Health

Pixabay photo

Individuals with gambling addictions can now receive help from a new program offered by Mather Hospital’s Chemical Dependency Program, 75 North Country Road, Port Jefferson. The new service offers individual and group counseling for those 18 and older.

“Most adults gamble as a recreational, fun activity. But for some, it can become an addiction as with alcohol or drugs. This program has been developed to help individuals gain skills to combat addiction,” said Alice Miller, LCSW-R, Director of Outpatient Chemical Dependency at Mather Hospital.

Warning signs of a gambling addiction include lying about gambling behaviors, missing time with family and friends, gambling to escape problems, getting into debt, and unsuccessfully trying to cut back or stop gambling. Some popular forms of gambling include online sports betting, casinos, lottery and scratch-off tickets, horse racing, bingo, raffles and office pools.

For more information about the hospital’s outpatient program contact Alice Miller at [email protected]. To make an appointment, please call the Central Scheduling Department at 631-331-8200.

Mediterranean diet. Pexels photo
Diet plays a large role in quality of life as we age

By David Dunaief, M.D.

Dr. David Dunaief

What if I told you that approximately 85 percent of the U.S. population is malnourished, regardless of socioeconomic status and, in many cases, despite being overweight or obese (1)? The definition of malnourished is insufficient nutrition, which in the U.S. results from low levels of much-needed nutrients. Sadly, the standard American diet is very low in nutrients, so many have at least moderate malnutrition.

Most chronic diseases, including common killers, such as heart disease, stroke, diabetes and some cancers, can potentially be prevented, modified and even reversed with a focus on nutrients, according to the Centers for Disease Control and Prevention (CDC). 

Here’s a stunning statistic: more than 50 percent of American adults have a chronic disease, with 27 percent having more than one (2). This is likely a factor in the slowing pace of life expectancy increases in the U.S., which have plateaued in the past decade and are currently at around 77 years old.

I regularly test patients’ carotenoid levels. Carotenoids are nutrients that are incredibly important for tissue and organ health. They are measurable and give the practitioner a sense of whether the patient may lack potentially disease-fighting nutrients. A high nutrient intake dietary approach can resolve the situation and increase, among others, carotenoid levels.

Benefits of high nutrient intake

A high nutrient intake diet is an approach that focuses on micronutrients, which literally means small nutrients, including antioxidants and phytochemicals – plant nutrients. Micronutrients are bioactive compounds found mostly in foods and some supplements. While fiber is not considered a micronutrient, it also has significant disease modifying effects. Micronutrients interact with each other in synergistic ways, meaning the sum is greater than the parts. Diets that are plant-rich raise the levels of micronutrients considerably in patients.

In a 2017 study that included 73,700 men and women who were participants in the Nurses’ Health Study and the Health Professionals Follow-up Study, participants’ diets were rated over a 12-year period using three established dietary scores: the Alternate Healthy Eating Index–2010 score, the Alternate Mediterranean Diet score, and the Dietary Approaches to Stop Hypertension (DASH) diet score (3).

A 20 percent increase in diet scores (indicating an improved quality of diet) was significantly associated with a reduction in total mortality of 8 to 17 percent, depending on whether two or three scoring methods were used. Participants who maintained a high-quality diet over a 12-year period reduced their risk of death by 9 to 14 percent more than participants with consistently low diet scores over time. By contrast, worsening diet quality over 12 years was associated with an increase in mortality of 6 to 12 percent. Not surprisingly, longer periods of healthy eating had a greater effect than shorter periods.

This study reinforces the findings of the Greek EPIC trial, a large prospective (forward-looking) cohort study, where the Mediterranean-type diet decreased mortality significantly — the better the compliance, the greater the effect (4). The most powerful dietary components were the fruits, vegetables, nuts, olive oil, legumes and moderate alcohol intake. Low consumption of meat also contributed to the beneficial effects. Dairy and cereals had a neutral or minimal effect.

Improving quality of life

Quality of life is also important, though. Let’s examine some studies that examine the impact of diet on diseases that may reduce our quality of life as we age.

