WHAT DO YOUR FARTS REVEAL ABOUT YOUR HEALTH?

Fluff, cutting the cheese, breaking wind, booty belch, whoopee, and anal salute are all different ways to refer to the standard and embarrassing fart. Did you know the average person farts approximately 14 to 23 times per day? As awkward as it may be, everyone needs to release gas from their body. It is part of the digestive process and is a necessary bodily function. What do your farts (passing gas) reveal about your general health?  

What is a fart? Flatulence, also known as a fart, is something everyone experiences. It's the release of intestinal gas, which forms as a result of digesting food. Gas can be found throughout the digestive tract, including the stomach, small intestine, colon, and rectum.

New York-Based Internist and Gastroenterologist, Dr. Niket Sonpal, explains what your flatulence is trying to tell you.

1. Do you have a balanced diet?

A balanced diet should provide the body with the proper number of vitamins and nutrients. Consuming the appropriate amount of fiber and healthy foods helps keep the digestive system working correctly. If you tend to pass gas more often than you would like, this could mean that the body is not receiving the correct nutrients. Avoiding foods that are processed and harder to digest and sticking to more natural ingredients, could decrease how often you toot. 

2. You may have a food intolerance.   

Not all food allergies can be life-threatening; however, they can still cause conflict day-to-day for some individuals. Food intolerances mainly affect the digestive system making it harder for the stomach to digest food properly. This can lead to smelly and awkward bloating, reflux, and diarrhea after a meal. For example, people with a dairy intolerance struggle to digest lactose, which results in the stomach becoming extraordinarily bloated and sends out foul smells out of the anus. 

3. Irritable Bowel Syndrome

Constantly farting throughout the day could be a sign of a health issue such as irritable bowel syndrome, diabetes, or, in extreme cases, colon cancer. Typically, these health issues cause extreme flatulence, odors or odd pressure on the rectum when they are about to be released. 

4. You are stressed. 

Symptoms of irritable bowel syndrome go hand in hand with stress. Stress and anxiety can lead to excessive swallowing of air, oxygen release, and digestion issues. These are three causes of having more gas than usual. When people are panicking or stressed, they often swallow more air than necessary, leading to bloating and pressure that needs to be released. On the other spectrum, hyperventilating allows an excess of oxygen to enter the bloodstream, which can also lead to gas problems. 

5.Pre-Menstrual Women  

That time of the month is already painful enough. There are changes in your bowel habits during this time caused by fluctuations in hormones. The shift in your hormones and bowel movements cause farting to become more frequent and smellier during this time of the month. Be mindful of accidentally passing wind while you are pre-menstrual.

6. You might have harmful gut bacteria.

Regular farting is an indicator of healthy gut bacteria and a properly working digestive system. Your body needs good bacteria in your intestine for it to remain healthy. Microbes in your gut are a positive thing because they eat up excess fiber and carbohydrates we do not use. Also, they produce beneficial bacteria. If you do not have any good bacteria, it can lead to constipation and bloating, which is unhealthy for your digestive system.

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NEW YORK GASTROENTEROLOGIST SHARES 7 WAYS TO BEAT THOSE SUGAR CRAVINGS

Sugar cravings are a formidable opponent to anyone trying to stay on a nutritious path. Sugar cravings can attack in the middle of the day or night, and it takes the will power of a comic book hero to say no to such temptation. But what if we can identify and address the underlying reason why we feel such a need for sugar? New York internist and gastroenterologist, Dr. Niket Sonpal who is also a faculty member at Touro College of Medicine says,  “If more people could learn to pinpoint the reasons why they experience sugar cravings they would have better tools to avoid breaking their nutritional goals.”

Here are Dr. Sonpal’s 7 Ways to Conquer Sugar Cravings

Drink water; you might be dehydrated.

Many people mistake thirst for sugar cravings. “We know that we want something fresh and cold and we usually identify that with sugary drinks,” says Dr. Sonpal. “When our bodies have a deficiency in fluids, it can’t efficiently breakdown glycogen, and this causes the urge to consume something sugary. In reality, what you need to do first is drink water and observe how you feel,” he explains.

