In the Ask a Doctor column, I answer readers' questions about anything and everything related to well-being and personal health. No topic is off limits. This year, readers asked questions about topics such as hair care, varicose veins and even hemorrhoids. Now, as we look back on 2024, here are the 10 most popular tips from the year.
BUILD A BETTER BREAKFAST HABIT
What we eat at breakfast can have an outsize impact on our health. That's because people tend to create a habit aroundbreakfast, while they vary other meals more often. Many patients in my gastroenterology clinic report eating the same breakfast almost every day for years.
To build a better breakfast habit, try making a few simple swaps: Rolled overnight oats in plain Greek yogurt with fresh fruit is a better choice than a bowl of cereal and a cup of fruit juice. Or try a breakfast sandwich with baby spinach, freshly shredded mozzarella and scrambled eggs on a whole-wheat English muffin - instead of sausage and American cheese on a plain bagel.
MINIMIZE YOUR TIME ON THE TOILET
Sitting and pushing for prolonged periods of time - which tends to happen while scrolling through social media on the commode - can compromise the supportive tissue in our anal canals. This may lead to symptomatic hemorrhoids. Symptoms can include itching, bleeding, a sense of fullness, an uncomfortable lump, inadvertent soiling and pain.
This is why I frequently remind my patients that they have one job, and one job only, when they take a seat.
SMELLY GAS? TAKE BISMUTH SUBSALICYLATE.
Ninety-nine percent of intestinal gas is made up of nitrogen, oxygen, hydrogen, carbon dioxide and methane. These gases are odorless; it's the 1 percent that contains sulfur, such as hydrogen sulfide, that ruins it for everyone else.
If you need a simple solution in a pinch - an upcoming work conference or a date in cozy quarters with someone special - take bismuth subsalicylate (Pepto-Bismol). Not only has it been shown to neutralize more than 95 percent of sulfide gases in the gut and to reduce symptoms of flatulence, but it can also prevent traveler's diarrhea. There is some concern about salicylate toxicity if you use it regularly long term, but if you need it for a day or two to ease your social discomfort, by all means, take 524 milligrams by mouth four times a day beforehand.
TRY LAVENDER OIL FOR SLEEP AND ANXIETY
From a purely medical perspective, it's hard to say that many essential oils are doing anything profound. The health claims linked to most varieties, such as citronella, bergamot, rose and sandalwood, are lacking in convincing data from clinical studies. But there is reasonable medical evidence for a few uses, including lavender oil aromatherapy for sleep and anxiety.
Lavender is thought to exert its effects on sleep and anxiety in our central nervous system in a somewhat similar fashion to the medication pregabalin, an analgesic. A 2022 meta-analysis looking at essential oil aromatherapy on sleep quality among cancer patients found lavender oil was moderately effective and performed better than other essential oils, such as chamomile or orange.
In the studies analyzed, lavender oil in aromatherapy was done through massage or directly inhaled after dilution - for example, putting the oil on a cotton ball that was kept around the patient's collar for 20 minutes.
ASK YOUR DOCTOR ABOUT IBUPROFEN ALTERNATIVES
Nonsteroidal anti-inflammatory drugs, or NSAIDs - such as ibuprofen, naproxen and aspirin - can seem great for treating pain in the short term. I don't get too concerned if my patients take one or two doses every now and then.
But through regular use, such as several times a month or more, NSAIDs are well known to increase intestinal permeability. In other words, NSAIDs can damage the lining of our guts.
Many people live with conditions such as migraines, chronic back pain or bad period cramps and take NSAIDs on a regular basis to treat their symptoms. If that's you, I'd advise you have a chat with your physician and explore NSAID alternatives. Personally, I'd rather reach for acetaminophen when I can.
AVOID ADDED FRAGRANCES
Scientists and clinicians are increasingly raising alarm over a group of chemicals used in many personal care products: phthalates. Phthalates - found in popular perfumes, nail polishes and hair-care products - have been linked to numerous adverse health outcomes: insulin resistance, cardiovascular disease and impaired neurodevelopment.
