Diabetes insipidus (DI) is a rare medical condition that disrupts the body's ability to regulate water, resulting in excessive thirst and an unusually high volume of urine. This condition affects the kidneys' ability to concentrate urine and causes individuals to produce between 3 and 20 quarts of dilute, colourless urine daily, compared to an average of 1 to 2 quarts. It is pertinent to note that DI is not related to diabetes mellitus, which disrupts the body's insulin production.

Types Of Diabetes Insipidus

This condition results from damage to the hypothalamus or pituitary gland, which impairs the production or release of vasopressin, a hormone responsible for water retention. When vasopressin levels are inadequate, the kidneys fail to conserve water, leading to excessive urination. It can result from Brain injuries or surgeries, tumours, infections or inflammation and aneurysms.

Nephrogenic Diabetes Insipidus

This type occurs when the kidneys fail to respond to vasopressin, causing excessive fluid loss. Common triggers include chronic kidney disease, and electrolyte imbalances, such as high calcium or low potassium levels. Additionally, medications like lithium

and urinary tract blockages can also cause Nephrogenic DI.

Gestational Diabetes Insipidus

A rare condition seen only during pregnancy, this occurs when the placenta produces an enzyme that breaks down vasopressin or increases prostaglandin levels, reducing kidney sensitivity to the hormone. Symptoms of this are usually mild and often resolve postpartum but can recur in future pregnancies.

Symptoms And Warning Signs

• Severe thirst, often leading to the consumption of over a gallon of water daily
• Frequent urination (polyuria), sometimes exceeding 20 quarts per day
• Nighttime urination and bed-wetting
• Weakness, muscle pain, and preference for cold drinks

In severe cases, dehydration may develop, manifesting as fatigue, dizziness, dry mouth, confusion, nausea, or fainting. Infants and children with DI may exhibit crankiness, poor feeding, slow growth, fever, or vomiting.

Causes And Risk Factors

DI stems from issues with vasopressin production or response. Central DI arises from damage to brain structures, while nephrogenic DI relates to kidney dysfunction. Risk factors include:

- Genetic mutations affecting water regulation

- Certain medications like diuretics or lithium

- Metabolic disorders that alter calcium or potassium levels

- Brain injuries or surgeries

Diagnosis And Testing

Diagnosing DI involves a combination of medical history, physical exams, and specialized tests:

- Urinalysis: Evaluates urine concentration and glucose levels to distinguish DI from diabetes mellitus.

- Blood tests: Check electrolyte, glucose, and vasopressin levels.

- Water deprivation test: Measures changes in weight, blood sodium, and urine concentration during fluid restriction.

- MRI: Detects abnormalities in the hypothalamus or pituitary gland.

- Genetic screening: Identifies inherited risk factors.

Although DI is rare, affecting about 1 in 25,000 people, early diagnosis and targeted treatment can significantly improve quality of life. Researchers continue to explore its causes and treatments to better support those living with this challenging condition.

Many people do not realise just how closely mental health and liver health are connected—especially when alcohol becomes a go-to coping strategy for stress, anxiety, or emotional overwhelm. What may seem like temporary relief can quietly evolve into a pattern that affects both the mind and the body in significant ways. Dhara Ghuntla, Psychologist affiliated with Sujay Hospital, 7 Hills Hospital, Criticare Hospital, in an interaction with Health and Me, spoke about the impact of stress, alcohol use and emotional eating on the liver.

In today’s fast-paced, high-pressure lifestyle, it is common for individuals to turn to alcohol to unwind or escape difficult emotions. In the short term, alcohol can create a sense of relaxation or numbness. However, over time, this reliance can shift into a habitual coping mechanism and eventually into dependence. While the psychological impact is often discussed, the physical consequences—particularly on the liver—are just as important.

The liver plays a critical role in detoxifying the body. Regular alcohol consumption places it under constant strain, impairing its ability to function effectively. Over time, this can lead to conditions such as fatty liver, inflammation, and even long-term liver damage. What makes this especially concerning is that early-stage liver issues often present with little to no obvious symptoms, allowing damage to progress unnoticed.

