Pelvic Congestion Syndrome 1 1

Let’s Talk About Pelvic Congestion Syndrome

Millions of women world-wide suffer from chronic pelvic pain. One of the causes of chronic pelvic pain is a condition called Pelvic Congestion Syndrome and it is not often talked about. I thought it was important to share this information to bring more awareness to this syndrome.

Pelvic congestion syndrome does share many of the same symptoms of endometriosis and adenomyosis and it important to have proper differential diagnosis and rule other causes of pelvic pain out first. Sometimes the varicose veins that cause pelvic congestion syndrome can be present alongside endometriosis and adenomyosis, or other pelvic issues.

In the past, a diagnosis of chronic pelvic pain left many women frustrated with few treatment options and a lack of available resources. Their doctors were often left perplexed, despite the endless negative laboratory test and imaging data as well as inconclusive consultations obtained.

In the last 10 years, improved medical understanding and increased awareness have lessened the confusion surrounding this condition and its distinct association with pelvic congestion syndrome (PCS). There are now more minimally invasive surgical solutions which give affected patients more treatments choices as well.

So what is Pelvic Congestion Syndrome (PCS)?

Pelvic congestion syndrome (PCS) is a chronic condition that occurs in women when varicose veins form below the abdomen within the pelvic region. Pelvic congestion is just like the varicose veins that some women have in their legs, but it affects the veins of the pelvis. Blood backs up in the veins, making them become enlarged and engorged. Pelvic congestion can also cause chronic pelvic pain in some women.

What are the symptoms of Pelvic Congestion Syndrome?

The main symptom of pelvic congestion syndrome is pelvic pain that lasts at least 6 months. The pain may be a heavy or aching feeling. Or the pain may be sharp. Usually the pain is only on one side, usually the left side. At times you may feel it on both sides. The pain is often worse at the end of the day. If PCS occurs in pregnancy it often first starts during or after a pregnancy. It may worsen after a later pregnancy.

Symptoms of Pelvic Congestions Syndrome can include the following.

  • Pain starts 7-10 days before your period
  • Pelvic pain is worse when you sit or stand
  • Lying down relieves pelvic pain
  • Varicose veins around the vulva, buttocks, and legs
  • Abnormal vaginal discharge
  • Swelling of the vagina or vulva
  • Tenderness of the abdomen
  • Pain during sex
  • Dysmenorrhea (painful menstruation)
  • Abnormal bleeding during menstruation
  • Backache
  • Depression
  • Fatigue
  • Increased urination
  • Irritable bowel symptoms
  • Hip pain
  • Lower back pain
  • Aches in your legs

The syndrome often causes a constant dull pain in the pelvic area that is said to worsen at different times of the cycle and in different situations. Experts believe it can be the source of pain in up to 30% of women who have chronic pelvic pain.

How is at Risk?

It’s more likely to develop in women who have previously given birth, but it can be found in women who have not had children. It is also hereditary so if someone in the family has it, you may be at a higher risk of having it.

What Are The Causes of PCS?

It is still not fully understood what the cause of pelvic congestion syndrome is. There may be multiple factors and causes.

Enlarged veins in the pelvis seem to play a major role. These large veins do play a major role in those that have chronic pelvic pain, but many women have enlarged veins and no symptoms.

Pregnancy may increase the risk for pelvic congestion syndrome. This is because veins enlarge during pregnancy to support the increased blood flow. This can permanently enlarge the veins and lead to symptoms.

Just like endometriosis and adenomyosis, hormones may also play a role in pelvic congestion syndrome. It is though that estrogen may play a big part of this by making veins wider (dilates). We do know that estrogen does drive disease inflammatory states. We also know that PCS is less common after menopause when estrogen levels tend to be lower.. Other hormones may also cause veins to grow wider and cause symptoms.

Excess weight and increased body fat may also cause increased inflammation and estrogenic response that leads to pelvic congestion syndrome.

Other factors such as dietary and lifestyle factors may exacerbate this condition as well.

How is it diagnosed?

PCS can be quite difficult to diagnose, and will need a multimodality approach to be able to firstly diagnose this properly and then apply appropriate treatment. PCS often requires a multidisciplinary approach because the differential diagnosis is quite long and varied. As mentioned before, some of the symptoms are the same as other inflammatory conditions such as endometriosis and adenomyosis. Multiple diagnostic procedures are needed to eliminate other possible causes for your symptoms. These procedures can include:

  • Ultrasound
  • Laparoscopy (keyhole surgery)
  • CT scan
  • MRI scan
  • Venogram

Ultrasound is often preferred as the first step in diagnosing PCS, as it is possible to detect the varicosities as well as assess the blood flow. The only problem with ultrasound is that is that it may not always pick the varicosities up.

