Tak­ing the Worry Out of Em­bar­rass­ing Con­di­tions

Oh, those em­bar­rass­ing bod­ily func­tions! Here’s what hap­pens to your body as you get older – and what you can do about it

Reader's Digest Asia Pacific - - Cover - BY JULIE STE­WART

1 WHY HAVE I SPRUNG A LEAK?

EV­ERY­BODY LOVES TO LAUGH, but what if a good joke makes you squirt a lit­tle? Stress uri­nary in­con­ti­nence is pretty com­mon, says Dr Alan Wein, chief of urol­ogy at the Perel­man School of Medicine at the Univer­sity of Penn­syl­va­nia. “The re­sult is, peo­ple can leak when they laugh, cough or sneeze.”

Blame the age­ing body. “The nerves and struc­tures that hold things in place, and pre­vent the ure­thra from mov­ing ex­ces­sively when you laugh, cough or sneeze, de­te­ri­o­rate,” he says. Pelvic mus­cle tears suf­fered dur­ing child­birth in­crease risk in women, while prostate surgery in­creases risk in men, says Wein.

ONE SO­LU­TION? Hit the loo more of­ten. This leaves less fluid to leak from your blad­der. Also, learn to squeeze: con­tract your pelvic mus­cles as if stop­ping your urine mid­stream. Do this for ten sec­onds, ten con­trac­tions, ten times a day to strengthen your uri­nary sphinc­ter mus­cles, and then squeeze when you cough or sneeze.

Not­ing what you eat and drink and when you go to the bath­room or leak will help your doc­tor de­ter­mine whether you have stress in­con­ti­nence or ‘ urge in­con­ti­nence’ (when your blad­der mus­cles con­tract be­fore your blad­der is full). Your doc­tor may ad­vise med­i­ca­tion or surgery, and can check for in­fec­tion or blad­der can­cer.

2 WHEN DID MY BREATH GET GROSS?

MOST BAD BREATH ODOUR is bred on the back of your tongue, says Pa­tri­cia Len­ton, di­rec­tor of the Oral Health Clin­i­cal Re­search Cen­ter at the Univer­sity of Min­nesota. Your tongue is like a shag car­pet, she says, and bac­te­ria hide be­tween the bumps. As we age, we take more med­i­ca­tions, and many cause dry mouth, ex­ac­er­bat­ing bad breath.

SOLUTIONS IN­CLUDE clean­ing your tongue with a smooth-edged tongue scraper, says Len­ton. “Start as far back as you can.” A mouth­wash with zinc and cetylpyri­dinium chlo­ride (CPC) is your best bet against stinky mouth bac­te­ria, stud­ies sug­gest.

When your mouth is at an al­ka­line pH, volatile sul­phur com­pounds are

re­leased. When you eat, your mouth be­comes more acidic, re­duc­ing the stench, adds Len­ton.

Get checked to rule out tooth de­cay and gum dis­ease, or even an un­der­ly­ing health prob­lem, such as a chronic si­nus in­fec­tion or kid­ney dis­ease. 3 WHAT’S HAP­PEN­ING TO MY TOENAILS? CRACKED, BRIT­TLE, dis­coloured and thick nails from a fun­gal in­fec­tion are em­bar­rass­ing, es­pe­cially if you like open-toed shoes. Fun­gus feeds on the nail, dam­ag­ing it, says Dr David Tran, an as­sis­tant pro­fes­sor at the Cal­i­for­nia School of Po­di­atric Medicine at Sa­muel Mer­ritt Univer­sity. Age is the big­gest risk fac­tor, ac­cord­ing to a pa­per pub­lished in PLOS Pathogens. Peo­ple with di­a­betes and con­di­tions that limit cir­cu­la­tion are also sus­cep­ti­ble.

Early treat­ment with a pre­scrip­tion top­i­cal so­lu­tion is best. A more se­vere in­fec­tion may need oral med­i­ca­tions that re­quire liver checks for harm­ful side ef­fects, Tran says. Laser treat­ment may be an­other op­tion worth in­ves­ti­gat­ing.

