Problems with your throat:

What you should know

Have you always had problems with your throat? Sore throats can be caused by many things. Viruses (such as those that cause colds and mononucleosis) can lead to a sore throat. Bacteria (such as those that cause strep throat) can also cause a sore throat, as can smoking, breathing polluted air and allergies to pet dander, pollens and molds. The throat is a fairly complex part of the anatomy, not only does it form part of the upper respiratory tract, but it helps with the initial stages of digestion along with helping form our speech.

In general, the throat is made up of the larynx (which includes the vocal folds), the pharynx, the epiglottis and the uvula; there are also lymph tissues in the throat called the tonsils and adenoids.

Dr. Chandra Jayasuriya ENT Surgeon of the General Hospital said that it was evident that there were more women being affected with throat ailments than men.

"Women have psychological issues like depression which results in 'a lump in the throat' that can cause throat ailments if they don't release their bottled feelings" she said. The General Hospital is equipped with a highly sensitive metal endoscope that can see the throat problems well enough to determine the cause of it. In this way, it is easier to get foreign bodies out of the throat as visibility is clear.

"There are two types of throat problems - acute and chronic" said Dr.Jayasuriya. The acute kind is when foreign particles penetrate the throat. "As we are an island nation, we tend to eat plenty of fish and so we have acute throat problems when fish bones get stuck in the throat that need to be taken out" she said.

Yet another ailment of the throat is tonsillitis which occurs when the tonsils (at the back of your mouth on each side of your throat) become infected by bacteria or a virus. It causes the tonsils to swell and can cause a sore throat and other symptoms.

"The body has its own defense mechanisms and one of them are the tonsils which secrete antibodies" said Dr.Jayasuriya. Further she commented, "When the tonsils become infected, they swell becoming red and inflamed and may show a surface coating of white spots".

Tonsillitis is extremely common in children and young people but it can occur at any age. The characteristics of the disease are pain in the throat and trouble swallowing.

The doctor said that surgery to remove the tonsils (tonsillectomy) may be vital for patients suffering from repeated, severe infections that refuse to respond to treatment and significantly interfere with their school or work schedule but it is now a relatively uncommon operation compared to previous practice.

Unilateral tonsils occurs when there is a malignancy in the tonsils and in some cases, one tonsil can be larger than the other. "In such instances, we have to check if the patient has cancer or not by doing a tissue diagnosis at the laboratory", said the doctor.

Many people underestimate the function of the throat as they are unaware of the delicate structures that are included and how these structures function.

Without the network of muscles and cartilage our lungs would slowly become damaged from inhaling food and fluid and would seriously compromise our survival.

Also, stratified epithelium also lines the throat which are cells arranged in layers covering internal and external body surfaces which are vital to protect. Gargling with salt water helps to get rid of a sore throat but the right quantity of salt should be put to water (2 teaspoons to 500ml water).

Among the bacteria that cause sore throats, the streptococcus group A is the most common - often known as 'strep throat'. The incubation period between picking up the infection and the disease breaking out is two to four days - sometimes it can be less.

With regard to chronic throat ailments, Dr.Jayasuriya said,"Some people come with 'cancerphobia' where one might suspect malignant tumours with a visible lump in the throat and opt to do a full body scan including X-rays, FBC (Full Blood Count) and an "Ultrasound Scan". She said that there was nothing lost in doing a fullbody scan but some think that the worst could happen with a minor malignancy.

"There is nothing lost in doing a fullbody scan but some think that the worst could happen with a minor malignancy" she said.

Dr.Jayasuriya advised that throat ailment-prone patients should avoid drinking alcohol and smoking since such bad habits are major contributors to throat problems. "A common throat problem in Sri Lanka is oral cancer which occurs when people chew betel leaves with various types of 'puwak' that worsens the condition" she said. Such habits should be stopped because not only are they bad for your mouth but it discolours teeth to a red colour and also isn't pleasant when people spit on the roads and streets of the city especially from buses which are hazardous to pedestrians.

Various other vital body systems connect to the throat like the salivary glands, lymph nodes, the voice box and even the ear and nose. Often, they are affected if the throat is infected.

"The best ways to avoid catching or passing the viruses and bacteria that can lead to a sore throat are to wash your hands regularly, avoid touching your eyes or mouth and cover your mouth when coughing or sneezing" concluded Dr. Jayasuriya.

