Deep Breathing Exercise for Nausea

Deep Breathing Exercise for Nausea.jpeg

One of the most common fears patients express when facing surgery is postoperative nausea, which can range from minor queasiness to protracted periods of vomiting. Feeling sick to one's stomach and throwing up after surgery is a common problem, affecting between a quarter and a half of those placed under general anesthesia, and more than half of those at high risk (women who don't smoke and have a history of motion sickness).

I've explored the science behind treating nausea with ginger (see Natural Nausea Remedy Recipe), but if you're too nauseous to eat, what do you do? Well, people are often sent home with anti-nausea rectal suppositories. Surveys, however, show that cultural and sexual attitudes may make a number of people sensitive to anything involving the rectum. Though the wording of the question researchers asked was, "are you happy to have a drug put in your back passage?" I can imagine many of the respondents thinking "well, maybe I wouldn't so much mind, but wouldn't exactly be happy about it," especially when you're feeling sick and throwing up.

For women who've had a C-section, they might not want to take drugs at all if they're breastfeeding, so researchers decided to put aromatherapy to the test. Research has shown that essential oils of both spearmint and peppermint are effective in reducing nausea and vomiting after chemotherapy, but this was after swallowing them.

Would just the smell of peppermint help with nausea? I explore this in my video Peppermint Aromatherapy for Nausea. Researchers had women take deep whiffs of peppermint extract (like you'd buy at a store) and it seemed to work. Eighty percent of the mint-sniffers felt better within just a few minutes, compared to no improvement in the placebo group who sniffed water with green food coloring, or the control group who didn't sniff anything.

The study was criticized for being small and for not using pure peppermint oil. Peppermint extract is peppermint oil plus alcohol. Maybe it was the smell of alcohol that made people better? And that's actually not too much of a stretch. In 1997, researchers reported a simple, innocuous, and inexpensive treatment for postoperative nausea and vomiting--the smell of isopropyl alcohol, which is what is found in those alcohol wipes, the little prep pads that nurses swab you with before shots. They found that they could just effectively tear one open and wave it under someone's nose and relieve nausea and vomiting in more than 80% of folks after surgery. It has been since shown to work as well as a leading anti-nausea drug, and may even work faster, cutting nausea in half within 10 to 15 minutes, rather than 20 or 25.

So was it the alcohol, the peppermint, or both? Researchers decided to put it to the test. They instructed patients to take three slow, deep breaths, smelling alcohol, peppermint, or nothing. The smell of peppermint cut nausea in half within five minutes, and so did the alcohol. But so did smelling nothing! So maybe it had nothing to do with the scent; maybe it was just the instruction to take slow, deep breaths. That would make it a really cost-effective intervention. Maybe it shouldn't be so surprising, given the proximity of the vomiting and breathing centers within the brain.

And indeed, controlled breathing was found effective with or without any scent. So next time you feel nauseous, inhale deeply through your nose to the count of three, hold your breath to the count of three, and exhale out the mouth to the count of three. Do that three times.

Ironically, the researchers continued to advocate using those nasty smelling alcohol pads even though they themselves showed they weren't any more effective than breathing alone. Why? Since isopropyl alcohol has a readily detectable odor, patients are more likely to think that their post-operation nausea and vomiting is being actively treated when they inhale alcohol vapors rather than just engaging in breathing exercises.


What do you think of still using the alcohol pads even though they were shown to offer no additional benefit? I have a whole video on such questions: The Lie That Heals: Should Doctors Give Placebos?

For those who can swallow, I offer more about powdered ginger in my video Dangerous Advice From Health Food Store Employees.

There's more on aromatherapy here:

What about actually eating the peppermint?

Of course, the best way to avoid postsurgical nausea is to try to avoid surgery in the first place. Those that eat healthy may be less likely to go under the knife. See Say No to Drugs by Saying Yes to More Plants.

In health,
Michael Greger, M.D.

PS: If you haven't yet, you can subscribe to my free videos here and watch my live, year-in-review presentations:

Image Credit: Sally Plank / Flickr. This image has been modified.

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Deep Breathing Exercise for Nausea

Deep Breathing Exercise for Nausea.jpeg

One of the most common fears patients express when facing surgery is postoperative nausea, which can range from minor queasiness to protracted periods of vomiting. Feeling sick to one's stomach and throwing up after surgery is a common problem, affecting between a quarter and a half of those placed under general anesthesia, and more than half of those at high risk (women who don't smoke and have a history of motion sickness).

