Medical News Today: Coconut oil: Healthful or unhealthful?

Coconut oil has been all the rage for some time. Endorsed by a number of celebrities as a superfood, this tropical-smelling fat — often liberally applied to our skin and scalps — is a favorite of many. But the question remains: is it healthful or not?
coconut oil
Are the health claims that adorn coconut oil based on fact or fiction?

Fat suffered a bad reputation for a long time and we were told to opt for low-fat options instead. But the tides turned eventually, prompting us to see fats in a new light.

Our lives became simpler. We learned how to avoid bad (saturated and hydrogenated) fats and eat good (unsaturated) ones to keep our tickers and arteries healthy.

Then the humble coconut came along in 2003, and the waters were once again muddied. Seen by some as a superfood but recently labeled by the American Heart Association (AHA) as part of the pool of unhealthful fats, the controversy goes on.

So, what are the scientific facts behind the coconut oil hype, and what are the latest developments?

Secret ingredient: ‘Medium-chain’ fatty acids

Many of the purported health claims surrounding coconut oil stem from research published in 2003 by Marie-Pierre St-Onge, Ph.D. — a professor of nutritional medicine at Columbia University in New York City, NY.

Prof. St-Onge found that in overweight women, consumption of medium-chain fatty acids — such as those found in coconut oil — led to an increase in energy expenditure and fat oxidation compared with women who ate long-chain or saturated fatty acids.

But Prof. St-Onge used a specially formulated fat diet in her study, not coconut oil, and she never claimed that coconut oil was the secret to the results seen in her research.

The rumor mill had begun to spin and coconut oil became widely hailed as a superfood.

In fact, a 2009 study involving 40 women showed that 30 milliliters of coconut — consumed daily for a 12-week period — increased good high-density lipoprotein (HDL) levels, accompanied by a reduction in waist circumference.

As more studies have followed, the picture became less clear-cut.

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AHA and WHO advise to limit consumption

Despite the number of studies casting coconut oil in a favorable light, the AHA issued an advisory note on dietary fats and cardiovascular disease in June 2017, recommending that we replace saturated fats with more healthful unsaturated fats. This includes coconut oil.

As the World Health Organization (WHO) state, “[U]nsaturated fats (e.g. found in fish, avocado, nuts, sunflower, canola, and olive oils) are preferable to saturated fats (e.g. found in fatty meat, butter, palm and coconut oil, cream, cheese, ghee, and lard).”

The reason? Saturated fat is bad for our cardiovascular health. However, there is another twist to this fascinating tale.

While low-density lipoprotein (LDL) is generally thought of as “bad” cholesterol, the HDL type is widely accepted as being its “healthful” counterpart.

Yet in 2017, we covered three studies that potentially turn what we know about fats and cholesterol on its head. The first strudy found that saturated fats may not “clog” our arteries after all, while the second one uncovered a link between “good” HDL and mortality.

The third study, published in November 2017, showed that high levels of HDL may not protect us from heart disease, as previously thought.

What is the latest?

One of the problems with the controversy surrounding coconut oil is the lack of good-quality, large-scale human studies. But adding to the body of evidence is a new study by the BBC’s “Trust me I’m a Doctor” team.

Together with Dr. Kay-Tee Khaw, a professor of clinical gerontology, and Dr. Nita Gandhi Forouhi, a professor of population health and nutrition — both at the University of Cambridge in the United Kingdom — the team compared the effects of coconut oil, olive oil, and butter in 94 human volunteers.

Each study participant was asked to consume 50 grams of one of these fats daily for 4 weeks. The results came as a surprise.

Those who consumed coconut oil saw a 15 percent increase in HDL levels, while this number only stood at 5 percent for olive oil, which is accepted as being good for our cardiovascular system.

If we are working on the premise that HDL is good, then these results speak in favor of coconut oil.

It is important to note, however, that the results of this study have not been peer-reviewed and must be treated as preliminary.

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Coconut oil: The verdict

So, is coconut oil healthful or not? As with many research areas, there is no straightforward answer.

If you are looking to lose weight, it’s worth bearing in mind that coconut oil is very high in saturated fat and one tablespoon contains 120 calories.

If it’s cardiovascular health that you are after, the official party line drawn by the AHA and WHO still puts coconut oil on the list of fats to limit. But who knows, maybe the tables will turn, and new guidelines will emerge.

In the meantime, coconut oil can be part of a healthful, balanced diet, if consumed in moderation.

However, it’s worth looking out for coconut oil in packaged foods, especially partially hydrogenated coconut oil. This is a source of trans fats, which the Food and Drug Administration (FDA) say increase the risk of heart disease.

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Medical News Today: Turmeric for IBS: Does it work?

Beyond being a staple of Asian cuisine, turmeric has long been used in traditional medicine to treat conditions from indigestion to depression. More recently, the spice has been associated with the treatment of irritable bowel syndrome.

This article will review the evidence behind the claims that turmeric can help symptoms of irritable bowel syndrome or IBS, discuss how it may be used, and if there are any risks.

What is turmeric?

Turmeric thrown into the air. May help with IBS
Turmeric may have healing properties that derive from its curcumin compound.

Turmeric has been used to treat conditions, including colds, digestive problems, and infections. Its potential healing properties come from curcumin, which is an anti-inflammatory compound it contains.

