Monthly Archives: April 2022

How can this combination of treatments help create positive change for individuals struggling with addiction?

The use of opiates and resulting overdoses continue to grow.1,2 Research shows that medications can be useful for curbing cravings and preventing the misuse of narcotics.3 Even though medications have proven helpful, the lack of motivation to change and the incentives for diversion limit treatment compliance.4,5 Individuals inaccurate and unhelpful beliefs about themselves and about substances often interfere with positive change.6 Cognitive behavior therapy (CBT) has been found to be helpful when used together with medication-assisted treatment (MAT).7-9

One of the problems individuals experience when misusing substances is the powerful immediate reinforcement they receive from taking the substance. Indeed, one of the primary reasons people use substances is the immediate reinforcement which, in the moment, is much more compelling than the long-term negative consequences of continued use. By the time most individuals voluntarily talk to an addiction specialist, they have likely experienced negative consequences, including diminished pleasure, negative side effects, and negative social consequences.

Key Techniques in CBT for Substance Use

Individuals who come to treatment are often conflicted. On one hand, they have experienced negative consequences; on the other hand, they are unable to imagine that their lives could be different or better. In CBT, we work with individuals to help them change the trajectory of their lives by placing a renewed focus on the things they value. We help them imagine how their own lives could improve if they were to pursue aspirations that are aligned with their personal values. When individuals place a renewed focus on their values and personal aspirations, they can connect the short-term and long-term consequences of their actions. Individuals find motivation to change their old habits and participate in healthier activities.

With a newfound desire to make changes in their lives, individuals need to make what are often difficult decisions. In CBT, we support individuals in making decisions by doing a cost/benefit analysis. The cost/benefit analysis helps elucidate the relative positive and negative elements of engaging and not engaging in a particular action. By conducting a cost/benefit analysis, individuals gain clarity about the things they value. Accordingly, individuals may make decisions about people with whom it is in their interests to associate, which places to frequent to further their goals, and what things they can do to help them move in a positive direction.

In the throes of addiction, individuals often lose their ability to manage their schedules. In CBT, we help individuals develop schedules with a focus on 2 types of activities. One type of activity increases their level of mastery of things they either need to do or want to do. These activities could include everything from basic hygiene to developing expertise in a profession. The second type of activity increases a persons experience of pleasure, without engaging in substance use. Individuals who suffer from addiction have often lost their ability to experience pleasure when not using drugs. A CBT therapist will help individuals select activities that match their interests and include them on a master schedule designed to include all the different activities they need to do. Having scheduled activities allows less time for the individual to seek out and use substances. The feelings of mastery and pleasure serve as positive reinforcement for engaging in the various activities.

When individuals are caught up in the dynamics of addiction, they often develop negative beliefs about themselves and their abilities. This can lead them to have negative expectations that become self-fulfilling prophesies when situations play out as they predicted. After a person engages in activities that increase their level of competence and pleasure, they gather evidence that contradicts their formerly held beliefs about themselves and about substances. The newly acquired evidence starts a cycle of reinforcement based upon positive assessment, statements, and feelings about themselves. Repeatedly engaging in activities that give them a sense of competence and/or pleasure, combined with positive experiences, lays the foundation for creating new beliefs about their capabilities and capacity for positive feelings.

The continuous use of substances over an extended period can cause a person to become numb to lifes events. Once an individual gives up using substances, the renewed experience of having feelings can be unnerving. Managing emotions can become an important target for therapy. Developing a routine sleep schedule, engaging in healthier eating, and moderating physical elements of emotions may all help an individual learn to better control their feelings. Relaxation techniques, mindfulness exercises, or other activities such as yoga, prayer, and meditation can be very effective ways of helping people tolerate and manage their experience of feeling emotions that they have not felt for a long time. These techniques can be used with people from all walks of life and with varying histories related to substance misuse.

