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Q: What does it mean when I have undigested food in my poop?

Many high-fiber foods, like corn, leafy greens, and certain nuts and grains, often pass through you only partially digested because the enzymes in your system don't break them down fully. Eating more slowly, really chewing each bite, drinking plenty of water, and consuming probiotic-rich foods (yogurt, kefir) are all smart steps to take to keep your digestive tract running smoothly and your stool looking "normal." (A healthy poo may look different from person to person. But, in general, stool should be a shade of brown and soft enough that it's easy to pass, but still compact.)

RELATED: 13 Best Foods for Your Gut Health

Though it may be a little gross, the occasional bit of undigested food in your (otherwise normal-looking) number two is typically nothing to fret about. But if it routinely happens along with diarrhea, you should bring it up with your doctor. Certain viral gastrointestinal infections can speed up the transit time of stool moving through your digestive tract, leading to diarrhea and the presence of undigested food. Diarrhea may also be a sign that your intestine is not absorbing nutrients properly, which can be a result of celiac or Crohn's disease. You should also see your doctor if you're experiencing cramping, bloating, or abdominal pain. It's possible you have a food intolerance or allergy, or irritable bowel syndrome.

RELATED: Why Exercise is Good for Digestion

Health’s medical editor, Roshini Rajapaksa, MD, is assistant professor of medicine at the NYU School of Medicine.

Missed GP appointments cost the NHS time and money and a new study reveals the extent of the problem.

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It was an operation that earned him acclaim, but the world’s first heart transplant also provoked hate mail and outspoken criticism of South African surgeon Christiaan Barnard, 50 years ago.

Critical letters

“We did not realise that it would take the public by storm and create such an outcry,” says Dene Friedmann, a specialist nurse on the cardiovascular team, standing in the same Cape Town operating theatre where the medical feat took place.

Its watery-green tiled walls, visited by schools and the public, stir many memories for her of the historic procedure – and its aftermath.

“There were people who wrote quite critical letters to Professor Barnard, horrible letters calling him ‘the butcher’,” says Friedmann, now in her seventies.

It rained insults

“I have heard of human vultures, but it is the first time I have saw one with a name on it,” said one letter dated just one month after the operation and sent from Illinois in the United States.

“You had the audacity to assume the authority of God by pretending to become the giver of life,” said another from Hong Kong.

The French magazine Paris Match summed up the ethical debate in a headline: “The battle of the heart. Do surgeons have the right?”

But the scientific community welcomed the technical advance – the United States had also been seeking the accolade – and ordinary citizens sent congratulations.

A political dimension

At the time the heart was not considered a mere organ – it was more a symbol of deeper meaning, for some, the bringer and taker of life itself.

Unlike today, there was no common legal definition of brain death and the surgical team did not want to be accused of removing a beating heart to give it to another human.

There was also a political dimension, with South Africa’s apartheid government delighted to have some good news.

“They used Professor Barnard as the ambassador for the country,” recalls Friedmann.

‘Empty chest’

It was on the first floor of Groote Schuur Hospital on December 3, 1967 that Louis Washkansky received the donor heart of Denise Darvall, the 25-year-old victim of a road accident.

Darvall’s father had agreed to the procedure. In the operating theatre Friedmann leaned in to assess Washkansky on the table.

“I looked into this empty chest with no heart in it, a man lying there without a heart in his body and just a lung heart machine keeping him alive. It was very scary,” she says.

In the room next door, Barnard ordered that Darvall’s ventilator be turned off. After about 12 minutes her heart stopped beating and it was quickly moved to the theatre where 53-year-old Washkansky awaited it.

“There were still a lot of medical ethics issues. It was the first time time that a heart transplant was being done… and he did not want anybody to be able to say we took out a beating heart from a patient,” Friedmann says of Barnard, who died in 2001.

“There was a feeling of nervousness: is this heart going to beat and take over the circulation? When it started, it was so exciting, so wonderful.”

The rhythm of life

Barnard, then 45, said of the operation: “The heart lay paralysed, without any sign of life. We waited – it seemed like hours – until it slowly began to relax. Then it came like a bolt of light.

“There was a sudden contraction of the atria, followed quickly by the ventricles in obedient response. Little by little it began to roll with the lovely rhythm of life.”