I've explored the science behind treating nausea with ginger (see Natural Nausea Remedy Recipe), but if you're too nauseous to eat, what do you do? Well, people are often sent home with anti-nausea rectal suppositories. Surveys, however, show that cultural and sexual attitudes may make a number of people sensitive to anything involving the rectum. Though the wording of the question researchers asked was, "are you happy to have a drug put in your back passage?" I can imagine many of the respondents thinking "well, maybe I wouldn't so much mind, but wouldn't exactly be happy about it," especially when you're feeling sick and throwing up.

For women who've had a C-section, they might not want to take drugs at all if they're breastfeeding, so researchers decided to put aromatherapy to the test. Research has shown that essential oils of both spearmint and peppermint are effective in reducing nausea and vomiting after chemotherapy, but this was after swallowing them.

Would just the smell of peppermint help with nausea? I explore this in my video Peppermint Aromatherapy for Nausea. Researchers had women take deep whiffs of peppermint extract (like you'd buy at a store) and it seemed to work. Eighty percent of the mint-sniffers felt better within just a few minutes, compared to no improvement in the placebo group who sniffed water with green food coloring, or the control group who didn't sniff anything.

The study was criticized for being small and for not using pure peppermint oil. Peppermint extract is peppermint oil plus alcohol. Maybe it was the smell of alcohol that made people better? And that's actually not too much of a stretch. In 1997, researchers reported a simple, innocuous, and inexpensive treatment for postoperative nausea and vomiting--the smell of isopropyl alcohol, which is what is found in those alcohol wipes, the little prep pads that nurses swab you with before shots. They found that they could just effectively tear one open and wave it under someone's nose and relieve nausea and vomiting in more than 80% of folks after surgery. It has been since shown to work as well as a leading anti-nausea drug, and may even work faster, cutting nausea in half within 10 to 15 minutes, rather than 20 or 25.

So was it the alcohol, the peppermint, or both? Researchers decided to put it to the test. They instructed patients to take three slow, deep breaths, smelling alcohol, peppermint, or nothing. The smell of peppermint cut nausea in half within five minutes, and so did the alcohol. But so did smelling nothing! So maybe it had nothing to do with the scent; maybe it was just the instruction to take slow, deep breaths. That would make it a really cost-effective intervention. Maybe it shouldn't be so surprising, given the proximity of the vomiting and breathing centers within the brain.

And indeed, controlled breathing was found effective with or without any scent. So next time you feel nauseous, inhale deeply through your nose to the count of three, hold your breath to the count of three, and exhale out the mouth to the count of three. Do that three times.

Ironically, the researchers continued to advocate using those nasty smelling alcohol pads even though they themselves showed they weren't any more effective than breathing alone. Why? Since isopropyl alcohol has a readily detectable odor, patients are more likely to think that their post-operation nausea and vomiting is being actively treated when they inhale alcohol vapors rather than just engaging in breathing exercises.


What do you think of still using the alcohol pads even though they were shown to offer no additional benefit? I have a whole video on such questions: The Lie That Heals: Should Doctors Give Placebos?

For those who can swallow, I offer more about powdered ginger in my video Dangerous Advice From Health Food Store Employees.

There's more on aromatherapy here:

What about actually eating the peppermint?

Of course, the best way to avoid postsurgical nausea is to try to avoid surgery in the first place. Those that eat healthy may be less likely to go under the knife. See Say No to Drugs by Saying Yes to More Plants.

In health,
Michael Greger, M.D.

PS: If you haven't yet, you can subscribe to my free videos here and watch my live, year-in-review presentations:

Image Credit: Sally Plank / Flickr. This image has been modified.

Original Link

Making Your Own Mouthwash

NF-Jan26 Making Your Own Mouthwash.jpeg

The effects of a vegetarian diet on systemic diseases like cancer, diabetes, and heart diseases have been studied and have revealed predominantly less systemic diseases in those eating plant-based diets. However, there have only been a few studies on oral health, which I covered in my videos Plant-Based Diets: Oral Health and Plant-Based Diets: Dental Health.

