added, "These patterns underscore the importance of a multidisciplinary approach, often bringing urologists into the care of patients with advanced disease."

Also read: 'I Wish Every Patient Knew This Before Their Lung Cancer Diagnosis'- Lessons From An Oncologist

Lung Cancer Is No Longer A Smoker's Disease

Giving a real-life example of how lung cancer is no longer a smoker's disease, Dr Sachin Kumar said, "A 50-year-old lady went to the clinic seeking a second opinion after being treated for "asthma" for several weeks. She complained of occasional breathlessness and a persistent cough. Despite inhalers, her symptoms continued. A simple chest X-ray revealed something entirely different: a massive pleural effusion (fluid around the lung). Further evaluation confirmed the underlying cause: *lung cancer that had spread to the pleura (the lining surrounding the lungs).

He added, "This case is a reminder that not every cough or episode of breathlessness is asthma. When symptoms persist or do not respond as expected, they deserve a fresh look. Sadly, lung cancer is no longer a disease seen only in older male smokers. In our own practice, we now diagnose around 2–3 new cases of primary lung cancer every three months, and nearly 40% of these patients are either women or people who have never smoked."

Kidney stones are no longer a disease seen only in middle-aged adults. Across urban India, nephrologists are witnessing an increasing number of young professionals developing kidney stones. Sedentary lifestyles, inadequate water intake, unhealthy dietary habits, obesity, and rising temperatures are all contributing to this growing problem.

It is estimated that nearly one in every ten Indians will develop a kidney stone during their lifetime, and almost half of these patients may experience recurrence if preventive measures are not adopted.

Why Are Kidney Stones Becoming More Common?

Kidney stones form when minerals and salts in the urine become highly concentrated and crystallize inside the kidneys.

Several lifestyle factors increase this risk:

• Drinking too little water

• Excessive salt intake

• Frequent consumption of processed foods and sugary beverages

• High intake of animal protein

• Obesity and sedentary lifestyle

• Diabetes and hypertension

• Prolonged exposure to hot weather causing dehydration

• Busy work schedules, air-conditioned offices, frequent travel, and ignoring the urge to drink water have become common contributors in urban populations

Also read: Adult Kidney Transplant Recipients Who Took COVID-19 Drug Remdesivir At Lower Risk Of Transplant Failure

Warning Signs

The symptoms depend upon the size and location of the stone. Small stones may pass unnoticed, while larger stones can produce severe pain. Common symptoms include:

• Sudden severe pain in the back, side, or lower abdomen

• Pain radiating towards the groin

• Burning during urination

• Blood in urine

• Increased frequency or urgency of urination

• Nausea and vomiting

• Fever with chills, especially if infection develops

• Persistent pain, fever, or difficulty passing urine should never be ignored, as these may indicate obstruction or infection requiring urgent medical attention

Also read: Why Dialysis Patients Should Check Their Fistula Every Day

Can Kidney Stones Be Prevented?

The answer is yes. Most kidney stones can be prevented through simple lifestyle modifications. The most important preventive measure is adequate hydration. Adults should drink enough fluids to produce at least 2–2.5 litres of urine daily, which generally requires about 2.5–3 litres of water per day, depending on climate and physical activity.

Other preventive measures include:

• Reduce salt intake

• Limit processed and packaged foods

• Moderate consumption of red meat

• Avoid excessive sugary drinks

• Maintain a healthy body weight

• Exercise regularly

• Control diabetes and high blood pressure

Contrary to popular belief, dietary calcium should not be avoided unless specifically advised by a doctor. In fact, normal calcium intake helps reduce oxalate absorption and lowers the risk of stone formation.

Modern Treatment Has Changed the Outlook

Fortunately, advances in technology have made kidney stone treatment highly effective and minimally invasive.

Small stones often pass with increased fluid intake, pain relief, and medications that relax the urinary tract. However, larger or obstructing stones require specialist treatment.

Current treatment options include:

• Extracorporeal Shock Wave Lithotripsy (ESWL): Non-invasive shock waves break stones into smaller fragments

• Ureteroscopy (URS): A thin endoscope is passed through the urinary tract to remove or fragment stones

• Retrograde Intrarenal Surgery (RIRS): Flexible laser technology allows treatment of stones inside the kidney without any external incision

• Percutaneous Nephrolithotomy (PCNL): Recommended for large or complex kidney stones through a small skin incision

• Compared with conventional open surgery, these procedures offer higher success rates, less pain, shorter hospital stays, and faster recovery

The Take-Home Message

Kidney stones are becoming increasingly common but are largely preventable. Adequate hydration, healthy dietary habits, regular exercise, and timely medical evaluation can significantly reduce the risk. Those who have already developed one stone should undergo metabolic evaluation and follow preventive advice, as recurrence is common.

Early diagnosis and timely treatment not only relieve pain but also protect kidney function and improve long-term health.