A study showed olive oil reduces the risk of stroke by 41 percent (5). The authors attribute this effect at least partially to oleic acid, a bioactive compound found in olive oil. While olive oil is important, I recommend limiting olive oil to one tablespoon a day. There are 120 calories per tablespoon of olive oil, all of them fat. If you eat too much, even of good fat, it defeats the purpose. The authors commented that the Mediterranean-type diet had only recently been used in trials with neurologic diseases and results suggest benefits in several disorders, such as Alzheimer’s. 

In a case-control study that compared those with and without disease, high intake of antioxidants from food was associated with a significant decrease in the risk of early Age-related Macular Degeneration (AMD), even when participants had a genetic predisposition for the disease (6). AMD is the leading cause of blindness in those 55 years or older.

There were 2,167 people enrolled in the study with several different genetic variations that made them high risk for AMD. Those with a highest nutrient intake, including B-carotene, zinc, lutein, zeaxanthin, EPA and DHA- substances found in fish, had an inverse relationship with risk of early AMD. Nutrients, thus, may play a role in modifying gene expression. 

Though many Americans are malnourished, nutrients that are effective and available can alter this predicament. Hopefully, with a focus on a high nutrient intake, we can improve life expectancy and, on an individual level, improve our quality of life.

References: 

(1) dietaryguidelines.gov. (2) cdc.gov. (3) N Engl J Med 2017; 377:143-153. (4) BMJ. 2009;338:b2337. (5) Neurology June 15, 2011. (6) Arch Ophthalmol. 2011;129(6):758-766.

Dr. David Dunaief is a speaker, author and local lifestyle medicine physician focusing on the integration of medicine, nutrition, fitness and stress management. For further information, visit www.medicalcompassmd.com.

Public officials gathered at the H. Lee Dennison Building in Hauppauge Monday, July 25, to announce the opening of grant applications for programs targeting the opioid crisis.

The first round of program funding, which will total up to $25 million, is made available through an approximately $180 million settlement Suffolk is expected to receive “in litigation recovery dollars” over the next 18 years between the county and various manufacturers and distributors.

Last year, Suffolk County Executive Steve Bellone (D) convened a joint legislative and executive task force to assess proper responses and coordinate efforts to counteract the opioid epidemic throughout the county.

A report prepared by the opioid task force suggests that the available funds target “prevention, harm reduction, treatment and recovery,” according to Bellone.

“These are the categories in which we will see the most significant gaps in programs and services and the greatest potential return on investment with respect to combating the opioid epidemic,” the county executive said. 

‘The decisions that were made really created the dramatic rise in opioid overdoses.’ —Sarah Anker

The task force’s report also recommends a process through which organizations and institutions can apply for the available funding. Starting this week and running through Aug. 22, an opioid grant application is available on the county’s website.

The program is open to public, private, for-profit and nonprofit organizations. “If you’re an agency or organization in this opioid fight and you have a proposal that will help, especially in the areas outlined in the report, then we want to hear from you,” Bellone said.

Also in attendance were several members of the Suffolk County Legislature. Presiding Officer Kevin McCaffrey (R-Lindenhurst), a member of the opioid task force, stated that he and his colleagues in the Legislature are committed to making the best use of these resources as possible.

“This money came with a cost and that cost was lives,” McCaffrey said. “Although we can never get those lives back again, we can … use this money to make sure that others don’t have to suffer and that we [don’t] lose more lives.”

The presiding officer spoke of the ways in which opioids affect communities and the toll they take on families. “Every one of us here knows somebody that has been affected, whether that person has passed away or went to treatment and is still in recovery,” he said, adding, “The scourge that this has caused for the families … you would not want to wish this on any family that’s out there.”

This is a disease, and I still see a system that doesn’t recognize it as such.’ — Kara Hahn

Legislator Sarah Anker (D-Mount Sinai), chair of the opioid committee, advanced several reasons to combat the opioid epidemic aggressively. She recalled the decades of drug profiteering, failed policies and the absence of federal oversight, which all contributed to a steady rise in opioid-related deaths nationwide.

“The decisions that were made really created the dramatic rise in opioid overdoses,” she said. “There are so many companies and people that created this tsunami of death and now we are here to pick up the pieces.”

