Dietitian, Dublin 6, Caoimhe McDonald

Take control of your IBS don’t let it control you – By Caoimhe Mc Donald

Dietitian, Dublin 6, Caoimhe McDonald

“Take control of your IBS don’t let it control you”   

Irritable bowel syndrome (IBS) is a chronic and relapsing bowel disorder. It affects up to 20% of adults and adolescents as well as children. It is 1.5 times more common in women than in men.  Symptoms include:

Dietitian, Dublin 6, Caoimhe McDonald

  • abdominal pain
  • bloating
  • constipation
  • diarrhoea
  • flatulence
  • poor appetite
  • indigestion

It is important to note that many conditions have symptoms that can mimic IBS. Inflammatory bowel disease, coeliac disease and microscopic colitis are a few. It is important that the diagnosis of IBS has been carried out, coeliac disease has been ruled-out and alarm features are absent.

Many people have had symptoms of IBS all their lives and done nothing about it. It is so often put down to having “a sensitive tummy”. As a Dietitian, I would estimate 60 – 70% of my patients suffer with IBS. It is very common for people to come to a dietitian for a different reason and drop it into conversation when discussing their diet. People wonder how it has become so much more common these days. However, when asked about their family history many report one or both of their parents have avoided a food for years as it “doesn’t agree with them”. 

Irritable Bowel, Dietitian, Rathmines

The truth is, more people feel comfortable discussing their digestive health and doing something about it. People live busy lives that can often be stressful and many are now more conscious of their diet and looking after their health. I have seen patients with such severe symptoms it has a huge impact on their quality of life. They are unable to attend work, they fear getting public transport, avoid social activities or not sleeping at night as a result. Why live with something like this when symptoms can be managed effectively?

Multifactorial

The exact cause of IBS is not known and it is thought to be multifactorial. Suggested causes may be; a previous gastrointestinal infection, prolonged antibiotic use, stress, medication, alcohol, poor diet and lifestyle factors. Two thirds of IBS patients perceive their symptoms are related to food. Symptoms can come and go and may be exacerbated in stressful situations which can make it difficult to identify the exact triggers.

So how do people go about managing their symptoms of IBS?

Dietitian, Dublin 6, Caoimhe McDonald

  • Medical management using anti-diarrhoeals, anti-spasmodics, laxatives or low dose antidepressants
  • Self-help – 7% treat themselves with no medical supervision
  • Herbal remedies
  • Psychological guidance
  • Probiotics
  • Lifestyle changes
  • Dietary guidance

Diet assessment and adjustment by a qualified dietitian is so important in the management of IBS. Many patients prefer dietary management rather than a reliance on medication. As a dietitian specialising in digestive health, it is very rewarding to see a patients’ symptoms improve. With guidance on diet, meal pattern, lifestyle factors and stress management, people will notice improvements. Some may immediately feel better after increasing fibre in the diet, increasing fluid and introducing exercise. Others may find eliminating certain foods beneficial or the use of a probiotic.

FODMAP Diet

There is a growing interest in restriction of short chain fermentable carbohydrates called FODMAPs (fermentable, oligosaccharides, disaccharides, mono-saccharides and polyols….a mouthful I know!) for IBS management. The low FODMAP diet is an exclusion diet specifically for patients with IBS which has been supported by 30 clinical studies. Research has shown that limiting these foods (high in FODMAPS) can alleviate the symptoms associated with IBS.  The low FODMAP diet should be done under the supervision of a dietitian as exclusion diets are at risk of nutritional inadequacy.

If you feel you could benefit from seeing a dietitian in relation to digestive health or any other dietary issue contact Caoimhe McDonald at Personal Health. Caoimhe has worked with patients with IBS for years and can help you identify the triggers for your IBS. Caoimhe will provide meal suggestions, recipes and shopping lists to make sure your diet is still balanced and you are getting all the nutrients you need.

In Conclusion, diet is not always the cause. It can be just one contributing factor to IBS. For many, stress management may be the best solution. Contact the Personal Health team to make an appointment with Consultant Dietitian Caoimhe McDonald or Psychotherapist Susan Duffy on 01 4964002.

pain, chronic pain, exercise, physio, physiotherapy

Do you really understand your pain? by Dee Ryan, Chartered Physiotherapist

Pain is often misunderstood, and as a result can cause fear. This fear and confusion can drive our pain experience. This blog explores the true meaning of pain with you. It might facilitate a different approach to your pain management, and hopefully can improve your coping strategies.

Pain is the body’s alarm system. It is designed to be a helpful response to protect you. This alarm system is assisted by your vision, hearing, smell and taste. For example, at halloween you see a bonfire, hear the wood crackling, smell/taste the smoke and feel the warmth. These sensory cues are helping your brain decide how best to respond to a given situation.

