Alzheimer's Disease is the number one cause of dementia (70% of cases). Causes include cardiovascular events whereby there is reduced blood flow to the brain, aging, genetics, etc. Risk factors include older age, family history, having Apolipoprotein E (ApoE), abnormal MRI, history of cardiovascular disease.
Associated with multiple changes including:
- Cognitive Differences ( difficulty finding words, disorientation, forgetfulness etc)
- A reduction in Daily Functioning ( getting lost, neglecting self care)
- Personality Changes ( social withdrawal, disinterest, easy frustration)
- Problem Behaviors ( obsessive/compulsive behavior, nightime restlessness)
- Mental Health Issues ( depression, paranoia, abnormal beliefs, anxiety etc)
To slow the disease:
1. Vitamin E (as dl-alpha-tocopheryl acetate) 1000IU twice a day
Based on a large clinical trial published in Journal of the American Medical Association (JAMA), a 5 year study with more than 600 participants showed that the Vitamin E group, taking 2000IU of Vitamin E per day, experienced significant delay of more than 6 months in progression of the disease (1). On top of that caregiver time also decreased by 2 hours each day which means better quality of life for both the patient and the caregiver.
2. Panax Ginseng or Korean Red Ginseng
The primary active ingredients in ginseng are ginsenosides and there are 7 main ones found in dietary supplements namely Rb1, Rb2, Rc, Rd, Re, Rf and Rg1. Some of them have been shown in laboratories to be able to reduce levels of a compound called amyloid beta peptide which is found in brains of Alzheimer's patients. Moreover it also improves blood flow.
3. Omega-3 Supplements
May improve the appetite and weight gain in Alzheimer's patients. They might even help with reducing depressive symptoms.
4. Lifestyle Changes
This includes finding the right protein, fat, and carb balance. Studies have shown that diet high in lean protein and healthy fats may protect against mild cognitive impairment. On top of that, more exercise not just physically but also mentally are really important. Play more crossword puzzles and reading will reduce the risk of AD. Lastly, make sure to take time to de-stress as chronic stress can increase the amount of stress steroids in your body and this can block brain activities as well as increase risk of AD.
It is important to remember in Alzheimer that heart healthy = brain healthy so prevention is extremely important.
1. Dysken MW, Sano M, Asthana S, et al. Effect of Vitamin E and Memantine on Functional Decline in Alzheimer Disease: The TEAM-AD VA Cooperative Randomized Trial. JAMA.2014;311(1):33-44. doi:10.1001/jama.2013.282834.
Bloating and distension have been reported in up to 96% of patients with irritable bowel syndrome (IBS) and in 20% to 30% of the general population, In fact, more than 50% of persons with bloating and distension report a significant impact on quality of life. In general, the term bloating refers to the subjective sensation of increased abdominal pressure without an increase in abdominal size, whereas distension describes the same subjective sensation but with a corresponding objective increase in abdominal girth.
Patients who are constipated commonly report bloating and more than 80% describing severe symptoms. The pathogenesis of bloating in patients with constipation is likely multifactorial. First, the direct mechanical effects of fecal impaction and colonic loading can mimic bloating. Second, colonic stasis may cause increased fermentation of the colonic contents by intestinal bacteria and, therefore, increased gas production. Other than that rectal hypersensitivity is also a common scenario found in IBS and patients with constipation. Interestingly, alterations in visceral sensitivity may explain why symptoms of bloating and distension may be worse in women during the perimenstrual phase as visceral sensitivity varies throughout the menstrual cycle and is generally most acute in the perimenstrual phase (1)
The most significant advance in the treatment of bloating has been the identification of a group of poorly absorbed short-chain carbohydrates (FODMAPs) and individually, these carbohydrates have been considered to be potential triggers of IBS symptoms for decades. In well controlled dietary trials, modification in diet to a low-FODMAP diet can decrease symptoms in at least 75% of IBS patients (2).
If there is severe constipation, laxatives can be used as initial treatment to ensure that constipation is aggressively managed. On top of that, consider using probiotics. A systematic review concluded that bloating is significantly reduced by the probiotic Bifidobacterium infantis 35624 (3).
There is emerging evidence that kiwifruit is effective in the treatment of constipation and bloating. Although the mechanisms remain unknown, kiwifruit appears to promote both laxation and gastric motility.
In conclusion, bloating and distension are highly prevalent symptoms with a marked effect on health status and quality of life. Emerging evidence indicates that targeting colonic motility, gut flora, visceral sensitivity, and dietary intake is helpful in controlling such symptoms.
1. Altman G, Cain KC, Motzer S, Jarrett M, Burr R, Heitkemper M. Increased symptoms in female IBS patients with dysmenorrhea and PMS. Gastroenterol Nurs. 2006;29(1):4-11.
2. Halmos EP, Power VA, Shepherd SJ, Gibson PR, Muir JG. A diet low in FODMAPs reduces symptoms of irritable bowel syndrome. Gastroenterology. 2014;146(1):67-75.e5
3. Brenner DM, Moeller MJ, Chey WD, Schoenfeld PS. The utility of probiotics in the treatment of irritable bowel syndrome: a systematic review. Am J Gastroenterol. 2009;104(4):1033-1049; quiz 1050.
Dr Nicole Ng (MBBS) is a medical doctor with a passion in women's health and medical research