Turmeric has recently attracted attention for its potential to reduce IBS symptoms. IBS is a common disorder of the digestive system that causes symptoms, such as stomach cramps, diarrhea, and constipation.

The cause of IBS is unknown, and there are currently no available cures. Symptoms of IBS are typically managed using medicine and lifestyle changes that tend to involve changes in diet.

Including turmeric as part of a healthful diet-based approach to managing IBS symptoms is an easy step to take.

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Does it work?

One study found that curcumin had a positive impact on gastrointestinal functioning in rats. The authors of the study suggested that their findings could have implications for the use curcumin in treating IBS symptoms. However, more studies are needed in humans to establish this conclusively.

A pilot study conducted in 2004 found that human participants with IBS who took 2 tablets of turmeric every day for 8 weeks reported reductions in abdominal discomfort and improved bowel movement patterns.

However, this study lacked a control group, and the authors concluded that more research was needed to rule out the placebo effect and other variables.

Turmeric has been associated with benefits for other disorders of the digestive system, including ulcerative colitis, a chronic condition that causes diarrhea and abdominal pain.

One study in 2015 found that adding curcumin to the regular treatment routine had a positive impact on the symptoms of ulcerative colitis.

There are some positive findings relating to the use of turmeric in reducing IBS symptoms, and these effects may also extend to other digestive disorders. However, more research is required to determine whether turmeric can have any real benefits for the treatment of IBS.

Side effects and safety

Turmeric root and powder for IBS
Turmeric can be purchased as a root or powder, and is also available as a supplement.

Curcumin is considered safe to consume for most people in doses ranging from 500 miligrams (mg) to 12,000 mg per day, for short-term use only. More studies are needed to determine toxicity associated with long-term use.

Some side effects can occur with regular turmeric use, including:

  • abdominal pain
  • digestive problems
  • nausea
  • blood-thinning

It is currently unclear whether curcumin supplements are safe for pregnant women, so it is important for these women to speak to a doctor before trying any supplements.

People with diabetes should also avoid consuming turmeric, as it can lower blood glucose levels. It may also interact with some medications, such as blood thinners or diabetes drugs, so people should be sure to talk to their doctor before taking curcumin supplements.

The U.S. Food and Drug Administration (FDA) do not regulate supplements, so the safety and contents of turmeric products cannot be guaranteed.

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How to use turmeric

Turmeric is commonly used to flavor foods from savory curries and soups to sweet cakes and smoothies. It can be purchased as a powder or in its root form. It is also possible to take curcumin supplements, which are normally available in health food stores.

Unlike turmeric in other forms, the supplements are highly concentrated doses of curcumin, so people should be sure to read the instructions on how much is safe to consume.


Turmeric has shown promise in initial studies for its positive effect on some IBS symptoms. In most cases, including turmeric or curcumin supplements, as a part of a healthful diet, will not pose any health risk for people with IBS.

Whether turmeric has any real benefits for IBS symptoms remains unclear, and further research in this area is required.

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Medical News Today: Scientists create new molecule to combat pain

Researchers from the University of Texas at Dallas have created an RNA-mimicking molecule that blocks the series of pain sensitization reactions that normally follow an injury.
two scientists in lab
Could this ‘decoy molecule’ help to create better drugs for pain?

They believe that what they have discovered about their “decoy molecule” will pave the way for a new class of drugs that prevent pain at the outset without risk of addiction.

A study paper published in the journal Nature Communications describes how the “synthetic RNA mimic reduces pain sensitization in mice” by blocking the creation of pain-signaling proteins.

“We’re manipulating one step of protein synthesis,” explains senior study author Dr. Zachary Campbell, whose laboratory specializes in researching the molecular mechanisms of pain.

“Our results indicate that local treatment with the decoy can prevent pain and inflammation brought about by a tissue injury,” he adds.

Need to tackle the opioid crisis

Around a third of the United States population — which is an estimated 100 million people — is affected by chronic pain, “the primary reason Americans are on disability.”

“Poorly treated pain causes enormous human suffering,” explains Dr. Campbell, “as well as a tremendous burden on medical care systems and our society.”

Another major concern is the rapid rise in prescriptions for opioid pain drugs that has occurred in recent years, which has been accompanied by increases in accidental overdoses as well as hospital admissions for addiction to the medications.

National U.S. survey data that was collected in 2015 shows that nearly 92 million people had used prescription opioids during the previous year. This figure includes around 11.5 million people who “misused” the drugs, the majority of whom said that they had obtained them to relieve pain.

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Pain relief that avoids the brain

Opioids are the “most widely used and effective” drugs for treating pain. However, they have a major disadvantage: they interact with areas of the brain that deal with reward and emotion.

The work that Dr. Campbell and his team are doing could lead to pain drugs that do not affect the brain.

They suggest that their study shows that “development of chronic pain requires regulated local protein synthesis” at the site of injury.

The decoy molecule that they have devised acts in molecular mechanisms that involve nociceptors, which are specialized cells at the site of injury that communicate pain signals to the brain.

Following an injury, messenger RNA molecules translate code held in DNA into instructions for making proteins that signal pain.

By mimicking RNA, the decoy molecule interrupts the process that makes the proteins. Injected into the site of injury in mice, it reduced “behavioral response to pain,” say the researchers.

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RNA-mimicking molecule slow to degrade

“When you have an injury, certain molecules are made rapidly. With this Achilles’ heel in mind,” says Dr. Campbell, “we set out to sabotage the normal series of events that produce pain at the site of an injury.”