FireBeachPain
A key point to understand about pain is that once the brain decides you’re in danger, you will feel pain with or without the presence of tissue damage.

YOUR BRAIN DRIVES YOUR PAIN

Pain can be straight forward. But like most things in life, it can also be a complex process requiring some patience. Pain from direct tissue damage is clearly understood – an ankle sprain for example, see our Rory McIlroy blog:

Here, for example, the ligaments are sprained and in an attempt to protect you (how loving!) your brain decides the ligaments are at risk and need healing. Subsequently pain is felt in order to allow ligament repair and remodelling.
Pain can also be reflective of behaviour, emotions, memories, belief systems and what the pain means to you. A nice analogy for this is to imagine the ingredients of emotion, stress, memory, belief and behaviour are mixed together and make up the batter to a special kind of cake called pain. This cake is cooked in a particular oven called the brain. How the cake of pain turns out is very much so dependent on the oven – what temperature it is cooked at, how long it is cooked for etc. So it is clear the brain directly influences the end product- the pain cake.

 

pain management Personal Health Dublin 6

Is your pain getting out of hand?

Regardless of analogies, there is a proven science to this…..

Our body house these incredible sensors which continuously send messages to the brain via electrical impulses (neural pathways). Some sensors report on temperature, some respond to mechanical change, others to chemical change. There is a certain type of wire called a nociceptor which delivers messages of danger to your brain. They respond to any form of stimulus which is considered a threat. Remember nociception is just the delivery postman of the message, not the message itself.
Not every message being delivered from the sensors reach the brain. At the level of the spinal cord there is a sorting process, and the number of messages being passed is under control. Similar to a bouncer manning a nightclub. The danger messages can sometimes be granted access and are delivered to the brain. Here the brain has to make a decision how best to react to all this information it has been given.

Dee Ryan Chartered Physiotherapist in Dublin 6 discusses the complexity of pain

Those shoes are quite nice mate…..

Next week

Next week I will discuss the various systems which the brain calls upon in its response to these issues. Similarly I will expand on the effects of pain over a prolonged period of time- known as ‘chronic pain’.
Be a friend and tag a friend who you feel will benefit from further understanding the processes involved in the pain experience!

And now my parting gift to you until next week….a superb video which explains pain in less than 5 minutes:
https://www.youtube.com/watch?v=RWMKucuejIs

 

Mobility, Flexibility, fitness, movement, health

The Pursuit of Flexibility

As the years go by, the pursuit of flexibility can be a wistful bygone goal. In reality we stiffen up a fair bit as time flies. So, what seemed to be regular flexible movement at one stage, now seems difficult to attain. Why do I groan all of a sudden when I’m standing up from a chair ???

Let’s be kind to ourselves here – mobility and flexibility are often impossible due to our lifestyle demands. Similarly, if we do find some free time, is stretching a priority? It seems so boring… Perhaps not?

Well, there is a lot more to flexibility than static muscle stretching…. A lot more!

And best of all, it can genuinely provide relief, positively affecting your mood.

 

Be kind to each other

Many components affect our flexibility including:

Joint Capsule
Muscle
Ligaments
Tendons
Nerves

I am going to focus on joint stiffness in the thoracic (mid) spine as this is a common presentation across office workers. It is also equally common in multiple sports including cycling, rowing, boxing, wrestling and hockey.  Here is why…

The thoracic spine is the area of our spine located between your neck and low back. Thoracic mobility is important for optimal movement. The mobility of spinal joints and their surrounding capsules adapt depending on the activities performed. Multiple sports require the athlete to move with their arms positioned in front of their body, this positional demands often result in the shoulders sitting forward and a round upper back consequently increasing the risk of developing stiffness in this area.

As the mobility of the thoracic spine affects the function of the shoulders, neck and low back, it is strongly recommended to spend time ensuring your thoracic mobility is being maintained. It is all about balance.

IMG_2129
The more time you spend sitting at your desk, or training, then the more time you need to invest in maintaining your mobility and flexibility. To prevent long-term changes the idea is to position your body in the opposite positions from what you train or work in. For most people this will involve mobilising your upper back in extension and in combined extension and rotation. In other words, straightening your spine.

Over the past years I have found the following thoracic mobility exercises to be highly effective in maintaining and restoring thoracic movement:

1.Thoracic extension on foam roller:

Stretches the pectoral muscles and forces extension in the upper back. Ensure your low back is flattened on the roller for most efficiency. Hold for 30 seconds. Repeat 2-3 times. You can alter the position of your arms between 90 degrees and 120 degrees to bias different areas of your upper back. See image below.