Try to Decrease Your Sugar Intake Gradually

Scans have shown that sugar fuels every cell in the brain.  “Our bodies view sugar as a reward. But too much of a good thing is not good at all in this case. By partaking in overconsumption of sugar you are reinforcing your body’s need for that reward, essentially becoming addicted to it,” explains Dr. Sonpal. But like many addictions, it is not a reasonable or sustainable strategy to quit cold turkey. If you feel as though you are out of control or moody without your first soft drink of the day or until you have a piece of chocolate, you need to consider slowly draining your system from that need for sugar.

Rethink social habits that drive you towards sugar

Many of us have social rituals during our day that help us destress amidst countless tasks and meetings. “If you have a standing ritual with a friend or coworker of eating a piece of cake after lunch every day or running to the coffee shop on the corner to get the most sugary caffeinated iced drink you can find, rethink those social behaviors,” says Dr. Sonpal. Try to put something else in place that is healthy but rewarding.

Evaluate your protein intake

Many famous diet plans like Paleo, Vegetarian, and Keto seek to reduce sugars in your food. Sometimes a good way to kick your sugar cravings to the curb is having some good ole’ fashion protein. “Protein reduces the speed with which your body processes sugars and in turn helps you need lower amounts to experience that reward. Eggs, black beans, broccoli, and chicken are really healthy ways to get that protein in to quench that yearn for sugar,” suggests Dr. Sonpal.

If push comes to shove, pick fruit

There will be times when your craving for sugar will be exacerbated by the stress of the day or however many days you’ve gone without consuming it. You may feel like you can have a cheat day. According to Dr. Sonpal, “Your best response to a worsening need for sugar is to eat a piece of fruit. If you get to a point where you feel frustrated, instead of eating processed sugar, eat fruit. Fruits are sweet and have natural sugar that can address your sweet tooth without throwing out your entire effort,” says the NYC gastroenterologist. With the fruit, you will get added vitamins and fiber.

Fiber is your friend

Fiber helps clean out your system, and it is processed more slowly by the body. Fiber helps you feel fuller for longer effectively reducing your craving for mid-meal snacks. “Many people will be very deliberate with their decision to reduce sugar in their meals but will ultimately cave in when their body needs a snack because a lot of the snacks we have in our pantry have sugar in them. Fiber and lots of water would help you stay full for longer periods,” Says Dr. Sonpal.

Observe your consumption of starch

Starches like white rice, white bread, pasta are complex carbs that the body process as simple carbs. They end up affecting the sugar levels in your body and feeding into your need for sugar as fuel for brain activity and energy. If you have cut out processed sugars but continue to eat an abundance of starches, then your next step is to progressively reduce your consumption of those foods as well to clean your system of the need for sugars.

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HOW TO AVOID ILLNESS AND OTHER MEDICAL CONSEQUENCES WHILE TRAVELING THIS MEMORIAL DAY WEEKEND

Memorial Day marks the unofficial start of summer.  According to AAA, more than 41.5 million Americans will travel this Memorial Day weekend by car, plane, or train. Nothing ruins a long-awaited vacation faster than getting sick or being in medical distress.  We turned to Dr. Niket Sonpal, an NYC internist and gastroenterologist for some tips on how to avoid health consequences will traveling.

Avoid Deep Vein Thrombosis

Deep Vein Thrombosis (DVT) occurs when a blood clot (thrombus) forms in one or more of the deep veins in your body, usually in your legs. Deep vein thrombosis can cause leg pain or swelling, but also can occur with no symptoms. For travelers, this can happen on long haul trips where you are not moving. Dr. Sonpal recommends if you are flying or on a train, to move around the cabin to get the blood flowing in your legs. If you are driving, take a break at a rest stop and walk around. Compression socks are also another option to prevent DVT.

Don’t Get Nauseous

People can experience motion sickness on virtually any mode of transportation. To combat this, Dr. Sonpal suggests Dramamine® Non-Drowsy Naturals, Dramamine®'s first non-drowsy formulation. It contains the clinically tested ginger dosage required for preventing and treating motion sickness. Other sources of ginger, including candies, gums, or ginger ale, may not contain a full clinical dose. For someone who is already experiencing nausea while traveling, it is a good idea to keep Emetrol on hand which is an over the counter nausea medication that does not cause drowsiness.