Anker referred to the $180 million made available to the county as “a drop in the bucket” compared to the billions in profits generated by those who have exploited opioid users in recent decades. While this money will catalyze the county’s efforts to rectify these past failures, she acknowledged that there remains much more work to be done.

“We’re going to use these funds for opioid addiction, prevention and helping those who are in treatment, but I implore the folks here listening to this press event to take an active role in helping those who have succumbed to addiction,” Anker said.

Legislator Leslie Kennedy (R-Nesconset), chair of the health committee, offered her own unique perspective on addiction, having witnessed its effects firsthand before joining the county Legislature.

“As a nurse for 30 years, as someone who has worked in an addiction facility on top of that for 10 years, I have lived the pain and have lived the death,” she said.

Kennedy acknowledged the contributions of those who initiated the lawsuit that made these funds available. While this money cannot compensate for the destruction of life and the carnage inflicted upon the community, she offered that this is a positive step in honoring those who are now lost to this disease.

“It’s not perfect, it’s not a lot, but if we didn’t sue, we would have nothing,” she said, adding that counteracting “addiction is a bipartisan effort.”

Another powerful voice for this cause is Legislator Kara Hahn (D-Setauket). She said she is familiar with the plight of opioid addiction, having witnessed the degradation of families and communities personally.

“This is a disease, and I still see a system that doesn’t recognize it as such,” Hahn said. “The disease model of addiction, trauma-informed practices, and recognizing what individuals go through when they face addiction is incredibly important.” She added, “We all have to work together, work strong, work hard and double down on our efforts.”

Applications for opioid grant funding will be open until Aug. 22 and can be accessed at: ce.suffolkcountyny.gov/opioidgrantsapplication

Suffolk County Legislators Kara Hahn and Sarah Anker present proclamations to Day Haven Adult Day Services’ Liz Fiodralisi and Elizabeth LeDonne. Photo from Leg. Anker's office

At a recent general meeting of the Suffolk County Legislature, Legislator Sarah Anker and Legislator Kara Hahn presented proclamations to Day Haven Adult Day Services and their employees Liz Fiordalisi and Elizabeth LeDonne in recognition of Alzheimer’s and Brain Awareness Month. 

For over 35 years, Day Haven Adult Day Services has provided Suffolk County’s seniors with therapeutic and engaging programs, specialized services for individuals with Alzheimer’s, intergenerational programs, and emergency respite care and support services for caregivers. As Site Supervisors for the Port Jefferson and Ronkonkoma Day Haven locations, Liz Fiordalisi and Elizabeth LeDonne have supervised, coordinated and facilitated various programs, which have assisted in preserving the physical and cognitive health of Day Haven’s program participants.

“It is my honor to recognize Day Haven Adult Day Services, Liz Fiordalisi and Elizabeth LeDonne,” said Legislator Anker. “Both of these women have had a positive impact on our senior communities and families that are affected by Alzheimer’s and related dementia. Thank you for everything that you do to support our community’s seniors, their families and their caregivers.”

“As someone whose family was directly impacted by both Alzheimer’s and Dementia, I am so grateful for individuals like Elizabeth and Liz,” said Legislator Hahn. “These caring women have dedicated their lives to making a difference in the lives of their participants. The work they do not only helps the individuals living with memory loss, it also helps the families by ensuring that their loved ones are in safe nurturing environment. For the families whose loved ones are in your program, the knowledge that we can count on you to provide the best care, is so comforting.”

Liz Fiordalisi has over 15 years of experience working in the field of senior care, including in assisted living, senior center and social adult day care settings.

In addition, Liz is an active community volunteer and currently holds the position of Corresponding Secretary for the Miller Place-Mount Sinai Historical Society. Elizabeth LeDonne, also has years of experience working in the field of senior care, including as a Care Coordinator for a home companion agency, and as a Recreation Director, and later Director of a Memory Care Unit for an assisted living facility. 

While working at Day Haven Adult Day Services, Liz Fiordalisi and Elizabeth LeDonne have prioritized creating a nurturing environment to enrich the daily lives of Day Haven’s program participants.

To learn more about Day Haven Adult Day Services and their available programs for seniors, families and caregivers, visit www.dayhaven.org. 

