What is Constipation

When bowel movements are difficult or happen less often than normal, constipation has developed. Everyone will experience it at some point in life and it is usually harmless.

The normal length of time between bowel movements varies widely from person to person, ranging from bowel movements three times a day to once or twice a week.

However, having no bowel movement for three or more days will usually result in stool becoming hard and difficult to pass.


Symptoms

• Fewer bowel movements than usual
• Straining to evacuate stool
• Hard and/or small stools
• Experiencing Tenesmus - a sensation of incomplete evacuation
• Abdominal swelling and tenderness
• Vomiting with reduced appetite

Causes

• Medications containing calcium or aluminum
• Dietary changes
• Colon cancer
• Excessive consumption of dairy products
• Eating disorders
• Irritable bowel syndrome
• Neurological conditions such as Parkinson's disease or multiple sclerosis
• Physical inactivity
• Dehydration
• Laxative abuse
• Pregnancy
• Haemorrhoids
• Narcotics, anti-depressants, and iron supplements
• Stress
• Hypothyroidism

Diagnosis

Doctors can order certain investigations to find the cause for constipation. For example:

• Blood tests to check hormone levels 
• Imaging studies like Barium studies to look for any blockages in your colon
• Colonoscopy 

What Should I Do If I Am Constipated?

• Unless instructed otherwise, drink two to four extra glasses of water a day 
• Warm fluids in the morning
• Increase fruits and vegetable intake
• Prunes, bran and cereal can help

When Should I Call My Doctor?

Call your doctor if:

• Constipation is a new problem for you
• Bloody stools develop
• Unexplained loss of weight associated with constipation
• Painful bowel movement
• Constipation beyond 2 weeks
• Pencil thin stools

Can I Prevent Constipation?

• Eat a well-balanced diet with plenty of fiber. 
• Drink lots of water
• Avoid caffeine
• Avoid milk if it causes constipation in you
• Exercise regularly.
• Be prompt to evacuate. Go to the bathroom when you feel the urge.

About The Author

Dr Lau Tzun Hon is a resident housecall doctor at CMY Medical. He received his MBBS (Hons) from Sydney University in 2001 and has served in the both private and government restructured hospitals prior to commencing his practice in Home Care.

While in the Government Restructured Hospitals, Dr Lau served primarily in the Department of Accident & Emergency Medicine and Anaesthesia. Upon entering the Private sector, Dr Lau worked in both public and private A&E departments before venturing into Home Care.

Over the years, he has developed a strong passion to maintain and  enhance the quality of life for patients under his care.  A strong believer that healthcare does not need to be financially straining, Dr Lau often delivers more value beyond expectations.

Influenza

Overview

Influenza is a viral infection that attacks your respiratory system — your nose, throat and lungs. Influenza, “the flu”, is a viral infection that attacks your nose, throat, and lungs.

In most cases, influenza resolves spontaneously. However, severe complications occur in certain people.

These high risk populations include:

• Children under 5
• Adults older than 65
• Nursing home Residents
• Pregnant women 
• Immunocompromised People
• Chronically ill Patients
• The Obese (BMI >40)

The best defense against influenza is to be vaccinated against it.


Symptoms

Runny nose, sneezing and sore throat. The difference between colds and the flu, however are marked. Colds usually develop slowly while flus are sudden.

Common signs and symptoms of the flu include:

• Fever over 38 Deg C
• Generalized aches and pains
• Rigors and Chills
• Headache
• Dry, persistent cough
• Fatigue and weakness
• Nasal congestion
• Sore throat

When To See A Doctor

If you have flu symptoms and are at risk of complications, see your doctor right away. 

Consumption of antiviral drugs within the first 48 hours can reduce the length of your illness and help prevent complications.

Causes

Flu viruses are transmitted via directly through the air. Carried by droplets of water in the breath, whenever an infected individual coughs, sneezes, or even talk, the virus spreads. Inhalation of these infected droplets results in infection. 

Infected individuals are contagious for about a week to 10 days after symptoms appear. 

Understand that the viruses are constantly evolving and changing. Hence, previous infections do not fully protect against new strains of the influenza virus.

Risk Factors

Factors that may increase your risk of developing influenza or its complications include:

• Age. The very young and very old are at increased risk. 
• Living conditions. Patients in facilities that recycle air or have other occupants in close proximity are at increased risk. 
• Weakened immune system. Cancer treatments, anti-rejection drugs, corticosteroids and HIV/AIDS all weaken your immune system making it easier to be susceptible to the flu.
• Chronic illnesses. Chronic conditions, such as asthma, diabetes or heart problems, may increases your risk of influenza complications.
• Pregnancy. Pregnant women, especially in the second and third trimesters and 2 weeks after delivery are at a higher risk. 
• Obesity.