“In essence,” he adds, “we eliminate the potential for a pathological pain state to emerge.” The new molecule that he and his colleagues have devised also overcomes a major challenge of RNA-based medicine: that RNA compounds metabolize very quickly.

“Molecules that degrade quickly in cells are not great drug candidates,” explains Dr. Campbell, adding, “The stability of our compounds is an order of magnitude greater than unmodified RNA.”

He notes that their study is the first to create a “chemically stabilized mimic to competitively inhibit RNA to disrupt RNA-protein interactions.”

He and his team suggest that their findings also improve our understanding of these interactions and open up a completely “new area of science.”

The ongoing opioid crisis highlights the need for pain treatments that don’t create addictions. Hopefully, this is a step in that direction.”

Dr. Zachary Campbell

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Medical News Today: 10 rashes caused by ulcerative colitis

Ulcerative colitis is a long-term condition that causes inflammation in the large intestine and the rectum. It can also cause skin problems.

This article explores how skin conditions are related to ulcerative colitis (UC), which is a type of inflammatory bowel disease (IBD).

It also considers how to reduce skin problems during a flare-up and when to see a doctor.

Skin conditions associated with UC

There is a range of different skin conditions that are associated with UC. These are explored below.

1. Erythema nodosum

young woman sitting on a bench scratching her arm
There are a number of different skin conditions associated with ulcerative colitis.

Erythema nodosum is the most common skin issue for people who also have UC. Up to 10 percent of people with UC may develop erythema nodosum.

Erythema nodosum causes tender red nodules to appear on a person’s arms or legs. These nodules may look like bruises.

In people with UC, this skin rash tends to come up during a flare-up and go away when UC is in remission.

2. Pyoderma gangrenosum

According to this 2012 review, pyoderma gangrenosum is the second most common skin problem that may affect people with UC.

This skin rash begins as a cluster of blisters on the shins, ankles, or arms. It often spreads and can form deep ulcers. If not kept clean, this may become infected.

Researchers believe this condition is caused by a problem with the immune system that may be linked to the cause of UC.

3. Psoriasis

Psoriasis is a skin condition caused by a problem with the immune system. It leads to red, patchy skin, covered with a build-up of dead skin cells.

Many people with UC and other types of IBD are also affected by psoriasis.

This 2015 study found that there were some genetic links between the genes that cause IBD and those that cause psoriasis. More research is needed to understand these connections fully.

4. Hives

Hives are red raised spots that may appear as a rash anywhere on the body. They form due to a reaction in the immune system.

Sometimes people react to the medication they are taking for UC, which can cause chronic hives.

5. Acne

A 2011 study found a link between taking a drug intended to treat cystic acne (isotretinoin) and developing UC. More research is needed to understand this link better.

6. Bowel-associated dermatosis-arthritis syndrome

Bowel-associated dermatosis-arthritis syndrome (BADAS) is a condition where small bumps form on the upper chest and arms, in addition to other symptoms. These bumps can then form pustules, causing discomfort. BADAS may also cause lesions on the legs.

Researchers do not fully understand the cause, but they think it may relate to inflammation as a result of bacteria in the gut. Having IBD makes it more likely a person will develop BADAS.

7. Pyodermatitis-pyostomatitis vegetans

Pyodermatitis vegetans and pyostomatitis vegetans are two skin conditions that are linked.

The former causes red pustules that burst and form scaly patches in the armpit or groin. The latter involves pustules in the mouth.

The two conditions are typically grouped together and called pyodermatitis-pyostomatitis vegetans (PPV).

This condition is associated with UC, though it is rare. Symptoms will typically occur after a person has had UC for a few years. Often, however, people are not diagnosed with UC until after a doctor has diagnosed PPV.

8. Sweet’s syndrome

Sweet’s syndrome is another condition that is linked to UC flare-ups.

When a person has Sweet’s syndrome, small red or purple bumps on the skin develop into painful lesions. They often form on the upper limbs, face, and neck.

9. Vitiligo

Vitiligo is a skin condition that destroys the pigment-producing cells in the skin. Vitiligo may lead to white patches forming anywhere on the body.

Researchers think that vitiligo is caused by an immune disorder. According to the National Institute of Health (NIH), around 20 percent of people with vitiligo also have another immune disorder, such as UC.

10. Leukocytoclastic vasculitis

Leukocytoclastic vasculitis (hypersensitivity vasculitis) occurs when small blood vessels under the skin become inflamed and die. The inflammatory reaction leads to the development of purple spots on the skin of the legs or ankles, called purpura.

The condition results from inflammation and is linked to UC flare-ups. Leukocytoclastic vasculitis typically goes away when UC is in remission

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How are UC and skin rashes linked?

young woman asleep on the sofa
Extreme tiredness is one of the major symptoms of ulcerative colitis.

UC can be a painful and uncomfortable inflammatory condition that affects both the large intestine and the rectum.

When a person has UC, small ulcers develop in the lining of their colon. These can produce pus and bleed.

The main symptoms of UC are:

  • ongoing problems with diarrhea
  • blood, mucus, or pus in stools
  • the need to pass stool often
  • extreme tiredness
  • loss of appetite
  • weight loss

Ulcerative colitis flare-ups

Although UC is a long-term condition, a person with UC may go weeks or months without symptoms. This is called remission.