An Illustrative Case Example

Maria was a 22-year-old college student when she was referred for treatment following her arrest for drug possession and distribution. Maria had excelled academically and in multiple sports during high school. She went to college on a softball scholarship and planned to become a physical therapist. Following her freshman year, Maria tore her rotator cuff. Initially, she thought it was a minor injury and continued to play and work out. The tear got worse and, despite surgery, ended her ability to play softball at the college level. The injury was devastating to Maria because not only could she no longer play sports, but she lost her scholarship, had continuous pain and disrupted sleep, and became depressed as a result. She struggled to keep up with her studies. Her greatest relief from the physical pain and emotional upset was the oxycodone she was given following surgery. Her depression made it difficult for her to fully engage in treatment, and although her doctor recommended ibuprofen and alternative treatments, she continued to request the medication. After several months, her doctors discontinued the opiate medication.

Maria, in the meantime, had connected with others who were able to provide street drugs to fill her increasingly greater need for relief. When she was cut off by her doctors, she turned immediately to her friends. Eventually, she expanded her network of people from whom she could acquire and with whom she would share drugs. This eventually led to her arrest. Marias relationship with her parents and her old friends suffered along the way, and her parents were very concerned about her. They expressed a desire to help her find solutions. Marias attorney referred her for CBT treatment after her arrest and before any court appearances.

Initially, Maria was friendly and expressed a desire to participate in treatment. She was quite clear, though, that she did not know how to get along without opioids. Maria felt responsible for getting herself into her current predicament and felt helpless; she thought her future was hopeless and that she had lost any measure of worth. Rather than reminding her of what she had lost or lecturing her about the consequences of her continued drug use, we started therapy by focusing on the things that were important to her before her injury. Sports, academics, family, and friends were always important to her. They all seemed intricately linked to one another, and her injury seemed to take away everything she cared about.

Acknowledging the losses and the difficulties she had experienced, we talked about what her life could be like if she was able to reclaim the things she valued. Her family and academics were still important to her, and although she could not play softball, she was still capable of exercising. In session, we had her imagine that she finished school, renewed her relationship with her parents, and engaged in tolerable levels of exercise. She did not believe that she could be a physical therapist and switched her major to occupational therapy. Her vision of her aspiration served as a strong motivator to get her life back on track.

Still, Maria could not consistently resist her cravings for drugs. We taught her relaxation exercises that she found helpful for her emotional state and calming her urges, but they were not universally effective. We talked about the possibility of medication to help with her cravings. She and her parents had concerns about relying on medications to resolve medication issues, but after doing a cost/benefit analysis of the advantages and disadvantages of trying the medication versus the advantages and disadvantages of not trying the medication, Maria decided to give it a try. The medication had both agonist and antagonistic properties that worked well for controlling her urges and, to some extent, helped with her lingering pain. With those benefits, we then discussed other alternative treatments for pain that included ibuprofen and physical therapy. When Maria gained control of her urges with medication, she felt stronger.

After receiving relief from physical pain and urges to use, Maria was better able to concentrate on achieving her desired life. Initially, she found it challenging to manage her time. We worked together on an activity schedule to make time for her classes and homework. For Maria, it was important that she have a schedule that made time for her parents and other supportive friends, exercise, a routine sleep schedule, and healthy eating. As she followed her schedule and became more active, she felt more confident and competent. She changed the way she thought about herself. Rather than thinking of herself as being helpless and worthless, she recognized the power she had to do many good things with her life and felt increasing more worthwhile as a person.

It had been 3 to 4 years after Marias rotator cuff injury when she was referred for CBT treatment. Simply stated, for a variety of reasons, she had deviated from her previously successful path in life. With about 12 months of CBT and medication, she was able to get her life back on course. At that point, she had been accepted into an Accelerated Rehabilitation Disposition (ARD) program of the court, had completed her bachelors degree, and was accepted into a masters program in occupational therapy. She was still taking her medication, but did not want to have to take it forever. She exercised, but did not get the same level of pleasure as she did from playing high-level competitive sports and was still working on accepting that she could not do what she did before. She was making new, supportive friends whom she liked, although when she saw her old teammates, she experienced sadness that she could not be one of them. Maria maintained her values in life and took major steps toward achieving her aspirations. One thing she recognized was the need for her to continue using the tools she learned to stay on her path of recovery.

Concluding Thoughts

Cognitive and behavioral strategies can be useful in treating opioid use disorder, either on their own or in conjunction with medication. Alone, or with medication, CBT can improve motivation, aid in important decision-making, jumpstart behavioral activation, and facilitate the development of new beliefs about drugs, oneself, and the future. Medication can help patients control their urges so they can better focus on the work of therapy.

