Monday, 17 June 2013 00:00

HEART BURN

I never knew my enjoyment of certain foods would come at a price, laments Simon Kuloba, a 36 year old Car Mechanic plying his trade in Mbale’s boisterous industrial area. “Soon after eating some foods, i experience pain, discomfort and an acidy feeling around my chest and upper abdomen. my productivity has steadily been going down. While many may dismiss it as a minor condition or more than just another uncomfortable inconvenience, Physician Steve Wantenyeli of Mukhuwa Health center, Mbale says heartburn acid reflux should not be treated lightly especially when it occurs frequently.
“Heartburn is a serious condition that should not be ignored. it affects 2 out of every 25 people in Uganda, at a rate of at least twice a week. digestive acids or bile in the stomach trigger heartburn by making contact with the lining of the esophagus.”
These digestive acids, Wantenyeli points out, are meant to stay in the stomach and not to go flow back to the esophagus.
“When digestive acids frequently go back to the esophagus, the delicate lining of the esophagus is slowly destroyed”.
Heartburn as a condition has nothing to do with the heart, Wantenyeli asserts. “It’s in effect a digestive problem that can lead to a more serious condition called barrett’s esophagus or cancer of the esophagus if a physician is not consulted.”
He adds that if heartburn is temporary, it can dealt with some simple dietary and lifestyle changes.
Dietian Omoding Samuel of Namakwekwe health clinic, Mbale stresses that if heartburn becomes chronic, it can lead to gastro esophageal reflux disease, disease he says occurs when acids from the stomach literally burn the esophagus(tube running from the throat to the stomach).

CAUSES
Heartburn occurs when people consume or partake on foods that are acid forming such as citrus fruits, tomatoes, fried and fatty foods, caffeine and garlic. Omoding states. “when highly acidic gastric juices from the stomach spurt up through one’s esophagus, irritation normally occurs,resulting in a pain (heartburn).”

Over eating, Omoding says is also one of the major causes of heart burn. “When one over eats, the stomach takes longer to digest the food resulting in stomach acid returning back up to the esophagus. This spawns an acidic reflux or heartburn”.
Some foods trigger heartburn more than others.
“If you partake on too much fast food, chocolate, consume to many fizzy drinks and combine these with either smoking or drinking alcohol, you increase your risk of developing heartburn” states omoding
Certain gastrointestinal disorders aggravate or make heartburn worse. physician Steve Wantenyeli says heartburn can be triggered off by a hiatal hernia which is where the stomach protrudes a little into the chest through the diaphragm.




SYMPTOMS

Dietian Omoding says factors such as age, lifestyle, family history and other medical conditions determine the severity of heartburn in most people.
In most cases however, many people experience the same symptoms as enumerated below.
• Pain caused by heartburn, Omoding says will be at varying levels. anywhere from your stomach upward, but most commonly in the throat.
This sporadic pain Omoding says can come and go or be constant, or be degenerate.
Where severe heartburn is experienced, the pain experienced by some people can be unbearable.
• A burning sensation caused by acids coming back up into the esophagus.
Omoding says the burning sensation comes in the form of a burp that gives a burning feeling.
• Heart burn Omoding says can make the throat become painfully sore with a burning sensation due to the constant aggravation of the stomach acids.




HEART BURN RELIEF TIPS

To steer clear of heartburn, Wantenyeli says, eat more frequently but in smaller portions. Overeating he says triggers heartburn. “try eating six smaller meals throughout the day. eating smaller portions enables your body to digest food more easily”.

To forestall heartburn, meals close to bed time should be avoided. Having one’s last meal about two to three hours before going to bed is important in stemming a heartburn tide, Wantenyeli adds.

Carrying excess weight around your middle section spells pressure on your stomach especially after eating.
This pressure, Wantenyeli says can eventually lead to or aggravate one’s heartburn condition.

Fried, greasy and fatty foods are foods one should stay away from as they cause or exacerbate heartburn.
Fats, Wantenyeli says weaken the lower esophageal sphincter muscle. As a consequence, stomach acids flow back up into the esophagus. This, at length, causes heartburn.

Over the counter acid reflux antacids can also be effective in alleviating heartburn.
“Antacid tablets like ranitidine, cimetidine, famotidine, and omeprazole magnesium are not only a good economical choice but therapeutic as well. if they are taken before bedtime, they come in handy in subduing heartburn. Wantenyeli stresses.