Periods of remission may be followed by flare-ups, where the person experiences many UC symptoms.

During a flare-up, a person with UC may experience symptoms in addition to those that affect the digestive system. These include:

  • rashes or patches of red, swollen skin
  • swollen or painful joints
  • mouth ulcers
  • red, irritated eyes

Why do skin rashes appear during flare-ups?

The inflammation in the body that causes UC can also affect the skin. This can lead to swollen and painful skin rashes.

According to a 2015 study, skin problems affect up to 15 percent of people with IBD, which includes people with UC.

The medication that a person might take to control their UC symptoms may also cause skin problems.

Reducing skin problems during a flare-up

People with UC often experience skin problems during flare-ups, so the best way to manage skin conditions related to UC is to manage UC itself.

A doctor can help a person with UC find the best methods for their symptoms and lifestyle.

When flare-ups occur, the following may help to reduce skin problems:

  • taking corticosteroids to reduce inflammation
  • eating a well-balanced diet to promote skin health
  • keeping the affected skin clean to reduce infection risk
  • covering the affected area with bandages
  • taking over-the-counter pain relievers

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When to see a doctor

person lifting up their lip to show mouth ulcer
Mouth ulcers are one of the non-digestive symptoms that may be experienced during a UC flare up.

If a skin complaint is particularly troublesome, it is a good idea to speak with a doctor to get a proper diagnosis and the right treatment.

If skin conditions are recurring or getting worse over time, it is a good idea to talk to a doctor about the best way manage them.

They can also help a person with UC find ways to manage their condition as a whole.

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Medical News Today: Which Fitzpatrick skin type are you?

Fitzpatrick skin typing is a way of classifying different types of skin. What does a person’s Fitzpatrick skin type tell us about their skin?

Making up nearly 16 percent of a person’s body mass, the skin is the body’s biggest organ. The sun’s ultraviolet rays can damage a person’s skin and may lead to signs of premature aging and skin cancer.

This article explores the Fitzpatrick skin typing system and also discusses how to protect each of the six different Fitzpatrick skin types from sun damage.

What are Fitzpatrick skin types?

Group of upturned palms showing different colors on the Fitzpatrick skin type scale
The Fitzpatrick skin types are defined by how the skin reacts to the sun.

Also known as the Fitzpatrick skin phototype, the Fitzpatrick skin type system was developed in 1975. It remains a useful way to determine skin type and skin cancer risk.

This 2013 study found that Fitzpatrick skin typing was most effective when a dermatologist carried out the assessment. Self-reporting a skin type was found to be less accurate.

The Fitzpatrick skin types were determined by interviewing many people about how their skin reacted to the sun.

There were clear trends in the data researchers gathered, which allowed them to identify six different skin types. It is important to remember that as these groups are based on anecdotal evidence.

A person may find their skin does not fit completely into any one category. If self-assessing, Fitzpatrick skin typing should be used as a guide rather than a definitive skin type.

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Types 1–6

The six Fitzpatrick skin types and associated skin, hair, and eye color are explored in the sections below. These skin types are numbered according to how much melanin is present in the skin.

Skin with very little melanin has little protection from the sun’s ultraviolet rays. As such, it is likely to burn.

Melanin pigment is a dark brown pigment that occurs in a person’s hair, skin, and irises. It causes the skin to tan in response to the sun’s ultraviolet rays.

Skin high in melanin is likely to tan, rather than burn. When the skin burns, it increases the risk of skin cancer. According to the Skin Cancer Foundation, 1 in 5 people in the United States will develop skin cancer during their lifetime.

Being able to classify a skin type according to how much melanin it contains helps predict how likely it is to burn.

How to protect each skin type

If a person understands which Fitzpatrick skin type they have, they can make an informed choice about how to protect their skin.

Skin protection advice for each Fitzpatrick skin type is explored below.

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Types 1 and 2

Woman applying sunscreen on skin.
Those with type 1 or type 2 skin should apply sunscreen before going outside.

People with Fitzpatrick skin type 1 or 2 have a high risk of sun damage and signs of aging on the skin. They are also at risk of developing skin cancers, such as melanoma.

According to the American Cancer Society, fair skin, freckling, and light hair is a skin cancer risk factor. These characteristics align with skin types 1 and 2, meaning those with these skin types need to take extra precautions.

To protect their skin, a person with skin type 1 or 2 should:

  • always wear sunscreen with an SPF of 30 or above
  • avoid sun exposure
  • sit or walk in the shade when possible
  • wear a wide-brimmed hat for protection
  • wear sunglasses that block out harmful UV rays
  • wear protective clothing if out in the sun for extended periods

These protective measures should reduce this risk of a person developing skin cancer and can help the skin stay looking younger for longer. However, it is still essential to check for any abnormalities.

A person with skin type 1 or 2 should do an all-over body check of their skin every month for any skin abnormalities.

Types 3 to 6

If a person has a skin type 3 to 6, they are still at risk of developing skin cancer. However, their risk is lower than for those with skin types 1 or 2.

It is still important for those with skin types 3 to 6 to use sunscreen regularly. To protect their skin, a person with skin type 3 to 6 should:

  • monitor and limit sun exposure
  • ïwear a wide-brimmed hat for protection
  • wear sunglasses that block UV rays
  • wear protective clothing if outside for extended periods
  • wear sunscreen with an SPF of 15 or above

As with other skin types, a person with a skin type between 3 and 6 should still check their skin all over for abnormalities every month.