Dr Miller is a seasoned clinician, trainer, and administrator who provides oversight to the training and clinical services at Beck Institute as the CBT program director. For more than 25 years, he held leadership positions in a large integrated health system, including roles as director of behavioral health at WellSpan Behavioral Health, as chair of psychology for a 580-bed acute care hospital, and as chief psychologist for an APA-approved internship in clinical psychology that he founded. As a clinician, Dr Miller has used CBT to help individuals of all ages with a myriad of presenting problems coming from forensic, community, educational, and medical settings. He has conducted workshops, written professional articles, and published several resource books for lay readers about personality, depression, anxiety, and stress.

References

1. Drug overdose deaths in the U.S. top 100,000 annually. Centers for Disease Control and Prevention. Press Release. November 17, 2021. Accessed March 24, 2022. https://www.cdc.gov/nchs/pressroom/nchs_press_releases/2021/20211117.htm

2. Substance abuse and addiction statistics. National Center for Drug Abuse Statistics. February 19, 2022. Accessed March 24, 2022. https://drugabusestatistics.org/

3. National Academies of Sciences, Engineering, and Medicine; Health and Medicine Division; Board on Health Sciences Policy; Committee on Medication-Assisted Treatment for Opioid Use Disorder. The effectiveness of medication-based treatment for opioid use disorder. In Medications for Opioid Use Disorder Save Lives. Eds. Mancher M, Leshner AI. National Academies Press. 2019.

4. Alfonsson S, Johansson K, Uddling J, Hursti T. Differences in motivation and adherence to a prescribed assignment after face-to-face and online psychoeducation: an experimental study.BMC Psychol. 2017;5(1):3.

5. Brown MT, Bussell JK. Medication adherence: WHO cares?Mayo Clin Proc. 2011;86(4):304-314.

6. Rezaeisharif A, Karimi A, Naeim M. Effectiveness of the cognitive restructuring approach on irrational beliefs and hopelessness in individuals with a substance abuse disorder: a randomized controlled trial. Addict Disord Their Treat. 2021;20(4):326-335.

7. Ray LA, Meredith LR, Kiluk BD, et nal. Combined pharmacotherapy and cognitive behavioral therapy for adults with alcohol or substance use disorders: a systematic review and meta-analysis.JAMA Netw Open. 2020;3(6):e208279.

8. Moore BA, Fiellin DA, Cutter CJ, et al. Cognitive behavioral therapy improves treatment outcomes for prescription opioid users in primary care buprenorphine treatment.J Subst Abuse Treat. 2016;71:54-57.

9. McHugh RK, Hearon BA, Otto MW. Cognitive behavioral therapy for substance use disorders.Psychiatr Clin North Am. 2010;33(3):511-525.

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Cognitive Behavior Therapy and Medication-Assisted Treatment for Opioid Use Disorder - Psychiatric Times

Increased use of Ayurvedic, naturopathy, and other such alternative medicines is reportedly leading to liver damage and many other complications during the Covid-19 pandemic, as per Dr Abby Philips of The Liver Institute, Center of Excellence in GI Sciences, Rajagiri Hospital, Aluva.

Dr Abby Philips, who goes by TheLiverDoc on Twitter, said that lack of knowledge and misconceptions about naturopathy and over-reliance on Ayurveda is leading to many such problems, especially triggered during the pandemic.

In an interview with India Today, Dr Philips alleged that there have been cases of liver damage related to the usage of Giloy, a common herb extensively used as Covid prevention medicine.

READ | Covid-19 not going anywhere for next 2-5 years, learn to live with it: Delhi health minister

Here is an excerpt of the interview with Dr Abby Philips:

Q. How has excessive usage of Ayurvedic and naturopathy medication affected people's health during the pandemic?

Much of the claimed benefits of Ayurvedic or other alternative practices for prevention and treatment of Covid-19 have been baseless and mostly extrapolated from weak foundational studies in the lab setting, none conclusively shown of use in human trials. Extraordinary claims require extraordinary evidence. Prevention of infection using herbs or herbal mixtures was rampant during the Covid-19 pandemic. Since these are not regulated like actual drugs and medicines, people were able to get them over the counter and use it for themselves. Even though none of these measures improved responses to Covid-19, some of these adversely affected our citizens.

