ASK THE DOC
Specialist surgeon and lecturer Dr Sarah Rayne answers your questions
Q: What’s the difference between probiotics and prebiotics?
A: Understanding how to improve our diet is becoming more important as food becomes more processed. ‘Probiotics’ refer to probiotic bacteria – ‘good’ bacteria such as lactobacillus that multiply in the gut and ensure that harmful bacteria don’t cause diseases. Good bacteria form part of your intestinal mucosal defence system (the relationship between your gut and these bacteria promotes good health by staving off diarrhoea, inflammation and other infections) and may have cancer-killing properties. These effects are being studied, but most doctors agree that these bacteria are a good way to support a healthy gut.
To maintain a healthy number of probiotic bacteria, you have to feed them what they like to eat – ‘prebiotics’. These are non-digestible carbohydrates (fibre and roughage) that the bacteria need to survive. Foods rich in prebiotics include bananas, oatmeal and grains, as well as green beans.
Eat ‘functional’ foods – anything that contains a probiotic or prebiotic – as they have a health benefit beyond their nutritional ingredients. ‘Live’ yoghurt has a mix of probiotic bacteria, prebiotics and other nutrients. Eating products fortified with probiotics won’t treat infections but may help keep your gut regular and healthy.
Q: I’ve been breastfeeding for six months and my hair has been thinning noticeably. Should I wean my baby off the breast?
A: Hair loss after pregnancy is a fascinating but normal event. While women try to be as well prepared as possible for the actual birth, they’re often unprepared for the changes to their bodies.
Breast swelling as a result of breastfeeding is expected – but did you expect your sex drive to change, your feet to get bigger (and perhaps stay bigger) and your hair to fall out? In fact, you haven’t lost any hair: during pregnancy, the changes in your hormones disrupt the normal cycle of hair loss and you stop shedding hair. That’s why your hair looks so thick and glossy when you’re pregnant. When you give birth and your hormones return to normal, you suddenly start shedding all that extra hair. You’ll notice the regrowth as shorter pieces of hair for the next year or so.
Women who don’t breastfeed experience the same thing, so you don’t need to wean your baby. Well done for getting this far! The good news is that the biggest changes in your hair occur in the first three to six months, so it’s unlikely you’ll lose any more.
Q: Why are my feet sore every morning? The pain passes after a while.
A: It sounds like you may be developing plantar fasciitis (fash-ee-eye-tis), which is painful inflammation of the sole of the foot caused by overuse and stress. The bones of the foot link together in an arch, and are held there by a tough fibrous band (plantar fascia) that attaches from the heel bone to the base of your toes. Planter fasciitis often starts with a feeling that you’ve bruised your heel, before developing into a pain in the sole of the foot inside the arch. Most commonly, as you mention, it’s worse in the morning or after sitting for a while.
Because the inflammation is shortening the plantar fascia, stretching it again and reducing the inflammation are the best treatment. You can take non-steroidal anti-inflammatories such as ibuprofen to help with the inflammation. (But if you have kidney or stomach problems, check with your doctor first).
At the same time, start doing a few exercises to help with the stretch. A physiotherapist can advise you, and there are good resources online such as the American Orthopaedic Foot & Ankle Society (www.aofas.org). Keeping weight off the foot when it’s really sore will also help, as will ice packs.