MRI may be needed, but even then, laparoscopy is the only procedure to definitely diagnose this condition. I often explain to women that if they have been in pain for a long time, the best option is a laparoscopy. This can also be used to exclude other pelvic pathology and also check to see if there is endometriosis etc too. Sometimes the varicosities may need to be tied off surgically as well and can be done via laparoscopy. Laparoscopy is the gold standard investigation of the pelvis and why it is the best option.

There may need to be input from other health professionals and modalities such as gynaecologists, anaesthesiologist, gastroenterologist, advanced trained laparoscopic surgeon, neurologist, haematologist, oncologist, psychiatrist, and urologist or urodynamic specialist may also be necessary. If someone sees a lot of this syndrome then they will be able to differentiate this without the need of involving too many other areas of medicine, but all other pathology and disease states do need to be carefully ruled out first.

When I help women with PCS, I have a very specialised team of healthcare professionals I work with that see this syndrome often and know what to look for very quickly and promptly. This is why it is very important to see the right people who know about these particular areas of women’s health conditions.

Treatments for Pelvic Congestion Syndrome 

Treatment for pelvic congestion syndrome is usually aimed at reducing and alleviating symptoms. Unfortunately, like endometriosis, there is no definite cure for the condition, and it can be challenging to treat if you don’t get to see the right healthcare practitioner, or healthcare team.

There are medications available to help relieve symptoms of PCS and these can include:

  • NSAIDs (nonsteroidal anti-inflammatory drugs)
  • chronic pain medications (such as gabapentin plus amitriptyline)

The most successful treatment currently is a minimally invasive surgical procedure called pelvic vein/ovarian vein embolization (PVE/OVE). This procedure blocks off the faulty varicose veins so that they can no longer enlarge with blood, thereby relieving the pain. that are believed to be the source of pain.

Embolization (PVE/OVE) offers a safe, effective, minimally invasive treatment option that is less expensive to surgery and less invasive. It is an outpatient hospital procedure which requires only conscious sedation. Once the procedure is performed, you can return home a few hours later the same day. Medical literature shows that the procedure provides complete or partial relief in approximately 90% – 95% of the cases. As with any procedure, there are risks, and not all women may be appropriate for this treatment option.

A laparoscopy may still be needed to definitely diagnose the varicose veins first, before embolization can be performed. This is why diagnosis and treatment of PCS does require a step by step multimodality approach. This is something that needs to be clearly understood.

Outlook

PCS isn’t a condition that is life threatening, but it does have the potential to significantly affect your quality of life. Symptoms such as chronic pain, pain during sexual intercourse, and dysmenorrhea can lead to a decrease in physical activity, loss of function, and depression. It can make daily life very hard and make it difficult to function in your personal and work life.

A diagnosis does not necessarily mean you will be affected to this extent and PCS varies greatly in terms of severity for each person. Not all women with PCS will have their daily life affected and some do not get pain at all.

The good thing is that there are treatments available to minimize the symptoms and help sufferers cope with this condition. It is important that you talk to your healthcare practitioner if you do have any of the symptoms of PCS.

It’s also important to talk to your healthcare practitioner about counseling, if needed, to help you cope with the significant chronic pain that can go along with having PCS. Chronic pain can impact on an emotional and psychological level and this can then lead to further exacerbation of pain. Many people just do not realise the impact the stress and emotions and mood disorders can have on pain conditions.

Last word

If you do have chronic pelvic pain and need assistance with diagnosis and management please give my friendly staff a call and ask how I may be able to assist you. I also work in with a good network of healthcare professions to help my patients get the best care possible. My motto is No Stone Left Unturned and I apply this to everyone that comes to see me for assistance with their health condition.

Regards

Andrew Orr

-No Stone Left Unturned

-Master of Women’s Health Medicine

-The Women’s Health Experts

 

 

10 Common Mistake seen with

10 Common Mistakes Seen With Endometriosis

1 in 10 women are diagnosed with endometriosis and it often takes up to 10 years to be diagnosed. The number 10 seems to be a recurring theme. So, for this post I am going to talk about the 10 common mistakes seen with endometriosis. Hopefully this helps to create some more awareness about this horrible disease and helps those who are suffering, or have not been diagnosed yet.

Below are the ten common mistakes I see with endometriosis.

1. Believing surgery has cured their disease

Many people with endometriosis are often led to believe, or have been told, that once they have surgery that their endometriosis is cured.

There is no cure for endometriosis, so surgery is not a cure. Hysterectomy is not a cure either.