At the same time, liver health has a direct influence on mental well-being. When the liver is compromised, it can affect energy levels, mood regulation, and cognitive function. People may experience increased fatigue, irritability, anxiety, low mood, or emotional instability. This happens because the liver plays an indirect but essential role in brain health through metabolism and toxin clearance.

The Vicious Cycle

This creates a self-perpetuating loop. A person feeling stressed, low, or anxious may turn to alcohol for relief. While it may help temporarily, it simultaneously places stress on the liver. As liver function declines, mental health symptoms—such as fatigue, irritability, anxiety, or low mood—can worsen. This often leads the individual to consume more alcohol, reinforcing the cycle.

Adding another layer, many individuals who rely on alcohol are often dealing with underlying issues such as depression, anxiety, sleep disturbances, or chronic life stressors. Alcohol is frequently used as a form of self-medication. However, instead of addressing these root concerns, it masks them temporarily while deepening both psychological and physical harm. Over time, this pattern increases dependency and makes recovery more complex.

The Gut–Liver–Brain Connection

Liver health is also closely tied to gut function and brain health. When the liver is under stress, digestion can be affected, nutrient absorption may decline, and energy levels can drop. This interconnected system—the gut, liver, and brain—plays a key role in emotional regulation and overall well-being. Disruptions in one area can ripple across the others, influencing how a person thinks, feels, and functions daily.

Breaking the Pattern

Recognising this connection is the first step towards change. Instead of turning to alcohol, healthier coping strategies can help regulate stress and support both mental and physical health. Practices such as yoga, meditation, regular exercise, journalling, and maintaining a balanced diet can significantly improve resilience and emotional stability.

Prioritising mental well-being, addressing underlying psychological concerns, and protecting liver health are not separate goals—they are deeply interconnected. Seeking timely support, whether through therapy, lifestyle changes, or medical guidance, can help break the cycle.

Reducing or eliminating alcohol use is not just about avoiding physical harm; it is about creating space to heal the underlying causes of stress and emotional distress. Supporting the liver, nurturing the gut, and caring for mental health together can lead to more sustainable and meaningful well-being.

You pick up a jar on the kitchen shelf and shudder. You take a flight of stairs, and that old pain sinks into your hip. You get up in the morning, and your shoulder feels as though it has been wrung out. You attribute it to age, to a long day on your feet, to just how things are now. But what if your body is trying to tell you something very particular and you have been missing it?

Dr Apoorv Dua, Consultant, Orthopaedics, ISIC Multispeciality Hospital, in an interview with Health and Me, said that this may be a sign of bursitis—a condition that is much more widespread than most people realise, and much more treatable than most people are aware. The expert went on to answer common questions regarding extreme pain that comes with this condition.

What is bursitis?

Bursae are small, fluid-filled sacs located between your bones, muscles, and tendons. Imagine them as the natural cushioning system of the body—shock absorbers that ensure your joints move smoothly and painlessly. Under normal circumstances, you do not even think about them. However, when inflamed, due to repetitive motion, prolonged pressure, injury, or infection, they make their presence known in a very noticeable manner. This is bursitis. Although it most often appears in the shoulder, elbow, hip, and knee, it may occur in nearly any joint in the body.

Who gets bursitis—and why?

This is where the lifestyle connection cannot be overlooked. Bursitis does not discriminate, but it has definite patterns. The weekend warrior who runs ten kilometres on Saturday after sitting at a desk all week. The housewife who spends hours cleaning floors or squatting in the kitchen. The office worker who has been stooped over a computer. The gym enthusiast who does not warm up. The retired teacher who begins a walking routine too vigorously. All these individuals may be silently placing stress on their bursae, and in many cases, bursitis is the eventual outcome.

Age also plays a role—the bursae, like most of our connective tissue, grow weaker with age. Certain medical conditions such as rheumatoid arthritis, gout, and diabetes can increase the risk. However, in many instances, the cause is simply the way we move—or do not move—in our day-to-day lives.

What does bursitis feel like?

A key characteristic of bursitis is pain that is disproportionate to the activity causing it. Reaching overhead, sitting on a hard surface, pressing on your elbow, or walking downhill—these are not dramatic movements, yet with bursitis, they may trigger a sharp, deep, or burning pain that interrupts you mid-action. The affected joint is usually swollen and tender. The area may feel warm to the touch. Movement becomes guarded. Sleep, particularly in cases of shoulder bursitis, can be difficult, as lying on the affected side aggravates the pain.