If you’re a smoker/drinker and suffer from heartburn more often, break your habit or cut down on alcohol or nicotine considerably.
Nicotine from cigarette smoke, Wantenyeli adds tends to irritate the lower oesophageal sphincter, which is a valve that stops stomach acids from rising up and irritating the esophagus.

Invariably keeping your head up, especially when eating, drinking or sleeping, can help subdue heartburn. Dietian Omoding Samuel says lying down 1 to 3 hours after eating and drinking increases the likelihood of heartburn occurring.
Another good remedy for that nagging heartburn can be got from your kitchen cabinet in the form of a tablespoon of both honey and apple cider vinegar in a cup of warm water. Omoding says a few common kitchen spices like cinnamon, ginger or sage tea, as well as cardamom in baked goods or cereal, can aid with chronic heartburn.
Heartburn, Omoding asserts can also be cooled off with stomach soothing drinks like papaya, guava, pear, or mango juice. “aside of that, a cold glass of buttermilk and foods such as blanched almonds, brown rice, soda crackers, and apples can be helpful. regular intake of milk however should be avoided especially if one suffers from lactose intolerance.”


Try as much as possible to avoid carbonated drinks such as energy drinks or juices, soda coffee, wine, etc. Omoding says carbonated drinks contain phosphoric acid, which in the course of time,causes burping. burping he says sends stomach acid to the esophagus, possibly forming cancerous lesions. This reflex eventually causes heartburn.

Chewing gum especially that without peppermint and spearmint, Omoding says is another effective way of subduing heartburn acid reflux.
Chewing gum he adds contains baking soda which is a natural heartburn remedy
“Chewing gum for about half an hour, after a meal produces saliva that counteracts stomach acids. this prevents heartburn”.
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Published in HEALTH
Friday, 04 October 2013 00:00

STORY OF WANIAYE A KAPOSIS SARCOMA PATIENT

 It is decline of evening, the silence is deafening, the bird chirps dying down. Whilst the village kids frolic, deeply engrossed in their play time. Without a shadow of a doubt, this Village provides the best and widest view of that famous Mbale landmark-mountain Wanale.

It is said a traveler without observation is like a bird without wings. Was i about to be that bird? No, so i kept moving, whilst at the same time, my eyes cast about keenly observing. As i traverse further through Mango Village, Namalogo Parish, Bumboi, Mbale, my eyes bask in a glow, as they feast on lots of interesting sights and sounds. The pity however that later stares me In the face when I come across frail, disheveled and diseased 27 year old Waniaye Yassin threatens to ruin my hitherto placid and enjoyable sojourn. On the face of It, Waniaye is awkwardly emaciated. He is clearly out of sorts with a sickness that is eating away both his legs. Saddled with this depreciating Illness, one would assume, Waniaye Is out of humor and despondent. On seeing him, I thought he was a Kill joy.

Waniaye however Is a far cry from that and hardly fits that stereotype of a very sick person. 

“To me, despondency with my kind of condition and circumstances, Is only Ingratitude, the hope I have now will help me overcome my situation”, Waniaye asserts The Illness has not locked away Waniaye’s smile, nor has It deprived him of his cheerfulness, buoyancy, warm-heartedness and courtesy.

It Is all evident as Waniaye welcomes me with a crack of a smile, I can only describe as hale and hearty. What Is apparent Is Waniaye’s frailty and illness has not dampened his spirits. The physical fatigue that however has come with his illness Is discernible. As It seems, his body has expended a great deal of energy fighting the Illness.

 

Abdullah Makhafu, an elder in the village deplores Waniaye condition. “Waniaye has become a shadow of what he used to be. the fact that his parents are not so well off, also makes his situation worse. he however hasn’t lost his allure, which endeared him to many in the village”, Makhafu notes

Waniaye was a sturdy guy. he loved playing football and was a star on the Village team. the Illness has however unfortunately severely run him down so bad. his condition is really pathetic. he can’t even walk now”, Mohammed Wakhatenge, a Village friend says

Both of Waniaye’s legs from the knees to his feet look gravely Infected with diseased patches of rotting skin. 