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Symptoms of tonsillitis and strep throat:

Sore throat - Fever - Headache - White patches in your throat or on your tonsils - Pain when you swallow - Red and swollen tonsils - Swollen, sore glands in your jaw and throat - Abdominal pain (usually in children)

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Easing the pain of a sore throat:

- Take acetaminophen, ibuprofen or naproxen to relieve pain.

- Gargle with warm salt water (1 teaspoon of salt per 1 cup [8 ounces] of water).

- Suck on throat lozenges or hard candy.

- Suck on flavored frozen desserts (such as Popsicles).

- Drink lots of liquids. They help keep your throat lubricated and prevent dehydration.

Is your career making you infertile?

by Peta Bee

Recent research suggests a superwoman lifestyle can affect hormones and even body shape, damaging a woman’s chances of having a baby.

Go-getting women with highpowered jobs and salaries to match might appear to have it all. But results of a new study suggest that, unwittingly, these twenty and thirtysomethings are reducing their chances of having children by doggedly pursuing demanding careers.Professor Elizabeth Cashdan, an anthropologist at the University of Utah, believes that the pressures that come with the superwoman lifestyle are to blame for hormonal and body shape changes that might affect fertility. The result? When it comes to starting a family, many women struggle to conceive.

In her research, published in a recent issue of the journal Current Anthropology, Cashdan found that career women were less likely to be curvaceous with the waspish waist and hourglass shape long associated with fertility and, instead, displayed the more masculine, straight-up-and-down figure that is less conducive to child-bearing.

With work stress and the drive to succeed, Cashdan says, comes a shift in hormonal balance that leads the female hormone, oestrogen, to be replaced by androgens, a class of hormones that includes testosterone and that are associated with strength, stamina and competitiveness.

Crucially, Cashdan says, this appears to affect a woman’s waist to hip ratio (WHR), a formula derived by dividing someone’s waist circumference by her hip measurement. Classic Marilyn Monroe types with large breasts and narrow waists typically have a curvy WHR of 0.7 (ie, their waist is 70 per cent of their hip circumference) which has been linked in numerous medical papers to optimal fertility. One 2004 study in the journal Proceedings of the Royal Society suggested that women with hourglass figures had about 30 per cent higher levels of the female reproductive hormone, estradiol, compared with other body shapes and that, as a result, they were roughly three times more likely to get pregnant.

Large-breasted and narrow-waisted women have also been shown to have higher levels of oestrogen and progesterone, other female hormones linked to fertility.

But when Cashdan analysed the WHR of women from 37 different populations and cultures, she found their average WHR to be above 0.8 - that’s less Sophia Loren or Jessica Alba and more Keira Knightley - a ratio that makes it harder to conceive.

“Although the hormonal profile associated with a high WHR may favour success in some stressful and difficult circumstances where women must work hard, there are well-known costs,” Cashdan says.

“Women may suffer lower fertility and possibly lower attractiveness to men who may have an innate preference for curviness.” Many of Britain’s leading infertility experts are unsurprised by the findings. “Certainly, at my clinics we see predominantly very successful businesswomen who do not have hourglass figures,” says Laurence Shaw, associate director of the London Bridge Fertility, Gynaecology and Genetics Centre and a spokesperson for the British Fertility Society (BFS).

“They are very slim, very straight-up-and-down.” Dr Martin Tovee, a psychologist at Newcastle University who has studied the influences on female body shape, says that it is determined by a number of different factors, but that being a go-getter could be one of them. “We know that if women over-exercise or diet obsessively, then their oestrogen levels drop and they become less fertile,” Tovee says. “So, potentially, working hard could affect fertility too.”

Super-skinny women who under-eat to stay that way have long been known to risk compromised fertility. Several years ago, Rose Frisch, an associate professor at Harvard School of Public Health, explained how too few calories and too little body fat triggers a woman’s brain to switch off her body’s ability to reproduce by gradually restricting the flow of a hormone called leptin.

There is what Frisch has described as a “razor-thin borderline” where a drop of just 3lb can tip a normal-sized woman into infertility without her realising it. She may continue to menstruate, but might not ovulate during her cycle. If body-fat falls much lower, then amenorrhoea occurs when the menstrual cycle simply stops.