For example, the rampant use of Giloy as prevention for Covid-19 was associated with severe liver injury leading to death and even liver transplantation in some of the affected. This is just the tip of the iceberg as many such cases due to the use of herbal supplements and multi-herbal products go undiagnosed, and hence the true incidence of this public health issue is not known at this time.

The data on Giloy-liver injury has been published from multiple centers in India and also in the form of a multicenter nationwide study recently.

Similarly, cases of Siddha medicine Kabasura Kudineer induced liver injury and heavy metal toxicities due to Ayurvedic herbal supplements were also well documented during the pandemic.

READ | Why you shouldnt miss the precautionary third Covid vaccine dose

Almost all of the published evidence on Ayurvedic herbals causing harm in the patient and the general population are not due to excessive use, but associated with prescribed suggested use. So, concluding that herbal-related side effects happen only with excessive use is wrong.

Q. About cases that are possibly related to over usage of ayurvedic and naturopathy.

We see up to three new cases of herbal liver injury in our outpatient department on a weekly basis, which drastically increased during the Covid-19 pandemic.

The common herbal liver injury cases that we see include Giloy, ashwagandha, turmeric, green-tea extract, gymnema (gurmar or madhunashini), and most of the time - due to multi-herbal drugs and multiple herbal supplements intake by a patient for a host of conditions such as diabetes, gas trouble, high blood pressure, kidney stones or gall bladder stones and fatty liver. In fact, none of the Ayurvedic herbals have been shown to be of use in any of these conditions.

The cases present with either acute hepatitis where there is just an increase in liver enzymes with or without jaundice, acute liver failure where acute hepatitis leads to liver failure requiring a transplant, or acute chronic liver failure where a stable chronic liver disease patient suddenly worsens and develops multiple organ failure after the herbal liver injury.

None of these are due to over usage - these patients use these herbal products within prescribed limits.

Q. What kind of side effects does Giloy have if consumed excessively?

Giloy can cause an autoimmune-like liver injury that can lead to liver failure requiring liver transplantation in a small group of affected patients. I must emphasize that it is NOT due to overuse or excessive use, but Giloy can cause severe liver injury when used in the prescribed doses also. This is called idiosyncratic liver injury where the liver injury is not dependent on the dose or frequency of the drug or supplement.

Almost all of the liver injury cases identified during the Covid-19 pandemic and also published in medical literature were due to normal, prescribed consumption of Giloy. Giloy has been known to modulate the immune system in such a way that it can lead to an autoimmune attack on the liver leading to severe hepatitis and liver failure.

Giloy must not be consumed by persons with autoimmune disorders and also by those in whom a diagnosed condition associated with autoimmunity, such as diabetes mellitus, hypothyroidism, lupus etc is already known.

Nonetheless, ideally, Giloy must not be consumed at all for any disease prevention or treatment, because strong evidence for clinical benefits with its consumption is lacking in current literature in the human population as studies are mostly done in lab settings, in cell cultures or fruit flies.

Q. What should be the Health Ministry's responsibility over excessive use of ayurvedic medicines?

The Health Ministry along with the Ayush Ministry must bring out joint statements with respect to Ayurvedic medications, for improving public health. This means that together, they must review current evidence of benefits and adverse events of specific herbal/alternative drugs or drug combinations and must inform the public with straightforward facts so that they (the public) and treating physicians can make an informed decision about whether they want to opt for such specific alternative treatment.

The ministry must also mention that it is not excessive use, but also prescribed and suggested doses that can lead to adverse events in the consumer. Who can develop organ damage and what are the safe limits of use of a particular herb are not usually studied with most of the supplements available in the market - because the required toxicity studies in phased trials have not been conducted. These facts must be known to the public.

Q. Any suggestions on Ayurveda, homeopathy, naturopathy, Unani, and another such alternative medicine usage by Covid patients?