What's the latest? In a study of 100 vegetarians compared to a 100 non-vegetarians, the vegetarians had better periodontal conditions, showing less signs of inflammation like gum bleeding, less periodontal damage, and better dental home care, brushing and flossing 2.17 times a day compared to 2.02 times a day. The difference in home hygiene is not that large, though, so maybe it was something about their diet. However, vegetarians may have a healthier lifestyle overall beyond just avoiding meat. The researchers controlled for smoking, but other factors like obesity can adversely affect oral health, so there may be confounding factors. What we need is an interventional study, where researchers take people eating the standard Western diet, improve their diets, and see what happens. But no such study existed... until now.

With professional support of nutritionists, the participants of the study (highlighted in my video What's the Best Mouthwash?) with existing periodontal disease changed their dietary patterns to so-called "wholesome nutrition," a diet emphasizing veggies, fruits, whole grains, potatoes, beans, peas, lentils, and spices, with water as the preferred beverage. To make sure any changes they witnessed were due to the diet, researchers made subjects maintain their same oral hygiene before and after the dietary change. What did they find? They found that eating healthier appeared to lead to a significant reduction of probing pocket depth, gingival inflammation, and levels of inflammatory cytokines, which mediate the tissue destruction in periodontal disease. Therefore, the researchers conclude that wholesome nutrition may improve periodontal health.

Why might diet help? Plant-based diets have a number of nutritional benefits in terms of nutrient density, but it also may be about improving balance between free radicals and our antioxidant defense system. Traditionally, dietary advice for oral health was just about avoiding sugar, which feed the bad bacteria on our teeth. We now realize that some foods and beverages, like green tea, possess antimicrobial properties to combat the plaque producing bacteria directly.

If plaque is caused by bacteria, why not use antibiotics? Many such attempts have been made, however undesirable side-effects such as "antibiotic resistance, vomiting, diarrhea and teeth stains have precluded their use." In a petri dish, green tea phytonutrients effectively inhibit the growth of these bacteria, but what about in our mouths? Researchers found that rinsing with green tea strongly inhibited the growth of the plaque bacteria on our teeth within minutes. Seven minutes after swishing with green tea, the number of harmful bacteria in the plaque scraped from people's teeth was cut nearly in half.

If you swish sugar water in your mouth, within three minutes the pH on our teeth can drop into the cavity formation danger zone. But if 20 minutes before swishing with sugar water, you swished with some green tea, you wipe out so many plaque bacteria that the same sugar water hardly has any effect at all. The researchers conclude that using green tea as a mouthwash or adding it to toothpaste could be a cost effective cavity prevention measure, especially in developing countries.

In the "civilized world," we have antiseptic mouthwashes with fancy chemicals like chlorhexidine, considered the gold standard anti-plaque agent. If only it didn't cause genetic damage. DNA damage has been detected in individuals who rinsed their mouths with chlorhexidine-containing mouthwashes, and not just to cells in the mouth. 13 volunteers rinsed their mouths with the stuff for a few weeks, and there was an increase in DNA damage both in the cells lining their cheeks as well as in their peripheral blood cells, suggesting that chlorhexidine was absorbed into their bodies. It reduced plaque better than other antiseptic chemicals, but it's doubtful whether chlorhexidine can still be considered the golden standard considering how toxic it is to human cells.

Are we left with having to decide between effectiveness and safety? How about a head to head test between chlorhexidine and green tea? Researchers found that green tea worked better than chlorhexidine at reducing plaque. Using green tea as a mouthwash may be cheaper, safer, and better. If, as a bonus, you want to sprinkle some amla powder (dried Indian gooseberry powder) into it, you may make it an even better plaque buster. Amla evidently shows an outstanding cavity-stopping potential not by killing off the bacteria like green tea, but by actually suppressing the bacteria's plaque forming abilities.

I now keep a mason jar filled with cold-steeped green tea (Cold Steeping Green Tea) with a spoonful of amla in the fridge and swish and swallow a few times a day. For extra credit you can gargle a bit with it too (see my video Can Gargling Prevent the Common Cold?).

Green tea shouldn't be the primary beverage of children, though, as the natural fluoride content may cause cosmetic spots on the teeth. For more check out my video Childhood Tea Drinking May Increase Fluorosis Risk.

