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Embarrassing Questions

ANSWERS TO THE HEALTH QUESTIONS YOU’RE TOO EMBARRASSED TO ASK

What’s worse than having cringe-worthy body odors, sounds and leaks? Having to admit it.

Fortunately, mortifying miseries—bad breath, excess sweating, passing gas, constipation and an uncontrolled bladder—can be fixed easily at home. But should you seek a doctor’s aid, you won’t be judged, says Dr. Katherine Holzman, a family practice physician with Memorial Hermann Medical Group Cypress.

“There’s no problem your doctor hasn’t heard of,” she says, “things you wouldn’t bring up in a social setting.”

Still embarrassed? Don’t worry. We went there, so you won’t have to, polling top experts about five distressing disorders, with likely causes, home remedies, doctors’ solutions and urgency.


SYMPTOM: PASSING GAS

LIKELY CULPRITS: Blame fast foods and super-healthy ones with high fiber, such as broccoli, black or pinto beans; carbonated or alcoholic beverages; and drinking with a straw (while swallowing air). So says Dr. Marianne V. Cusick, a colon and rectal surgeon affiliated with Memorial Hermann-TMC and UT Physicians Colon and Rectal Center -- Southeast.
DIY: Change your diet: Limit carbonated sodas or alcohol. Don’t use straws. Add a Probiotic dietary supplement or over-the-counter products, such as Gas-X or Beano.
RX: You needn’t see your doctor unless you also have sudden bowel habit changes or abdominal discomfort.
URGENCY: “Flatulence is normal,” Dr. Cusick says. “It’s not urgent unless you’re in pain.”
STATS: Passing gas becomes more likely as we age.
RANDOM FACT: You could buy gas deodorant such as Devrom, with a compound found in Pepto Bismol, “but it’s more recommended to change your diet than mask the odor.”

SYMPTOM: CONSTIPATION

LIKELY CULPRITS: Having only one or two bowel movements weekly? Suspects include a fiber-poor diet, inactivity, dehydration, a thyroid imbalance or medications for pain, diabetes or urinary tract infections (UTIs), Dr. Cusick says.
DIY: Bulk up on fiber-rich veggies and fruits, drink 64 ounces of water and walk or exercise up to 30 minutes daily.
RX: Your physician will review your diet, activity and meds and examine your colon if needed.
URGENCY: Serious ills are unlikely, but if constipation persists your doctor should “rule out anything big, bad or scary,” Dr. Cusick says, such as colorectal cancer or diverticulitis (in which intestinal pockets are inflamed). “Substantial, consistent bleeding warrants an ER visit.”
STATS: While occasional constipation is normal, “no women in their 30s should have persistent constipation,” Dr. Cusick says.
RANDOM FACT: Your pain may be abdominal, but the problem could be in your neck. Around age 60, women’s thyroid glands can churn certain hormones sluggishly.

SYMPTOM: EXTREME SWEATING

LIKELY CULPRITS: Sweat is vital to lower body temperature in extreme heat. (Hello, Houston!) Anxiety, stress, hot drinks, caffeine, spicy food, obesity, scalding showers or peri-menopause also spur perspiring. But if your hands are slick and your clothes are drenched—even in winter—you may have a genetic disorder, hyperhidrosis, says Dr. Sidra Yunas, who is board certified in obstetrics and gynecology and affiliated with Memorial Hermann -- Texas Medical Center.
DIY: Use antiperspirant, which blocks sweat ducts, not deodorant, which only tries to mask odor, Dr. Yunas says. Shed weight, and curtail spicy foods such as curry, onion, garlic and hot sauce. Switch to cotton and other breathable or wick-away fabrics.
RX: Dermatologists, ob/gyn and family physicians can prescribe stronger antiperspirants or inject Botox and similar drugs to paralyze or block sweat glands.
URGENCY: “Hyperhidrosis is not dangerous in itself—just distressing,” says Dr. Holzman. But night sweats accompanied by fever or coughing could signal tuberculosis or other infections in those under 35.
STATS: One to five percent of men and women suffer hyperhidrosis. If a parent has the condition, one in four offspring also will.
RANDOM FACT: A rare defect can make sweat blue, green or black, Dr. Holzman says.

SYMPTOM: BAD BREATH

LIKELY CULPRITS: Without brushing or flossing thoroughly, bacteria can grow, releasing sulfuric compounds reeking of rotten eggs. Auto-immune diseases as well as decongestant, blood-pressure, colon and antidepressant drugs can cause dry mouth, Dr. Holzman says, and lacking saliva fuels bacteria, the root of morning breath.
DIY: Drink more water but avoid pungent sulfuric foods such as garlic and onions. Brush twice daily, and floss and tongue-scrape once, Dr. Holzman says. Sugar spurs germ growth, so trim it from your diet. Instead chew sugar-free gum with xylitol, which boosts saliva, your mouth’s own rinse.
RX: Increase dental visits to treat cavities and gum disease. Better-fitted dentures and retainers may help, Dr. Yunas says. Your doctor may change your meds and treat strep throat, sinus infection or gastro-intestinal acid reflux.
URGENCY: Pain and fever merit prompt dental visits to screen for dental abscess or infection in the soft tissues of the mouth, such as tonsils, Dr. Holzman says.
STATS: While a third of adults have bad breath, one fourth of those who seek medical aid do so needlessly, Dr. Cusick says.
RANDOM FACT: Wait an hour between brushing teeth and rinsing with mouthwash, Dr. Yunas says. Otherwise, detergents in toothpaste may deactivate germ-fighting chemicals in mouthwash.

SYMPTOM: UNCONTROLLED BLADDER

LIKELY CULPRITS: Spicy foods, caffeine and alcohol are among causes. Urinary tract infections, diabetes, stroke, moderate dementia, obesity, chronic coughs and Parkinson’s Disease raise risk, says Dr. Hajar Ibrahim Ayoub, assistant professor of surgery in the division of Urology, Urinary Tract and Pelvic Reconstruction at McGovern Medical School at UTHealth. Also, childbirth weakens pelvic muscles, creating issues later in life. The most common types of urinary leakage are urge incontinence (leakage with a sudden uncontrollable urgency), stress incontinence (leakage with coughing, sneezing or physical activity) or a mixture of both.
DIY: Ditch spicy foods, carbonated beverages, caffeine, nicotine and alcohol, which trigger bladder spasms. Oddly, you should drink more water. Otherwise, crystals in concentrated urine can irritate the bladder and worsen urgency.
RX: Seek care if you’re depressed or avoiding company and exercise for fear sneezing, coughing or walking will trigger an “accident,” or if you find yourself constantly looking for the bathroom and needing to go Dr. Ayoub says. Your physician may wean you from leak-promoting over-the-counter antihistamine, cough and allergy meds, as well as prescription diuretics, sedatives, muscle relaxants and blood-pressure drugs, while checking for UTIs in those with sudden-onset of incontinence. If needed additional tests and/or images can rule out less likely causes, such as kidney/bladder stones or cancer, etc. Kegel exercises and other pelvic floor muscles physical therapy techniques with lifestyle modifications is typically the first line treatment.
If physical therapy fails for “urgency”, further treatment from a urologist might be needed.
RANDOM FACT: Many people with urinary incontinence also have bowel issues since nerves controlling both originate from the same root nerve

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The information presented in this article is educational and not intended as medical advice or the practice of medicine. Specific aspects of your outcomes and care should be addressed and answered after consultation with your physician.

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