Ayurveda, naturopathy, Unani, and Siddha have absolutely no role in the prevention or management of Covid-19. Any evidence to claim that they are useful is flimsy and weak. There are no human clinical trials that are of ideal quality and that have been replicated by several research groups that allow us to prescribe Ayurveda, siddha, or Unani as a preventive or therapeutic modality for Covid-19. This is a plain simple fact and the truth. So, opting for such alternative treatments is not without risks and is definitely without any known benefits.

Now, regarding homeopathy, it is well known that homeopathy does not work for any disease condition and is currently regulated to oblivion by many scientifically progressive nations worldwide. Only in India, the blind promotion of a non-science, quackery-based Homeopathy is taken forward. The best, unknown aspect of Homeopathy for Covid-19 is that Homeopaths themselves have studied Arsenicum album 30C, the Homeopathic remedy peddled by the Ayush Ministry for Covid-19 prevention, and found that Arsenicum Album 30C is absolutely useless for the prevention of Covid-19.

(Dr Abby Philips is a senior physician-scientist in Hepatology, The Liver Institute, Rajagiri Hospital, Kerala. He is also a faculty member of the Guidelines Committee on Drug-Induced Liver Injury of the Asia-Pacific Association for Study of Liver (APASL) and Clinical Advisor and Doctoral Advisory Committee Member Department of Cell and Tissue Culture Sree Chitra Tirunal Institute for Medical Sciences & Technology (Government of India). )

READ: How govt spent Rs 35,000 crore on procuring Covid-19 vaccines | RTI Exclusive

ALSO READ | Nothing to panic, says NTAGI chief after India confirms cases of XE variant of Covid

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Surge in self-medication leading to liver damage during Covid, says Dr Abby Philips - India Today

If you are over the age of 65 and have rheumatoid arthritis (RA), your physician may not be treating you as aggressively as recommended by American College of Rheumatology (ACR). Updated in 2021, the guidelines endorse early treatment with DMARDs (disease-modifying antirheumatic drugs), medications that help decrease pain and prevent joint damage. However, a study published in ACR Open Rheumatology in January 2022, conducted by researchers at University of Michigan (UofM) Medicine, found that older people were receiving this treatment in far fewer numbers than younger people who had RA.

Rheumatoid arthritis is a progressive disease; early, aggressive treatment can reduce symptoms such as fatigue and prevent irreversible joint damage.

The research team used the National Ambulatory Medical Care survey to analyze almost eight million ambulatory visits by patients aged 65 and older from 2005 to 2016 for RA, an inflammatory autoimmune disease that affects more than one million Americans. We discovered that while the guidelines recommend that everybody with the RA diagnosis should be on some form of treatment, less than half of older adults are on any form of treatment, which is lower than what we expect. In the younger population, that number is closer to 80 percent. There is undertreatment overall with the DMARDs. Even among those, the biologics are the newer medications that have significantly changed the outcomes with rheumatoid arthritis, and that are prescribed in fewer proportions in older adults, says Jiha Lee, MD, MHS, a rheumatologist at UofM Health and lead author of the study.

It concluded, DMARD use for older adults with RA remains low from both rheumatologists and PCPs [primary care physicians], including biologic DMARDs, even though American College of Rheumatology guidelines recommend earlier and more aggressive treatment of RA.

Also of interest is that 74 percent of the visits were with rheumatologists; the rest were with primary care physicians PCPs. The study found that any DMARD use was recorded at 56 percent of rheumatologist and 30 percent of PCP visits. Among visits with any DMARD use, 20 percent of rheumatologist visits had two or more DMARDs compared with 6 percent of PCP visits.

If the disease is less than treated, there's a slew of consequences that can happen with that. The most obvious ones are decreasing quality of life, increase in depression rate, increase in pain. I think it's really one of the things that we should pay attention to, says Vinicius Domingues, MD, rheumatologist from Daytona Beach, Florida, and medical advisor to CreakyJoints.

Dr. Lee theorizes that the difference in prescribing can be due to several factors, one of which is ageism. She points to research published in Rheumatology, where rheumatologists were presented with the same clinical scenario of an RA patient, only changing the ages. When the same disease script was for an older patient, the rheumatologists were less likely to suggest aggressive treatment. There may be hesitancy on the patient side but there also may be the same hesitancy on the physician side, she says.

