What doctors do to avoid Christmas lurgies, hangovers and burnout
The festive season is the peak time for super-infectious bugs, indigestion, over-indulging and stress. Medical experts offer their tips for staying healthy over Christmas.
The festive season is the peak time for super-infectious bugs, indigestion, over-indulging and stress. Medical experts offer their tips for staying healthy over Christmas.
Canapes and glasses of fizz are hard to resist in party season, but too many seasonal treats can upset your gut, causing acid reflux and heartburn, bloating, constipation and diarrhoea.
Add in stress, alcohol and over-indulgence, and you have a perfect storm for gut problems when you least need them, says Professor Peter Whorwell, consultant gastroenterologist at Wythenshawe Hospital, Manchester, and author of Take Control of Your IBS: The Complete Guide to Managing Your Symptoms.
“Avoiding too much fizz – in champagne and prosecco, but also in soft drinks such as cola, mixers and fizzy water – is a good tip for avoiding bloating, a common problem at this time of year,” explains Professor Whorwell. “The carbon-dioxide gas in fizzy drinks stretches the gut, which causes discomfort and pain.”
Professor Whorwell says that alcohol is generally bad news for the gut because it relaxes the lower oesophageal valve and lets stomach acid back up into the throat, causing acid reflux and heartburn. “Try an antacid remedy such as Gaviscon to neutralise this,” he suggests. Fatty foods delay gastric emptying, and can make discomfort and bloating worse.
“Alcohol will irritate the gut, especially if you have IBS, but as a general rule of thumb, wine is better than beer, red wine is worse than white, and spirits are less trouble than wine.”
“Stress and a change of diet pre-Christmas can also cause constipation,” says Professor Whorwell. “Try eating two kiwi fruit before bed to tackle that problem.
“If you’re constipated, it’s also really important to eat breakfast as eating stimulates the gastrocolic reflex, a natural physiological response where eating stimulates an urge to have a bowel movement.
“The reflex allows the colon to move existing waste, to make room for new food entering the stomach.”
Aside from getting your flu and Covid-19 vaccinations, and taking a daily vitamin D supplement over the winter, wearing a scarf to cover your nose may help to ward off respiratory infections, according to Professor Ron Eccles, retired director of the former Common Cold Research Centre at Cardiff University.
“A scarf makes the nose warmer, and the respiratory viruses replicate best at the normal nasal temperature, which is 32°C," he explains. "Warming the nose may slow replication of respiratory viruses.”
Immunologist Dr Jenna Macciochi, honorary lecturer at the University of Sussex, suggests supporting your immunity by making a soup with sauteed garlic, onions and leeks as the base – prebiotics needed as food for beneficial bacteria that make up your gut microbiome. These help train and educate your immune system.
“Add in carrots, celery, mushrooms and leafy greens, then stir in lentils or beans for protein and fibre,” says Dr Macciochi. “Finish with herbs, a squeeze of lemon and a sprinkle of pumpkin seeds on top.”
She also recommends eating more fermented foods, such as sauerkraut, kimchi, live yogurt and kefir. “These bring live microbes and fermentation products that can help support a more diverse gut microbiome, and in turn support your immune system.
“A high fermented food diet has been shown to increase microbiome diversity and reduce unwanted inflammation, to ensure your immune system is working at its best.”
Norovirus, known as the winter vomiting bug as infections tend to peak in the colder winter months, is one of the most infectious viruses on Earth. It causes projectile vomiting, watery diarrhoea and stomach cramps.
“The virus is so small and infectious that a tiny, pea-sized amount of virus is apparently enough to infect the whole planet,” says Dr Dave Partridge, consultant microbiologist at Sheffield Teaching Hospital and past president of the British Infection Association.
“It is 100 times more infectious than some other causes of gastroenteritis, so tends to spread through hospitals and households very quickly and easily.”
You can catch norovirus if you come into contact with someone who has been infected with it, touch a surface contaminated with the virus then touch your mouth, or eat or drink food or water coated with the virus.
“If someone in your household has come down with norovirus, you need to be extra-vigilant with cleaning to stop it spreading,” advises Dr Partridge.
“Wear disposable gloves to clear up, then throw them away. Clean all hard surfaces with diluted bleach, and sterilise toothbrushes in bathrooms where virus particles may be lingering – use boiled water, then cover them with a plastic bag. Afterwards, wash your hands with warm, soapy water, rather than using alcohol hand gels, which are less effective.
"If you are stripping bedding, use disposable gloves and wash at 60°C to destroy the virus. Anyone infected should avoid food preparation for at least 48 hours after their symptoms start.”
