Wednesday, September 12, 2012

Hypertension

 Transport Network inside the Body

Image Credit: http://www.boonhealth.com/2234/review-of-blood-flow/
Your circulatory system is the transport network inside your body. It consists of may streets. Veins and arteries play the role of "highways" by carrying blood cells and the plasma throughout the body. The pressure of the blood flow inside the blood vessel which is produced primarily by contraction of the heart muscles is called "Blood Pressure" [BP].

If this pressure is elevated, it is called "Hypertension" and it is "silent killer" which you can hardly find symptoms.

 

 

What are the two measurements of BP?

The two measurements are called Systolic and Diastolic pressure. It's because the pressure results from two forces; the first force occurs as the heart pumps blood into the arteries which is called Systolic pressure. The second force- Diastolic pressure occurs when your heart rests between beats. According to the Ayurvedic medicine, your body consists of three main doshas; Vata, Pitta and Kapha and it is Vata which is responsible for the circulation of the blood.
According to the American Heart Association Guidelines:
  • Normal blood pressure: Systolic - 90 to 120 mmHg / Diastolic - 60 to 80 mmHg
  • Prehypertension: Systolic - 120 to 139 mmHg / Diastolic - 80 to 89 mmHg
  • Stage 1 high blood pressure: Systolic - 140 to 159 mmHg / Diastolic - 90 to 99 mmHg
  • Stage 2 high blood pressure: Systolic - 160 to 180 mmHg / Diastolic - 100 to 110 mmHg
  • Hypertensive crisis: Systolic - > 180 mmHg / Diastolic - >110 mmHg
     
Image Credit: http://www.vertex42.com/ExcelTemplates/blood-pressure-chart.html

 

 Causes

Dietary factors -
The food you eat is digested by "digestive fire- Jatharagni" and plasma- Rasa dhatu is produced. It nourishes all the other tissues and maintains blood and circulates all over the body. Over consumption of the oily, fast food or the items with preservatives and chemicals cause impaired digestion, thus leads to accumulation of ama- toxins, and further leads to high blood pressure.

Image Credit: http://runsongreen.com/high-blood-pressure/
Another interesting and overlooked cause of high blood pressure is food allergies. In 2004 a record of 3,740 gluten intolerant adults on a gluten free diet reported that their blood pressure is significantly lower than the general population.
Soft drink, refined fructose and sugar consumption increase phosphate depletion of the liver cells which ultimately causes increasing uric acid. Uric acid is an inhibitor of nitric oxide- your natural blood pressure lowering agent.

Potassium (K) helps to balance the Sodium (Na) level in your cells. And it is essential to maintain blood pressure, cardiac function as well as to prevent clotting inside the vessels, whereas a lower level of Na can help lowering high blood pressure. Lack of Potassium consumption in diet may cause accumulation of Sodium in your blood. And high Sodium content in your diet also can cause your body to retain fluid, which increases blood pressure.

Sedentary lifestyles -
The more you weigh, the more blood you need to supply oxygen and nutrients to your tissues. And people who are inactive- with lack of exercise tend to have higher heart rates. The higher your heart rate, the harder your heart must work with each contraction and as the volume of blood circulated increases, so does the pressure on your artery walls.
"Belly fat" - intra-abdominal fat surrounding the abdominal organs is a highly metabolically active tissue with powerful, damaging effects and it is linked to hypertension. In fact, researchers believe that excess belly fat is a greater risk factor for chronic heart failure than overall obesity.

Smoking -
Smoking raise your blood pressure immediately. And the chemicals in cigarettes damage the lining of the artery walls. It causes narrowing of your arteries and increasing of your blood pressure.

Medications -
Many common over-the-counter and prescription medications can cause high blood pressure. e.g. contraceptive pills, ibuprofen, antibiotics, anti-inflammatory painkillers and antidepressants. The blood-pressure-raising effects of these drugs are more pronounced particularly in people with preexisting hypertension, renal failure and elders.

Loss of sleep -
Staying up late at night strains your body enormously. When you are exposed to light at night, it dramatically affects your body's production of melatonin, a hormone secreted by the pineal gland in the brain primarily during sleep. Exposure to light when melatonin secretion is highest [1AM - 2 AM] is particularly harmful and it raises blood pressure levels.

