Q&A: Flu Shot; Abdominal Pain; Bruising

Q. I received a flu shot this year and still got the flu? Why is this–I thought a shot was supposed to prevent the flu?

A. Despite your own particular case of flu, the Centers for Disease Control and Prevention (CDC) reported influenza activity as “moderate” so far this year—small comfort for someone who has actually suffered from the flu. But perhaps there is some comfort in knowing that you probably had a milder form of the flu than if you had not been vaccinated. Medical professionals advise that people continue to get their annual flu shots for this reason.

Data from the CDC show that this year’s (fall 2016) flu vaccine reduced the risk of flu-related medical visits by about half, compared to no vaccine. Overall effectiveness against types A and B influenza was 48 percent for the flu season so far, according to a Feb. 17, 2017 report.  Vaccine effectiveness against influenza A viruses was 43 percent, and 73 percent against influenza B viruses. Most flu infections were caused by the A strain, which poses “special challenges” because it undergoes more frequent and extensive genetic changes than influenza B or H1N1 (swine flu) viruses, CDC researchers say. Flu-related hospitalization rates were much lower in this past 2016-2017 flu season than the preceding 2014-2015 season, because the A viruses that presented were different from the recommended vaccine component.  

Q. My husband has been suffering from severe abdominal pain, bloating, and cramping. For the moment, he refuses to go to a doctor. What could be the cause of his symptoms?

A. It’s possible he’s suffering from inflammatory bowel disease, which encompasses celiac disease, Crohn’s disease, irritable bowel syndrome (IBS), or ulcers. Irritable bowel syndrome is the most common functional gastrointestinal disorder, affecting 10-15 percent of the population worldwide. Symptoms of these diseases, ranging from the aforementioned to bleeding to stool urgency, can cause havoc with life’s daily routine, impacting, sleep, relationships, and overall quality of life.

Of course, your husband should consult his health care provider about his symptoms, but it’s possible you can deal with some of the issues through diet. Recent data show that a low “FODMAP” diet ( Fermentable, Oligosaccharides, Disaccharides, Monosaccharides, and Polyols) can help people suffering from IBS. In a study, patients were put into two groups, a low FODMAP (LFD) group and a control group (the control group’s diet consisted of cutting down on large meals, binge eating, caffeine, and alcohol). After six weeks, more than 50 percent of the participants on the LFD had reduced symptoms of bloating, diarrhea, stool urgency, and reduction in abdominal pain compared to only 20 percent of the control group. The FODMAP diet is considered an elimination diet, in which certain carbohydrates, such as wheat, certain fruits and vegetables, sugar substitutes, and milk, are excluded from the diet so that the patient suffering symptoms can determine which foods are “trigger” foods. The elimination phase can last two to four weeks, while the reintroduction phase can last six to eight weeks. It is the sugars in these foods that are harder for certain people to digest. The undigested sugars pull water into the intestinal tract, which become fermented by bacteria in the GI tract, which leads to pain, bloating and discomfort.

Q. I bruise so easily. Is there anything I can do to prevent bruises?

A. As you get older, your skin becomes thinner and you lose some of the protective layer of fat underneath. So if you bump your leg against a chair, you can easily break the blood vessels just under the surface of your skin and cause a bruise. Blood-thinning drugs such as aspirin and warfarin (Coumadin) can make you bruise more easily because they affect blood clotting. Some supplements, such as gingko, garlic, and fish oil, can have a similar effect. There isn’t much you can do to avoid bruises, aside from clearing your house of any clutter so you don’t trip. If you’re concerned about your appearance, you can cover bruises with makeup until they heal. Occasional bruising shouldn’t be cause for concern, but bruising that occurs without an obvious cause should be checked out by your doctor, because it could indicate a bleeding disorder.

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