Ask the Doctor: What causes annoying sounds from my stomach?

Doctor,  I have this annoying noise that comes from my stomach. The noise comes anytime and it is embarrassing. My friends insist ‘worms are hungry.’ What could be the problem? Sarah Amoit

Usually as food, liquids and gas pass through the stomach and intestines, they may make some noise (borborygmi) which may not be audible to another person nearby. The rumblings are a normal part of digestion and movement of food in the alimentary canal.

That said if food (or waste matter) is too liquid as when one is about to have diarrhoea, or intestines contain too much gas, the borborygmi are likely to be much louder with a person nearby taking notice to the victim’s embarrassment.

Anything that may cause diarrhoea including an intestinal infection, food intolerance and malabsorption, or that causing too much gas in the alimentary canal like eating too much dietary fibre, peptic ulcer disease and hunger may lead to growling stomach.
Hunger leading to loud stomach growling could have been the reason why people in your locality think that taking long without eating ‘may starve parasiting intestinal worms whose loud complaints may even be noticeable to a bystander.’

Taking lots of water with fibre or high fructose foods such as ripe bananas, checking out a medical problem like peptic ulcer disease and addressing it , taking little food but more often to avoid an empty stomach are some of the ways you can mitigate a howling stomach though by and large the causes are harmless. 

Will I get used to the drugs and erect well?

Doctor,  Do ARVS cause impotence? I was doing well sexwise but once I was found HIV positive and given ARVs, I can barely erect let alone have sex well. –Simon

Men as they get older (as early as the 40s or 50s) may get erection problems but most times these are related to disease conditions such as diabetes or psychological problems including stress and anxiety.

When one is newly diagnosed with HIV infection, the shock of the new diagnosis, stigma, and anxiety about passing on HIV to the partner and unborn children may on their own lead to erection problems which may impact on sexual performance.

That said, some HIV drugs , especially those called protease inhibitors may lead to erection problems requiring that you consult your doctor about the ARVs you are taking and your next step instead of abandoning treatment and risking the virus turning resistant to drugs being used. 

The doctor will also counsel you and if need be, give you appropriate treatment for erection problems. 

Is it safe to visit the dentist when pregnant?

“Oral health is a mirror for general health, wellbeing and quality of life”
 Pregnancy is a thrilling time filled with excitement and anticipation for your new baby. Oral health management is often overlooked, and we tend to forget how important it is in this period. 

A gestational woman requires various levels of support; medical, preventive care, physical and emotional assistance.
 However, health professionals often do not provide oral health care to pregnant women due to dissent from the expectant mother. 
At the same time, pregnant women including some with obvious signs of oral disease, often do not seek or receive care due to misconceptions from hear-say. 

Dentists may delay certain elective procedures so that they coincide with periods of pregnancy devoted to maturation versus organogenesis, other times the practitioner needs to alter their normal pharmacological arsenal to address the patient’s needs versus the foetal demands. 
Common conditions 
Maintaining optimum oral health during pregnancy is vital for you and your new baby.

 Some of the commonest oral conditions acquired during pregnancy include:
• Pregnancy Gingivitis: Hormonal changes associated with pregnancy exaggerate the gum tissue response to bacteria causing inflammation and easy gum bleeding which worsens an already existing gum disease
• Pyogenic granuloma: Also known as pregnancy epulis are benign swellings on gums associated with hormonal changes and poor hygiene.

• Dental Erosion: Frequent nausea and vomiting in pregnancy exposes teeth to stomach acid which if left unattended causes erosion on tooth surfaces and sensitivity.
• Dental caries: Pregnancy also caries an additional risk of caries due to morning sickness and increased oral acidity, increased cravings for sugary foods/snacks and decreased attention to oral health.

The three trimesters 
Concerns of dental treatment in pregnancy are however not invalid and can be related to the three trimesters for a better understanding.
In the first trimester, concerns are twofold:
1. The developing child is at greatest risk of teratogens during the organ forming stage of pregnancy. Teratogens include medicines, alcohol, radiologic exposure among others

2. It is known that one in five pregnancies undergo spontaneous abortions therefore dental procedures (or any other medical procedures) carried out near this time may be assumed to be the cause therefore breeding concern to the family and practitioner as to whether this could have been avoided.

 In the second trimester, organ formation is complete, and the mother has comfortably adjusted to the pregnancy, yet the foetus has not grown to a potentially uncomfortable size that would make being still for a long period difficult. Most treatment procedures can therefore be safely carried out.

In the third trimester, foetal growth continues, and the focus of the dentist is now the risk to the upcoming birth process and comfort to the pregnant woman (Dental chair positioning and avoidance of drugs that affect bleeding time). Laying on the back for prolonged periods can lead to supine hypotension syndrome (dizziness and fainting) as the foetus compresses major blood vessels in the back. The dentist would position you to the left with the right hip raised at an angle to prevent this and continue with treatment successfully.

Next week, we shall discuss how ental treatment can be carried out safely. 
For more information  visit our website at www.ugadent.org  
The writer is a Dental  Surgeon  working with The Dental Spa