Avoid Bloating on a Plane

If you get gassy on a plane, you’re not alone! Dr. Sonpal explains that “as the pressure around you decreases, the gas in your belly isn’t constrained as much and it expands. This can make you feel bloated or become distended.” It is essential to avoid foods that cause gas or have salt. Skip the tomato juice in flight and stick with non-carbonated water. Avoid alcohol, cruciferous vegetables, dairy and high sodium snacks such as salted peanuts or pretzels. Foods that are protein packed, magnesium-rich and high in Vitamin C are good options.

Sanitize Your Surfaces

Planes and trains are a breeding ground for illness.  The former is awful due to re-circulated air. Most travelers would be appalled if they really knew how germy their tray tables are! Dr. Sonpal suggests sanitizing wipes for your tray table, seat belt clip and hand rests of your seats on planes and trains. When you exit a restroom on a plane or train and touch the door handles, be sure to use hand sanitizer even if you already washed your hands.

Get Your Shots Before Traveling Abroad!

Before you even book your trip, make sure you’re up to date on your shots. If you’re traveling to an area where you’re at risk for picking up an illness like malaria, you might be prescribed preventative medication. Dr. Sonpal suggests that “people should use the CDC website for recommended vaccines for travel abroad or see a travel clinic. The health risks posed to Americans vary based on the country they are traveling to.”

Don’t Touch the Ice!

When traveling to a different country, most people are very cautious about only drinking bottled water.  Many folks forget that ice is simply frozen water and put it into their soft drinks or alcoholic beverages. Contrary to what one might think, freezing water does not kill bacteria. The only way to be sure it is safe is if you boiled the water and then froze it.

Avoid Jet Lag

Even a relatively short time change from EST to PST (3 hours) can cause jet lag. With some international travel from the United States, the time difference can be as much as twelve hours. If you're traveling east, try going to bed one hour earlier each night for a few days before your departure. Go to bed one hour later for several nights if you're flying west. If possible, eat meals closer to the time you'll be eating them at your destination. Dr. Sonpal suggests that you set your watch to the new time before you leave. Once you reach your destination, try not to sleep until the local nighttime, no matter how tired you are.

Essential Medicine/Supplies to Travel With

Dr. Sonpal stresses never to check your medication with your baggage, always keep it in your carry on. Have a fresh re-fill on prescription medication with extra doses in case you get stuck at your destination. In addition, here are some essential over the counter meds/supplies to travel with:

• Benadryl- For allergic reactions such as insect or bee bites.

• Pepto Bismol- For diarrhea

• Laxative such as Dulcolax

• An antibiotic ointment such as Neosporin

• Common cold/sinus remedies such as Mucinex or Claritin

• Pain relievers such as Tylenol or Motrin

• Anti- Nausea medication such as Emetrol

• Motion Sickness medication such as Dramamine. If you are the driver, be sure to take the non-drowsy version.

• Electrolyte tablets for dehydration

• Hydrocortisone cream to relieve itching from rashes, bites, poison ivy, etc.

• Aloe to soothe sunburned skin

• Band-Aids

• Digital Thermometer

• Nasal Spray to prevent clogged ears while flying

• Tweezers

• Eye Drops

• Epi-Pen if you are prone to severe allergic reactions

How to Find a Reliable Physician if you are Traveling Abroad

The US embassy in your destination country (http://www.usembassy.gov/) can help you locate medical services and will notify your family and friends in the event of an emergency. When selecting a doctor, make sure that he or she can speak your language. The following resources provide lists of doctors and clinics that can care for travelers:

The International Association for Medical Assistance to Travelers (www.iamat.org; membership required, but it is free)

Joint Commission International (www.jointcommissioninternational.org)

The International Society of Travel Medicine (www.istm.org)

Travel Health Online (www.tripprep.com; gets information from various sources so quality is not guaranteed)

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BEFORE YOU GO COLD TURKEY ON AN RX-READ THIS!

