Author name: aventino

By Dr. Eleonora Galosi, Neurologist at Aventino Medical Group, Rome Understanding the Subtle Onset of Autoimmune Neurological Diseases “Often, autoimmune diseases of the nervous system begin subtly,” explains the neurologist. They may present with mild, difficult-to-interpret disturbances: persistent fatigue, muscle weakness, tingling, slight coordination issues, balance problems, or clumsiness in movements. These symptoms are often underestimated or attributed to stress. Yet, they can be the first signs of autoimmune neurological conditions such as multiple sclerosis, encephalomyelitis, and autoimmune neuropathies. Recognizing them early makes it possible to start effective treatments and prevent disease progression. What Are Autoimmune Diseases of the Nervous System? Autoimmune neurological diseases occur when the immune system mistakenly attacks nerve cells or their protective sheaths (myelin). The result is an acute or chronic inflammatory process that disrupts the transmission of nerve signals at various levels, leading to a wide range of neurological symptoms. The most well-known include multiple sclerosis, neuromyelitis optica, Guillain-Barré syndrome, and myasthenia gravis. Each condition has a different course and can affect individuals of varying ages and clinical profiles, including young adults. The Importance of Early Diagnosis Timely diagnosis is the first step in limiting neurological damage and improving quality of life. Diagnostic protocols are based on a thorough clinical evaluation, brain MRI, neurophysiological tests, and sometimes more invasive procedures such as cerebrospinal fluid analysis through lumbar puncture. Acting in the early stages helps reduce relapses, slow progression, and tailor therapy. It is crucial to consult specialized centers with experienced neurologists who can recognize even the less obvious forms of the disease. A multidisciplinary, integrated approach is essential to ensure maximum safety and consistency in care. Today, treatments for autoimmune neurological diseases include immunomodulatory or immunosuppressive drugs, corticosteroids, monoclonal antibodies, and supportive symptomatic therapies. The choice of treatment depends on the diagnosis, the stage of the disease, and the patient’s characteristics. In recent years, research has opened new frontiers: more selective drugs, personalized treatments based on immunological markers, and regenerative medicine approaches. Neurological rehabilitation also plays a key role in improving residual function and patient autonomy. Living with an Autoimmune Neurological Disease Receiving a diagnosis of an autoimmune neurological disease means reorganizing daily life. Psychological support, stress management, a balanced diet, and tailored physical activity can all help maintain mental and physical well-being. Multidisciplinary care—including the neurologist, physiotherapist, psychologist, and nutritionist—is now considered an integral part of therapy. The family and social environment also play a vital role: understanding the disease helps manage it with greater confidence and peace of mind. Conclusion Detecting these disorders early paves the way for more targeted treatment plans and better life prospects. Staying informed, consulting specialists, and paying attention to the body’s warning signs helps keep open the possibility of managing the disease more effectively. Take Care of Your Nervous System Turn to qualified specialists for a personalized, multidisciplinary health pathway.

By Dr. Nicola Verdirame, Nurse at Aventino Medical Group, Rome Introduction: a concrete service for complex needs Autoimmune diseases such as rheumatoid arthritis, systemic lupus erythematosus, and multiple sclerosis require continuous care and sometimes delicate procedures. Home nursing care, which I provide on behalf of Aventino Medical Group in Rome, is designed to guarantee patients qualified technical support directly at home. The goal is to simplify therapy management, reduce the need for travel, and ensure continuity of care in line with medical instructions. Home nursing services: comprehensive and accurate interventions From routine treatment to more specialized procedures Daily activities include infusions, administration of biologic therapies, blood sampling, advanced dressings, and catheter management. All procedures are performed according to the indications of Aventino Medical Group physicians and in line with the guidelines of the Italian National Institute of Health and the WHO. Providing these services at home helps save time, reduce the stress of travel, and maintain therapeutic continuity even in complex clinical situations. Coordination with specialists Teamwork when needed When the clinical picture requires it, home nursing activities are integrated with the input of the various specialists following the patient: rheumatologists, neurologists, internists, and other professionals from our clinic. This coordination ensures that every procedure is carried out according to the therapeutic plan, guaranteeing maximum safety and consistency of care. The nurse as caregiver trainer The effectiveness of this role is fully expressed in the ability to transfer knowledge and practical skills to the caregiver. The nurse teaches the family member to: This training process not only relieves the caregiver of emotional and practical burdens but also makes them an active and aware participant in the care pathway. By feeling more competent and confident, the caregiver can provide higher-quality assistance, significantly contributing to the patient’s well-being and quality of life. The home nurse thus becomes a point of reference, a valuable ally for the whole family, ensuring continuity of care that goes beyond the simple professional service. A service that facilitates disease management Technical expertise at the core of care Home nursing is not just about avoiding travel: it is an organizational model that allows patients to receive specialized care promptly and in full compliance with medical prescriptions. Technical interventions performed with attention and precision make managing autoimmune diseases simpler and safer for patients and their families. Conclusion Home nursing care represents essential support for those facing complex and continuous therapies. Through my work with Aventino Medical Group, it is possible to receive qualified services, including the most delicate ones, directly at home, in coordination with the specialists involved in the patient’s care. 👉 Book a home nursing service to evaluate together the most suitable pathway for your needs.