Stress and Anxiety -
Stress activates several biochemical pathways, sympathetic nervous system, which controls the release of two hormones - epinephrine and norepinephrine, elevate heart rate and constrict blood vessels. Stress also activates the renin-angiotensin system, which regulates blood pressure. Moreover, stress causes increased production of angiotensin 2, which is also linked to hypertension.


 Prevention

Dietary Solutions -
Diet plays a major role of lowering blood pressure. A diet rich in fruits, vegetables, and low-fat dairy products and reduced amount of saturated and total fat lowers the hypertension.

Vegetables -
Image Credit: http://www.info-on-high-blood-pressure.com
  • Leafy green vegetables: Spinach, Kale, Lettuce, Swiss chard, Chinese cabbage, Mustard greens, etc. are high in minerals and fiber and low in calories. They also contain a variety of phytochemicals and antioxidants; beta-carotene and lutein which fight plaque inside the blood vessels, thus helping in lowering blood pressure.
  • Cruciferous Vegetables: Broccoli, Cauliflower, Brussels sprouts, Cabbage and Bok choy are high in glutamic acid - the most common amino acid found in vegetable protein. It reduces the blood pressure and also the chances of stroke.
  • Carrots: High in beta-carotene and Potassium, maintains and regulates the normal blood pressure. Carrots can be juiced with a few herbs like mint or parsley, to maximize the benefits.
  • Sweet potatoes: Rich source of fiber which helps to flush out cholesterol from your blood stream.
  • Tomatoes: A good source of Potassium and Calcium, and contain many vital vitamins like A, C and E. They also contain lycopene, an antioxidant, help to lower high blood pressure. Lycopene prevents LDL cholesterol from sticking to the blood vessel walls, which protects the heart from raising blood pressure.
  • Bitter Melon/ Bitter gourd: A good source of amino acid called citrulline and it is essential to increase the amount of nitric monoxide and vitamin C, which helps to eliminate active oxygen to maintain nitric monoxide longer in the blood vessels which reduces blood pressure.
  • Celery: Contains 3-N-butyl-phthalide which has been tested to lower blood pressure; it also regulates blood flow by relaxing the muscles and it is also known to reduce weight.

Spices -
  • Garlic: Reduces bad cholesterol and also found in research that it lowers the blood pressure.
  • Onions: Contain quercetin- an antioxidant flavonol which reduces hypertension, prevent heart disease and stroke.
  • Oregano: Contains the compound carvacrol which has been proven to be effective against blood pressure.
  • Cardamon: A study demonstrated that blood pressure was effectively reduced by using cardamom. It also improves antioxidant status while breaking down blood clots but without altering blood lipids and fibrinogen levels significantly.
  • Cinnamon: Prevents heart disease and diabetes.

Fruits -
  • Banana: Rich in Potassium.
  • Prunes: Contains high Potassium and low Sodium levels.
  • Melons: A rich source of Potassium and Magnesium, which aids in bringing down the blood pressure. The carotenoids present in the melon, prevent hardening and narrowing of the vessel walls, thereby reducing the chances of constricted flow of blood through them.
  • Berries: Blueberries, Strawberries and Raspberries are rich in vitamin C, potassium, fiber and antioxidants. Blueberries contain a compound called pterostilbene which helps in preventing the build-up of plaque in the arteries.
  • Citrus Fruits: Grapefruit, lime, lemon, oranges and tangerine etc. are full of vitamin C, phytonutrients and bioflavonoids. The phytonutrients and bioflavonoids are anti-inflammatory in nature, and prevent clots inside the vessels. Bioflavonoids also help controlling cholesterol.

Herbs -
Get your Natural Healthcare physician's advice for the best herbal supplement
  • Gokshura: Diuretic and ACE inhibitor.
  • Sarpagnadha: By the action on the vasomotor center, it leads to generalized vasodilatation, with a lowering of blood pressure.
  • Gulkand [sweet preserve of rose petals]: Have a soothing and calming effect both physically and mentally.
  • Hawthorn Berry: Opens the coronary arteries and stimulates good blood circulation. And also keeps the arteries and veins from hardening, causing blood clots and strengthens the heart muscle to make it more effective in pumping blood throughout the body.
  • Olive Leaf: Maintains good blood circulation and helps in lowering blood pressure and preventing an irregular heartbeat.
  • Gingko Biloba: Helps in improving blood circulation by preventing the arteries from getting blocked.
  • Turmeric: Contains curcumin that helps to lower cholesterol in the body. And improves the flow by preventing blood clots. It is also good in strengthening the blood vessels and aiding liver disorders.