Dr. Nick Fitterman with a copy of the $1 million check from New York State. Photo from Northwell Health

With financial support from New York State, Huntington Hospital is building it, and they hope undocumented and uninsured community members will have an easier time receiving care.

Dr. Nick Fitterman with a copy of the $1 million check from New York State. Photo from Northwell Health

At the former site of a Capital One Bank building at 1572 New York Avenue in Huntington Station, Huntington Hospital is renovating the building to create the Northwell Family Health Center at Huntington.

The center, which will open in the fall of 2023, will replace the Dolan Family Health Center in Greenlawn and will provide preventive care for children and adults.

The square footage of the new center will be about the same as the original family center but will have more clinical space. The current location in Greenlawn, which is 26 years old and will remain open until the Huntington Station location is up and running, has 3,000 square feet for meeting space. Huntington Hospital will dedicate that space to clinical programs.

The new location is “aligned with public transportation to improve the access for the people it serves,” said Dr. Nick Fitterman, executive director at Huntington Hospital. About 30% of the people who currently go to the Greenlawn facility have difficulty getting to the location. “Many of the people [the new site] serves can walk to the center.”

Working with Island Harvest, the Northwell Family Health Center will address food insecurity as well as overall health. Patients with high blood pressure, diabetes and heart failure will receive nutritional counseling which, coupled with the food banks, can provide the appropriate and necessary foods.

Those patients without diseases will also have access to fresh food through Island Harvest, Fitterman said.

In addition to providing a place for people who otherwise might not have a health care connection, the site will reduce some of the burden created when people use an emergency room for conditions that, when properly monitored, won’t require urgent services.

“When you come to a health care center like this, you get a continuity of care,” said Fitterman. That provides “better outcomes at a lower cost.”

At the Greenlawn facility on Wednesday, state Assembly Speaker Carl E. Heastie (D-Bronx) and Assemblyman Steve Stern (D-Dix Hills) presented the health center with a $1 million grant from New York State which will support the transition to the new facility, Fitterman said.

Donations from community members also help the center, which is being built to address a “gap in our community,” which exists in every community across the country, the doctor said.

On Wednesday, the Dolan Family Health Center in Greenlawn planned to host a baby shower for over 40 women who were expecting children.

The women are “single moms with no network of support,” Fitterman said. With balloons and tables filled with wrapped supplies like diapers, “we are connecting them to each other” to provide connections among these families.

The people coming to the center would otherwise not get antenatal care, which not only “improves their heath, but improves the health of their unborn babies,” Fitterman added.

It is very important to stay hydrated and drink plenty of fluids, especially if you have a history of stone formation. METRO photo
Once you’ve had one stone, your risk for others increases

By David Dunaief, M.D.

Dr. David Dunaief

Kidney stones can have no symptoms, but more often they present with the classic symptoms of blood in the urine and colicky pain. This pain can be intermittent or constant, and it can range from dull to extremely painful, described by some as being worse than giving birth, shot or burned. The pain may radiate from the kidneys to the bladder and even to the groin in males, depending on the obstruction (1).

Stones are usually diagnosed through the symptoms and either abdominal x-rays or non-contrast CT scans.

Unfortunately, the first line treatment for passing kidney stones — at least small ones — involves supportive care. This means that patients are given pain medications and plenty of fluids until the stone(s) pass. Usually stones that are <4mm pass spontaneously. Location is an important factor as well, with stones closest to the opening of the urethra more likely to pass (2).

Generally, if you’ve passed a kidney stone, you know it. In the case of a stone too large to pass naturally, a urologist may use surgery, ultrasound, or a combination of methods to break it into smaller pieces, so it can be passed.

Unfortunately, once a patient forms one stone, the incidence of others increases significantly over time. The good news is that there are several lifestyle changes you can make to reduce your risk.

Hydrate, hydrate, hydrate

First, it is very important to stay hydrated and drink plenty of fluids, especially if you have a history of stone formation (3). You don’t have to rely on drinking lots of water to accomplish this. Increasing your consumption of fruits and vegetables that are moisture-filled can help, as well.