SEE A DOC­TOR if your nails change markedly. A par­tic­u­lar pat­tern of ­dis­coloura­tion can be the re­sult of skin can­cer, which is of­ten di­ag­nosed late when it oc­curs un­der nails. 4 WHO MOVED THE BATH­ROOM? IF YOU’VE EVER lost con­trol of your bow­els be­fore get­ting to the toi­let, don’t freak out – you have plenty of com­pany. A re­cent peer-re­viewed US study re­ports that fae­cal in­con­ti­nence, also known as ac­ci­den­tal bowel leak­age (ABL), af­fects around 15 per cent of peo­ple over 70.

“As we get older, our nerves and mus­cles de­gen­er­ate,” says Dr Satish S.C. Rao, di­rec­tor of the Di­ges­tive Health Cen­ter at Au­gusta Univer­sity in Ge­or­gia. The same squeez­ing ­ex­er­cises that help with uri­nary ­prob­lems can also strengthen your anal sphinc­ter, giv­ing you ex­tra time to get where you’re go­ing.

Be­cause cer­tain foods can cause prob­lems, ask a gas­troen­terol­o­gist for a breath test to see whether you prop­erly metabolise foods that in­clude the fruit sugar fruc­tose, the milk sugar lac­tose, and fruc­tan, a string of

mol­e­cules in foods such as wheat prod­ucts, onions, gar­lic and ar­ti­chokes, rec­om­mends Rao. IN SOME PEO­PLE, the rec­tum – usu­ally a ‘com­pli­ant reser­voir’ – stiff­ens into a tube that can’t ac­com­mo­date pile-ups. In this case, your doc­tor may use a bal­loon to stretch your rec­tum, or rec­om­mend surgery. Also see your doc­tor if you have chronic di­ar­rhoea, blood or pus in your stool, fever, di­ar­rhoea at night, de­hy­dra­tion or un­ex­pected weight loss.

5 WHERE DID TH­ESE SPOTS COME FROM?

MOST DARK SPOTS caused by the sun are not dan­ger­ous, but a der­ma­tol­o­gist can help you stay on top of chang­ing pat­terns that can sig­nal prob­lems, says Dr Jane Grant-Kels, di­rec­tor of der­matopathol­ogy at the Univer­sity of Con­necti­cut.

About 14 per cent of mid­dle-aged peo­ple have harm­less brown spots, also known as age spots, notes a study in PLOS One. Th­ese ap­pear more as you age, in places ex­posed to UV rays, such as your face, hands and fore­arms. Use a skin-light­en­ing cream. A der­ma­tol­o­gist can zap them with ­liq­uid nitro­gen or a laser.

Se­b­or­rheic ker­atoses – ge­netic wart-like growths that range in colour from yel­low to brown to black – are harm­less. Grant-Kels en­cour­ages most pa­tients to leave the spots alone, but a der­ma­tol­o­gist can freeze them for you. Red bumps called cherry an­giomas – clus­ters of di­lated blood ves­sels – are be­nign, but a doc­tor can freeze them off or ex­cise them with a laser or a scalpel. IF ANY SKIN SPOT CON­CERNS YOU, see your der­ma­tol­o­gist. Aus­tralia and New Zealand have the high­est ­in­ci­dences of skin can­cer in the world, ac­cord­ing to Can­cer Coun­cil Aus­tralia and Melanoma New ­Zealand. Symp­toms for basal and squa­mous cell can­cers in­clude an ­un­usual growth that doesn’t heal. Signs of melanoma in­clude a new spot, or one that itches or changes size, shape or colour, or a sore that doesn’t heal.

6 IS IT ME, OR IS MY NOSE GET­TING BIG­GER?

AL­THOUGH THE BONES in our faces stop grow­ing around age 15, the car­ti­lage in our noses and ears con­tin­ues to stretch, says Dr Steven Daveluy, an as­sis­tant pro­fes­sor of der­ma­tol­ogy at Wayne State Univer­sity in Michi­gan.