Another reason we may want to avoid antibacterial mouthwashes is that they can kill off the good bacteria on our tongue that are instrumental in enhancing athletic performance with nitrate-containing vegetables (See Don't Use Antiseptic Mouthwash). For more on this, check out my video from yesterday, Antibacterial Toothpaste: Harmful, Helpful, or Harmless?

Need a reminder what amla is? More on dried Indian gooseberry powder power in:

In health,
Michael Greger, M.D.

PS: If you haven't yet, you can subscribe to my free videos here and watch my live year-in-review presentations Uprooting the Leading Causes of Death, More Than an Apple a Day, From Table to Able, and Food as Medicine.

Image Credit: Norio Nakayama / Flickr

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Preventing and Treating Colon Cancer with Turmeric Curcumin

NF-Oct20 Turmeric Curcumin and Colon Cancer .jpg

The low incidence of bowel cancer in India is often attributed to natural antioxidants such as curcumin, the yellow pigment in the spice turmeric, used in curry powder. However, it is important to remember that the benefits of a diet are seldom produced by a single ingredient in that diet. For example, diets rich in beta-carotene lower the risk of tobacco-related cancers, but beta-carotene pills do not. That doesn't stop researchers from trying, though.

Back in 2001, in a last ditch attempt to save the lives of 15 patients with advanced colorectal cancer that didn't respond to any of the standard chemotherapy agents or radiation, researchers started them on a turmeric extract. The extract appeared to help stall the disease in a third (5 out of 15) of the patients, suggesting that turmeric extract may clinically benefit at least some patients with advanced refractory colorectal cancer.

If we were talking about some new kind of chemotherapy, and it only helped one in three, we'd have to weigh the benefits against chemo side effects, such as losing our hair, the sloughing of our guts, intractable vomiting, maybe being bed-ridden. Therefore, a drug scenario, a one in three benefit may not sound particularly appealing. But when we're talking about plant extract proven to be remarkably safe, it would be worth considering even if it just helped 1 in a 100. With no serious downsides, a one in three benefit for end-stage cancer is pretty exciting.

To see if colon cancer could be prevented, five years later, researchers at Cleveland Clinic and John Hopkins School of Medicine tested two phytochemicals, curcumin (from turmeric) and quercitin, (found in fruits and vegetables such as red onions and grapes) in people with familial adenomatous polyposis, an inherited form of colon cancer in which individuals develop hundreds of polyps that may become cancerous unless prophylactically removed. (See Turmeric Curcumin and Colon Cancer). Researchers gave supplements of curcumin and quercetin to five such patients who already had their colons removed, but still had either polyps in their rectum or in a little intestinal pouch. Each patient had between 5 and 45 polyps each, but after six months on the supplement they ended up with on average fewer than half the polyps, and the ones that were left had shrunk in half. One patient got rid of all polyps by month three, but then they seemed to come back. The researchers asked the patient what's what, and it turned out that the patient stopped taking the supplements. So researchers put the patient back on the phytonutrient supplements for another three months, and the polyps came back down with virtually no adverse events and no blood test abnormalities.

By studying people at high risk for colon cancer, the researchers were able to show noticeable effects within just months. But polyposis is a rare disease; they were only able to recruit five people for the study. Thankfully, smokers are a dime a dozen. After another five years, researchers put 44 smokers on turmeric curcumin supplements alone for a month and measured changes in their colorectal aberrant crypt foci, which may act like the precursors to polyps, which are the precursors to cancer. After just one month there was a significant drop in the number of these abnormal crypt foci in the high dose supplement group but no change in the low dose group. There were also no dose-limiting side effects (although the stools in the participants did turn yellow).

The low cancer rates in India may also be related to phytate consumption (Phytates for the Prevention of Cancer) and plant-centered diets (Back to Our Roots: Curry and Cancer).

More on turmeric and Cancer in Carcinogenic Blocking Effects of Turmeric and Turmeric Curcumin Reprogramming Cancer Cell Death.

Given the poor systemic absorption of turmeric compounds, what cancers other than that of the digestive tract may be directly affected? See my follow-up video Topical Application of Turmeric Curcumin for Cancer.

In health,
Michael Greger, M.D.

PS: If you haven't yet, you can subscribe to my free videos here and watch my live year-in-review presentations Uprooting the Leading Causes of Death, More Than an Apple a Day, From Table to Able, and Food as Medicine.

Image Credit: sea turtle / Flickr

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