Calcium from diet vs. supplements

One of the simplest methods is to reduce your intake of calcium supplements, including foods fortified with calcium. There are two types of stones. Calcium oxalate is the dominant one, occurring approximately 80 percent of the time (4). Calcium supplements, therefore, increase the risk of kidney stones. When physicians started treating women for osteoporosis with calcium supplements, the rate of kidney stones increased by 37 percent (5). According to findings from the Nurses’ Health Study, those who consumed highest amount of supplemental calcium were 20 percent more likely to have kidney stones than those who consumed the lowest amount (6). It did not matter whether participants were taking calcium citrate or calcium carbonate supplements.

Interestingly, calcium from dietary sources actually has the opposite effect, decreasing risk. In the same study, those participants who consumed the highest amount of dietary calcium had a 35 percent reduction in risk, compared to those who were in the lowest group. Calcium intake should not be too low, for that also increases kidney stone risk. Changing your source of calcium is an important key to preventing kidney stones.

Watch your sodium intake

It’s important to reduce sodium for many reasons, but we’ll provide one more here. Again, in the Nurses’ Health Study, participants who consumed 4.5 g sodium per day had a 30 percent higher risk of kidney stones than those who consumed 1.5 g per day (6). The reason is that increased sodium causes increased urinary excretion of calcium. When there is more calcium going through the kidneys, there is a higher chance of stones.

Limit animal protein

Animal protein also may play a role. In a five-year, randomized clinical trial, men who reduced their consumption of animal protein to approximately two ounces per day, as well as lowering their sodium, were 51 percent less likely to experience a kidney stone than those who consumed a low-calcium diet (7). These were men who had a history of stone formation. The reason animal protein may increase the risk of calcium oxalate stones more than vegetable protein is that animal protein’s higher sulfur content produces more acid. This acid is neutralized by release of calcium from the bone (8). That calcium can then promote kidney stones.

Reverse blood pressure naturally

Some medical conditions may increase the likelihood of stone formation. For example, in a cross-sectional study with Italian men, those with high blood pressure had a two times greater risk of kidney stones than those who had a normal blood pressure (9). Amazingly, it did not matter whether or not the patients were treated for high blood pressure with medications; the risk remained. This is just one more reason to treat the underlying cause of blood pressure, not just the symptoms.

The most productive way to avoid the potentially excruciating experience of kidney stones is to make these relatively simple lifestyle changes. The more changes that you implement, the lower your likelihood of stones.

References: 

(1) emedicine January 1, 2008. (2) J Urol. 2006;175(2):575. (3) J Urol. 1996;155(3):839. (4) N Engl J Med. 2004;350(7):684. (5) Kidney Int 2003;63:1817–23. (6) Ann Intern Med. 1997;126(7):497-504. (7) N Engl J Med. 2002 Jan 10;346(2):77-84. (8) J Clin Endocrinol Metab. 1988;66(1):140. (9) BMJ. 1990;300(6734):1234.

Dr. David Dunaief is a speaker, author and local lifestyle medicine physician focusing on the integration of medicine, nutrition, fitness and stress management. For further information, visit www.medicalcompassmd.com.

Warmer winters are likely contributing to the steady rise of tick populations and the spread of tick-borne diseases in the area. Illustration by Kyle Horne @kylehorneart
By Chris Mellides

As winters on Long Island become milder due to climate change, the existing tick problem on Long Island will likely intensify.

Already, municipalities along the North Shore have engaged the public to discuss the dangers of ticks and consider possible remedies. 

During a Village of Port Jefferson Board of Trustees meeting July 5, one concerned resident said, “Another child just got bit by a lone star tick and she can’t eat meat for the rest of her life.”

The meat allergy in question is Alpha-gal syndrome. AGS is a tick-borne disease commonly transmitted by lone star ticks, which are commonly carried by deer, according to the U.S. Department of Health and Human Services. 

The instances of the prevalent Lyme disease have nearly doubled in the years 1991-2018, based on findings from the Centers for Disease Control and Prevention. As the climate becomes warmer, the size of tick populations and the spread of tick-borne diseases are projected to increase. 

Village trustee Rebecca Kassay, whose background is in environmental community outreach, is well aware of the problem that these pests pose to the larger community. She considers recent public interest in tick activity to be worth the board’s attention. 