By Dr. Pier Giacomo Cerasuolo, Rheumatologist at Aventino Medical Group, Rome Autoimmune rheumatologic diseases represent one of the most complex challenges in modern clinical practice. These are conditions in which the immune system, by altering self-recognition mechanisms, attacks healthy tissues, causing chronic inflammation and potential permanent damage. Joints are often involved, but it is not uncommon to also observe skin, neurological, or internal organ manifestations. Early diagnosis and targeted treatment can significantly modify the natural course of these diseases, preserving joint function and improving quality of life. A Case to Understand: Early Rheumatoid Arthritis Some time ago, I followed a young woman, whom I will call Laura, 35 years old. She presented with pain and swelling in the small joints of her hands, morning stiffness lasting more than an hour, and profound fatigue that compromised her daily routine. Laboratory tests showed positivity for rheumatoid factor and anti-CCP antibodies, associated with elevated inflammatory markers. We promptly started treatment with a conventional DMARD (Disease-Modifying Anti-Rheumatic Drug), complemented by a gentle physiotherapy program and dietary advice aimed at reducing systemic inflammation. After just a few months, follow-up showed clinical remission: joint swelling had resolved, and Laura had returned to her work and daily passions, showing how crucial it is not to ignore even early, non-specific symptoms. Another Perspective: Systemic Lupus Erythematosus Another significant case concerns a 28-year-old man, whom I will call Marco, who presented with persistent low-grade fever, migratory joint pain, and a butterfly-shaped facial rash after sun exposure. Blood tests revealed positivity for antinuclear antibodies (ANA) and native anti-DNA, along with reduced serum complement. In this case, beyond controlling joint symptoms, it was essential to prevent involvement of possible target organs such as kidneys and heart. Treatment was initiated with synthetic antimalarials, low-dose corticosteroids, and later targeted immunosuppression with biotechnological drugs. A multidisciplinary approach involving a nephrologist and a dermatologist helped stabilize the clinical picture and prevent serious complications, allowing Marco to continue his university studies with the disease under control. Common Features and Diagnostic Approach Rheumatoid arthritis and lupus are just two examples of autoimmune rheumatologic diseases. Other conditions include scleroderma, Sjögren’s syndrome, and spondyloarthritis. These pathologies share the importance of careful clinical assessment, integrating patient-reported symptoms, objective findings from examination, and supportive tests: inflammatory markers, specific autoantibodies, advanced imaging. Early identification of disease activity is crucial to intervene before irreversible damage occurs. Innovative Therapies and Integrated Approach Today, rheumatologic therapy follows the principle of “treat to target”: defining a therapeutic goal (remission or low disease activity) and constantly monitoring outcomes, adapting therapy based on response. Conventional DMARDs, new biologic agents, and small molecules have expanded treatment options, allowing a personalized approach tailored to both patient and disease characteristics. Equally fundamental are non-pharmacological interventions: adapted physical exercise programs, nutritional support to reduce systemic inflammation, and psychological counseling to manage the chronic stress that often accompanies these conditions. Current Perspectives and Quality of Life Clinical experience confirms how essential a shared care pathway is, with regular follow-ups and constant dialogue between physician and patient. International guidelines emphasize the importance of a multidisciplinary approach that values the whole person, not just the disease. Today, thanks to research progress and targeted therapies, many people with autoimmune rheumatologic diseases lead active and independent lives. The challenge remains demanding, but prospects have improved dramatically compared to the past. ✨ If you live with a rheumatologic disease or suspect its early symptoms, consulting a specialist can make all the difference. At Aventino Medical Group, our multidisciplinary approach aims to provide attentive and personalized care.

