Take it or leave it.

Thursday, February 23, 2017


I found out a dear friend has been suffering recurrent bouts of what appears to be the stomach flu and so I offered to share any medical advice she may find useful to alleviate symptoms of this most inconvenient and uncomfortable condition. 

I sent her a detailed questionnaire the purpose of which was to rule out serious conditions, narrow down the diagnosis and possibly even reach a likely culprit. Included in this questionnaire were questions about coffee consumption and alcohol and artificial sweeteners and new foods, travel and stress and sleep. Because the cruel combination of diarrhea, fever, aches and stomach pain three times in 6 months is more than anyone should have to bear. 

But the virus responsible for stomach flu in adults (norovirus, to give it a name, which infects people most frequently from October to April and causes the symptoms my friend has been suffering, within 1 to 3 days of exposure and lasting about as long) has various strains, and so it is not impossible that a person could get reinfected with such regularity. Does my friend eat at dirty restaurants, associate with sick people, eat too many oysters? Oysters are a major source of norovirus, which is typically spread to other people by contact with stool or vomit of infected people and through contaminated water or food. We ate oysters a couple weeks ago, but she didn't have any symptoms back then, nor did I. Ah the unknown!

What we do know is that the gut is the center of health. Immune cells (Peyer's patches) litter the small intestine and form an important part of the immune system by monitoring intestinal bacteria populations and preventing harmful overgrowth of pathogenic (disease-causing) organisms. The appendix, which some ignoramuses consider a vestigial organ with no function in the guts of modern humans, is located where the small intestine and the large intestine meet and it is rich in infection-fighting lymphoid cells, which suggests it plays a major role in the immune system, arguably more so for those who eat a diet rich in cellulose-rich plants. My friend's diet is more meat-friendly.  Bacterial flora need to be kept in balance with a diet emphasizing fruits and vegetables, prebiotics which nourish and sustain these probiotics. Or else unfriendly bacteria, and also viruses, will flourish. 

Norovirus replicates in the small intestine and after a day or so takes over the gut. Friendly bacteria will crowd it out and reduce symptom length and severity. I told this to my friend, and suggested a Tylenol/Advil mix for pain relief to get her through the day, plus probiotics in the form of kimchi and kombucha to bolster her intestinal tract health. And to avoid eating out so much, since a stranger's hands are more likely to transmit infectious organisms to your grub than you are if you prepare you own meals. Sometimes watching what you eat and how it's made is all that it takes to keep the doctor at bay. I hope I saved my friend a trip to a specialist, which can often involve unnecessary tests and procedures. Like my cousin, who complained of heartburn and bought himself a upper endoscopy just like that. 

Last week I visited my GP to investigate some urinary issues I'd been having and left the exam room after getting my prostate fondled. I haven't had any symptoms since. Maybe my prostate just needed a little TLC. Assuming the position was a first for me. And I came away with a negative STD screen, so there was that. Here I feared there was an outside chance I'd been living with syphilis for the last 15 years. Priceless, is a little peace of mind, and worth the two hours in the doctor's waiting room. Call me a minimalist, or maybe just lazy, but I'd just as soon take a friend's informed advice. 

But not everybody has a pal like me. To my friend's credit, she knew she had the stomach flu even before answering my detailed questionnaire. Her answers to these personal questions just served to bring us closer. I believe that a chummier world would be one in which the handshake was replaced by the sniffing of behinds. Taking a cue from the canines. My friend has one, a canine that is. And puppies can transmit disease. I should mention the fact next time we get together to sniff one another's butts, would that the day would come....

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