The challenge with bursitis is that its symptoms can resemble other conditions—tendinitis, arthritis, a muscle strain, or even a ligament tear. Many individuals self-diagnose, self-treat with painkillers, and hope it will go away. Sometimes it does. However, chronic, untreated bursitis may persist for months and, in some cases, lead to complications.

Bursitis diagnosis

A thorough clinical examination is usually the first step. A skilled orthopaedic specialist can identify the affected bursa through specific physical assessments. Imaging, such as ultrasound or MRI, may be recommended depending on the case to confirm the diagnosis, rule out structural damage, or guide treatment.

If infection is suspected—indicated by increased redness, fever, and rapidly worsening pain—fluid may be aspirated from the bursa and tested. Septic bursitis is a serious condition that requires immediate medical attention and is treated differently from the more common non-infectious type.

Bursitis treatment

The encouraging fact about bursitis is that it responds well to treatment, particularly when detected early. Most cases are managed with a combination of rest, activity modification, ice application, and anti-inflammatory medication. Physiotherapy also plays an important role, helping to correct movement patterns, strengthen supporting muscles, and restore the full range of motion.

In more persistent cases, a corticosteroid injection into the bursa may provide rapid and significant relief by reducing inflammation at its source. Surgery is rare and is typically considered only in chronic, recurrent cases that do not respond to conservative treatment.

Prevention is better

In many instances, bursitis is linked to lifestyle—and that presents an opportunity for prevention. Even small changes can help: warming up before exercise, avoiding excessive strain on joints, maintaining a healthy weight to reduce pressure on hips and knees, and ensuring workstations are ergonomically designed.

Pain often becomes background noise—something we get used to, work around, and push through. However, bursitis reminds us that the body communicates with precision. That pain when you pick up a jar, that discomfort on the stairs—it is not simply ageing. It is a signal worth discussing with your doctor.

The bulge that appears when an internal organ pushes through a weakened muscle wall will not recede with rest or medication—it will, in most cases, grow larger and more uncomfortable over time. Surgery is the only definitive treatment. What has changed significantly in recent years is what that surgery looks like and what recovery from it requires.

Dr Rajesh Sharma, Director – General Surgery, Minimal Access & Bariatric Surgery, CK Birla Hospitals, Jaipur, in an interview with Health and Me, spoke about the introduction of robotics in hernia treatment and how it can benefit patients.

How hernia surgeries are becoming less painful

With advances in surgical technology, minimally invasive approaches have significantly improved patient outcomes. One of the most important developments in recent years is robotic-assisted hernia surgery using the da Vinci Surgical System. In robotic surgery, the surgeon operates from a console equipped with a high-definition, three-dimensional, magnified view of the surgical field. The robotic system translates the surgeon’s hand movements into extremely precise movements of miniaturised instruments inserted through small incisions. The system also filters natural hand tremors and provides a greater range of motion than the human wrist, enabling meticulous dissection and suturing.

For hernia repair, these capabilities allow surgeons to perform delicate steps such as accurate defect closure and optimal mesh placement, which are important for the long-term durability of the repair.

Benefits for patients

Robotic hernia repair offers several advantages for patients:

1. Smaller incisions and minimal scarring
2. Reduced postoperative pain
3. Lower risk of wound complications
4. Shorter hospital stay
5. Faster return to normal activities

Because the procedure is minimally invasive, most patients experience earlier mobilisation and quicker overall recovery compared with traditional open surgery. Robotic surgery is particularly useful in complex, recurrent, or large ventral hernias, where precise reconstruction of the abdominal wall is important. While not every hernia requires a robotic approach, the technology expands the surgeon’s ability to perform advanced minimally invasive repairs with improved ergonomics and visualisation.

The future of hernia surgery

The integration of robotic platforms such as the da Vinci system represents a major step forward in modern general surgery. By combining surgical precision with minimally invasive techniques, robotic hernia repair aims to enhance patient comfort, improve recovery, and deliver durable surgical outcomes.