Belly bulges
Your Health
________________________________________DR GITA MATHAI
A protruding belly button is commoner in boys and may run in families
Everyone would love an eight pack abdomen, but for some it may remain just a dream. Their abdominal wall has unsightly bulges and protuberances, which may be a well rounded paunch or even hernia.
Some children have a protruding navel or belly button, which is noticed soon after the remnant of the umbilical cord falls off. When the baby cries or strains, the tummy bulges at the umbilicus. The swelling is called an umbilical hernia. It is commoner in boys. It may run in families and be associated with other diseases like thyroid deficiency or inborn errors of metabolism.
The foetus receives its nutrition through umbilical blood vessels that are attached to the navel. The abdominal muscles also fuse at that point. There is an area of weakness there which can cause a defect in the abdominal wall muscles. The intestines may protrude through this. Usually, the intestines can be pushed back when the child is quiet and lying down.
By the age of three or four years, the abdominal musculature develops and the hernia disappears on its own. It usually does not cause any symptoms till that time. If the skin over the hernia changes colour, or if the child starts to cry incessantly, consult a doctor. It may mean the intestine has got trapped in the hernia and its blood supply is being compromised, strangling the bowel.
Strapping the bulging belly button with plaster, tying it with a bandage or fixing a coin over it won’t help. On the contrary, it may be harmful as a piece of intestine may get caught in the bandage and stop the blood supply. This then becomes a medical emergency. If the hernia persists after the age of three, it needs to be surgically repaired.
Hernias can also suddenly appear near the umbilicus in adults. This “paraumbilical hernia” is situated just above the navel and occurs through a weakness in the abdominal wall muscles. It may be due to pregnancy, obesity or poor abdominal muscle tone. It may also appear if fluid accumulates in the abdomen as a result of kidney or liver disease. The hernia may contain fat or intestines.
Paraumbilical hernias that appear during pregnancy may disappear on their own. In others, they need to be surgically corrected, even if they are painless. Bits of bowel or other intestinal content can suddenly become trapped in them, precipitating an emergency. There is a band of fibrous tissue connecting and holding together the musculature of the two halves of the abdomen. If this is weak and separates out, it may cause a condition called “divarication of the rectus abdominus”. It is common in obesity. The affected area is usually long and stretches over the abdomen from the umbilicus to the rib cage. As the defect is large, the intestine does not become trapped inside. If there is no umbilical hernia, it can be left alone. Surgical repair is a variation of a “tummy tuck” and is done purely for cosmetic reasons.
If there is a small defect in the linea alba (fibrous structure running down the midline of the abdomen), a ping-pong ball sized bulge can occur at the spot. This is called an “epigastric hernia”. It needs to corrected.
About 75 per cent of hernias occur lower down in the groin area and are called “inguinal hernias”. They are commoner in men. They can extend from the lower part of the abdomen to the scrotum in men and to the labia in women. They are caused by a congenital defect in the abdominal wall. Some men push the contents of the hernia back into the abdomen and then use a “surgical truss” to hold it there.
The surgical treatment of hernias has changed over the years. Traditional techniques involved opening the abdomen and suturing the muscle layers. Hospital stays were prolonged and recovery slow. Now, laparoscopic repairs can be done, reducing the hospital stay to two or three days. Fine sterile surgical mesh can be used to cover the defect. The hernia is then less likely to recur as there is no tension on the layers of the abdominal muscles.
Some hernias can’t be prevented. Congenital abdominal wall defects are less likely to manifest as hernias if
• The BMI (body weight divided by height in metre squared) is 23
• Core strengthening exercises (oblique sit ups, plank position) are done daily
• Lifting heavy weights is avoided
• Weight-lifting exercises are done after proper training and conditioning.
Dr Gita Mathai is a paediatrician with a family practice at Vellore. Questions on health issues may be emailed to her at yourhealthgm@yahoo.co.in
Saturday, February 20, 2010
Saturday, February 13, 2010
fair and lovely
All’s not fair
Your Health
DR GITA MATHAI
PRIDE OR PREJUDICE? Beauty lies in a healthy, glowing skin and confident personality
Remember those TV commercials in which a dark complexioned girl found it impossible to get a suitable boy until she used a fairness cream? The ads continue, only with a slight difference: finding a groom has given way to finding a career path — as an airhostess, a sports anchor or beauty queen. The fair factor remains, as is engraved in our psyche. And it’s not just women who are being sent the unfair message; men too are told they must use fairness creams to win a girl or shine in their career.