By Dr. Megon Bresciani, Allergist-Immunologist at Aventino Medical Group, Rome Understanding the Immune System and Its Dysfunctions Autoimmune diseases represent a complex and fascinating area of modern medicine. In these conditions, the immune system—normally tasked with defending the body against viruses, bacteria, and other external threats—makes a critical error in identification and begins attacking healthy tissues. This phenomenon, known as the loss of immune tolerance, underlies common conditions such as systemic lupus erythematosus, rheumatoid arthritis, and Hashimoto’s thyroiditis. Studies published in leading international journals, including The Lancet and Nature Reviews Immunology, show that early and targeted diagnosis can significantly slow disease progression. The allergist-immunologist plays a key role in detecting these immune alterations and guiding an accurate diagnostic process, working closely with other medical specialists. Early Diagnosis and Immunological Markers A crucial aspect of managing autoimmune diseases is identifying specific biomarkers that signal an altered immune response. These markers, detectable through targeted blood tests or radiological imaging, allow for early intervention—often before irreversible tissue damage occurs. Depending on which systems are affected by the autoimmune process, the allergist-immunologist collaborates with rheumatologists, dermatologists, endocrinologists, neurologists, and even nutritionists, whose involvement is often recommended in managing inflammation. Having these skills available within a single medical center facilitates diagnosis, while a shared, multidisciplinary evaluation enables effective and cutting-edge treatment strategies. Therapeutic Approaches and Personalized Care Once the involved immune mechanisms are identified, the goal becomes to modulate the immune response in a targeted way. Options include immunosuppressive medications, new-generation biological therapies, and innovative protocols validated by clinical studies. The allergist-immunologist also considers potential allergic comorbidities, such as rhinitis or dermatitis, which may complicate the clinical picture and require additional treatment. Reducing inflammation, preserving organ function, and improving the patient’s quality of life are tangible goals of this integrated approach. Conclusions The role of the allergist-immunologist in autoimmune diseases is therefore central—not only in correctly identifying the condition, but also in coordinating the input of multiple specialists to define personalized therapeutic strategies and prevent future damage. Relying on experienced professionals and a multidisciplinary team ensures comprehensive care, always aligned with the most up-to-date scientific evidence. 👉 Learn more on our dedicated Allergology page at Aventino Medical Group

 By Prof. Manon Khazrai, Nutritionist at Aventino Medical Group, Rome Introduction: the role of diet in rheumatic diseases Rheumatic diseases are chronic inflammatory conditions affecting joints, muscles, and connective tissues. Alongside pharmacological treatments, numerous studies highlight how proper nutrition can help modulate inflammatory processes and improve overall clinical outcomes.A balanced, well‑structured diet supports ongoing therapies, helps preserve joint function, and promotes an optimal nutritional status. Mediterranean diet and inflammation management Among the most recommended dietary models for patients with rheumatic diseases, the Mediterranean diet is one of the most effective. Characterized by a high intake of fruits, vegetables, legumes, whole grains, oily fish, and extra virgin olive oil, this diet has been associated with reduced inflammatory markers and improved quality of life.Adopting this dietary pattern alongside medical treatments can help reduce joint stiffness, pain, and systemic symptoms, while also enhancing therapeutic response. Key nutrients for patients with rheumatic diseases Certain nutrients play a particularly important role in managing rheumatic conditions.Fiber from fruits, vegetables, and whole grains helps maintain gut balance and reduces inflammation.Antioxidants found in colorful vegetables and fruits help counter oxidative stress and protect tissues.Omega‑3 fatty acids, present in oily fish or certain supplements, modulate inflammatory responses and may help relieve pain. General guidelines To promote joint health and overall well‑being, it is recommended to:● prioritize fresh, minimally processed foods;● increase the intake of legumes, nuts, and extra virgin olive oil;● limit simple sugars, saturated fats, and ultra‑processed products.Maintaining these dietary choices over time can provide tangible benefits by reducing inflammation and improving quality of life. Conclusion and invitation A proper diet is a fundamental support for those living with a rheumatic disease. It does not replace medical treatments but works synergistically to reduce inflammation and enhance therapeutic outcomes. For more detailed guidance and a nutritional plan tailored to your clinical condition, you can request a nutritional consultation at the Aventino Medical Group in Rome. 👉 Book a nutritional consultation to explore this approach further.