It is also important for those with darker skin types to look out for acral lentiginous melanoma. This is a dark spot on the skin, which may develop on the palms on a person’s hands or the soles of their feet.

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All skin types

Using artificial tanning beds and machines is harmful to all skin types. This 2013 study suggests that if a person uses an artificial tanning bed before they reach the age of 35, they are 75 percent more likely to develop melanoma later in life.

For this reason, it is important to avoid artificial tanning beds regardless of skin type.

When to see a doctor

Things to talk to a doctor about include:

  • new moles
  • existing moles that are getting bigger
  • the outline of a mole becoming blotched
  • a spot changing color from brown to black
  • a spot becoming raised or developing a lump in the middle
  • the surface of a spot changing texture and becoming rough or ulcerated
  • moles that are itchy or tingly
  • moles that bleed or weep
  • spots that look unlike any other spots


Fitzpatrick skin types are a useful way of assessing skin type in order to understand the best way to protect skin from the sun. Avoiding sun damage helps to reduce the risk of skin cancer.

It is always important to check for any early signs of skin cancer on a monthly basis, regardless of skin type. This is especially true for those who live south of the equator, where the sun is stronger and more damaging to the skin.

If a person has any concerns about skin cancer or has spotted an abnormality on their skin, they should speak to a doctor.

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Medical News Today: Popular morning sickness drug ‘ineffective,’ study reveals

Morning sickness can put a real strain on pregnant mothers. And when diet or non-medicinal treatments fail, a drug that contains doxylamine and pyridoxine is often prescribed. However, the drug’s effectiveness has been called into question.
morning sickness remedy
Morning sickness can range from mild to debilitating and affects around 80 percent of pregnant mothers.

In 2017, researchers working at the University of Toronto in Canada and the Keenan Research Centre of the Li Ka Shing Knowledge Institute of St. Michael’s Hospital, also in Toronto, Canada, reanalyzed a pivotal doxylamine and pyridoxine clinical trial from the 1970s and made a fairly surprising finding: the data had substantial flaws.

Digging even deeper, Dr. Navindra Persaud — from the Department of Family and Community Medicine at St. Michael’s Hospital as well as the Department of Family and Community Medicine at the University of Toronto — and colleagues reanalyzed another clinical trial using an updated version of the drug, this one from 2010.

The recent trial was part of the reason that the Food and Drug Administration (FDA) approved the popular morning sickness drug known as Diclegis.

Commenting on his findings, Prof. Persaud told me, “The medication seems to be ineffective based on the results of this trial. I was shocked to learn this about a commonly prescribed medication.”

The results of Prof. Persaud’s analysis are now published in the journal PLOS ONE.

‘Only FDA-approved’ morning sickness drug

Diclegis is the only drug approved by the FDA for the treatment of morning sickness in pregnancy. According to its manufacturer Duchesnay, it has been prescribed to 33 million women worldwide.

In Canada, where the drug is known as Diclectin, it is prescribed at least once for every two births.

I asked Prof. Persaud why he decided to look into the drug. “I used to prescribe this medication,” he explained. “I was taught to prescribe it. The medication was recommended as the first line medication for nausea and vomiting during pregnancy.”

When I looked carefully at the clinical practice guidelines that recommended this medication, they did not cite supporting studies. So I tried to find the basis for the recommendations. It was surprisingly difficult to obtain information about this commonly prescribed drug.”

Prof. Navindra Persaud

When the results of the clinical trial were initially published in the American Journal of Obstetrics & Gynecology in 2010, the study authors concluded, “Diclectin […] is effective and well-tolerated in treating nausea and vomiting of pregnancy.”

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Drug ‘significantly better than placebo’

The study involved 261 pregnant women, all of whom completed a 2-week course of daily Dicletin or placebo treatment. As the authors explained in the paper, “Diclectin led to significantly greater improvement in NVP [nausea and vomiting of pregnancy] symptoms as compared with placebo.”

This was based on a drop in what is known as the PUQE score. PUQE stands for pregnancy-unique quantification of emesis/nausea, with a score of 3 meaning no symptoms and a score of 15 being the most severe.

Pregnant mothers in the placebo group saw a 3.9 drop in their PUQE score from 8.8 at the start of the study, while those in the treatment group saw a 4.8 point drop down from 9.0.

In addition to the PUQE score, the team also saw a greater improvement in the global assessment of well-being score, less time taken off work, and fewer women seeking alternative treatments when they received the drug.

More pregnant mothers asked to keep taking the drug after the study finished than the placebo.

The key finding remains the PUQE score.

But while the difference seen in the clinical study may be statistically significant, Prof. Persaud uncovered that the results were not in line with what the clinical trial set out to achieve.

‘Expected difference in PUQE score of 3’

Citing the original clinical study report and the FDA review of the study, Prof. Persaud explains that the difference in PUQE score between the drug and the placebo groups was expected to be 3 points — a far cry from the difference reported in the clinical trial.

He told me that “[he] was […] surprised that important information about the trial was hidden until now. Although some results were published in 2010, the earlier reports did not mention the fact that a difference of 3 points on the 15-point symptom scale was prespecified as the minimal important difference (or the smallest difference that a patient would deem as important).”

I asked him why he thought the FDA decided to license the drug in light of the results not meeting the expected differences.