Coming as it did during the apartheid years race became a consideration when selecting a donor, but only to avoid allegations of prejudice.

The pioneering operation could in fact have been performed weeks earlier, when a coloured man’s heart became available.

“Professor Barnard had decided that the first donor had to be a white person, because of apartheid. We did not want anyone to say ‘You are taking out a black person’s heart to put it in a white patient’,” says Friedmann.

Collapsed immune system

She also squashed the rumour that persists about a black South African, Hamilton Naki, participating in the first transplant but that he was deprived by the apartheid government of any recognition.

“He was very talented, but he never operated on patients,” says Friedmann, who worked with Naki on many laboratory tests on dogs.

Just 18 days after the world first of the Washkansky operation, the patient died. The autopsy revealed that his lungs gave out, but not the heart, because his immune system had collapsed, resulting in pneumonia.

Today, a heart transplant – while still a high-risk procedure – no longer makes headlines.

Around 3 500 transplants are carried out each year, of which about 2 000 are in the United States.

About 88% of patients survive the first year after surgery, 75% survive for five years, and 56% 10 years after the operation, according to the US National Heart, Lung, and Blood Institute (NHLBI).

^{Image credit: Wikimedia Commons}

While research for the very first heart transplant had been going on for a while, it was a marriage of events that lead to the actual surgery taking place. Here is a recap of one of the greatest medical breakthroughs in history. 

2 December 1967

Late afternoon, approximately 15:30 Denise Darvall (25) (pictured below) and her parents Edward and Myrtle Darvall drive down Main Road, Salt River, in the direction of Milnerton. They are on their way to visit friends for afternoon tea. They stop across Wrench Bakery to purchase a caramel tart. 

A couple of minutes later Denise and Myrtle, having bought the cake, are walking back to the car where Eric is waiting. At that moment, a police reservist named Frederick Prins jumps a red traffic light, hitting Denise and Myrtle.

On the scene of the accident Myrtle is killed instantly. Denise is badly injured after hitting her head on the wheel cap and being flung onto the pavement. Coincidentally Mrs Ann Washkansky drives past the scene of the accident. She had just visited her ill husband, Louis Washkansky, in hospital. He is suffering from heart failure. An ambulance takes Denise to the casualty unit at the Groote Schuur Hospital.

Later that afternoon Denise is declared brain dead by Drs Coert Venter and Bertie Bosman. She suffered fatal head injuries. When two experienced doctors both declare a patient brain dead, it’s official. There was nothing more they could have done to save Denise. Doctors realise they might have a suitable heart donor. 

Early that evening Denise’s father, Edward Darvall gives permission for Denise’s heart and kidneys to be donated as he knows she would have given permission herself if it had been possible.

Later that evening, around 21:00 Sister Georgie Hall receives a phone call from the hospital. She is required to come help prep Louis Washkansky for the first heart transplant. Chris Barnard phones Ann Washkansky from the hospital, telling her what’s about to happen.

Before midnight the team starts to prep for surgery.

3 December 1967

Just after midnight Denise Darvall is wheeled into the theatre and prepped for her heart to be removed.

Approximately before 01:00 Louis Washkansky is anaesthetised and his chest opened for the first heart transplant to take place.

05:43 The actual transplant is now complete. The theatre team waits with bated breath for the heart to start beating on its own.

05:52 Denise’s heart starts to quiver in Louis Washkansky’s chest. The theatre team hold their breath: “Will this heart be able to beat after being weaned off the machine?” Then the pressure picks up and the heart starts beating. “Dit gaan werk!” (It’s going to work!) yells Dr Christiaan Barnard. 

Around 06:00 Dr Christiaan Barnard leaves the theatre.

Later that day the world starts taking note of the world’s first heart transplant.

Later that week Louis Washkansky’s heart function begins to normalise.

21 December

Unfortunately Louis Washkansky passes away from pneumonia, which wasn’t directly caused by the transplant. The first heart transplant would still be considered a resounding success.  

^{Image credits: The Heart of Cape Town Museum, Wikipedia}

Beauty is more than skin deep. Way more.

We live in an age of selfies and social media, where both men and women find themselves under a lot of pressure to present a flawless skin to the world.