May all Beings be Healthy!

Dr. Indunil Weerarathne


References
http://www.nhlbi.nih.gov/health/public/heart/hbp/hbp_low/hbp_low.pdf
http://repository.ias.ac.in/67930/1/18_PUB.pdf

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Wednesday, October 5, 2011

Constipation



Constipation is one of the most common gastrointestinal complaints in the world. Those reporting constipation most often are women and adults ages 65 and older.

How it is defined the normal bowel movement?
The following bowel habits are considered as normal;
  • Bowel movement once a day
  • Bowel movement thrice a day
  • Bowel movement once in every three days

According to Ayurvedic medicine, stool [Purisha] is very important since it is a component of trimala [three waste products] a main factor that contributes to decide person’s health. Constipation occurs when there’s a derangement of mainly vata. The clinical definition of constipation is having any two of the following symptoms for at least 12 weeks-not always consecutive-in the previous 12 months:

Image credit
http://gbengaadebayo.com/preventing-constipation/
· straining during bowel movements
· lumpy or hard stool
· sensation of incomplete evacuation
· sensation of anorectal blockage/obstruction
· fewer than three bowel movements per week

Constipation is a symptom rather than a disease. There are several causes for the constipation. Mainly; dietary habits, impaired bowel movements, suppression of urge of defecation and lower GIT diseases like, haemorrhoids, fissures, anal stenosis etc. People who ignore the urge to have a bowel movement may eventually stop feeling the need to have one, which can lead to constipation. Some people delay having a bowel movement because they do not want to use toilets outside the home. Others ignore the urge because of emotional stress or because they are too busy. Children may postpone having a bowel movement because of stressful toilet training or because they do not want to interrupt their play.

Constipation occurs when the colon absorbs too much water or if the colon's muscle contractions are slow or sluggish, causing the stool to move through the colon too slowly. As a result, stools can become hard and dry. Common causes of constipation are;
  •  Low fiber in the diet
  • Lack of physical activity (especially in the elderly)
  • Medications: pain killers (especially narcotics), antacids that contain aluminum and calcium, hypertension medications (calcium channel blockers), iron supplements etc.
  • Changes in life or routine such as pregnancy, aging, and travel
  • Abuse of laxatives- flushing out of the body important vitamins, minerals and especially the friendly bacteria known as flora.
  • Dehydration


There some specific diseases that cause constipation including neurological disorders, metabolic and endocrine disorders, and systemic conditions that affect organ systems. These disorders can slow the movement of stool through the colon, rectum, or anus.

Neurological diseases
  • Multiple sclerosis
  • Parkinson's disease
  • Chronic idiopathic intestinal pseudo-obstruction 
  • Stroke 
  • Spinal cord injuries

Metabolic and endocrine conditions
  • Diabetes
  • Uremia
  • Hypocalcaemia
  • Hypothyroidism

How to prevent constipation?
Add plenty of fruits, vegetables and salads in your diet. Chew food thoroughly and eat only when hungry. High-fiber foods include beans, whole grains and bran cereals, fresh fruits, and vegetables such as asparagus, Brussels sprouts, cabbage, and carrots are good for constipated people. For people prone to constipation, limiting foods that have little or no fiber, such as ice cream, cheese, meat, and processed foods, is also important.

Fiber-both soluble and insoluble-is the part of fruits, vegetables, and grains that the body cannot digest. Soluble fiber dissolves easily in water and takes on a soft, gel-like texture in the intestines. Insoluble fiber passes through the intestines almost unchanged. The bulk and soft texture of fiber help prevent hard, dry stools that is difficult to pass. Both children and adults often eat too many refined and processed foods from which the natural fiber has been removed. A low-fiber diet also plays a key role in constipation among older adults, who may lose interest in eating and choose foods that are quick to make or buy, such as fast foods, or prepared foods, both of which are usually low in fiber. Also, difficulties with chewing or swallowing may cause older people to eat soft foods that are processed and low in fiber.