Have you ever had a friend tell you that they stopped taking their anti-depressant because they feel happy now?  Or what about the boyfriend who stops taking his high blood pressure meds because, “everything is fine, and he’s working out and eating right?” Lastly, how you ever suffered from anxiety and been prescribed Valium or Clonopin and abruptly stopped taking it because you were no longer anxious? If any of these are familiar scenarios, know that abruptly ceasing certain medications at best, can make you sick, and at worst can cause death. We turned to Dr. Niket Sonpal an NYC Internist and Gastroenterologist and Dr. Duy Nguyen, a Psychiatrist at Beachway Drug and Alcohol Center in Florida. With their combined expertise, they explain the prescription drugs that are dangerous to stop without consulting a doctor and tapering down.  See if one your meds is on this list!

Blood Pressure Medications

Medication to control high blood pressure only works if you take it. If you stop taking anti-hypertensive medication without discussing it with your doctor, you put yourself at risk for a stroke. High blood pressure is the most important preventable risk factor for stroke, according to the American Heart Association (AHA) and the American Stroke Association (ASA). Dr. Sonpal says that “The higher the blood pressure, the higher the risk for stroke and other health consequences such as brain aneurysm. Unfortunately, some people with high blood pressure stop taking their medication. If their blood pressure returns to normal, they may feel that they no longer need the medication. But normal blood pressure means the medication is doing its job; halting medication will allow blood pressure to rise again, putting the person at risk for stroke and other complications of hypertension.”

Antidepressants

Dr. Duy Nguyen has seen many a patient stop taking drugs such as Prozac, Wellbutrin, Celexa, and Zoloft without first consulting with him. He is adamant that patients don’t go this route. He says, “Withdrawal from antidepressants can cause insomnia, confusion, anxiety, panic, agitation, nightmares and worsened depression. People may also experience fatigue, nausea, vomiting, dizziness, muscle spasms, headaches and loss of coordination. If you wish to be off of an anti-depressant or switch to another, speak to your doctor first and have them devise a safe schedule to titrate you down and/or replace with another.” 

Benzodiazepines

You are likely familiar with these under the brand names Valium, Clonopin, Xanax, and Ativan.  These are most commonly used to treat anxiety and panic. For people who only take these once in a blue moon (for fear of flying or public speaking), the body and brain are not addicted. For those who take one or more of these medications daily, they cannot be stopped cold turkey! Dr. Nugyen strongly cautions that, “Benzodiazepine drugs can cause serious withdrawal symptoms including seizures, tremors, hallucinations, heart palpitations, insomnia, nausea, and increased anxiety. If you wish to stop or reduce your intake of these drugs, consult with your doctor to develop a titration schedule. If you have been taking high doses of these drugs over a long period of time, you may need more supervised medical support such as a drug detox program where you are monitored 24/7 by nurses and given supplementary non-benzo medications to ease withdrawal symptoms.” 

Prednisone and other steroids.

Prednisone is prescribed as a potent anti-inflammatory for a variety of conditions, including asthma, allergies, hives, inflammatory arthritis and gout. If you’ve been taking prednisone for more than one to two weeks and just stop it, you may get into trouble. Dr. Sonpal explains that “When you are taking prednisone tablets, your own adrenal gland production of cortisol declines. When you abruptly stop taking prednisone, the result may be low cortisol. This causes weakness, nausea, vomiting, diarrhea and abdominal pain. It’s not fun and can be very serious. Wean off of it under the schedule determined by your doctor”

Antibiotics

Too often patients with a bacterial infection begin a course of antibiotics with every intention of following their doctor’s orders, then cutting their treatment short when they’re feeling better. “What they don’t realize is that this can cause problems in the future. Antibiotics are prescribed in the dose that ensures every last bit of the targeted bacteria in your body will be destroyed,” explains Dr. Sonpal.  He adds. “If you stop taking your antibiotics a few days before you’re supposed to, any remaining strains of the bacteria, the ones that were already strong enough to make it through the first few doses of the medicine, will survive in your system, and will be resistant the next time you take those same antibiotics.”

Opioid pain medications. 

