Monday, July 30, 2018

Getting a Good Night's Sleep

We spend approximately one-third of our lives asleep, but sometimes sleep can be elusive.
Almost everyone has experienced transient insomnia--the occasional inability to fall asleep, or waking up feeling unrefreshed. Thankfully, it's usually short-lived, lasting only a few days.

Chronic insomnia, however, lasts much longer. A common condition, it may be brought on by medical or psychiatric causes, such as colds, pain, or depression. But 10 percent of all insomnia occurs in the absence of any medical or psychiatric disorder and is called primary insomnia.

Primary insomnia seems to have a life of its own and often begins after someone has experienced a significant stressful event that may disrupt his or her sleeping pattern. To make up for lost sleep during this stressful period, the individual may develop poor sleep habits that perpetuate the insomnia long after the problem has passed.

Sticking to the following good sleep habits help most people sleep well:
  • Keep a regular schedule. Regular times for getting up, eating meals, taking medicines, doing chores, or other activities help to keep your inner clock running smoothly.
  • Establish a relaxing pre-sleep ritual. Activities such as taking a warm bath, reading for ten minutes, or having a light snack let your body know that bedtime is near.
  • Go to bed only when sleepy and get out of bed if you're not sleeping. By spending long periods awake in bed, your body learns that it's OK to be awake in bed.
  • Exercise regularly. It's best to exercise in the late afternoon about six hours before bedtime.
  • Avoid caffeine, alcohol, and smoking around bedtime. In fact, don't drink caffeinated beverages within six hours of bedtime.
  • In general, don't nap. If you must, it's best to take naps during the mid-afternoon.
If establishing these habits is either difficult for you or doesn't seem to be working, let your doctor know. Further assessment and treatment may be required.

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Monday, July 23, 2018

What does it mean when your stomach 'growls'?

Stomach "growling" is typically associated with hunger or an absence of food in the stomach.  The medical term for intestinal rumbling is borborygmus (bor-boh-RIG-mus).  If you say this out loud, you may find that pronouncing the word mimics the sound produced when your stomach growls.  In fact, the word borborygmus is an example of onomatopoeia, a word that imitates a sound. It comes from a Greek word that translates as "rumbling".
Sounds heard in the abdomen involve activity of the smooth muscle that lines the stomach and small intestine.  This muscle produces peristalsis, a progressive wave of contraction and relaxation that forces food, gas, and liquids through the stomach and intestines.  Peristalsis, like the beating of the heart, is under the control of the autonomic nervous system, occurring on a regular basis without requiring conscious effort.

After eating, peristalsis increases to move food through the digestive tract.  If one hasn't eaten in a while, peristalsis also increases and produces the rumbling noise associated with hunger.  This rumbling is more commonly associated with hunger than satiety because it is louder when the stomach and intestines have no food in them to muffle the sound.  So while stomach growling is most commonly associated with hunger, it can also occur after eating when the stomach is full.  And the sound does not just come from the stomach, but can be generated by the small intestines also.

In some cases, as with viral gastroenteritis ("stomach flu"), the sounds can be accentuated due to an increase in peristalsis. Increased amounts of gas in the intestinal tract may also bring about excessive abdominal rumbling.  One cause for this is lactose intolerance, a condition that occurs when the body does not make enough of an enzyme called lactase. With insufficient lactase in the intestine, lactose sugar, commonly found in dairy products, is instead broken down by gas-producing bacteria in the bowel.

Bowel sounds can be reduced when intestinal peristalsis is slowed down. This could be due to taking an opiate medication, receiving general anesthesia or undergoing bowel surgery.  A more serious situation may exist when bowel sounds stop altogether. This could indicate a problem such as bowel obstruction or an abdominal infection.

In general, the sounds produced in the abdomen, including growling, are not a sign of disease.  Stomach growling may be socially embarrassing, but in most cases is just a sign that the gastrointestinal tract is doing its job.

Sources for article: 
Abdominal sounds from Medline Plus
Why does your stomach growl when you are hungry? from Scientific America
Why does my stomach growl and make noises? from Tufts Now

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