WHY DO SIGHT PROBLEMS INCREASE WITH AGE?

With advancing age, degenerative changes occur in every part of the body, including eyes. In fact eyes are one of the most overused parts of our body, working constantly non stop during waking hours.

The first change to occur with aging is loss of near vision. The eye muscles responsible for accommodating one to see near objects clearly weaken after 40 years or so, causing difficulty in activities like reading and sewing. If this is not corrected, it tends to affect far vision as well, due to eye strain. This manifests as blurred vision.

The lens (focal point for convergence of rays of vision) tends to become opaque with age, affecting vision. Macular degeneration (macula is central point of retina, the part where image of object visualized is focused to be conveyed higher up for interpretation) also occurs with aging. This also affects vision. Thus visual problems occur due to multiple reasons as one ages. Smoking, alcohol use, high blood pressure, uncontrolled diabetes, malnutrition, genetic factors, infections affecting the eyes, are some of the risk factors which hasten these changes and aggravate them.

Use of a diet containing adequate amount of vitamins B.complex and A, antioxidants, protecting eyes from exposure to dust, strong sunlight, keeping eyes clean, taking care of hypertension and diabetes, among others, chronic diseases affecting the eyes, avoiding alcohol and tobacco, are measures that can delay vision changes in eyes with aging.

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I HAVE DEVELOPED A LOT OF ACNE

Doctor,

I am aged 17 and will be completing high school next year. Recently, I developed a lot of acne on my face and it really makes me very uncomfortable around my peers. What could be the cause and how do I solve this irritation?

Peter

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Dear Peter,

Acne is a fairly common problem in adolescence and teen years of life. Exceptionally, some people get it even as adults. It is said to be due to changes in hormone balance hence more in adolescents and teenagers. Women become prone to develop acne during menses and pregnancy. Hormonal contraceptives and drugs like corticoids, increase susceptibility to develop acne. It may be one of the skin diseases occurring early in case of HIV infection.

Acne occurs due to blocking of skin pores by oil, dead cells of skin, sebum and bacteria. Too much oil is produced by oil glands, dead skin cells accumulate in pores and bacteria builds up in skin pores. Bacteria called Proprionibacterium acne is also implicated in causing acne. Excess of fried food and white sugar is said to precipitate and aggravate acne, though this is not substantiated by studies. A genetic component also exists. Somebody having a blood relative with acne is more likely to develop them.

Blockade of skin pores causes blackheads, white heads, reddish eruptions, any one or more of these lesions may exist at same time. Acne commonly occurs on face, chest, neck and back. There may be no symptoms or it may be slightly itchy. They are benign and as such do not cause any problem. Only risk is of secondary bacterial infection occurring due to scratching of the acne. Popping the acne can cause permanent scarring on face, adding to the ungainly look caused by it.

Treatment consists of keeping face clean dry and not oily. Oil based lotions and creams are best avoided. The face should be washed with a mild soap and lukewarm water. There are many topical ointments available for treatment of acne. These consist of resorcinol, salicylic acid, benzoyl peroxide, and other ingredients. People respond differently to these topical ointments. Antibiotics like tetracycline, erythromycin, clindamycin, are given in ointment form for local application or as tablets, to clear the bacterial infection and subsequent ongoing inflammation.

Derm abrasion is yet another option for clearing persistent or severe acne not responding to other treatments. Here the superficial layer of the skin is scraped off entirely, with the hope that new skin coming will come clean. Acne may also be removed by electrolysis or laser treatment.

Besides there are several home remedies which claim to cure acne or at least suppress them. These are like honey and cinnamon face pack, use of turmeric paste, e.t.c.

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HOW SHOULD I FEED MY FAMILY THIS CHRISTMAS?

Editor,

The Christmas festive season is coming and one thing that stands out is binge eating. What issues are likely to arise from this and how would you advise I feed my family?

Mbabazi

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Dear Mbabazi,

Christmas is indeed to be enjoyed. It is a time for friends and family members to get together, eat, drink and make merry. But for some people enjoyment simply means to gorge in good food and drinks, which is not very healthy. How much load of food can one tolerate, without becoming sick depends on many factors.

The height and weight of the person, their regular eating habits regarding quantity of food consumed, the overall health status of the person or any other factor causing dyspepsia, are some of the factors which determine his tolerance towards binge eating.

Usually when food is swallowed, process of digestion begins right within the oral cavity, where saliva moistens the bolus and helps in swallowing. Digestive enzymes from salivary glands are activated.

The process of digestion continues till the stomach and then digested food reaches intestines, where necessary nutrients are absorbed and waste material is passed out as stools. In binge eating, load is put on the entire digestive system hampering its efficiency.

The resultant poor digestion causes sense of bloating of stomach, abdominal pain, burning pain in chest, nausea, vomiting, one or more of these symptoms. Some people even vomit within half to one hour of overeating. Due to indigestion, sleep of a person can be disturbed as acid reflux occurs, causing bitter taste in mouth, burning pain, nausea and or vomiting.

One suffers on the next morning of binge eating as well due to bitter taste in mouth and abdominal discomfort with sensation to vomit. Eating in excess affects the efficiency of bowel movements as well, resulting in constipation.

This adds on to the discomfort. At times, an individual can have increased frequency of stools after binge eating, which causes much distress. Moreover, nutrients are not absorbed in proportion of quantity of food, if one overeats the extra food kind of goes waste.

Thus there are many hazards of binge eating, but no advantages. Therefore it is best avoided.

Small frequent meals are good for all days including festive season.

Even the tastiest food can be relished more when eaten in small quantities, without falling sick. If possible, evening meal can be taken early instead of late in the evening, so that the digestive system finds enough time to process it. Fried and very hot spicy food should be taken in small quantity, unless one is habituated to it. If possible, snacks and special festive dishes can be prepared from nutritious ingredients particularly for children.

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I GET CONSTIPATION WHEN I BOOZE

Doctor,

I get constipation every time I take a lot of booze. How are these two related, and what generally causes one to get constipation?

Nina

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Dear Nina,

A lot of booze can indeed cause one to get constipation. This occurs due to multiple reasons. Alcohol causes dehydration due to removal of water and electrolytes.

Water content of stools is also reduced, thus causing dry stool, which is hard and difficult to pass. Loss of water and electrolytes also reduces peristaltic movements of the bowel, aggravating the constipation.

The bowel movements are also reduced due to effect of alcohol on brain causing generalized lethargy and stupor. One can desire not to pass motion at scheduled time, even if bowels are loaded due generalised daze caused by drinking binge of booze.

This causes constipation at that moment and if frequent can cause chronic constipation. Regular intake of alcohol tends to damage the nervous system affecting bowel movements and causing chronic constipation.