Around mid­dle age, the bones and fat in our cheeks sink in­wards, ­mak­ing our noses look more pro­nounced. “Maybe it got only less than one ­mil­lime­ter larger – be­cause the cheeks shrunk, it adds up,” Daveluy says. In ad­di­tion, grav­ity pulls your ear­lobes, es­pe­cially if you’ve spent years wear­ing heavy ear­rings.

AP­PLY­ING SUNSCREEN to your nose and ears daily will help stave off age-re­lated dam­age that makes skin droopy, Daveluy says. But cos­metic surgery is the only way to shrink your nose or ears.

If your nose is thick­en­ing and red, you might have rhino­phyma, a ­com­pli­ca­tion of un­treated rosacea. See your doc­tor; med­i­ca­tion, laser treat­ment or surgery can help.

7 WHY DID I GET SO GASSY?

WHEN THE BAC­TE­RIA in your gut fer­ment food in your colon, gases such as hy­dro­gen and car­bon diox­ide are re­leased, caus­ing even healthy peo­ple to pass gas up to 20 times a day. As we age, some peo­ple let go more of­ten and with more odour. For in­stance, some de­velop trou­ble di­gest­ing lac­tose, mak­ing them feel bloated and caus­ing more erup­tions.

An over-the-counter anti-gas medicine with sime­thicone can break up gas bub­bles. Swal­low pro­bi­otics. When taken con­sis­tently, th­ese good bac­te­ria can help calm gas, bloat­ing and other com­po­nents of ir­ri­ta­ble bowel syn­drome, ac­cord­ing to a study re­view pub­lished in the Amer­i­can Jour­nal of Gas­troen­terol­ogy. Or spoon up a daily help­ing of 140–230 grams of pro­bi­otic yo­ghurt.

Some peo­ple strug­gle with gas, bloat­ing and belch­ing be­cause they suck in too much air when they drink fizzy bev­er­ages or smoke cig­a­rettes. “It’s funny how of­ten this comes up,” says Dr Wil­liam Chey, di­rec­tor of the GI Nu­tri­tion and Be­hav­ioral Well­ness pro­gram at the Univer­sity of Michi­gan. “Peo­ple come in for bloat­ing and

belch­ing, and they’re drink­ing eight Diet Cokes a day.” Also, avoid con­sum­ing a lot of sugar-free sweets and gums con­tain­ing sugar ­al­co­hols such as sor­bitol, man­ni­tol and xyl­i­tol. Your body can’t ab­sorb them, and that can cause bloat­ing and gas.

IF GAS, BLOAT­ING OR BURPING

strikes of­ten, a gas­troen­terol­o­gist can help ­de­ter­mine if you have a chronic ­prob­lem di­gest­ing cer­tain foods, says Rao of Au­gusta Univer­sity.

8 WHAT DID YOU SAY?

MANY PEO­PLE SUF­FER some agere­lated hear­ing loss in one or both ears: 8.5 per cent of those aged ­55-64; 25 per cent of those aged 65-74; and half of all peo­ple over 75. While all those rock con­certs didn’t help, there are other con­trib­u­tors, in­clud­ing age­ing, ge­net­ics, smok­ing, a poor diet and di­a­betes, says Dr Craig New­man, sec­tion head of au­di­ol­ogy at the Cleve­land Clinic. Th­ese all de­stroy hair cells in the in­ner ear that send au­di­tory sig­nals to your brain.

GET A HEAR­ING AID. Once hair cells are dam­aged, they’re ka­put. And the longer you wait, the harder it will be to treat. For­tu­nately, the brain can ­‘ re­learn’ the abil­ity to hear. “That means you have to ‘teach’ your brain to hear again, by wear­ing hear­ing aids reg­u­larly,” New­man says.

But if you sud­denly lose most, or all, of your hear­ing, “get to the doc­tor within hours,” New­man cau­tions. ­De­pend­ing on the cause – virus, ­re­ac­tion to med­i­ca­tion or, in rare cases, be­nign tu­mours called acous­tic neu­ro­mas – steroids or an­tivi­ral med­i­ca­tions can help. Sud­den dizzi­ness and hear­ing loss with ring­ing in the ears should also get you to a ­doc­tor as soon as pos­si­ble.

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