All surgery does is deal with the expressed disease and that is it. It does not prevent further regrowth of the microscopic implants of endometriosis that are waiting to express and develop into lesions again. While surgery is a very valid medical option to address acute pain caused by the disease, it is not a cure. It only helps with symptomatic relief.

2. Not doing follow-up management of the disease after surgery

We know that despite the best medical interventions that women with endometriosis often will still be in pain, or have further expression and regrowth of the disease.

As mentioned previously, surgery is a valid treatment option for acute pain and for when hormones and medications are not working. But, from my experience I do see many have the surgery and then are not doing any ongoing management, except for pain medications. This isn’t necessarily the person’s own fault either. Many are also poorly managed post surgery and are not aware that they will need ongoing management of their disease state. As mentioned, many are literally just unaware that their disease can, and will grow back without ongoing support and healthcare management. It is crucial that all women with endometriosis receive ongoing care and management of their disease from an appropriately trained endometriosis expert.

3. Endometriosis care requires a multimodality/team approach

There is no one single medicine, or modality, that can effectively deal with endometriosis and this is why a multimodality/team approach is needed.

Surgery is just one treatment approach, which is also needed to definitively diagnose the disease, and then for when the disease is acute and nothing else is working. But surgery alone is not adequate to deal with the disease as a stand alone therapy.

Endometriosis is estrogen driven so there does need to be some form of progesterone support to help suppress further expression of the disease. This can be in varying forms and something I will discuss in another post.

There also need to be support of the microbiome and working on the microcirculation to the pelvic area and reproductive organs. There also need to be ongoing emotional support and care such as counselling, or psychology

There also needs to be dietary changes (low inflammatory based diet), physiotherapy, exercise, complementary medicines, acupuncture, nutritional medicine other modalities. All of this can be done alongside ongoing medications and medical support. Each individual with the disease has different symptoms and will require different multimodality care and support, based on their individual needs.

4. Not seeing the right surgeon

I know I always talk about it, but this is because many who are suffering from endometriosis and the associated symptoms, just have not seen the right person in the first place.

In every profession there is good and bad. There are those who specialise in a certain area, and there are those who don’t. The same goes for medicine and the same goes for surgeons too.

When needing a diagnosis, or surgical intervention for endometriosis, it is imperative to see an advanced trained laparoscopic surgeon who specialises in the excision of endometriosis. This way you also know that this surgeon is not only advanced trained and highly skilled, but also specialises in endometriosis and every aspect of it.

Not all gynaecologists and surgeons specialise in endometriosis and some dabble in it and are not highly skilled in the actual surgical requirements to effectively excise the disease properly. Some surgeons do not even do excision surgery and tend to just to ablation only. This is not how you surgical deal with endometriosis.

These advanced trained surgeons also have to do a certain number of surgeries per year to attain the status of being advanced trained. Someone who does a few surgeries here and there is definitely not advanced trained. These advanced trained surgeons also do extra years of surgical training and are the best of the best and why anyone who is suspected of having endometriosis, or has endometriosis need to see these surgeons only.

Too many women are under-serviced surgical, by poorly skilled surgeons, who are not specialised in endometriosis and who are not advanced trained and this is where all the problems start. It can also lead to making the patient worse and only leads to further suffering and years of pain as a result. It also means that the advanced trained surgeons then have to fix up the mess these other surgeons created.

The hard thing is some women are limited by demographic and location when it comes to being able to see an advanced trained surgeon. Unfortunately most of them do private work, and any in the public system have long waiting lists and may only do one day a week public surgical lists. You may not even get to see them unless you see them privately first and they put you on there public waiting list.

5. Not seeking help and intervention early enough

There is two parts to this that need attention and need discussion. We know that it often takes up to 10 years (or more) to be diagnosed with endometriosis. This means that a hell of a lot of women are being missed and dismissed by GP’s, allied healthcare practitioners, complementary medicine practitioners, specialists and so forth. This isn’t meant to be negative, or an attack on any one profession. These are the facts and something that cannot be ignored. It also needs to be discussed.

Then we also have parents waiting way too long to seek help for daughters, using the wait and see if it will go away approach. I see this often and I am often getting asked if a parent should just wait and see if their daughters pain will magically disappear. I often have to point out that if my daughter was passing out, or laying on a bathroom floor crying with pain, I would not be waiting to see if it was going to go away. Early intervention is the key to any disease. The wait and see approach is often the reason many women end up with years of fertility issues and years of pain, and other associated symptoms of endometriosis. The longer a disease is left to spread, the more damage it does, and the harder it is to treat.

