We're less than a week away from Diwali, about 45 days away from Christmas, and closer to another lockdown. The last time the world went into stringent lockdown limitations, the biggest concern was not only Coronavirus, but also existing underlying diseases. Many stayed home for months with a complete 360 degree change in lifestyle, temper, mental health and food habits. This lockdown, as we all gear up to consume more festive food, and get back to an inevitable sedentary lifestyle with more vulnerability towards obesity and triggering underlying health issues, Asian Voice reached out to Dr Ravi Misra, consultant gastroenterologist and endoscopist to talk about the challenges of this development, especially related to digestive health. Dr Misra specialises in inflammatory bowel disease (IBD), irritable bowel syndrome (IBS), reflux, diagnostic and therapeutic endoscopy.
What do you think has been the biggest learning about digestion and digestive health during the pandemic, especially for the Asian community that follows a certain traditional culture of eating and cooking?
The pandemic has changed people’s lifestyle and with that their eating habits. It is too early to say what the result of these changes will have on health. One would assume eating healthy home cooked food rather than eating out would be beneficial.
With the inevitable sedentary lifestyle in the given circumstances, how does one's digestive health get affected?
A number of my patients have experienced weight gain due to reduced commuting and increased access to food at home. Gut bacteria are crucial in the digestion of food. Physical exercise impacts gut bacteria by increasing the presence of beneficial bacteria. In contrast, a prolonged sedentary lifestyle is associated with reduced beneficial bacteria and increased risk of chronic diseases. A sedentary lifestyle will also increase risk of heart disease and diabetes.
Have patients in your understanding been able to consult doctors during the pandemic who were suffering from existing underlying health conditions?
There has been a significant change in practice with telephone rather than face to face appointments but the opportunity to consult with your doctor should always be available. I think there was a misconception that GP surgeries and hospitals were not treating other medical conditions. We encourage patients to consult their doctors if they have any concerns and attend hospital if they feel unwell. Managing underlying health conditions appropriately is important to prevent complications. We noticed the number of patients being diagnosed with bowel cancer dropped significantly during the first lockdown as people were not presenting to their doctor. This is something we wish to avoid.
With the advent of fad diets and various home remedies for digestion, how much do you think one's digestion gets affected? Is it a good way to go?
Social media enables the proliferation of fad diets which quickly become popular despite limited evidence. There is a huge variation between individuals in the way we react to the same foods and often a ‘one size fits all’ approach is unlikely to be effective. I would advise against extreme or oversimplified diets which may actually worsen your condition. Scientific experiments have demonstrated the anti-inflammatory properties of turmeric. Natural products which are free of preservatives are generally good for digestion. The tried and tested advice of a varied diet with fruit, vegetables, drinking plenty of water and avoiding processed foods is probably the best way to go.
What precautions can one take to avoid irritable bowel movement, inflammation and heartburn? Is food the end and the be all of triggering them or there are other causes?
Food is an important trigger in irritable bowel syndrome. Patients often describe bloating related to specific foods however there is wide variation in which foods cause symptoms. General advice would be to trial avoiding dairy and gluten products to see if there is any benefit but patients should keep a food diary to see which specific foods trigger their symptoms. Stress is certainly an important factor as well and identifying coping strategies that work for you is helpful. Inflammatory bowel disease is influenced by genetics, environment, lifestyle as well as food. There is extensive research examining the role of food in triggering inflammation. Heartburn is an extremely common symptom which can be exacerbated by alcohol, smoking, caffeine and food.