Other concerns are:

There are a lot of other factors that play into this that have yet to be further understood. But that doesn't mean that older patients should be receiving less aggressive treatment if there are better outcomes to be achieved, says Lee.

Dr. Domingues agrees, The risk of side effects increases as you get older, so physicians often want to protect these patients, but actually, you're doing a disservice to them if you don't treat the disease.

Doctors need to get patient-informed consent. Outline to the patient the benefits and possible risks. If the answer is yes, you move forward. If the answer is no, you try to find an alternative medication that has less side-effect profile. And if nothing is achieved, then again, it's the patient decision at the end of the day, but you have to include them into the conversation, explains Domingues.

As noted earlier, PCPs tend to underprescribe for RA significantly more than rheumatologists. Lee urges seeing a rheumatologist over a PCP, if you can. Seeing your primary care doctor can help achieve early diagnosis but they're not the ones who should be responsible for prescribing the DMARDS. Its always much appreciated when they do so there is early treatment, but they should be referring you to a specialist, says Lee.

If you, as an older patient, feel your symptoms are not being well controlled, bring it up to your physician. If your doctor dismisses your concerns with Youre 78, thats what 78 feels like, look for another doctor. Domingues says patients need to be empowered to speak for themselves. You have to voice your concerns about trying to differentiate what is inflammatory arthritis, and what is osteoarthritis, regardless of age. You should mention to your doctor if treatment is not working, you're still complaining of joint pain, joint stiffness, and joint swelling. If your doctor continues not to listen, get a second opinion.

Lee adds, We see patients in the office visits but patients live with this on a day-to-day basis. The more aware and informed they are about their symptoms that they can communicate back to the physician is going to really help inform how to optimize medication use.

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Rheumatoid Arthritis Is Undertreated in Older Adults - Everyday Health

Inflammatory bowel disease (IBD) is an umbrella term for several conditions that affect the intestinal tract. IBD happens when the immune system mistakenly attacks healthy tissue in the intestines.

These are the two main types of IBD:

IBD is a chronic condition that requires lifelong management. Theres no cure for ulcerative colitis or Crohns disease.

There are treatments for IBD, with the goals of reducing inflammation, easing symptoms, and reducing flare-ups.

Lets go over current treatment options for IBD and see whats on the horizon.

The main treatments are medicines and surgery. Your doctor will recommend treatment based on whether you have ulcerative colitis or Crohns disease, as well as the severity of your symptoms.

Some medications are meant for short-term use and others can be taken longer. You may require a combination of medicines. Also, your needs will likely change over time based on symptoms, flare-ups, and remissions.

If you have any other conditions or develop one along the way, that must be taken into account. Among the medications used to treat IBD are:

Aminosalicylates, which may help prevent flare-ups and keep you in remission. These include:

Biologic therapies, which help block proteins that cause inflammation. These include:

Other newer therapies are:

Corticosteroids can help when youre having a flare-up. Theyre fast-acting and meant for short-term use. These include:

Immune system suppressors reduce inflammation and help prevent flare-ups. They can take a few weeks to a few months to start working. These include:

Your doctor may prescribe other medicines for specific symptoms. These may include:

In cases where medications arent working well enough, surgery may help improve quality of life. Some types of ulcerative colitis and Crohns disease surgery are:

Complications of IBD that can be treated surgically include:

Certain lifestyle choices may help with symptoms and affect how you feel overall.

A severe case of IBD can make it difficult to get the nutrients you need through food. But if youre thinking of taking dietary supplements, speak with a doctor so you can do it safely and effectively.

Depending on your symptoms, your doctor may recommend changes to your diet, such as:

Keeping a food diary can help you figure out which foods cause problems. Creating the right diet plan for you can take time, and it may help to meet with a dietitian.

Stress doesnt cause IBD. But living with IBD can be stressful, and that can affect you physically. You may be able to reduce the effects of stress by:

Research suggests that psychological interventions may be helpful for some people with IBD. These may include:

More research is needed to assess the effectiveness of these therapies as they relate to IBD. But if youre feeling stressed out or overwhelmed, you might want to consider seeking help from a qualified therapist. It may also be helpful to join a support group for people with IBD.