Teenagers are not too young to have endometriosis and we are now seeing young girls as young as 5 years old having endometriosis found.

The other issue we see if women who know that they have the disease, putting off seeing someone for fear of more surgery, or fear of being dismissed. Again, this only leads to further complications and disease growth and thing being harder to treat.

Once a woman has endometriosis, the reality is that she may need further surgical intervention. But, it is needed to help with symptomatic relief and reduce inflammatory response in the body. The other thing is that by going and seeing someone who specialises in endometriosis, they are trained to help you manage your disease properly.

There may also be some non-surgical options that can be used and help with symptoms and disease management as well. But, you need to go in the first place, to get the help you need. Please do not put off getting your health and disease state managed properly. If you are in a bad place with your disease, make sure you get on that phone and book yourself in with someone who specialises in endometriosis.

6. Trying to manage the disease by yourself

I’ve covered this a bit in the last statement, but so often I see women trying to manage endometriosis themselves. This only leads to a vicious cycle that keeps going around and around and nothing good ever comes of it. The disease does not get managed properly, the symptoms get worse and then it all becomes way harder to effectively treat and manage.

Sometimes if things are left too long, there can be permanent damage that is not repairable. This is definitely why people should not try to manage their own disease and symptoms themselves.

If your disease state and associated symptoms are out of control and you aren’t being managed properly, please get on that phone and book in to see someone as soon as possible. Do not put it off any longer. Now is the time to do something about it, not tomorrow, or next year.

7. Getting medical advice from support groups

I am a big advocator of anyone with a long-term health issue receiving emotional and physical support. It is a must. But, it needs to be via trained professionals who are specialised to help you properly.

While I am also a big fan of support groups, I am not a fan of non-medically trained, non-healthcare people giving healthcare and medical advice to people within these groups. I love seeing the emotional support in these groups, but I don’t love it when I see people getting medical advice about medications, hormones and medical procedures. This is dangerous. I’ve even seen advice given on how to take ones own IUD out and this is when I have to speak out.

By getting medication advice, medical advice, surgical advice and any other healthcare advice from someone who is not appropriately trained, you are actually putting yourself in great danger. Please do not take the advice of anyone who is not a healthcare practitioner, or a specialist in endometriosis. Sure, get the emotional support from like minded people, and people who understand what you are going through, but leave it there.

The other thing is just being careful of not getting caught up in some of the negativity of some groups, where you also then start to focus and become your disease. You are not your disease and to move forward you need proper healthcare and lots of positivity.

8. Letting pain and associated symptoms get out of hand

Some of this I’ve also spoken about, but this is one thing I see often as well. Many people are at a point of self-managing with pain medications that are not working effectively any longer. This then leads to increased reliance and dependence of pain medications and it can also lead to increase pain and associated symptoms.

I have talked about pain medications and the withdrawal affects in previous posts. I have also talked about how increased pain medication use can actually cause pain and lead to further inflammation in the body. I have also talked about the addiction of pain medications too. It is a catch 22 situation. (Click here to see previous posts mentioned)

The point I am trying to make here is that if your pain levels and associated symptoms are getting out of hand, then you need to do something about it. Please do not try and manage your pain and symptoms on your own. Increasing your medications can have detrimental effects on your body and long term health consequences.

If you have to increase your pain medications, it means something is drastically wrong and that your pain levels need urgent professional attention. Your endometriosis expert/specialist is trained to help you get your pain levels and associated symptoms managed properly.

There may also be something else going on that could be sinister and require urgent medical attention. Never presume that all your symptoms are related to your disease. Seeking proper medical health and ongoing management, could just save your life.

9. Buying into the label and letting your disease own you

Having a chronic health condition myself, I know all too well how easy it is to fall it the trap of buying into the label of the disease. I also know all too well by doing this, you are letting the disease own you.

I also understand how hard it is on the bad days, not to get down about everything and think that there is no help, and how unfair things are. Yep, I truly get it. But, I also know that the more one focuses on the negative, and constantly lives in the disease state, the harder it is to truly move forward and get better.

Our thoughts and being negative can exacerbate pain pathways and they can also disrupt the healing pathways as well. If you listen to people that have overcome and illness, or a disease, they will always tell you it was by getting the right help and being positive. Positive mental outlook is very underrated in healthcare and its healing effects.

This is why I sometimes mention about being careful in certain support groups, where the focus is constantly on the disease, the label, and the negative. It isn’t good for anyone when that is all you hear. You need support, but you need to surround yourself with positive people, see the right healthcare team and also remember that you are not your disease, and it does not own you.