Other changes that may help treat and prevent constipation include drinking enough water and other liquids, such as fruit and vegetable juices and clear soups, so as not to become dehydrated, engaging in daily exercise, and reserving enough time to have a bowel movement. In addition, the urge to have a bowel movement should not be ignored.

Liquids add fluid to the colon and bulk to stools, making bowel movements softer and easier to pass. People who have problems with constipation should try to drink liquids every day. However, liquids that contain caffeine, such as coffee and cola drinks will worsen one's symptoms by causing dehydration. Alcohol is another beverage that causes dehydration. It is important to drink fluids that hydrate the body, especially when consuming caffeine containing drinks or alcoholic beverages.


Herbal Remedies for constipation
Image credit
http://www.health-reply.com/constipation-natural-remedies/
Ayurvedic remedies for constipation are different than standard medications. While the traditional laxatives provide relief, they do not cure the underlying causes. On the other hand the particular Ayurvedic remedies tackle the problem from different fronts, balancing the particular effected doshas in the process. Though I mention some of the common remedies here, I highly recommend you to meet your Ayurvedic physician for a better relief from constipation.
  • Infusion of Triphala powder [5g in 120 ml warm water] twice a day.
  • Ripe bael fruit is regarded as best of all laxatives. It cleans and tones up the intestines and a very effective home remedy for constipation.
  • One or two teaspoons of aloe gel can be taken twice a day.

You can find an interesting article about elimination and some good herbal medicines for constipation here;
http://www.kitchendoctor.com/midlife_tuneup/colon_cleanse.php

May all beings be healthy!

Dr. Indunil Weerarathne

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Friday, July 29, 2011

Diarrhoea - Atisara


Diarrhea- Atisara in Sanskrit means "excessive passage of watery stools"- "Ativa sarati iti Atisaram". Diarrheal disease is the second leading cause of death in children under five years old and is responsible for killing 1.5 million children every year. It is defined as the passage of three or looser or liquid stools per day or more frequently than is normal for the individual [WHO].

According to Ayurveda diarrhea is categorized under the diseases caused by Agni mandya- impaired digestive power. If we analyze the causes of diarrhea, we could conspicuously see almost all the causes end up with Agni mandya. According to the Ayurvedic medicine, Jatharagni [digestive power] consists of mainly three components; Pachaka Pita, Samana Vata and Kledaka Kapha. Imbalance between any of these doshas causes Agni mandya, mainly Kledaka Kapha and Samana Vata. For instance, an oil lamp lights with the aid of oil, air and fire. If there is excessive oil by any means, it would be extinguished as well as with the excessive air. But the action of the air varies from time to time. Here, air resembles with Samana Vata and oil with Kledaka Kapha. The result of Agni mandya is the accumulation of ama [undigested food particles] within the digestive tract, and it leads to diarrhea.

You would ask about the infectious diarrhea. Does Ayurvedic Medicine describe only about the concepts of doshas? The answer is "No". It describes that diarrhea can also be caused by Krimi- worms/ micro-organisms. Like modern medicine, Ayurvedic Medicine has also mentioned several types of diarrhea. However, one of the latest types of diarrhea is radiation induced Diarrhea. I am not going to compare both allopathic and ayurvedic types, but I assume that radiation induced diarrhea co-relates with Vataja Atisara, which is mainly due to vitiation of Vata. Radiation damages the cells of the body. Any damage to the cells causes "Dhatu Kshaya" - destruction of Dhatu. With the destruction of Dhatu, absorption of the food from the small intestines is defected. Then it causes a reverse effect on the Jatharagni [digestive power], and the result is the accumulation of ama. According to some of the modern concepts, radiation-induced diarrhea results from motility disturbances. Radiation damages the smooth muscles of small intestines, and hence bacterial overgrowth, which leads to diarrhea.
http://www.jci.org/articles/view/18326




How do you manage a patient suffering from diarrhea? In any event, the patient should not be given heavy foods, but a light and thinly liquid diet. Gruels [Yavagu] prepared with the admixture of digestive drugs can be given in their proper order. In a case marked by colic and flatulent distension of the abdomen, fasting should be first advised.