Opioids are prescription analgesics like codeine, morphine, and hydrocodone (an active ingredient in Vicodin), and if you’ve been taking any of them long term, abrupt discontinuation can cause symptoms like diarrhea, generalized pain, restlessness, and anxiety. “Withdrawing from opioids is no joke,” says Dr. Nguyen. He adds, “Depending on your level of addiction, a patient may need in-patient medical detox followed by a drug rehab program, the latter of which will deal with the emotional aspects of eliminating the addiction.”

Diabetes Medication

When your blood sugar seems to be under control, you may decide you want to stop taking your diabetes medications. Dr. Sonpal explains that “If you’re a type 1 diabetic, your body will never be able to create its own insulin, so it’s pretty clear that you can never stop taking insulin. But if you’re a type 2 diabetic, you may be able to explore alternatives with your physician. Since this type of diabetes evolves and changes over time, you need to consistently evaluate your treatment plan with your doctor.” This could involve reducing the dose of your current medication or trying newer medications. But it’s imperative that you not take any action on your own with regard to adjusting your medication without first consulting with your physician.

Thyroid Medication

If you have hypothyroid—whether due to Hashimoto's, Graves' disease treatment, thyroid surgery, or congenital hypothyroidism—failing to take your thyroid hormone replacement medication can pose many risks to your health. If you don't feel better after taking your medication for several months, you may need a dosage adjustment or a change in medication—not a complete stop of your regimen. Dr. Sonpal explains that “There isn't a natural or herbal replacement for thyroid hormone. Much like patients with type 1 diabetes and their need for insulin, your system needs thyroid hormone for survival. But there are no natural substitutes for antithyroid medications.” 

Some Risks of Ceasing Thyroid Medicine Include:

• Blood pressure irregularities

• Elevated cholesterol, including treatment-resistant high cholesterol and increased risk of heart disease

• Low body temperature; feeling perpetually cold

• Fatigue, muscle weakness, or joint pain

• Depression

• Memory problems

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WINTER HEALTH MYTHS BUSTED!

There are endless winter health myths that we have heard from well intentioned grandparents and parents. They have become so ingrained in us that we take them as cold hard facts. Many of these myths have no more basis in reality than Santa Claus. Of course, everyone wants to stay as healthy as possible during the frosty months. In order to do so sensibly, we turned to Board Certified NYC internist and gastroenterologist Dr. Niket Sonpal.

Myth: Allergies go away in the winter

Allergies might be the real source behind your stuffy nose and scratchy throat this season. According to the Asthma and Allergy Foundation of America, one in five people suffer from indoor/outdoor allergies, and the indoor variety can actually be worse in the winter. Dr. Sonpal cautions that, “If your symptoms last longer than 10 days or ease up after taking an antihistamine, it might be time to visit an allergist.”

Myth: I wash my hands all the time with hand sanitizer, so I should be fine.

Hand sanitizer will kill most viruses, but not all. You must make sure you use the right amount of hand sanitizer and let it dry completely. Dr. Sonpal points out that,” Some viruses, like norovirus, which causes vomiting, is not killed by hand sanitizer. Soap and water are best to get rid of all bacteria and viruses, but the hand sanitizer is better than nothing at all.”

Myth: It’s cold out, I don’t need sunscreen.

The sun’s rays are just as strong in the winter months as they are in the other seasons. Snow and ice can reflect even more sunlight, up to twice as much. Grab the SPF 30 and put it on, regardless of the temperature. Don’t forget those sunglasses to keep your eyes safe as well.

I’ll just drink some alcohol to keep myself warm.

Although it may feel like drinking alcohol is making you warmer, it does not. Dr. Sonpal says that, “when you drink, the blood vessels dilate or get bigger, and blood flows to your skin and away from your internal organs. So, it may feel like you are getting warmer, but you are not.”

Myth: The Flu Shot Gives You the Flu

According to a new survey from the National Foundation for Infectious Diseases and Rite Aide, 44 percent of American women view the flu as a serious threat to their health. Yet nearly half (49 percent) do not intend to get a flu shot this year because they believe the vaccine can give them the flu. The U.S. Centers for Disease Control and Prevention recommends the flu shot for anyone older than 6 months of age. Dr. Sonpal stresses that, “The shot does not contain a live virus, making catching the flu from it impossible.”