According to the National Institutes of Health, some people with Crohns disease can benefit from resting the bowel for a few days or weeks.

This involves drinking only certain liquids or not eating or drinking anything at all. You may need intravenous (IV) nutrition during this time, so its crucial that you do this under a doctors care.

Treatment for IBD has come a long way in recent decades. A wider selection of drugs for ulcerative colitis and Crohns disease is allowing a more personalized approach to treatment. Still, not everyone responds well to treatment.

The Crohns & Colitis Foundation has identified five priorities for research:

Theres also plenty of ongoing research into new and emerging therapies, such as:

You can keep up with the latest research and clinical trials through The Crohns & Colitis Foundation.

Ulcerative colitis and Crohns disease are chronic diseases. Either of these can go into remission for long periods but remission is not a cure. Theres always the chance of a relapse.

Theres no shortage of online or word-of-mouth claims of a cure for IBD. They usually involve sales of expensive:

While some of these things may improve symptoms, they are not a cure. And even natural products can interfere with medications or increase symptoms of IBD. Consult with a doctor before making drastic changes to your diet or taking new supplements of any kind.

You can learn more about complementary therapies from the National Center for Complementary and Alternative Medicine.

Maintaining a healthy diet can help manage symptoms. But theres no specific diet known to cure IBD. Its important to continue with regular medical check-ups even when youre in remission.

Ulcerative colitis and Crohns disease are the two main types of IBD. Both are chronic, inflammatory conditions that require lifelong management.

Despite claims to the contrary, theres no cure for IBD. However, there are many medications to help control flare-ups and manage symptoms. And in some cases, surgery can result in long-term remission.

Research into the exact cause of IBD is ongoing. Its a piece of the puzzle that may eventually lead to a cure. In the meantime, new and more effective treatments are improving quality of life for many people with IBD.

If you have IBD, see your doctor regularly. If your medications arent working, ask about the latest advances in treatment, as well as lifestyle adjustments that might help.

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There's No IBD Cure, But Research Is Ongoing - Healthline

Namami Wellness and Health Edu, an emerging healthcare and hospitality company, has announced the launch of its futuristic wellness centre, Namami Health Retreat and Wellness Sanctuary,at the banks of Periyar River in Ernakulum, Kerala. This retreat provideseducation and services in wellness and health through the ancient sciences of Yoga, Ayurveda, and complementary alternative medicine while integrating scientific approaches to provide a holistic 360-degree approach to enhance life expectancy.

Namami Health has partnered with different national and international organisations like The Yoga Institute, PNNM Ayurveda Medical College and Hospital, Lexi Health and Dr. Shettys Aesthetics to bring on board certified experts in Ayurveda, Naturopathy, Yoga, Acupuncture and fitness. The Namami Approach masters the field of Advanced Aesthetics by providing state-of-art Face and Body Contouring treatments with TESLA Former, Pollogen Maximus and Medifacial.

It also offers different treatments and experiences under Complementary Alternate Medicine, Namami Integrative Methods and Health Technology. Equipped with modern science and advanced technology, the team at Namami offers differentiated Wellness Formulas, keeping the guests needs and requirements in mind.

Speaking on the launch, Vikram Vishwanath, Founder & Director, Namami Wellness and Health Edu, says that, Namami Health Retreat and Wellness Sanctuary is uniquely conceptualized to provide the best of both worlds and create a steady platform to combine remedial traditional wisdom with modern day science and technology. With an aim for all to lead a happier, and healthier version of oneself, our retreat goes beyond everyday wellness retreats and curates tailor made packages with best remedies, functional medicine, post-operative care, treatments, cuisines, activities and accommodation through strategic partnerships and associations in the lap of nature and luxury.

For families with children, the retreat host plenty of fun-filled activities to help develop a childs cognitive skills and creativity. Indoor and outdoor activities are thoughtfully planned to engage every childs interest and imagination. Focusing on Digital Detox, it engages in activities like flameless cooking, jungle gyms, yoga with kids, etc. Families together can take a leisure stroll in the Butterfly Garden, and enjoy bird watching, nature walks, treks and trails.