Herbal remedies for the diarrhea
Drinking a ginger tea digests ama and it increases appetite as well. A mixture of ginger juice with honey is also useful. Hingwashtak, Trikatu and Bilva fruit powders are good remedies, which increase appetite as well as digest ama. Nutmeg is the households remedy for treating loose motions. It reduces unwanted mobility of the intestine, relieves colic and controls loose motions. Infusion of slightly toasted cumin in boiled water is also effective. Then Kutaja (Holarrhena antidysenterica) powder can be given with honey. Pomegranate juice/ powder cures the loose motion and also increases the digestive capacity. Can these herbs use even in radiation-induced diarrhea? Probably Yes, because almost all the herbs are radio-protective as well.

You can find some good products for diarrhea from the following websites.
http://www.ayurvedicbazaar.com/digestion.php
http://www.sacred-medicine.org/ayurveda/parasites.php
http://www.sacred-medicine.org/ayurveda/fruit_powders.php


Dr. Indunil Weerarathne

Sunday, November 14, 2010

Flood borne diseases

Image credit: www.lankapage.com
This post is going to be little special as there's a special reason to write this. Colombo received highest rainfall in 18 years and many roads in Colombo and its suburbs have also been inundated as a result of the heavy rains. Nearly 186,900 people, the majority of them in Colombo, have been affected as of 11 November, according to the National Disaster Management Centre (DMC).
However I'm not going to give you a report of the rain. But as you know, there is a possibility of epidemic diseases spreading in the country due to the recent floods in various parts of the island. The Epidemiology Unit of the Ministry of Health announced the risk of the spreading of dysentery diseases, skin diseases and respiratory diseases and especially they pointed out that their could be an increase in the spread of the Influenza A (H1N1) virus.
According to WHO, floods can potentially increase the transmission of the following communicable diseases:
  • Water-borne diseases, such as typhoid fever, cholera, leptospirosis and hepatitis A
  • Vector-borne diseases, such as malaria, dengue and dengue haemorrhagic fever, yellow fever. 
And also various skin and soft tissue infections such as;
Impetigo, Cellulitis, Furuncles (staphylococcal), Scabies, Lice, Athlete’s foot, Eczema, Fungi and other skin allergies.

Typhoid fever - 
  • High fever
  • Malaise
  • Headache
  • Constipation or diarrhoea
  • Rose-coloured spots on the chest
  • Enlarged spleen and liver.

Cholerabaracke in Hamburg w√§hrend der Cholerae...         Image via Wikipedia
Cholera -
Symptoms usually start suddenly, one to five days after ingestion of the bacteria.

  • Profuse painless diarrhoea which is "rice water" in nature and may have a fishy odor.
  • Vomiting of clear fluid.
Leptospirosis - It is transmitted to humans by exposure of abraded skin or mucous membranes [nasal, oral or eye] to water or wet soil or food and water that has been contaminated by urine from asymptomatic chronically infected animals, especially rodents.
  • Initial symptoms - Abrupt onset of fever, Chills, Muscle pain esp. in calf muscles and back, Headache, Cough, Nausea, Vomiting, Diarrhoea and Red eyes.
  • Second phase of disease occurs after a short period of relative well being. They can present with; Aseptic meningitis, Myocarditis, Pneumonia, Nephritis and Hepatitis with jaundice.
Hepatitis A -
  • Prodrome
    • Patients may have mild flu like symptoms of anorexia, nausea and vomiting, fatigue, malaise, low-grade fever (usually <39.5°C), myalgia, and mild headache.
  • Icteric phase
    • Dark urine appears first (bilirubinuria).
    • Pale stool.
    • Jaundice occurs in most (70-85%) adults with acute hepatitis A virus infection
    • Abdominal pain occurs in approximately 40% of patients.
    • Itch (pruritus) is generally accompanied by jaundice.
    • Arthralgias and skin rash. Rash more often occurs on the lower limbs and may have a vasculitic appearance.
Malaria -
Caused by single-cell parasitic protozoa Plasmodium; transmitted to humans via the bite of the female Anopheles mosquito. Parasites multiply in the liver attacking red blood cells resulting;