“As time goes on and as climate change is affecting our area, one of the effects is these more mild winters,” Kassay said. “When there’s not a deep freeze for a prolonged period of time, the ticks don’t have that die-off like they used to and, as that happens, we’re seeing a steady increase throughout Long Island and the Northeast of tick populations.”

Wooded areas and athletic fields are more prone to being havens for these external parasites that are carried by wild animals like mice and deer and typically affect mammals, though other organisms are also fair game to these blood-feeding, eight-legged insects. 

“I’m going to be looking into messaging, making sure that there’s accurate information that gets out to parents,” Kassay said, adding, “What are ticks? What are the dangers of [them]? And how important it is to regularly check for ticks both on their children and themselves?”

Barbara Sakovich, Port Jeff clerk, shared that while the village does not spray for ticks, private homeowners are permitted to spray their own properties.

Referring to the July 5 meeting, Sakovich said in a statement, “Deputy Mayor Snaden, as well as an attendee in the audience, discussed tick tubes and that they can be somewhat effective to manage the tick problem in the mice population.” The village clerk added, “A lint roller can be effective in removing ticks from clothing after being outside.” 

The New York State Department of Health lists several diseases known to be carried by ticks. However, the severity of symptoms has raised a number of eyebrows. Lyme disease is the most common but anaplasmosis, rickettsiosis, ehrlichiosis and tularemia are also contracted via bioactive molecules in tick saliva.

Tick bites affect parents and children alike, and the Port Jefferson Village website recommends that afflicted residents should “call your physician as soon as possible so appropriate preventative treatment can be given.”

“There’s a vigilance and an awareness that needs to be spread and hopefully our community will not be learning about these things through personal experience,” Kassay said. “Rather, [we need] neighbors talking to neighbors and parents talking to parents and sharing this information so that through information we can prevent other children from suffering [from AGS].”

Chris Hasbrouck shows off a recently picked cucumber from his garden at St. Johnland Nursing Center in Kings Park. Photo from St. Johnland
A hobby turns into a passion

St. Johnland resident Chris Hasbrouck has put his free time into gardening with bountiful results. Sunflowers, eggplant, tomatoes, green beans, cucumbers and strawberries fill the raised garden beds outside of Lawrence Hall where Chris resides.

A former stockbroker, Hasbrouck, who is 55, suffered a stroke that left him in need of round-the-clock care. “My father had a vegetable garden, so when I was looking for a hobby, it just seemed like a natural choice,” he said.

Originally from Centerport, Hasbrouck started his gardening obsession 4 years ago and today has a crop of vegetables he shares with nurses and therapists at St. Johnland.

Five beaches remain closed as of July 17.

Due to heavy rainfall yesterday and rain forecast for Monday, the Suffolk County Department of Health Services has issued an advisory against bathing at 47 beaches listed below. The advisory is based on the potential that bacteria is in excess of New York State standards.

The beaches covered by the advisory are located in areas that are heavily influenced by stormwater runoff from the surrounding watersheds or adjacent tributaries, and, because of their location in an enclosed embayment, experience limited tidal flushing.

Health officials recommend that bathing and other water contact be suspended in affected areas until the waters have been flushed by two successive tidal cycles, at least a 24 hour period, after the rain has ended. This advisory will be lifted Tuesday, July 20, 2022, unless sampling reveals elevated levels of bacteria persisting beyond the 24-hour period.

Additionally, Bayport Beach, which closed on Friday, and four more beaches that closed on Saturday remain closed due to excess bacteria. The four beaches that closed on Saturday include Amityville Village Beach, Tanner Park Beach in Copiague, Benjamin Beach in Bay Shore, and Ronkonkoma Beach in the Town of Islip. The beaches will reopen when bacteria subsides.