By Dr. John Lawrence Dennis, Psychologist – Aventino Medical Group, Rome More Than Physical Pain When I meet someone newly diagnosed with a rheumatic disease, I often see more than just physical pain. There’s a shift taking place—an invisible weight settling in as they begin to reimagine their future. It’s not just about symptoms or treatment plans. It’s about identity, relationships, daily habits, and an uncertain horizon. The Emotional Impact of a Diagnosis As a psychologist, I’ve learned how deeply a diagnosis can shake a person. It can bring relief—finally understanding what’s been happening—but also fear, grief, and anxiety. That emotional mix is entirely human. And it’s precisely why psychological support should be part of the care pathway from the very beginning. Creating a Space to Process Emotions In my work, I help people find space to process these emotions. Talking openly, without judgment, can prevent emotional distress from quietly taking over. It’s also the first step in reclaiming a sense of agency. Building Coping Strategies Together, we develop coping strategies that are realistic and tailored to the person’s life. Stress management techniques, cognitive reframing, mindfulness, and even something as simple as journaling or reconnecting with joy—these are small tools that, over time, build resilience. Practical Tools That Help Here are some of the practices I often introduce: Emotional and Physical Health Are Intertwined What I want people to know is this: emotional wellbeing and physical health are not separate. When we tend to one, we influence the other. Chronic stress can worsen inflammation and pain. Depression can make it harder to follow treatment. But with the right support, people often become more motivated, more in tune with their needs, and better able to stick with their care. A Path Toward Hope and Healing Living with a rheumatic disease is not easy. But it doesn’t have to mean living without hope or direction. Psychological care doesn’t make the illness disappear—but it can transform how you carry it. It can help you feel more like yourself again.And that, to me, is what healing really means.

by Dr. Stefano Picca, nephrologist at Aventino Medical Group, Rome When the kidneys become ill and stop working, life is at risk. Not all kidney diseases are irreversible (Chronic Kidney Disease – CKD). When kidney damage is reversible (Acute Kidney Injury – AKI), renal function often needs to be temporarily replaced by dialysis (blood purification) while awaiting recovery. Dialysis can be performed by drawing blood from a patient’s vessel and passing it through a machine that “cleans” it (hemodialysis) or through a catheter placed in the abdomen between the intestinal loops. The abdomen is periodically filled and drained with a sterile solution that purifies the blood flowing in the abdominal cavity (peritoneal dialysis – PD). The latter is simpler to implement, less expensive, and is the dialysis modality recommended in low‑income countries. A Decisive Encounter In 2013, I had the opportunity to meet Professor Mignon McCulloch during a conference. She was the head of the Pediatric Nephrology Department at the Red Cross Children’s Hospital in Cape Town, South Africa. She was running (and still runs) the largest educational program for the diagnosis and treatment of pediatric AKI with dialysis in Africa. I came from a personal experience developed in a “high‑technology” context at the Bambino Gesù Pediatric Hospital in Rome, surrounded by sophisticated machines, cutting‑edge electronic devices, and numerous specialized collaborators. I was simply astonished when I heard the question: “How can you save from death a patient with AKI when you have no material, no trained personnel, and very little time left?” It sounded to me like the ultimate challenge. With her sponsorship, I became an Educational Ambassador of the ISN and began traveling to French‑ and English‑speaking African countries to teach PD. The “Saving Young Lives” Initiative The training was part of the Saving Young Lives (SYL) initiative of the ISN. It consists of adapting non‑dedicated material for PD and training inexperienced doctors and nurses in its implementation. For example: An Enriching Experience About 200 doctors and nurses have been trained during my activity in South Africa, Côte d’Ivoire, Senegal, Gabon, Algeria, and Cameroon.Outside Africa, I have also been invited to Haiti and India. On a personal note: I have had a long career, full of satisfactions, but without a doubt, this was the most rewarding choice of my entire working life. Results Doctors and nurses trained by the SYL program have treated more than 500 patients using PD, achieving a 65% survival rate. “A catheter can save a life.”