While the review by the FDA was very thorough, the review does not address the fact that the 3-point difference between groups was not found in the trial.”

Prof. Navindra Persaud

In his paper, he explains, “The FDA summary review indicated a ‘small, but statistically significant improvement'” and noted that “although the treatment effect is small, there are no other FDA-approved treatments for nausea and vomiting of pregnancy.”

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Placebo just as good as drug?

Commenting on the results of the trial and his reanalysis, Prof. Persaud explained, “In this trial, women given a placebo had large improvements in symptoms over 2 weeks. By the end of the 2-week trial, women given a placebo had symptom scores around 4 and the lowest possible score on the symptom scale is 3.”

“So the results of this study indicate that no studied treatment could have had a substantial benefit over the placebo,” he added.

With millions of women worldwide having taken the drug over the years, could it be the placebo effect that causes the improvement in symptoms?

Explaining his take on the situation, Prof. Persaud said, “We may find that nausea and vomiting during pregnancy may be like the common cold: it is common, it causes substantial suffering, it can occasionally cause serious complications, and it does not have a highly effective treatment.”

So, is it likely that the drug will be withdrawn from the market based on Prof. Persaud’s findings? He doesn’t think so.

“It is very unusual for medications to be removed from the market because of ineffectiveness,” said Prof. Persaud. “Medications are withdrawn when they are found to be harmful after approval but even this is quite rare. So it is unlikely that this medication will be withdrawn.”

What to do when morning sickness strikes

I am no stranger to morning sickness, having endured a seemingly never-ending bout last summer during my second pregnancy. Here is what Prof. Persaud told me about other treatment options.

“[…] [R]ecommended treatments include P6 acupressure, antihistamines such as diphenhydramine, and other nausea treatments such as metoclopramide.” However, he did add the following caveat: “None are proven to be highly effective.”

Prof. Persaud also pointed me in the direction of a 2015 systematic review examining treatments for nausea and vomiting during pregnancy. While some — such as ginger, chamomile, vitamin B-6, and lemon and mint oil — were effective for some women, the “[…] review found a lack of high-quality evidence to back up any advice on which interventions to use.”

“[…] All of those results […] should be taken with a grain of salt,” Prof. Persaud said, echoing the review’s findings.

If you are looking for more information about coping with morning sickness, check out our handy guide “Morning sickness: 10 tips to relieve it.”

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Medical News Today: All you need to know about vaginal boils

A vaginal boil is a pus-filled lump that develops outside the vagina as a result of a blocked hair follicle or oil gland.

While boils can occur in any area of the body, they are commonly found outside the vagina, on the labia, or in the pubic area.

Some people may use the term boil and abscess interchangeably to describe a vaginal boil. However, abscesses are usually deeper skin infections than boils.

Some skin conditions can be similar to a vaginal boil. While most will heal on their own, others may require medical attention to avoid a worsening infection.

What are the causes?

woman looking concerned due to vaginal boils
Vaginal boils may be caused by many different conditions.

There are a variety of conditions and factors that can cause vaginal boils.

Infectious organisms

Boils can be caused by bacteria, such as Staphylococcus aureus, Escherichia coli, and Chlamydia trachomatis.

Skin conditions

One skin condition that can cause vaginal boils is folliculitis, which occurs when bacteria infect a hair follicle.

This infection is often a side effect of irritation caused by shaving or waxing hair from the pubic area. A bump may be painful and start small but can grow larger and into a boil.


Another common cause of a vaginal boil is a Bartholin gland cyst. This type of cyst is caused by an infection of the Bartholin glands, which are located under the skin near the vaginal opening. These glands can become blocked, causing a cyst or round, hard bump to form. If the cyst becomes infected, it can cause a boil to form.

Sexually transmitted infections

Sexually transmitted infections and genital piercings can also be underlying causes of vaginal boils.

Women with oily skin or those with thicker pubic hair growth are more at risk for vaginal abscesses, according to The Royal Women’s Hospital.

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Home remedies

There are a range of home remedies that a woman can try. These include:

Applying warm (not hot) compression

Run a soft washcloth under warm water and apply the warm compress to the vaginal boil for 10 to 15 minutes. This may cause the boil to leak some pus. A person should not squeeze the boil.

Using a sitz bath

A sitz bath can be purchased at most drugstores as a plastic ring that can be filled with warm water and placed over a toilet bowl. Another option is to sit in a shallow bath filled with lukewarm water.

Keeping the area clean and dry

Wash the boil with antibacterial soap, clean the soap off using clean water from a spray bottle, and dry the affected area gently with a soft washcloth. Avoid rubbing or touching the boil. Always wash the hands with soap and water before cleansing or applying any topical antibiotic ointments to the area.

Wearing breathable underwear

Clean, cotton underwear can allow the skin to “breathe.” Women should avoid wearing tight underwear that can rub against the boil and inflame it.

Taking over-the-counter pain relievers

If the boil is mildly painful, a woman can take an over-the-counter pain reliever, such as acetaminophen or ibuprofen. If these medications do not control the pain, the woman should see her doctor.

Home treatments to avoid

Just as some at-home treatments can be beneficial, there are others that can be irritating or cause further damage.

A woman should never attempt to prick or squeeze a vaginal boil on her own. If the area is draining, she should cover it with a clean, dry bandage.

She should also avoid using any lotions, baby wipes, or ointments that are highly fragranced.