However, Cashdan’s findings suggest that career women can become infertile even if they don’t lose excessive weight. The very androgenic hormones that underly the women’s professional mettle are also responsible for transferring fat from hips to waist. And the more fat that settles on her belly, the lower her level of female hormones such as oestrogen. “What is at issue here is not overall body weight, but its distribution,” Laurence says.

“The new study suggests that these driven women with high-achieving Type A personalities have a lesser oestrogenic state, which doesn’t favour their chances of conceiving.”

The stress of some women’s lifestyles also plays a significant role.

In research at Emory University’s School of Medicine in Atlanta, Professor Sarah Berga of the department of gynaecology and obstetrics, has shown how stress often triggers a cascade of events that result in reduced levels of two hormones crucial for ovulation.Women with hectic jobs on top of busy lives, she says, are most at risk.

In one of her studies, Berga found that women who didn’t ovulate had excessive levels of the stress hormone cortisol present in their brain fluid, often due to trying to squeeze in too much work and exercise.

“Your brain is hard to fool,” Berga says. “If you are under-eating, overworking and over-exercising, then the hypothalamus - the part of the brain that controls the release of hormones - keeps a running tally of what you are doing.” Around 20 per cent of women who are infertile have problems with ovulation, and lifestyle factors, including anxiety and stress, are often to blame.

Berga found that talking therapies, such as cognitive behavioural therapy, could reverse stress levels and boost the chances of a woman getting pregnant. But, she stresses, it is not just a case of telling career women to “pull themselves together”.“To the observer these women actually look very well pulled together,” Berga says.

“Many don’t report feeling stressed and will even say that everything is just fine. But they may have unrealistic attitudes about themselves and others. Often they think that they can do more work than is realistic, and their sense of worth depends upon their achievement.” If a woman takes her foot off the pedal, it can certainly help.

Laurence says that, ultimately, her sensitivity to oestrogen is determined when her oestrogen receptors are established during puberty. You can’t change what you are given, he says, but good nutrition, a balanced exercise plan and fewer hours spent getting stressed can pay off.

“Oestrogen makes someone relaxed, calm and thoughtful, the perfect state in which to become pregnant,” he says. “It is no biological mystery that so many studies have shown men are drawn to women who are curvaceous and have a narrow waist, indications of health and fertility.”

Vital statistics A study of 6,000 women by researchers at Northern Carolina State University found that just 8 per cent of females now have the sort of hourglass figure flaunted by 1950s film stars A 2007 survey of 9,000 British men and women at University College London (UCL) revealed that, since 1951, the average bust size has increased by 2in to 39in and hips by a further 2in to 41in.

However, waistlines have increased a massive 6.8in, meaning that women no longer go in in the middle.Last year, Dr Devendra Singh from the University of Texas analysed 345,000 texts to confirm that the Western male’s preference for a slim-waisted woman has been generally constant throughout the centuries A 2004 survey by researchers at UCL and the London College of Fashion showed that 20 per cent of women now have a pear-shaped figure (with hips larger than their bust), whereas 46 per cent are cylindrical or straight-up-and-down.

Timesonline.co.uk

Understanding GERD

Almost everyone experiences chest pains, heartburn, abdominal pains and acid reflux at some time. However, in some individuals, the feeling is frequent or severe enough to cause significant problems. Known as Gastro significant problems. Known as Gastro Esophageal Reflux Disease (GERD), such discomfort may be caused by the reflux of acidic stomach juices. When the muscular value at the bottom of the oesophagus (gullet or food passage) is relaxed, stomach contents flow up into the oesophagus and cause pain and sometimes corrosion or ulceration.

Reader's Digest asked Dr. Lui Hock Foong, consultant gastroenterologist and Chairman of the National Foundation for Digestive Diseases in Singapore, what you need to know about GERD.

Why is GERD a condition that we need to be more aware of?

GERD symptoms are an indicator of excessive acid exposure in the oesophagus and it may lead to long-term consequences such ad inflammation and narrowing of the food passage. Another condition is Barrett's transformation of the lining of the lower food passage, which increase the risk of cancer in that area.

What are five things people can do to help prevent GERD?

1. Have regular mealtimes

2. Avoid overeating avoid eating close to bedtime

3. Avoid smoking. Take alcohol in moderation

4. Maintain a healthy bodyweight

5. Where possible, minimise stress

Courtesy: Readers Digest