Most people have a bias for fair skin. They consider it more attractive and subconsciously place it higher on the socio-economic scale. Newspapers are replete with matrimonial ads for “fair and beautiful” women.
Skin colour is genetically determined — it depends on the skin colour of both the parents. If one parent is dark and the other fair, the child is more likely to be dark. Dark skin contains more melanin, a pigment that gives skin its colour and protects against sunburn and skin cancer. This means dark skin is superior for adaptation and survival in the process of evolution.
People do various things to appear fair. Those who can spare only a few minutes apply a liberal coat of talcum powder before stepping out. The powder may be slightly yellow (as it may be mixed with sandalwood or turmeric), pink (calamine or some other colouring agent) or white, giving the person a ghostly, unnatural shade. Perfume and other additives in the talcum may cause allergy, itching, rash or sunlight sensitivity, leading to unsightly blotchy skin with dark and light patches.
Beauty parlours offer “skin peeling” face packs. They strip the superficial tanned and pigmented layers of the skin. Stripping does make a person appear 10 to 20 per cent fairer, but only temporarily. Once the skin grows back, the original colour returns. Stripping should not be done on a regular basis as it damages the skin. Also, it should never be done if there are pimples or cuts.
Manufacturers of fairness creams claim they do not use any harmful ingredients. As a rule, they must mention all the components on the packaging. The list, however, is often incomplete. Moreover, the percentage of each component is seldom stated. Companies hide behind the façade of it being a “trade secret”.
Most fairness creams contain sunscreen to prevent tanning. This is usually harmless. Some may have a bleaching agent, the concentration of which should not be more than 3-4 per cent. Higher concentrations may cause severe reactions with irritation, itching, blistering and severe pain.
Around 20 per cent of skin pigmentation can be reversed by applying 2 per cent hydroquinolone alone or in combination with 0.05-0.1 per cent tretinoin. Fairness creams often contain these chemicals.
What many people don’t know is that they may cause paradoxical sunlight sensitivity with sunburn if the skin is exposed to sunlight after application. Higher concentrations of these chemicals are dangerous and have been shown to cause cancer and birth defects in mice. They are banned in some countries.
If the cream contains steroids, it will cause thinness and atrophy of the skin. If used for prolonged periods, sufficient quantities can get absorbed and produce side effects like weight gain and facial hair.
“Natural herbal” products too are not 100 per cent safe. They contain refined plant extracts which may cause allergy.
Ayurvedic fairness creams contain heavy metals like mercury. These can get absorbed and accumulate in the deeper layers, causing liver and kidney damage.
The fairness industry in India is worth around Rs 1,400 crore. Advertisements often assert that people can become several shades fairer in four to six weeks. But they do not state how long the change lasts.
Any change in skin colour achieved with creams is not permanent. The superficial layers of the skin may change to a lighter shade. Actually, thousands of these cells are shed every day. It’s the deeper layers that contain the genetically determined quantities of melanin. As they grow out in three or four weeks, the dark colour returns. This means the products have to be used continuously, which may lead to side effects.
The safest products are probably the homemade ones. Make a mixture of 500 ml of coconut oil, 500 ml of sesame oil and 100 ml of olive oil. Apply a small quantity 10 minutes before a bath.
Homemade face packs can be made by mixing curd, honey and lemon juice. The lactic acid in the curd and citric acid in the lime act as mild bleaching agents, while the honey soothes the skin.
Before falling prey to an elusive dream, remember that regular exercise and a healthy, balanced diet will give you a glowing skin, toned body and a confident personality. This surely is worth more than just “fair” skin.