When to see a doctor

If the boil fails to respond to at-home treatments or over-the-counter medications or seems to be getting worse instead of better, a woman should seek medical attention.

A woman should also seek treatment if she observes any signs of infection, such as blood-streaked pus or the boil or surrounding skin is hot to the touch. The woman must also see her doctor if she develops any signs of a systemic infection, such as fever.

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Medical treatments

Draining the boil is effective for the most severe boils. A doctor may apply an antibiotic ointment and apply a sterile bandage to allow the boil time to heal.

Boils that are deeper in the skin or show signs of cellulitis, a bacterial infection affecting the inner layers of the skin and the fat layer, may require treatment with oral or intravenous (IV) antibiotics. The type of antibiotic prescribed depends on the nature and severity of the person’s infection.

Can they be prevented

Maintaining a healthy weight may help to avoid vaginal boils
Maintaining a healthy weight is recommended to help prevent vaginal boils.

Changing underwear frequently and practicing excellent hygiene can help to prevent vaginal boils.

Keep the area clean by washing the body and vaginal area at least once a day with antibacterial soap.

Regular hand-washing can also help to reduce bacterial exposure.

However, practicing careful hygiene does not guarantee that a woman will not develop a vaginal boil.

Other preventive tips include:

  • Maintaining a healthy weight can prevent additional skin folds developing, which can increase the risk of infection.
  • Refraining from sharing personal items including towels and underwear can reduce the risk of infection.
  • Changing into clean underwear after exercising can help prevent infection.
  • Avoiding highly fragranced soaps, dyes, douches, and powders because these can irritate the tissues in the vaginal area and increase the risk of infection.

If a woman experiences chronic vaginal boils, she should talk to her doctor about further preventive options. For example, a doctor may prescribe birth control pills to reduce the amount of oil-producing hormones that can contribute to infections.

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Ideally, a boil will shrink in size over the course of a week. If a women’s vaginal boil does not improve with at-home treatments, she should seek medical attention to keep the infection from spreading more deeply.

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Medical News Today: Dopamine deficiency: What you need to know

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Medical News Today: Endometrial ablation: What you need to know

Endometrial ablation is a procedure to remove the uterine lining. It may help women who have heavy or prolonged periods or bleeding in between periods.

A doctor will typically prescribe medication or an intrauterine device (IUD) to help relieve heavy or problematic periods. If these treatments do not work, endometrial ablation is another option.

This article explores the endometrial ablation procedure and things to consider, including side effects, complications, and recovery time.

What is endometrial ablation?

Doctor holding model of female reproductive system.
An endometrial ablasion is a procedure to treat excessive bleeding during or in between periods, by removing part of the lining of the uterus.

Endometrial ablation is the removal of the lining of the uterus with the aim of reducing or stopping menstrual flow.

The proper name for the uterus lining is “endometrium.” The word “ablation” means to destroy. These two words give the procedure its name.

A 2015 study found endometrial ablation to be an effective treatment for abnormal uterine bleeding (AUB).

Some women choose to have this procedure if they have already tried medication or an IUD to treat AUB.

AUB is when a woman has:

  • very heavy periods (more than tampon’s worth of blood every hour)
  • periods that last more than a week
  • bleeding between periods
  • bleeding that causes anemia
  • bleeding that causes other health problems

Up to 30 percent of women seek help from a doctor for AUB during their lifetime.

Endometrial ablation may completely stop a woman from having periods, or it may just reduce the amount of bleeding. Doctors will only perform the procedure on women who are not pregnant and do not want to become pregnant.

The procedure is not a treatment for any menstrual or uterine problems that are caused by cancer.


Endometrial ablation is not a form of surgery, as it does not involve surgical incisions.

Before the procedure, doctors may need to take a sample of a woman’s uterine lining to test it for cancerous or pre-cancerous cells. Endometrial ablation is not suitable for women with cancer.

A doctor will also carry out a visual examination of the uterus using imaging tests, such as ultrasounds, before the procedure. This is to rule out polyps or benign tumors, which may be causing heavy menstruation.

It is also essential to check that a woman is not pregnant. If she has an IUD device, this must be removed before the procedure.

During the procedure, the doctor will insert a thin tool into the vagina and up to the uterus. The steps that follow depend on what type of ablation is taking place.

Types of endometrial ablation

The type of instrument a doctor uses will depend on which procedure is being carried out. There is a range of different types of endometrial ablation, including:

  • Hydrothermal: This involves fluid being pumped into the uterus and heated for 10 minutes, which destroys the uterine lining.
  • Balloon therapy: A balloon is inserted into the uterus through a tube and filled with heated fluid. As the balloon expands, it destroys the uterine lining.
  • High-energy radio waves: An electrical mesh is inserted into the uterus and expanded. Strong radio waves are then passed through the mesh, which causes it to heat up, destroying the uterine lining.
  • Freezing: Also known as cryoablation, a thin probe with a cold tip freezes and destroys the lining of the uterus.
  • Microwave: Microwaves are passed through the uterus, which destroys the uterine lining.
  • Electrical: An uncommon practice is to destroy the uterus lining by passing an electrical current through it.

Endometrial ablation is often carried out in a doctor’s office. Sometimes it may be carried out in the hospital or a surgical center.

Partial endometrial ablation

A 2016 study found that an alternative version of the procedure, called partial endometrial ablation (PEA), was also an effective treatment.