Dr Partridge says that symptoms usually subside after two or three days, but during this time it’s important to keep hydrated with sips of water and rehydration salts to restore electrolyte balance and avoid dehydration (particularly if you’re older or have a compromised immune system).
He says people are most infectious when they have symptoms and for several days afterwards, but the virus can survive on surfaces for up to two weeks.
“There’s no cure for the common cold, and it’s a self-limiting illness that usually resolves itself within seven days, but that’s not to say there isn’t anything you can do to relieve your symptoms,” says GP Dr Micheal Zemenides, co-founder of The A-Z General Practice at the HCA Wellington Hospital in north London.
“Some people don’t realise that you can take both paracetamol and ibuprofen to reduce pain, fever and inflammation (provided that ibuprofen isn’t contraindicated for you), as they work in different ways," says Dr Zemenides. "They can be taken either together at the same time or staggered two hours apart. Just be careful not to exceed the daily maximum dosage for each of those.
“Nasal decongestants can help with a blocked-up nose if you take three or four doses a day (as directed) over a five-day period, and there’s also evidence that sedating antihistamines can relieve sneezing and a runny nose. These are best taken before bed.”
Studies in children have shown that honey can reduce nighttime cough symptoms better than no treatment or a placebo, and may have a similar effect to the cough medicine dextromethorphan.
“Rest and keeping well hydrated with fluids are also very important,” says Dr Zemenides.
Some studies have shown that sucking zinc lozenges may shorten the duration of a cold by 33%, although Dr Zemenides says the quality of the evidence on this is poor.
The National Institute for Health and Care Excellence says that some patients may want to try the herbal remedy pelargonium for relief of cough symptoms, but adds that the evidence base is limited.
Rehydration is key to recovery. “Try to drink a pint of water before you go to bed, or keep it on your bedside table so that you can sip it during the night," says Dr Zemenides. "Even better if you can add rehydration salts to restore your electrolyte balance.
“There’s no miracle cure but in the morning, top up on more fluids as soon as possible. Eat some bland food like toast, bananas or porridge, and take ibuprofen or paracetamol for a headache.
“If you’re feeling nauseous, you can buy anti-sickness drugs or an anti-reflux drug such as esomeprazole from a pharmacy."
“Whatever you do, avoid the 'hair of the dog’ – that’s just delaying your hangover to the afternoon.”
The Mayo Clinic also recommends drinking bouillon, a light vegetable broth, and avoiding drinking alcohol for 48 hours.
“Lots of people think they have a stuffy nose, itchy eyes and are sneezing because they have a cold, but in some cases it’s a mould allergy caused by your Christmas tree,” says allergy specialist Dr Jose Costa.
“Studies have shown that pine trees can carry up to 50 different moulds. These are released as spores in the air when we bring them indoors at Christmas.
“We also need to be careful with the dust that trees can carry when we bring them into our homes, as this can lead to breathing problems – as can Christmas decorations stored for months in the attic, which might also have mould and dust in them.”
Dr Costa recommends shaking your Christmas tree outdoors to get rid of dust and mould spores, hosing it down with water (taking care to dry it out before bringing it into the house), or using a leaf blower on it. “If your symptoms persist, take an antihistamine,” he says.
“Christmas can get a bit overwhelming,” says Dr Chris Etheridge, medical herbalist and chair of the British Herbal Medicine Association. “There’s this pressure for everything to be perfect, and some people just burn out with all the stress, anxiety and exhaustion.”
Dr Etheridge recommends the herbal remedy rhodiola rosea (Kalms Rhodiola, £9.99 for 20 tablets, available from Amazon). This brand has the Traditional Herbal Remedy (THR) logo, which means the ingredients are safe, regulated and of high-quality.
“You can feel its calming effects within hours, but it also boosts your mood, helps you get things done and gives you energy,” says Dr Etheridge.
“It's believed to support the adrenal gland function, which regulates how your body responds to stress, as well as blood pressure and metabolism.”
Rhodiola is an adaptogen – a class of herbs, plants and mushrooms used in traditional medicine to help the body cope with stress. It grows in inhospitable places such as Siberia, and legend has it that the Vikings used it before long voyages and strenuous activities.
An article in the journal Molecules, published in 2022, discussed research evidence on rhodiola, with the authors concluding that it could enhance the body’s resilience to physical and mental stresses, and has a normalising effect on the body.
“In rare cases, it can interact with prescription drugs, so seek advice from a pharmacist or medical herbalist before buying,” says Dr Etheridge.
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