IMG_3255 (1)

 

2. Segmental flexion and extension over the foam roller:

Place fingers on temples to promote thoracic extension. Position the foam roller horizontally and roll along your upper back. Stop at the segments which feel more uncomfortable and stiff. To bias the mobility at these segments, slowly extend over the roller towards the ground. Support your lower back whilst doing this by tucking your bum in. See pictures below as the athlete moves from thoracic flexion into segmental extension.

IMG_3256 IMG_3257

 

 

 

 

3. Bows and Arrows:

Position yourself in side-lying so that shoulders and hips are in line. Bend your knees so that your hips and knees are in line (this offloads your low back ensuring the movement is coming form your upper back). Outstretch both arms. Reach the top hand past the bottom hand and then pull backwards as though drawing the arrow on a bow. In this drawing back motion, aim to have the top shoulder facing up towards the ceiling. This is a slow and controlled movement and aim for 10 repetitions 2-3 times on each side. See the images below.

IMG_3258

IMG_3259

4. Shaking it all out:

Finally, if all else fails….Try loosely and gently relaxing your stomach, if you have ‘a belly’ (everybody does by the way) let it real and hang over your belt. Then gently allow some light  shaking through all the main joints, neck, shoulder, spine, hips, knees, ankles and feet. Just like the way Diego Maradona used to warm up for football games…..

 

 

Tag a friend if you feel this article is relevant to them, or that co-worker who constantly complain of upper back stiffness! If you have any further questions or queries regarding thoracic mobility or wish to purchase a foam roller contact us at Personal Health on 01 4964002 or email info@personalhealth.ie.

Ronan Fallon Physiotherapist Dublin 6

Muscle Strains and Timeframes – ‘When will I recover?’

Muscle strains and injuries are usually caused by a shearing effect such as a contact injury or a strain. The muscle fibres and their surrounding tiny blood vessels rupture hence the pain.
The healing process for the human body is incredible – the repair cycle kicks in within hours.

It is a complicated physiological process but in a nutshell you’re looking at a cycle of 21 days until your muscle is getting close to where it used to be prior to injury. Due to this process, it is very important to be patient and listen to your body.

 

The Trap 
The classic trap is that you begin to feel ok and pain free by day 7-10 and think “I’m good to train again tonight”. Unfortunately, this is a recipe for a re-injury and starting the whole process all over again.

 

Management 
Therefore, correct management of muscle strains and injuries is very important to prevent re-injury and chronic repetitive problems. In these cases the majority of clients just need a helping hand to guide the process from acute management through to a short rehabilitation/strengthening  programme.

 

Return 

The key component for the majority of clients is getting back to regular routines, sporting/exercise etc. in a responsible and time efficient manner.

 

 

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How can Personal Health make the difference for you….?

Use Our App!

  • Our Personal Health App uses rehabilitation videos filmed in line with best practice in e-learning
  • no more guesswork around your technique
  • your doctor/physio can prescribe from a library of over 1000 exercises ranging from basic to dynamic agility based rehabilitation
  • track your progress with interactive rating scales & charts
  • facilitates regular contact with your doctor/physio as we distance monitor your progress

 

Thanks for taking the time to read this

Ronan Fallon, Director of Physiotherapy

Andrew Dunne Managing Director Personal Health

The Orchestra & The Human Body

Dublin_Philharmonic_Orchestra_performing_Tchaikovsky's_Symphony_No_4_in_Charlotte,_North_Carolina

If you’re over 35…..Listen to your body instead of looking at it so much. All your vital internal instruments will thank you – you might even start to sound like a nice melody!

From the time you are born to around the time you turn 30, your muscles grow larger and stronger. But at some point in your 30s, you begin to lose muscle mass and function, a condition known as age-related sarcopenia. Nothing overly serious, but to summarise, it’s to do with nerve cells, brain signalling and hormonal changes.

We’ve all been down this road at some point….

  • Going for a run (too much too soon until it hurts)
  • Buying a new bike that gathers dust in the shed
  • Trying ‘High Intensity’ exercise
  • Abstaining from any of the good stuff in life

The truth is we have difficulty maintaining an ideally healthy lifestyle because of various factors (as above) and external stressors, such as job demands, cost of living and just being beautifully flawed!

But our health matters…..It’s frustratingly complex.

Personal Health

So what do we suggest at Personal Health?

  • Consult with our Medical team about your lifestyle choices
  • Exercise for 30 minutes with our Physiotherapists
  • Make small practical changes to your diet, with the help of our dieticians
  • Learn how to make behavioural changes to your sleep
  • Outsource your health concerns to an expert medical team