Mabogi Hakim, a venerable elder In the village says a pitiful condition like Waniaye’s may inevitably fuel rumors of a cast spell. “In this part of the country where superstition Is rife, a condition’s like Waniaye’s will get people talking and poisoning other’s ears. Already I have caught wind of rumors spreading that his condition was caused by witchcraft. that of course is not true”, Mabogi states.

Waniaye Is of course cognizant of that fact, “I know when friends and relatives look at my diseased legs; they assume a spell has been cast on me. their words won’t break my bones however. It is a cancerous condition that sure looks like It will destroy both my legs. I cannot walk on my own. these lesions on my legs get worse every day and with the constant swelling comes excruciating pain. I need financial help to get treatment”, Waniaye explains.

 

Waniaye says his Illness started manifesting at the threshold of 2009, soon after his A “levels. 

“My parents took me to Mbale Hospital at first. I was put on treatment for 2 months. whilst there, my condition didn’t change much despite the treatment, I was getting. at first I was in the dark about this condition, but when the doctors refered us to Mulago, It became clearer. A biopsy was done and I was diagnosed with a skin cancer called Kaposi Sarcoma”, discloses Waniaye 

I have been on chemotherapy since then. on several occasions however, I have missed my doses due to financial constraints.

In October last year, my condition deteriorated severely, after I missed my dosage 3 times. my parents were hard up, Waniaye Reveals.

 

Missing a dose, spells restarting the dosage again. “Whenever I go for an injection, I have to part with ugx 300,000 on each injection and most times, my parents are financially constrained. the six times, I have been to Mulago, I have not been In a position to complete my treatment.

Every time, I don’t complete my treatment, I feel like a damper has been placed on me but It Is the reality of my situation and there is not much I can do”, Waniaye says plaintively

 

 

Amina Shuyo, Yassin’s Mother casts her mind back, “Since January 2010, Waniaye has not been able to move on his own. my son’s dreams have been shattered. he had just finished his senior six and was planning to join university when this Illness started rearing its ugly head.

We didn’t see any signs of an illness brewing until he started developing the painful swellings on his right leg. he now seems more like a cast away, a paraplegic, his legs have been in a long drawn out painful rut, decaying away, despite the treatment and medication he has been receiving”, Shuyo says

 

“What began as an itchy small dark mole under his right foot has degenerated since. at first we thought he had a problem with his right foot bone. his right foot starting swelling and developing a wound under It. The infection later spread to his left leg too”. Shuyo discloses

 

CHALLENGES

 

Amina Shuyo says finances have been the family’s major drawback. 

“his treatment has come at a high cost. we have not been able to afford some of the chemotherapy drugs and this has often caused a relapse in his condition. transport and the fact that we also have to support his other brothers and sisters have also been a major challenge”, Shuyo asserts

 

DOCTORS PERSPECTIVE

Doctor Partha Mukhopadhyay, Consultant Clinical Oncologist at Nakasero Hospital, says Kaposi Sarcoma Is the most frequently diagnosed cancer In several African Countries. Uganda has one of the highest concentrations of Infectious related cancers Including Kaposi Sarcoma, which Waniaye seems to be suffering from. 

“Each year, Infection related cancers kill roughly 1.5 million people worldwide. the most common symptoms of Kaposi Sarcoma are the appearance of red or purple patches on the skin. The patches then grow Into lumps, also known as nodules. Kaposi Sarcoma can also lead to tumors that appear as lesions on the skin, In the mouth and throat”, Mukhopadhyay explains

 

Doctor Mukhopadhyay emphasizes that a number of treatments can be relied on to treat Kaposi Sarcoma depending on how fast or slow the condition spreads. 

“The early detection and treatment of any type of cancer can greatly Increase one’s chances of survival. Surgery can be applied to remove small tumors caused by Kaposi sarcoma. Chemotherapy or radiotherapy too can be utilized to kill cancerous cells.

With proper treatment, Kaposi sarcoma can be controlled, though there are chances, It could re-occur especially, If a patient misses treatment. deaths resulting from It however are rare”, Mukhopadhyay Stresses. 

According to a report published by researchers on the Makerere University Infectious diseases Institute website, Kaposi sarcoma Is the most common cancer In Uganda.

The researchers say Kaposi sarcoma accounts for six out of every ten cancer diagnoses made at the Uganda cancer Institute.

 

Published in HEALTH