 Beaches affected by the advisory:

Sound Beach POA East Brookhaven Sound Beach Advisory Rainfall related
Sound Beach POA West Brookhaven Sound Beach Advisory Rainfall related
Tides Beach Brookhaven Sound Beach Advisory Rainfall related
Beech Road Beach (NSBA) Brookhaven Rocky Point Advisory Rainfall related
Broadway Beach (NSBA) Brookhaven Rocky Point Advisory Rainfall related
Friendship Drive Beach (NSBA) Brookhaven Rocky Point Advisory Rainfall related
Shoreham Village Beach Brookhaven Shoreham Advisory Rainfall related
Shoreham Beach Brookhaven East Shoreham Advisory Rainfall related
Stony Brook Beach Brookhaven Stony Brook Advisory Rainfall related
Shoreham Shore Club Beach Brookhaven East Shoreham Advisory Rainfall related
Miller Place Park Beach Brookhaven Miller Place Advisory Rainfall related
Scotts Beach Brookhaven Sound Beach Advisory Rainfall related
Woodhull Landing POA Beach Brookhaven Miller Place Advisory Rainfall related
Bayberry Cove Beach Brookhaven Setauket-East Setauket Advisory Rainfall related
Bayview Beach Brookhaven Setauket-East Setauket Advisory Rainfall related
Grantland Beach Brookhaven Setauket-East Setauket Advisory Rainfall related
Indian Field Beach Brookhaven Setauket-East Setauket Advisory Rainfall related
Little Bay Beach Brookhaven Setauket-East Setauket Advisory Rainfall related
Soundview Beach Association Beach Brookhaven Old Field Advisory Rainfall related
Terraces on the Sound Brookhaven Rocky Point Advisory Rainfall related
Eagle Dock Community Beach Huntington Cold Spring Harbor Advisory Rainfall related
Cold Spring Harbor Beach Club Beach Huntington Lloyd Harbor Advisory Rainfall related
West Neck Beach Huntington Lloyd Harbor Advisory Rainfall related
Lloyd Neck Bath Club Beach Huntington Lloyd Harbor Advisory Rainfall related
Lloyd Harbor Village Park Beach Huntington Lloyd Harbor Advisory Rainfall related
Gold Star Battalion Park Beach Huntington Huntington Advisory Rainfall related
Head of the Bay Club Beach Huntington Huntington Bay Advisory Rainfall related
Nathan Hale Beach Club Beach Huntington Huntington Bay Advisory Rainfall related
Baycrest Association Beach Huntington Huntington Bay Advisory Rainfall related
Bay Hills Beach Association Huntington Huntington Bay Advisory Rainfall related
Crescent Beach Huntington Huntington Bay Advisory Rainfall related
Knollwood Beach Association Beach Huntington Huntington Advisory Rainfall related
Fleets Cove Beach Huntington Huntington Advisory Rainfall related
Centerport Beach Huntington Centerport Advisory Rainfall related
Huntington Beach Community Association Beach Huntington Centerport Advisory Rainfall related
Centerport Yacht Club Beach Huntington Centerport Advisory Rainfall related
Steers Beach Huntington Northport Advisory Rainfall related
Asharoken Beach Huntington Asharoken Advisory Rainfall related
Hobart Beach Huntington Northport Advisory Rainfall related
Crab Meadow Beach Huntington Northport Advisory Rainfall related
Wincoma Association Beach Huntington Huntington Bay Advisory Rainfall related
Valley Grove Beach Huntington Eatons Neck Advisory Rainfall related
Prices Bend Beach Huntington Eatons Neck Advisory Rainfall related
Short Beach Smithtown Nissequogue Advisory Rainfall related
Nissequogue Point Beach Smithtown Nissequogue Advisory Rainfall related
Long Beach Smithtown Nissequogue Advisory Rainfall related
Schubert Beach Smithtown Nissequogue Advisory Rainfall related

High-fiber salads can help fight hemorrhoid pain. METRO photo
Simple methods to prevent constipation can help

By David Dunaief, M.D.

Dr. David Dunaief

For some reason, there’s a social stigma associated with hemorrhoids, although we all have them. They’re vascular structures that aid in stool control. When they become irritated and inflamed, we have symptoms — and often say we “have hemorrhoids,” when we really mean our hemorrhoids are causing us pain.

Many of us have suffered at one time or another from inflamed hemorrhoids. They affect men and women equally, though women have a higher propensity during pregnancy and childbirth. When they’re irritated, hemorrhoids may alternate between itchy and painful symptoms, making it hard to concentrate and uncomfortable to sit. This is because the veins in your rectum are swollen. They usually bleed, especially during a bowel movement, which can be scary. Fortunately, hemorrhoids are not a harbinger of more serious disease.