Winter weather makes you store fat and gain weight

Our bodies do not go into some kind of winter hibernation mode, stockpiling every ounce of fat to use for the lean times. It seems logical, like a throwback to our days living in caves foraging for food, but in reality, any weight gain comes from our winter habits. Dr. Sonpal points out that, “we tend to exercise less in winter. We eat more hearty meals and comfort foods, including more sugary snacks and desserts (especially around the holidays).”

Myth: You Lose Most Heat Through Your Head

The saying goes “we lose 90 percent of our body heat through our heads.” But a 2006 study found that the head accounts for about 7 percent of the body's surface area, and that heat loss in the region is fairly proportional, according to LiveScience. "Your head is another extremity, and it's susceptible to cold, so you should wear a hat, but it doesn't lose any more heat than another part of your body," says Dr. Sonpal.

Myth: Chicken Soup Will Cure Colds

Many cultures teach us to drink warm liquids like tea, hot apple cider, and soups when we’re dealing with colds. It’s true that something like chicken soup may help soothe and ease congestion, but much like vitamin C, hot soup won’t do immediate wonders.

Myth: Being Cold Gives You a Cold

No matter what your grandma might have told you, spending too much time in the cold air doesn’t make you sick. One study found that healthy men who spent several hours in temperatures just above freezing had an increase in healthy, virus-fighting activity in their immune systems. In fact, you’re more likely to get sick indoors, where germs are easily passed.

Myth: Feed a cold, starve a fever

Dr. Sonpal says that, “This is another myth that comes from a time when people didn't understand the science of body chemistry. The thought was that if you had a cold, food would warm you up. Conversely, if you had a high fever, not eating would cool you down. This is just patently bad medical advice. In both cases, good nutrition gives your body the fuel it needs to fight infections and recover from an illness. When you have a fever, your body is burning energy at a rapid rate, and that needs to be replenished. So, by all means feed your cold; but also feed your fever, or any other illness. Even if you have stomach issues, find a way to take in lost fluids and electrolytes.”

About Dr. Niket Sonpal:

Dr. Niket Sonpal is a native of Long Island NY and a graduate of Medical University of Silesia – Hope Medical Institute in Poland. After completing his residency in Internal Medicine at Lenox Hill Hospital, he was selected to be the 2013‐2014 Chief Resident at Lenox Hill Hospital–Northshore LIJ Health System. He is an Adjunct Assistant Professor at Touro College of Osteopathic Medicine and Clinical instructor at Kingsbrook Jewish Medical Center, Brooklyn. Dr. Sonpal has completedhis Fellowship in gastroenterology & hepatology at Lenox Hill Hospital and will continue his work in the field of medical student and resident test preparation. He now serves as the associate program director for the Internal Medicine Residency Program at Brookldale University medical center.

He is the co‐author for the best-selling Master the Boards: USMLE Step 2 CK, Master the Boards Step 3, And Master the Boards: Internal Medicine. He is also the Chief Operating Officer for Medquest Test Prep, Director of Medical Education for Picmonic Test Prep, and a recognized expert on medical test prep.

About Dr. Niket Sonpal:

Dr. Niket Sonpal is a native of Long Island NY and a graduate of Medical University of Silesia – Hope Medical Institute in Poland. After completing his residency in Internal Medicine at Lenox Hill Hospital, he was selected to be the 2013‐2014 Chief Resident at Lenox Hill Hospital–Northshore LIJ Health System. He is an Adjunct Assistant Professor at Touro College of Osteopathic Medicine and Clinical instructor at Kingsbrook Jewish Medical Center, Brooklyn. Dr. Sonpal has completedhis Fellowship in gastroenterology & hepatology at Lenox Hill Hospital and will continue his work in the field of medical student and resident test preparation. He now serves as the associate program director for the Internal Medicine Residency Program at Brookldale University medical center.

He is the co‐author for the best-selling Master the Boards: USMLE Step 2 CK, Master the Boards Step 3, And Master the Boards: Internal Medicine. He is also the Chief Operating Officer for Medquest Test Prep, Director of Medical Education for Picmonic Test Prep, and a recognized expert on medical test prep.

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