  • Cycles of fever
  • Chills
  • Sweats
  • Anemia
Dengue and Dengue hemorrhagic fever - 
Aedes aegypti in Dar es Salaam, Tanzania                            Image via Wikipedia
The clinical features of dengue fever vary according to the age of the patient.
  • Infants and young children may have a fever with rash.
  • Older children and adults may have either a mild fever or the classical incapacitating disease with abrupt onset and high fever, severe headache, pain behind the eyes, muscle and joint pains, and rash.
Dengue hemorrhagic fever (DHF) is a potentially deadly complication that is characterized by high fever, often with enlargement of the liver, and in severe cases circulatory failure. The illness often begins with a sudden rise in temperature accompanied by facial flush and other flu-like symptoms. The fever usually continues for two to seven days and can be as high as 41°C, possibly with convulsions and other complications.

Yellow fever -
Infection can occur in one or two phases.
The first, "acute", phase usually causes;

  • Fever
  • Muscle pain with prominent backache
  • Headache
  • Shivers
  • Loss of appetite
  • Nausea or vomiting.
However, 15% of patients enter a second, more toxic phase within 24 hours of the initial remission. High fever returns and several body systems are affected. The patient rapidly develops jaundice and complains of abdominal pain with vomiting. Bleeding can occur from the mouth, nose, eyes or stomach. Once this happens, blood appears in the vomit and faeces. Kidney function deteriorates. Half of the patients who enter the toxic phase die within 10 to 14 days, the rest recover without significant organ damage.

Swine flu -
It affects the upper respiratory tract and its symptoms are similar to that of the Human Influenza Virus.

  • Sore throat
  • Headaches
  • Fever with chills
  • Aching limbs
  • Fatigue
  • Running nose
  • Diarrhoea
  • Vomiting
  • Pneumonia and respiratory failure [signs of a more serious swine flu infection]
How to avoid Flood borne diseases:
1. Hygiene and clean water:
Cleanliness is the most important aspect of protection against diseases. Clean food, air and surroundings are all essential aspects.
-Drink boiled water only.
-Wash vegetables with clean water and steam them well to kill germs.
-Avoid eating uncooked foods and salads.
-Drink plenty of water and keep your body well hydrated.
-Do not allow kids to play in stagnant polluted water filled puddles.
-Always wear dry and clean clothes.
-Lime juice, Cloves will help to prevent GIT infections like Cholera, Dysentery etc.

2. Vector control:
Insect repellants may be used.
-Fumigating the house with smoke of dried Neem leaves in evenings for 1-2 minutes is an excellent ayurvedic method to keep mosquitoes away.
-Tulsi is also used as a mosquito repellant.

3. Control of Skin diseases:
Walking in dirty water during rainy season leads to numerous fungal infections which affect toes and nails. Diabetic patients have to take a special care about their feet.
-Always keep your feet dry and clean.
-Avoid walking in dirty water.
-Keep your shoes, socks and raincoats dry and clean.
-Drying clothes with fumes of Loban and dry Neem leaves is recommended in ayurvedic texts.
-Apply castor oil or sesame oil for cracked feet and skin.
-A freshly prepared paste of turmeric, neem and sesame seeds is recommended in Ayurveda for fungal infection between toes.

4. Control of respiratory diseases:
Precautions have to be taken to prevent dampness and growth of fungus (mold) on and around the house especially where asthmatic patients live.
-Spray the walls with cinnamon to prevent mold growth.
-A pinch each of long pepper powder and rock salt mixed in warm water reduces cough.
-Ginger tea is good in boosting immunity as well as digesting toxins.


Herbs and drugs that can be used in epidemics:
  • Cumin, Fennel, Coriander, Turmeric, Ginger and Asafoetida are good immune boosters in any condition.
  • Nawarathna Kalka - Diarrhea, Abdominal pain and vomiting
  • Buddaraja Kalka - Cough, Breathlessness and Bronchial Asthma
  • Seetharama Vati, Sudardhana powder- Fever 
  • Sarvavishadi Thailaya- Boils abscesses, Ulcers, Skin ailments
Ayurveda Sri Lanka invites you to gather to help displaced people to return back their homes.
Finally I would like to thank my dear friend who reinforced me to share this post with you.

Dr. Indunil Weerarathne