Wed, 15 Aug 2001

Put work aside, find time to exercise

Dear Donya,

Recently, I always feel pain in the back of my neck and around my shoulders. Sometimes, I feel sore all over, completely exhausted. I used to exercise, like jogging, riding the bike and playing basketball. I stopped exercising in 1999 since I have to leave home early in the morning and arrive back home at night around 8 p.m. I don't have enough time to exercise, even on weekends. My job really takes all my time.

I'm 34 years old, about 90 kg, and 165 cm tall. I drink non- fat milk, have three oranges plus orange concentrate plus an apple a day. Why do I always feel tired even though I sleep eight hours every night.

-- Anna

Dear Anna,

From your information, you are overweight. This exhausted feeling can arise from an incorrect sitting position. Start exercising. You must find time for exercise. For your neck pain you can do neck stretching exercises like bending your neck from right to left and front to back.

I am not sure if you are telling me that orange drinks and apples are all you ingest. I suggest having low fat, low sodium, small but routine meals. In my opinion, it is best to eat fresh fruit than orange concentrate because it has natural sugar.

-- Dr. Donya

Dr. Donya,

I'm Ratna and I'm 20 years old. I study dentistry and wonder if you can give me some information about orthodontics.

I also have a problem. I get attacks of diarrhea at the wrong times, like during holidays or at exam time. Is this because there's something wrong with me, or because my stress level is too high. Sometimes it's not actually diarrhea but sudden cramps in my lower abdomen, either on the left or right side.

-- Ratna

Dear Ratna,

Thank you for the letter and, I sorry, I cannot help you about orthodontics.

As for your bowel problem, it sounds like irritable bowel syndrome (IBS) to me. IBS is one of the most common gastrointestinal disorders, affecting about 15 percent of the population. It appears to be much more common in women than men.

The cause of the disease, sometimes known as spastic colon, is unknown. The disease is always characterized by chronic or recurrent gastrointestinal symptoms for which no structural or biochemical cause can be found. It is thought to involve nerves controlling sensation and contractions in the digestive system.

The common symptoms are abdominal pain (usually in the lower abdomen area), cramping, frequent diarrhea, abdominal gas, bloating, and diarrhea alternating with constipation, mucus in the stool, bowel urgency or incontinence, and a feeling of incomplete evacuation after a bowel movement. The symptoms appear during periods of major stress, such as during school examinations, and subside once the stressful event has passed.

The causes involve physiological, emotional, cognitive, and behavioral factors. These are all believed to be involved in symptom generation.

Physiological factors implicated in the etiology of IBS symptoms include: visceral hypersensitivity to spontaneous contractions and to balloon distention of the bowel, autonomic dysfunction, including exaggerated colonic motility response to stress and alterations in fluid and electrolyte handling by the bowel, and an alteration in the gastrocolonic response.

Because there is no diagnostic marker associated with IBS, the diagnosis is one of exclusion and is based on symptoms.

-- Dr. Donya