The Doctorial LifeHacks: Diwali vs Your Digestive System

First published in Made In India, October 2016 edition.

Dr Rahul Barmanray

Ms Pallavi Nagpal

Dr Varun Sharma

Dr Subramanian Muthusamy

Thalis filled with sweets, the smell of incense in the air, tables overflowing with gifts. These are usually the first things that come to mind when we think of Diwali season, the celebration of light triumphing over darkness, knowledge defeating ignorance, and hope overcoming despair. But after days of visiting all the aunties and uncles, going to functions, and sitting at pujas, you might not feel so triumphant. Lots of eating, little sleep, a few too many whiskeys with coke, and maybe even a paan or two can leave you feeling tired, hungover, constipated, and regretting that last mithai. We’ve all been there; here’s what a doctor might do:

I asked Lakshmi for blessings on my bank account, not my acid count – what do you do about reflux?

Jalebi, barfi, laddu, soan papdi; wonderful creations but all full of sugar and little else. While ok to have once in a while, it is easy to have too much at festival time. Add alcohol and some spicy food into the mix and you have a sure recipe for acid reflux that will keep you awake and in pain all night.

While it would be best to simply not have more than too much, some aunties can be very persistent. When we get reflux we:

  • Don’t drink lots of water – Some water will dilute the acid in your throat and make you feel better but more than a glass increases the stomach volume, pushing even more acid up into the throat.
  • Don’t lie down – Gravity will bring the acid back out of the stomach and straight into your mouth.
  • Take an antacid – Most antacids contain a substance that combines with stomach acid to make it harmless. They work fast and you can even take it before you start eating to prevent reflux in the first place.
  • Take acid suppressing medications (also known as PPIs) – For reflux that doesn’t respond to antacids try a proton-pump inhibitor (PPI) such as pantoprazole, omeprazole, or esomeprazole. These are available in pharmacies without a prescription. Take on an empty stomach before you start eating for the best effect. PPIs are safe to use in the short term and can even be used ongoing for severe reflux.

I haven’t opened my bowels in days, looks like it’s castor oil and prune juice for me – any other tricks?

As great as it tastes, mithai also lacks fibre so will take a long time to get through your bowels. Add to this the constipating effect of alcohol and pretty soon you’re doubled over in pain, calling to Lord Dhanvantari to relieve you. There are many home remedies for constipation and if you have something safe that works for you, use it. When we become constipated we:

  • Drink more water – Dehydration is common with all that dancing and alcohol. Some more water may be all it takes to get the bowels moving again.
  • If cooking at home use wholemeal grains, brown rice, and minimise sugar – If you’re in charge of the cooking choose foods with high fibre. Your guests will thank you, especially those with diabetes!
  • If eating out take extra fibre – If you’re at a friend’s house and are surrounded by sugar and white grains you can take some extra fibre. Psyllium husk and metamucil are quite popular but there are many fibre tablets you can buy without a prescription.
  • Take laxatives – If you haven’t been to the toilet in a few days it’s time to something a bit more heavy duty. Laxatives such as docusate with senna, lactulose, and macrogol-based medicines can all be used, depending on whether you prefer tablets, syrups, or liquids. If you have worsening abdominal pain or haven’t opened your bowels in more than 3 days you should seek medical attention as constipation can become a severe medical problem.

Do you have to keep those diyas burning all night, I’m trying to sleep – what do you suggest?

With all the endless Diwali functions, aunties and uncles coming over to visit, family dinners, and pujas to attend, you might be pretty tired by the end of it all. But with all that sugar keeping you buzzing and your stomach (hurting) from so much food, you might find it hard to get to sleep. When faced with difficulty sleeping we:

  • Exercise before bed – Exercising 2-3 hours before bed raises the body temperature. As it cools over the next few hours, this drop in temperature triggers sleep. So if you’re at a function, make sure you hit the dancefloor for a good night’s sleep!
  • Keep the same pre-bed routine – Doing the same things in the same order before bed e.g. brushing your teeth, reading a book, lets your body know it’s time to get to sleep.
  • Repay the sleep debt – If you can’t avoid staying up late on one or a few nights, get to bed early the next night. The sleep time lost must be made up at least partially to prevent you from feeling tired and rundown during the day.

Did Kalpana get home ok? She was pretty drunk by midnight – what do you do?

So you woke up at six to clean the house before going to Meenal Aunty’s house with the family. After a big lunch and too many sweets you head to Rakesh Uncle’s barbecue in the park where you have a few beers and more food. You then arrive home to change, only to leave immediately because you’re late for the Indian Association’s Diwali function. The buffet is just too good so you again eat more than you should and by the time it’s home time no one’s in any state to drive. The rest of the family goes home in an Über and leaving the car you head to Crown with the youngsters. By the time you crawl into bed at four you’re feeling a bit unwell and dreading the morning.

When you wake up at ten the house is already empty and your head is pounding like Ravana hammering all twenty of his spears on the inside of your skull. You drink some coffee and with sunglasses on take a tram to the function centre. As you’re driving home you get pulled over by the police and blow 0.07 on the breathalyser. Your arguing is of no use and soon you’re sitting on the side of the road waiting to be picked up.

It’s easy to over-indulge during the festive season. We stay safe by:

  • Eating first – Food, in particular fatty foods, slows the absorption of alcohol from the stomach, reducing your risk of becoming too drunk too quickly.
  • Spacing drinks – Leave at least half an hour and preferably an hour from when you start one drink before starting the next (yes, shots included!)
  • If driving, drinking less than one standard drink per hour – The standard 80kg adult Caucasian male metabolises roughly one standard drink per hour. This reduces if you are female, lighter, or South Asian. Keeping in mind that one full strength beer is 1.5 standard drinks, you have to be very careful if you want to stay under 0.05.
  • Having a buddy – A good rule of thumb is if you’re too drunk to drive a car you may not be safe by yourself. Share a taxi or sleep at a friend’s place but make sure someone sees you get home (and that you see your mates safely home).

So how can you overcome this ladoo minefield without being disrespectful?

We tend to Identify your favourite sweet and commit to trying it before they become persistent. “Wow, aunty you made my favourite milk barfi. I’ll have to try some!” Once you’ve committed to trying your favourite sweet, keep up the same level of excitement and share half. “Bhaiya this is so good, you have to try some!”

Also, we often think we’re hungry, when we’re actually just thirsty! Drinking water before every meal and alcoholic beverage helps with eating to your appetite and staying hydrated to avoid a hangover the next day.

And ALWAYS put food on a plate. Snacking off a shared platter makes it difficult to gauge how much you’ve actually eaten. We also eat with our eyes, so seeing a plate full helps our brain accept that we’ve actually eaten enough. If you’re able to get away with saying no thanks/I’m full/next time, go for it! If not, try a small amount to keep your host happy.

While it’s important to be aware of how much and what kinds of foods you’re eating, it is also important to not become upset or guilty if you do have to eat half a ladoo to make someone you care about happy. Just pick the aunty with the best cooking skills 😉