by Dr. Nico Naumann, gynecologist at Aventino Medical Group, Rome A medical vocation serving women across borders As a physician specializing in fertility issues, throughout my career I have determined to lend my expertise to women and children in developing countries. My work with various NGOs has taken me to Ethiopia and Sierra Leone as an Ob/Gyn and assisting patients in Rome in providing necessary gynecological care. I have treated cases from HIV in pregnant women to tuberculosis leading to infertility to female genital mutilation victims both in Italy and abroad. Destination Lebanon: a natural calling It therefore came as no surprise when a colleague asked me to join the Italian NGO, Second Generation Aid (SGA) operating in Lebanon, to assist their efforts in this complex yet compelling country situated right in the heart of the turbulent Levant. Ongoing crisis, ongoing need Given the seemingly endless political crises in Lebanon, and the unrelenting onslaught from neighbouring hostilities, Lebanon’s populace is in dire need of medical assistance, specialized physicians, and medicines. Our mission would be to examine and consult with patients and aid in the distribution of needed medicines throughout a network of monasteries and schools. I was looking forward to going to this intriguing part of the world and doing what I could do to assist the aid efforts there. On the road: a mission fueled by logistics and commitment So it was last April that I departed Rome with a team of physicians, including an ophthalmologist, a dermatologist, a pharmacist and a physical therapist for Second Generation Aid headed for Beirut. We were met by our mini‑bus driver, George, who also doubled as guide and bodyguard throughout our mission. Our first stop would be at the Sanctuary of Saint Charbel, the patron Saint of Lebanon. Two days later we went up north to a school run by Catholic nuns and so on, changing location every two or three days, visiting 40‑60 patients from the community each time. SGA saw to it that medicines were shipped ahead of our mission as well as essential instruments such as a portable ultrasound. This was made possible solely due to the coordination of the Italian branch of UNIFIL, the UN contingent operating in the buffer zone between Israel and Lebanon. A nation divided, a people in need It’s common knowledge that Lebanon is a rich melting pot of peoples from all walks of life; a multitude of religions, sects, and classes all intermingling in its fair land. Sadly, its extraordinary diversity is overshadowed by those in positions of power, or seeking power, who aim to divide this kaleidoscope into warring factions, all for political gamesmanship. For those of us on the ground, everyone is a person worthy of dignity and care. United beyond faiths: the power of local solidarity We relied on Lebanon’s Christian community – both the Maronite and Catholic churches – to bring in the patients we would be seeing. They canvassed the countryside, bringing us patients from every denomination: Sciite, Sunni, Orthodox, Protestant, Druse and Alawite. It was a testament to the rich mosaic of the Lebanese people – and to our common humanity – how wars, turbulence and strife affects everyone alike, regardless of denomination. Medicine in the field: when symptoms reflect life under threat As a gynaecologist, I saw patients suffering from a variety of issues or disease, from digestive irregularities and colitis, to menstrual cycle issues and infertility, to skin diseases and circulatory system pathologies, to even young people with hypertension. But what they had in common were the physical effects of living under the constant menace of bombardments and death. Listening to heal: treating more than the body An additional psychological strain was the concern for their children. Our team was trained to listen attentively and show them that they had not been abandoned. A lesson from Lebanon: peaceful coexistence is possible But what struck me most about my experience criss‑crossing Lebanon and witnessing this tapestry of ethnicities and lived experiences coming together (and that would include more recent Palestinian and Syrian refugees welcomed as well), was a sense among the people of their amazing capacity for peaceful coexistence. Faith, hospitality, and the practice of coexistence Indeed on several occasions I met Muslims busily getting integrated into a dominant Christian community – and vice versa. Many of the clergy I met proudly affirmed their resolve to keep their doors open to the most needy. A number of them would visit a Syrian refugee camp on a weekly basis to offer material and emotional support. A beacon on the border: Sister Beatrice’s school A special mention goes to that school in the north on the Syrian border. The school was founded and run by Catholic nuns under the towering figure of Sister Beatrice from Cyprus. She had started it in the 1980s by first renting out some rooms for classes, ultimately