Complications

These include:

• Pneumonia
• Bronchitis
• Asthma flare-ups
• Heart problems
• Ear infections

Treatment

Often, rest and fluids are sufficient for management of the flu. Doctors might prescribe an antiviral medication if you present early. These drugs may shorten the duration of illness and reduce the likelihood of developing serious complications.

Side effects of these Antiviral medication side effects may include nausea, vomiting and other more serious complications like hallucinations. As a result, it has been recommended that further studies be performed on antiviral drugs.

Self-Management

If you do come down with the flu, these home measures will ease your symptoms:

• Consume clear fluids.
• Get sufficient Rest..
• If necessary, painkillers like paracetamol can be used for symptom control

Prevention

The Center for Disease Control and Prevention recommends annual flu vaccination for everyone over the age of 6 months.

Each year's seasonal flu vaccine covers three or four influenza viral strains anticipated to thrive in the upcoming season.

Infection Control

• Wash your hands. Frequent Handwashing is strongly recommended. 
• Contain coughs and sneezes. Wear a mask or cover your mouth when coughing or sneezing
• Avoid crowds. Avoid crowded areas as the flu virus is spread through air

About The Author

Dr Lau Tzun Hon is a resident housecall doctor at CMY Medical. He received his MBBS (Hons) from Sydney University in 2001 and has served in the both private and government restructured hospitals prior to commencing his practice in Home Care.

While in the Government Restructured Hospitals, Dr Lau served primarily in the Department of Accident & Emergency Medicine and Anaesthesia. Upon entering the Private sector, Dr Lau worked in both public and private A&E departments before venturing into Home Care.

Over the years, he has developed a strong passion to maintain and  enhance the quality of life for patients under his care.  A strong believer that healthcare does not need to be financially straining, Dr Lau often delivers more value beyond expectations.

What Is Gastroenteritis

“Gastroenteritis” refers to inflammation and infection of the Gastrointestinal tract, commonly known as the “stomach flu” and is often associated with diarrhoea and vomiting.


Symptoms

Watery Diarrhoea, vomiting, stomach pain, abdominal cramps, fever, nausea and headaches are all known symptoms of Gastroenteritis.

As a secondary consequence, patients can become dehydrated. Clinically, patients will experience dry skin, dry mouth, feeling light headed and thirst.


Stomach Flu and Children

Children and toddlers dehydrate faster than adults. The child that constantly complains of persistent diarrhoea, nausea/vomiting and presents with dry skin is likely dehydrated. For toddlers, watch for dry and fewer diaper counts throughout the day.

Children with gastroenteritis should be kept at home away from school or day care centers until all the symptoms abate. It is best to have a full medical consult before returning to school.

There are vaccines available against viruses that cause Gastroenteritis. Do enquire with your attend physician.


Causes  of Gastroenteritis

There are many ways gastroenteritis can be spread:

• Contact with someone who has the virus.
• Contaminated food or water.
• Unwashed hands after going to the bathroom or changing a diaper.

Most commonly, Gastroenteritis is caused by a virus, either of the rotavirus or norovirus strains.

Rotavirus is the world's most common cause of diarrhea in infants and young children. Norovirus is the most common cause of serious gastroenteritis and also foodborne disease outbreaks in the U.S.

Bacteria, on the other hand, such as E.Coli, Campylobacter and Salmonella can also trigger severe Gastroenteritis. They can be spread by unwashed hands after toileting, poorly cooked poultry, eggs, poultry juices, and even through live poultry.

Another common bacteria of the shigella strain, is often found in day care centers as it typically spreads via contaminated food and drinking water.

Parasites can also cause gastroenteritis, but it's not common. Parasites like giardia and cryptosporidium spread via contaminated swimming pools or contaminated water.

Other less common causes of gastroenteritis include:

• Heavy metals (arsenic, cadmium, lead, or mercury) in drinking water.
• Eating a lot of acidic foods, like citrus fruit and tomatoes.
• Toxins that might be found in certain seafood.
• Medications such as antibiotics, antacids, laxatives, and chemotherapy drugs.

About The Author

Dr Lau Tzun Hon is a resident housecall doctor at CMY Medical. He received his MBBS (Hons) from Sydney University in 2001 and has served in the both private and government restructured hospitals prior to commencing his practice in Home Care.

While in the Government Restructured Hospitals, Dr Lau served primarily in the Department of Accident & Emergency Medicine and Anaesthesia. Upon entering the Private sector, Dr Lau worked in both public and private A&E departments before venturing into Home Care.

Over the years, he has developed a strong passion to maintain and  enhance the quality of life for patients under his care.  A strong believer that healthcare does not need to be financially straining, Dr Lau often delivers more value beyond expectations.