PEA is defined as ablating or resecting only the anterior or posterior endometrial wall, instead of the entire uterine lining.

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Woman with a c-section scar on her lower abdomen.
Women who have a C-section scar are not advised to undergo endometrial ablation.

Endometrial ablation is not the right option for all women with problematic menstrual bleeding.

The procedure is not advisable for women who are pregnant or who are considering getting pregnant in the future. Endometrial ablation can make getting pregnant much more difficult.

Endometrial ablation is also not advisable for women who have:

Recovery time

Endometrial ablation does not have a long recovery time. Here is a short timeline outlining what most women experience after the procedure:

  • Within 24 hours: Some nausea and the urge to pee.
  • For a few days: Cramping or bleeding.
  • A week later: Being back to a regular routine.
  • For up to 3 weeks: Watery or bloody discharge.

Side effects

Possible side effects include:

  • foul-smelling discharge
  • fever
  • chills
  • intense cramping or stomach pain
  • heavy bleeding
  • continual bleeding more than 2 days after the procedure
  • trouble passing urine

If a woman experiences any of these symptoms after having endometrial ablation, she should seek medical attention to reduce the risk of infection and other complications.

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Doctor speaking to female patient about results using tablet.
An endometrial ablation is a procedure that rarely causes any serious side effects or complications.

Endometrial ablation is not a high-risk procedure, but there is a small chance of:

  • infection
  • bleeding
  • a hole being made in the uterus
  • nearby organs being affected
  • fluid used in the procedure getting to the lungs

These complications are rare. It is a good idea to discuss any concerns about risks with a doctor to get reassurance.


Endometrial ablation works well to stop or reduce menstrual bleeding for women who experience heavy or long periods or bleeding in between periods. It is not an option for all women.

Endometrial ablation is usually only carried out as a last resort — if other methods, such as medication or an IUD, have not worked.

The procedure is not suitable for all women, including post-menopausal women. It is a good idea for a woman to talk to her doctor to check whether she is suitable to undergo the procedure.

The results from the procedure are not always permanent.

If a woman continues to experience heavy or long periods after having endometrial ablation, she should speak to her doctor. The doctor will be able to recommend an alternative treatment.

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Medical News Today: How you speak to your child may fuel obesity

A recent study provides new insight into how language impacts childhood obesity. The researchers found that the parents of obese children were more likely to use direct statements to prevent them from consuming calorific treats.
Happy family eating
A new study investigates language and its role in childhood obesity.

Now that 1 in 3 children in the United States are either overweight or obese, every parent is concerned about their child’s eating habits. Understanding how and why some children become obese is urgent.

The way that parents behave and interact while feeding their children is known to be important, but the story is complex. Restricting food can actually, paradoxically, increase how much a child eats overall.

Researchers recently set out to investigate a part of this conundrum: the role of language. They wanted to understand how the way in which we speak to our children about what they should or should not eat impacts dietary choices.

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Language and obesity

It’s a given that the way in which a parent speaks to their child has an impact on their behavior. And, according to the latest research — which is now published in the Journal of Nutrition Education and Behaviorthis also applies to eating habits.

Lead researcher Dr. Megan Pesch, who is a developmental and behavioral pediatrician, believes that the current study is the first to examine “the impact of parental direct imperatives in restricting a child’s intake of unhealthy food.”

Currently, there is little advice available on how to speak with children about their dietary choices. As Dr. Pesch explains, “So many of the guidelines are focused on what not to do. There’s a lot of emphasis on what parents shouldn’t be doing and what doesn’t work.”

In the study, Dr. Pesch and team — from the University of Michigan C.S. Mott Children’s Hospital in Ann Arbor — videotaped 237 mothers (or primary caregivers) and their children, who were aged 4–8. The caregivers were all from low-income homes, a demographic known to be particularly at risk of childhood obesity.

The caregiver-child pairs were alone in a room and were presented with different foods, including chocolate cupcakes.

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Dispelling parenting myths

There is a stigma attached to the parents of obese children. Often, people assume that they simply allow their child to eat whatever they want, whenever they want. This study demonstrated that the reverse was true. As Dr. Pesch explains, “They were attentive and actively trying to get their children to eat less junk food.”

However, the scientists noted a subtly different linguistic approach. According to their findings, the caregivers of obese children were 90 percent more likely to use direct language, such as “Only eat one” or “You’re eating both of those? No! Don’t! Oh my gosh.”

The mothers of children at a healthy weight, however, were more likely to use indirect phrases, such as “That’s too much. You haven’t had dinner.”

This is the reverse of what might be expected; a more direct, firm message is thought to be most effective when talking to a child regarding discipline, or sleep, for instance.

Indirect or subtle statements don’t seem to work as well in general parenting. Direct messages are usually easier for kids to interpret and understand where the limits are. But there’s more sensitivity around how to talk to children about eating and weight.”

Dr. Megan Pesch

The authors note a number of limitations to the study. For instance, the caregivers knew that they were being filmed as part of an experiment, which could have altered their behavior.

Also, only individuals from lower socioeconomic backgrounds were involved, and the new findings may not apply to other demographics.

As this is the first study of its kind, there will need to be much more work before firm conclusions can be drawn. Only then can solid advice be given to parents. Dr. Pesch and her team plan to continue this line of investigation.

“We hope,” she says, “to find better answers to the ultimate question of what parents should do to help set their child up for healthy eating long-term.”

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