There are two types of hemorrhoids: external, occurring outside the anus; and internal, occurring within the rectum.

When they are outside

Fortunately, external hemorrhoids tend to be mild. Most of the time, they are treated with analgesic creams or suppositories that contain hydrocortisone, such as Preparation H, or with a sitz bath, all of which help relieve the pain. Because they can be self-treated, they generally do not require an appointment with a physician. The most effective way to reduce bleeding and pain is to increase fiber through diet and supplementation (1). 

Sometimes, however, there is thrombosis (clotting) of external hemorrhoids. In these cases, they may become more painful and require medical treatment. If you have rectal bleeding and either have a high risk for colorectal cancer or are over the age of 50, you should see your physician to make sure it is not due to a malignancy or other cause, such as inflammatory bowel disease.

When they are inside

Internal hemorrhoids can be a bit more complicated. The primary symptom is bleeding with bowel movement, not pain, since they are usually above the point of sensation in the colon, called the dentate line. If there is pain and discomfort, it’s generally because the internal hemorrhoids have falled out of place, due to weakening of the muscles and ligaments in the colon. This prolapse allows them to fall below the dentate line.

The first step for treating internal hemorrhoids is the same as for external hemorrhoids: add fiber through diet and supplementation. Study after study shows significant benefit. For instance, in a meta-analysis by the Cochrane Systems Data Review 2005, fiber reduced the occurrence of bleeding by 53 percent (2). In another study, after two weeks of fiber and another two-week follow-up, the daily incidence of bleeding decreased dramatically (3).

When issues are more severe

There are several minimally invasive options, including banding, sclerotherapy and coagulation. The most effective of these is banding, with an approximate 80 percent success rate (4). This is usually an office-based procedure where rubber bands are place at the neck of each hemorrhoid to cut off the blood flow. To avoid complications from constipation, patients should also take fiber supplementation. 

Side-effects of the procedure are usually mild, and there is very low risk of infection. However, severe pain may occur if misapplication occurs with the band below the dentate line. If this procedure fails, hemorrhoidectomy (surgery) would be the next option.

Preventing hemorrhoid problems

First, sitting on the toilet for long periods of time puts significant pressure on the veins in the rectum, potentially increasing the risk of inflammation. Though you may want private time to read, the bathroom is not the library. As soon as you have finished moving your bowels, it is important to get off the toilet.

Get plenty of fluids. It helps to soften the stool and prevent constipation. Exercise also helps to prevent constipation. It is important not to hold in a bowel movement; go when the urge is there or else the stool can become hard, causing straining, constipation and more time on the toilet. 

Increasing your fiber intake

Eating more fiber helps to create bulk for your bowel movements, avoiding constipation, diarrhea and undue straining. Thus, you should try to increase the amount of fiber in your diet before adding supplementation. Fruits, vegetables, whole grains, nuts, beans and legumes have significant amounts of fiber. Grains, beans and nuts have among the highest levels of fiber. For instance, one cup of black beans has 12g of fiber. 

Americans, on average, consume 16g per day of fiber (5). The Institute of Medicine (IOM) recommends daily fiber intake for those <50 years old of 25 to 38 grams, depending on gender and age (6). I typically recommend at least 40 grams. My wife and I try to eat only foods that contain a significant amount of fiber, and we consume approximately 65 grams a day.

You may want to raise your fiber level gradually; if you do it too rapidly, be forewarned – side-effects are potentially gas and bloating for the first week or two.

References: 

(1) Dis Colon Rectum. Jul-Aug 1982;25(5):454-6. (2) Cochrane.org. (3) Hepatogastroenterology 1996;43(12):1504-7. (4) Dis Colon Rectum 2004 Aug;47(8):1364-70. (5) usda.gov. (6) Am J Lifestyle Med. 2017 Jan-Feb; 11(1): 80–85.

Dr. David Dunaief is a speaker, author and local lifestyle medicine physician focusing on the integration of medicine, nutrition, fitness and stress management. For further information, visit www.medicalcompassmd.com.