The resort offers 79 rooms and villas, a range of culinary experiences, curated recreation spaces and a holistic approach towards a healthy lifestyle. The contemporary interiors expand the local living experience based on the traditional principles of architecture, construction and carpentry. Backed by the lush green forests of Kerala, Namami Health Retreat offers a peaceful environment for everyone on the road towards healthy lifestyle.

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Namami Health and Wellness Retreat launched in Kerala - Hotelier India

Living with arthritis and bearing with all the swelling and pain in joints is not easy. The movement restriction and unbearable pain can make everyday tasks difficult for arthritis patients. Two of the most common types of arthritis are osteoarthritis and rheumatoid arthritis, the latter being an autoimmune disorder. There is no treatment for arthritis but it can be managed effectively with diet modifications and regular physical activity. (See pics: Suffering from joint pain? Follow these Ayurveda tips for relief)

Studies have established how eating plant-based food can help improve gut bacteria composition and reduce inflammation and joint pain. In arthritis, inflammation of joints is common and by including anti-inflammatory foods in the diet, the symptoms of the joint disease can be managed. There are certain herbs and spices that make a significant impact in controlling inflammation in the body.

Prachi Mittal, Nutritionist, Diet Couture suggests herbs and spices that arthritis patients should have.

1. Aloe Vera

It is one of the most commonly used herbs in alternative medicine. Its available in many forms, such as pills, powder, gels, and as a leaf. It has anti-inflammatory properties. It doesnt have the negative gastrointestinal effects of nonsteroidal anti-inflammatory drugs (NSAIDs), commonly used for arthritis pain.

2. Ginger

Ginger is extremely effectively in managing arthritis as it helps block inflammation pathways in the body. You can include ginger in your diet by making a tea infused with fresh ginger, add powdered ginger to baked goods,

add powdered ginger or fresh ginger root to savoury dishes, or add grated fresh ginger in a salad or stir fry.

3. Green Tea

It is a popular beverage and the antioxidants in it may help fight the inflammation that occurs with RA or OA

You can take green tea as a beverage, powder (matcha) for sprinkling on food or adding to smoothies or supplements.

4. Turmeric

It is used for ages and has anti-inflammatory properties. This can be added to milk or to other curries and dishes.

5. Cinnamon

There are many ways to incorporate honey and cinnamon in your diet and lifestyle. Adding it to oatmeal, teas, or smoothies is a great option.

Apart from eating the above-mentioned foods, processed foods, salt, red meat, alcohol, among other foods that exacerbate arthritis' joint pain and inflammation must be avoided.

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Fight arthritis pain with these amazing herbs and spices - Hindustan Times

This year, the day marks the 266th birth anniversary of famous German physician Dr Christian Friedrich Samuel Hahnemann the founding father of this branch of medicine

Representational image. AFP

World Homeopathy Day is observed on 10 April every year to celebrate the contribution of homeopathy to the world of medicine. The day marks the 266th birth anniversary of famous German physician Dr Christian Friedrich Samuel Hahnemann. Hahnemann is known as the founding father of this branch of medicine.

Apart from esteeming the founder, the day also gives people an opportunity to understand the glorious history of homeopathy and the countless miracles this crucial branch of medicine has been pulling off in the last few centuries. Homeopathy is one of the alternative practices of medicine that generally works by triggering the healing responses of the patients own body and causing fewer side effects.

It is believed by the practitioners that any sickness can be healed by inducing symptoms similar to it. Homeopathy medicines dismantle the origin of the disease completely and leave no chance for their revival in patients bodies.

History

Hahnemann was a renowned scientist, great scholar, and linguist and he was born in Paris on 10 April in the year 1755. He pioneered these alternative medicines in the late 18th century to heal diseases that seemed to be impossible nuts to crack. Hahnemann passed away on 2 July, 1843.

Significance

The day is observed to boost the success rate and create ways to develop homeopathy and make it a well-known practice of medicine around the globe. World Homeopathy Day is celebrated to spread awareness among people about the advantages of this branch of medicine and to find out the challenges associated with it and to create ways to deal with the challenges for its development and growth.

The Union government has also introduced a separate portfolio named the AYUSH ministry which encourages the Indian traditional branches of medicine like ayurveda, homeopathy, and yoga.

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World Homeopathy Day 2022: From history to significance, heres all you need to know - Firstpost