Dr Gita Mathai is a paediatrician with a family practice at Vellore. Questions on health issues may be emailed to her at yourhealthgm@yahoo.co.in
Your Health
DR GITA MATHAI
PRIDE OR PREJUDICE? Beauty lies in a healthy, glowing skin and confident personality
Remember those TV commercials in which a dark complexioned girl found it impossible to get a suitable boy until she used a fairness cream? The ads continue, only with a slight difference: finding a groom has given way to finding a career path — as an airhostess, a sports anchor or beauty queen. The fair factor remains, as is engraved in our psyche. And it’s not just women who are being sent the unfair message; men too are told they must use fairness creams to win a girl or shine in their career.
Most people have a bias for fair skin. They consider it more attractive and subconsciously place it higher on the socio-economic scale. Newspapers are replete with matrimonial ads for “fair and beautiful” women.
Skin colour is genetically determined — it depends on the skin colour of both the parents. If one parent is dark and the other fair, the child is more likely to be dark. Dark skin contains more melanin, a pigment that gives skin its colour and protects against sunburn and skin cancer. This means dark skin is superior for adaptation and survival in the process of evolution.
People do various things to appear fair. Those who can spare only a few minutes apply a liberal coat of talcum powder before stepping out. The powder may be slightly yellow (as it may be mixed with sandalwood or turmeric), pink (calamine or some other colouring agent) or white, giving the person a ghostly, unnatural shade. Perfume and other additives in the talcum may cause allergy, itching, rash or sunlight sensitivity, leading to unsightly blotchy skin with dark and light patches.
Beauty parlours offer “skin peeling” face packs. They strip the superficial tanned and pigmented layers of the skin. Stripping does make a person appear 10 to 20 per cent fairer, but only temporarily. Once the skin grows back, the original colour returns. Stripping should not be done on a regular basis as it damages the skin. Also, it should never be done if there are pimples or cuts.
Manufacturers of fairness creams claim they do not use any harmful ingredients. As a rule, they must mention all the components on the packaging. The list, however, is often incomplete. Moreover, the percentage of each component is seldom stated. Companies hide behind the façade of it being a “trade secret”.
Most fairness creams contain sunscreen to prevent tanning. This is usually harmless. Some may have a bleaching agent, the concentration of which should not be more than 3-4 per cent. Higher concentrations may cause severe reactions with irritation, itching, blistering and severe pain.
Around 20 per cent of skin pigmentation can be reversed by applying 2 per cent hydroquinolone alone or in combination with 0.05-0.1 per cent tretinoin. Fairness creams often contain these chemicals.
What many people don’t know is that they may cause paradoxical sunlight sensitivity with sunburn if the skin is exposed to sunlight after application. Higher concentrations of these chemicals are dangerous and have been shown to cause cancer and birth defects in mice. They are banned in some countries.
If the cream contains steroids, it will cause thinness and atrophy of the skin. If used for prolonged periods, sufficient quantities can get absorbed and produce side effects like weight gain and facial hair.
“Natural herbal” products too are not 100 per cent safe. They contain refined plant extracts which may cause allergy.
Ayurvedic fairness creams contain heavy metals like mercury. These can get absorbed and accumulate in the deeper layers, causing liver and kidney damage.
The fairness industry in India is worth around Rs 1,400 crore. Advertisements often assert that people can become several shades fairer in four to six weeks. But they do not state how long the change lasts.
Any change in skin colour achieved with creams is not permanent. The superficial layers of the skin may change to a lighter shade. Actually, thousands of these cells are shed every day. It’s the deeper layers that contain the genetically determined quantities of melanin. As they grow out in three or four weeks, the dark colour returns. This means the products have to be used continuously, which may lead to side effects.
The safest products are probably the homemade ones. Make a mixture of 500 ml of coconut oil, 500 ml of sesame oil and 100 ml of olive oil. Apply a small quantity 10 minutes before a bath.
Homemade face packs can be made by mixing curd, honey and lemon juice. The lactic acid in the curd and citric acid in the lime act as mild bleaching agents, while the honey soothes the skin.
Before falling prey to an elusive dream, remember that regular exercise and a healthy, balanced diet will give you a glowing skin, toned body and a confident personality. This surely is worth more than just “fair” skin.
Dr Gita Mathai is a paediatrician with a family practice at Vellore. Questions on health issues may be emailed to her at yourhealthgm@yahoo.co.in
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