For Andrea Gore, a professor of pharmacology and toxicology at the University of Texas at Austin, who runs a laboratory studying the effects of endocrine-disrupting chemicals, the harms are clear enough that she advises everyone to try to reduce their exposure, especially parents starting a family and those with young children.
"I recommend avoiding added fragrances altogether - in perfumes, scented lotions and shampoos, even scented detergents and antiperspirants," she said in an email interview.
RACING HEART DUE TO ANXIETY? TRY THIS TRICK.
You can slow a rapid heart rate, caused by anxiety and even cardiac arrhythmias, using a classic technique called vagal maneuvers. These are simple actions that engage the vagus nerve - the major nerve connecting the brain to your internal organs.
To try a vagal maneuver, I recommend the straw trick: Place a straw in your mouth and pinch the other end closed. Blow for about 15-20 seconds. If you don't have a straw, place your finger in your mouth and blow against it as if it were a straw. The technique is one example of a "Valsalva maneuver" - named after the Italian physician who discovered it.
Vagal maneuvers have up to a 54 percent success rate in returning the heart rate to normal, but they are typically not considered long-term solutions. Getting the right evaluation and treatment for a racing heart is critical.8. Make this change to lower your Parkinson's disease risk
There is still a lot we don't know about how Parkinson's disease develops. But as a physician-scientist who studies the disease's origins, I regularly recommend one promising intervention to my patients: aerobic exercise. Even one hour per week of moderate to vigorous exercise - such as tennis, biking, swimming or jogging - has been shown to make a significant difference.
I know. "Exercise more" can feel like such clichéd advicecoming from a doctor. But exercise is one of the best-studied interventions in Parkinson's disease. It's been shown to both lower the risk of developing Parkinson's disease entirely, as well as to delay diseaseprogression among people already diagnosed. That's a huge deal: If you think about it, there are very few drugs that do both of those things for any disease.
WORRIED ABOUT GLUTEN? THIS DIET MAY HELP.
I have lots of patients in my gastroenterology clinic who report a sensitivity to gluten, a component of wheat, but test negative for celiac disease. In celiac disease, a common autoimmune condition that is rising worldwide, gluten triggers inflammation in the small bowel. But many people without celiac disease perceive a variety of symptoms they connect to eating gluten: bloating, diarrhea, and even brain fog, fatigue or joint aches.
While some patients do truly have a gluten-specific sensitivity, there's a good chance it's not actually the gluten that's the issue. In an Italian study of nearly 400 patients complaining of symptoms related to gluten intake, the vast majority - 86 percent - did not experience any symptom improvement with a gluten-free diet.
Instead, I often advise a trial of a low-FODMAP diet, particularly for those with irritable bowel syndrome. FODMAPs are a group of fermentable carbohydrates found in wheat and many other foods that are notorious for gastrointestinal distress.Examples of FODMAPs include onions and garlic; fruits such as apples and pears; lactose-containing foods such as soft cheeses and milk; and nuts such as cashews and pistachios.
TELL YOUR DOCTOR A FUN FACT ABOUT YOURSELF
Many patients lament how hurried their doctor's appointments feel. Believe me, I get it. Because as a doctor, I hate it, too. In many cases, 15 minutes isn't enough time for physicians to get all the information they need.
So as a patient, what can you do?
Try weaving in a quick fun fact about yourself. I know this may sound odd when we're talking about a lack of time. But decades of research in the biopsychosocial model of medicine have taught us that patient and physician outcomes are better when we integrate the patient's story into our care.
It takes an extra 15-30 seconds, but I go out of my way to ask new patients to tell me a fun fact about themselves that I make note of with their permission. In doing so, not only do I remember their medical histories better, but we both find it almost invariably brings a tiny, coveted spark of joy.