But it turns out that having a healthy skin is important for more than just creating a good impression.

Our skin is the largest organ in our body. In fact, it protects all of our internal organs from external threats like environmental pollutants, UV rays and microorganisms.

According to the National Institute of Arthritis and Musculoskeletal and Skin Diseases, keeping your skin healthy means you are protecting your body against germs as well as damage to your bones, muscles and internal organs. 

Besides keeping harmful microbes out and your body infection free, your skin also keeps fluids inside your body to prevent dehydration.

How your skin works

“Our skin looks like a brick-and-mortar structure,” explains Dr Juanita Kilian, a transdermal scientist at Nimue. “A healthy skin will look like a solid brick wall, with the biolipids forming the mortar between the bricks.”

At any given moment you’re exposed to more than 9 000 different pollutant molecules. And when biolipids – the mortar – “fall out”, cracks open up in your skin.

“Water evaporates through these cracks and microorganisms are then able to penetrate deeper into your skin. The more compromised the barrier is, the less it will sense that something is wrong and start to protect it.”

That’s why it’s important to create a solid brick-and-mortar structure to maintain a healthy skin.

Health benefits of a healthy skin

Having a flawless complexion is more than just about looking good. A flawless skin is also a healthy skin.

“You need a 24-hour intact barrier to protect you from external elements,” explains Dr Kilian. “You need a product that is constantly replacing that barrier.”

When you see someone with a “polished” look, it means their skin barrier is intact.  

The stronger the structure of your skin, the fewer microorganisms will penetrate the skin, which will result in fewer breakouts and irritations, and less sensitivity. “If there are cracks, the microorganisms can penetrate through them. If the barrier is compromised, the skin will be more sensitive to anything – pollutant molecules or UV rays.”

Maintaining moisture

The skin should regulate its own moisture. “When the skin can regulate its own moisture content, you have the best level of skin health,” says Dr Kilian.

We can use the “rain coat effect” to explain how moisture works. If for example if you wear a rain coat while out running, you’ll sweat underneath the coat, and when you take it off the moisture will evaporate.

“That’s what happens when you use something like petroleum jelly – the product keeps the moisture in, but the moment you remove it, the moisture disappears. And you have to reapply.”

Dr Kilian says you need to teach your skin to regulate its own moisture content so it can adapt to seasonal or climate changes.

About the pH balance

The ideal pH level for skin ranges from 5.5 to 6.5.

“The skin likes to see things that are familiar to it,” explains Dr Kilian. “If you apply product that is between 5.5 to 6.5 it will let the product through. If the pH drops too low, the barrier is compromised and the skin will become irritated.”

You get a similar effect if the pH is too high. “This tends to happen with cleansing products that cause an alkaline effect. Some people will say their skin feels tight after washing it. The moment your skin feels tight the mortar is gone between the bricks and you pH will be too high, most likely 7 or 8.”

A skin product should normalise the skin’s pH balance.

Hormonal imbalances

A skincare product can never influence hormonal fluctuations. “But the hormonal changes do cause a reaction in the skin. If it causes inflammation, we need to treat that,” explains Dr Kilian. “We can treat the symptoms.” 

Usually when you have high oestrogen levels, your skin tends to produce more sebum.

“Microorganisms live in the sebum oil. More sebum equals more microorganisms. The moment the skin starts to produce more sebum, the product normalises it. When you have normal levels of sebum you’ll have fewer microorganisms living on the skin, and fewer breakouts.”

Start today

Unfortunately somewhere along the way our attitude towards our skin as an organ went all wrong. 

Dr Kilian says, “Skin health became a superficial beauty thing. Why are we treating this organ any different to how we treat other organs? We look at what we eat because that’s what we’re putting inside our bodies, but how often do we look at ingredients when we buy products for our skin?”

The need to to look after our skin is often perceived as not being that urgent. “If you have a heart attack today, for example, you might be dead by tomorrow. But if you get severe sunburn today, chances are skin cancer will only begin to surface 10 years from now. People think it’s not a problem – I’ll worry about it when it happens.”

^{Image credit: iStock}

Mandy Freeman

French firm Sanofi says it may worsen the potentially deadly disease in those not infected so far.