building a school which today teaches around 500 children, from Kindergartners to 15‑year‑olds. All students are taught in Arabic and learn English and French as well. In addition, the school houses 50 special needs children, where they also learn to cook and garden and become autonomous. Leaving with gratitude, returning with purpose In the end, I felt that our NGO efforts had been well‑received, and I returned to Rome knowing that we had alleviated some of the suffering, even for the short time we were there. But for each person assisted, I also knew there was another who required surgery in a modern hospital setting that was simply not available to them. A commitment renewed by the hope of parents I intend to continue volunteering with Second Generation Aid, and our intention is to return two or three times a year, resources permitting. Getting the call to be of some assistance in Lebanon was quite an honour, but it was those nervous parents, or parents‑to‑be, who, despite all the challenges were looking forward to bringing up children in this world in the hopes of a

 By Dr. Giuseppe Martinelli, gynecologist at Aventino Medical Group, Rome When the priest from the Vincentian Order married Giulia and me, we promised to devote part of our time and medical profession to the works run by their Order. The opportunity came a few months after I left the hospital following the unilateral termination of my contract. An unexpected invitation My wife’s friend from Apulia, sister Vincenziana, the head of Caritas in Albania, who often spent her summers cooling off in the Lucanian hills, immediately seized the opportunity when she heard of my new availability. She invited me to join her in Albania, in the province of Elbasan, where she directed a foster home in Mollas and a youth center in Cerrik. Many women there had no access to preventive care or gynecological assistance — some hadn’t been examined in years. A young woman in search of help In that context, I was asked to examine a young woman who helped the sisters manage the foster home, which still today hosts about a dozen abandoned children. She deeply longed for a pregnancy but had already suffered at least two late miscarriages. The gynecological exam seemed normal, but thanks to an ultrasound — done with a machine brought from Italy and restored through the efforts of the Rotary Club of the Apulia and Basilicata District — the cause emerged: a uterine septum dividing the cavity, preventing a full-term pregnancy. A possible solution The only option was to surgically remove the septum through a hysteroscopic metroplasty, under general anesthesia and with a minimally invasive technique. It required a well-equipped clinic, with an operating room, proper instruments, and trained staff — not easy to find in Albania, nor financially accessible. The clinic, the departure, the operation Thanks to the sisters’ providence — and the patient’s determination — a private clinic agreed to cover the costs, on the condition that I would perform the procedure. We scheduled the best time, and I left for Albania. I managed the preoperative preparation, coordinated the operating room staff, and ensured all equipment was functioning. The operation went smoothly, and the patient was discharged that same afternoon, after just a few hours of observation. Follow-up and waiting Follow-up care was handled remotely, with the nuns acting as intermediaries. I advised waiting before attempting a new pregnancy. After a few months, her menstrual cycle normalized, and symptoms improved from the very first cycle. Regular gynecological and ultrasound checkups every three months confirmed she could finally conceive. A new life The wait wasn’t long. There was fear that the pregnancy might end like the previous ones, but with the right care, attention — and the will of the Lord — she reached the seventh month. In the meantime, she had moved to Greece with her husband. She was hospitalized and gave birth to a baby girl — premature, but alive and full of life — who still brings joy to their home. On September 2, 2023, Sister Camilla wrote to me: “Hi Beppe, Bona sent me this message, I’m so happy. Thank you for your professionalism.” And the young woman’s message said: “Good morning Mater Camilla! Yesterday I gave birth to a baby girl. I feel great. Thank you so much! Thanks to you, today I am a MOTHER!” Coincidence… or love for one’s work? Coincidences or just chance? Perhaps. But also a bit of determination and a great deal of love for one’s work — the most genuine and rewarding form of compensation for time devoted to others. A mission that continues The collaboration with the foster home goes on. Today, three of us regularly travel to Albania: my wife Giulia, an endocrinologist and internist; our friend Giuseppe, a pediatrician everyone calls Pino; and myself, a gynecologist. Every time we go, it’s a celebration! A simple and concrete way to place our profession at the service of those who need it most.

By Dr. Valeria Gianfreda, Colonproctology and pelvic floor surgeon – Aventino Medical Group, Rome When holidays upset your gut New schedules, unfamiliar beds, hot weather, less privacy… and your gut rebels. Many people experience slower intestinal transit while on holiday, with bloating, heaviness and difficulty passing stool. These are common complaints, but often underestimated. Even those who are regular at home may suddenly feel “blocked” after just a few days of travel. What really changes when you travel? Several factors contribute:● Hotel diets, often high in protein and low in fiber● Reduced physical activity● Disruption of sleep-wake rhythms● Dehydration, especially in summer● And even the embarrassment of using unfamiliar bathroomsAll these factors slow down peristalsis — the natural intestinal movements that support evacuation. The taboo to overcome: how we go to the toilet Talking about the bowel is still taboo — let alone how we actually go. Yet posture, timing and stool shape are key signs of our well-being. Overcoming embarrassment and learning to listen to these signals can make a real difference. Posture, timing and habits: how to go properly The way we evacuate matters. The classic 90° sitting posture on the toilet isn’t the most physiological. In a squatting position, the angle between rectum and anus straightens, making stool passage easier.A small stool under the feet that lifts the knees helps recreate this condition, reducing effort and preventing constipation and hemorrhoids.Another crucial aspect is timing: don’t ignore the urge, but don’t linger too long either — especially reading or on the phone. Evacuation is a reflex and coordinated act that must be respected at the right moment. Don’t ignore the signs: look into the toilet Observing your stool is a simple but often neglected habit. The Bristol Stool Chart, used in medicine, classifies stool by shape and consistency:● Type 1–2: hard pellets and dry segments → sign of constipation● Type 3–4: smooth, sausage-like shapes → regular transit● Type 5–6: soft or mushy fragments → accelerated transit● Type 7: watery → diarrhea or infectionOccasional changes can be normal. But if changes persist or are accompanied by pain, blood, or weight loss, a specialist evaluation is needed. How to help your gut travel with you To avoid getting “blocked” while on holiday, follow some simple but evidence-based tips:● Drink 1.5–2 liters of water daily, more if it’s hot or you’re exercising● Get 25–30 grams of fiber a day, combining soluble fibers (oats, fruit, legumes) and insoluble ones (leafy greens, bran, whole grains)● Move every day: even a 20–30 minute walk stimulates bowel movements● Respect your natural rhythms — take time in the morning for breakfast… and for the toilet, without rush or distractions If regularity doesn’t return on its own, the following may help:● Probiotics with specific strains like Lactobacillus rhamnosus GG, Bifidobacterium lactis or Saccharomyces boulardii, which help modulate gut flora and reduce bloating● Fiber supplements like psyllium or inulin that increase stool bulk — introduced gradually and with proper hydration● Mild mechanical-lubricant laxatives, like mineral oil. Prolonged use of osmotic laxatives is discouraged, as they may impair natural defecation These strategies help maintain regularity even away from home, avoiding discomfort during holidays. When to seek specialist evaluation If constipation lasts more than three weeks, recurs periodically or affects your quality of life, it’s time to see a specialist. Guidelines from the European Society of Coloproctology (ESCP), the National Institute for Health and Care Excellence (NICE) and the World Gastroenterology Organisation (WGO) recommend clinical evaluation in case of persistent or associated symptoms. Signs and symptoms to watch for:● Hemorrhoidal prolapse and/or associated internal or external rectal prolapse● Obstructed defecation syndrome: sensation of incomplete and fragmented evacuation● Colicky abdominal pain in flare-ups Possible diagnostic exams:In addition to a colon-proctology consultation: transanal ultrasound, anorectal manometry, colonoscopy, and dynamic defecography X-ray. Accurate assessment helps rule out pathologies and tailor therapy to improve bowel function long-term. Warning signs – according to ESCP and NICE guidelines A specialist consultation is advised if one or more of the following appear:● Persistent constipation lasting over 3 weeks● Sensation of incomplete evacuation or rectal blockage● Recurrent anal bleeding or blood mixed with stool● Unintentional weight loss● Recurring abdominal pain● Family history of colorectal cancer or inflammatory bowel disease● Alternating constipation and diarrhea Your gut doesn’t go on holiday: listen to it Taking care of your gut means improving your quality of life. Even on holiday, you can respect your rhythm, adopt small precautions — and why not — learn more about your body. Talking about stool should not be taboo: it’s a sign of health awareness. Colorectal and Pelvic Surgery – Aventino Medical Group