10. Believing that there is no help out there

I know many people have had a hard time and some have really had a terrible journey getting to where they are now. It is one of the reasons I am so big on giving people the facts about this horrible disease and trying to help women get the proper help they need. It is also the reason I do what I do now.

Having lived with a chronic disease and having dealt with my share of really bad experiences, I know all too well what many of you have been through. I thoroughly get it and I understand on all levels.

While many people have been missed and dismissed and many have seen their fair share of terrible healthcare practitioners, I do need to point out that there are some very good ones also. Never let your last experience by carried over with you. Not all healthcare practitioners are bad. There are actually some amazing practitioners out there who are experts in endometriosis.

Like I have said before, in every profession there is good and bad and this is why it is important to do your homework. Don’t just go off a friend’s recommendation, or some recommendation from your mother. Do your homework and make sure the person you are seeing actually specialises in your disease. You also need to be realistic that you need a multimodality team approach, and that you may need to see a few practitioners within a network of specialists.

When you do find someone you think may fit the profile of a true endometriosis specialist, make sure when you see them that they take a full history, listen to all your concerns, give you appropriate care and advice and are empathetic in helping you move forward with appropriate care and health management.

The one thing I tell people is to not go in with a negative attitude based on previous bad experience either. This can then lead to further angst and anxiety and could get a good practitioner offside too. At the same time, while you need to not take your last experience with you, you do need to make sure the person you are seeing is right for you. It is all about balance and not judging each person you see as being the same.

But, if the person you do see has no idea, then don’t be scared to say “Thanks, but not thanks” and be on your merry way. There is no harm in getting multiple opinions and the honest truth is that is what you need to do. Never just take ones person’s advice and be done with it. Get a second, or third, or tenth opinion if you have too.

Last, but not least, if you are struggling and are at a point you believe there is nobody to help you, please remember there is always someone out there. Never give up hope about that. There are some amazing people out there who will know how to help you properly and get you the help and care you need. You just need to find them. There are endometriosis experts out there and when you find them, they will help you.

Final word

If you do need help and assistance with endometriosis, or need help getting diagnosed properly, please give my staff a call, or send an email, and find out how I may be able to assist you. I do consultations in person and online as well. There are some conditions with online consultations, but my staff will explain all this too you. You may also need to come and see me in person, so I can make sure you get all the appropriate investigations and testing done too. I also have a team of experts I work and refer to as well. I do see people from all over Australia, far and wide, and some from overseas as well.

Take care

Regards

Andrew Orr

-No Stone Left Unturned

-The Endometriosis Experts

 

Microbiome

The Importance Of Properly Restoring The Microbiome For Optimum Health

One of the things I teach my patients is the importance of properly restoring the microbiome for optimum health and also reducing inflammation in the body.

Many people’s daily bloating, fluid retention, gastrointestinal symptoms, health issues, chronic disease states are being exacerbated by an unhealthy balance in this unique ecosystem we call the microbiome.

The problem is that many people do not really understand the importance of the microbiome, and even many healthcare professionals do not fully understand how to help with proper microbiome repair and restore.

Many people are also led to believe that by just taking probiotics, that this is enough to restore the healthy bacteria in the gut/microbiome.

I wish it was that easy, but it isn’t and this is why many people continue to have gastrointestinal issues, inflammation and chronic health issues, despite thinking that are doing the right thing for their gut health.

What is the Microbiome?

The human gastrointestinal tract (GIT) is host to an extraordinary amount of microorganisms composed of bacteria, viruses and microbes, collectively known as the microbiome. The microbiome is the name given to all of the genes inside these microbial cells.

Every human being has anywhere between 10 trillion and 100 trillion microbial cells all working together in a symbiotic relationship. This benefits both the microbes and their hosts, as long as the body is in a healthy state.

Recent scientific advances in genetics mean that humans know a lot more about the microbes in the body. There has been lot of time and money put into researching the interactions within the human body’s ecosystem and their relevance to health and disease.

The two terms ‘microbiota’ and ‘microbiome’ are often used to mean the same thing and are used interchangeably. I will explain the differences between them and how both are being used and researched in modern medicine.

You exist in a symbiotic relationship with your bacterial ecosystem, and there is a two-way relationship that makes your health inseparable from that of your microbiome and vice versa.

The benefits of a healthy microbiome/microbiota

The benefits of a healthy microbiome/microbiota, extend beyond the gut and digestive system and has a significant systemic impact on some the following:

  • Nutrient metabolism
  • Body composition (weight)
  • Cardiovascular health,
  • Chronic disease states
  • Inflammation in the body
  • Pain pathways
  • Immunity
  • Mental Health
  • Neuroendocrine function
  • Gene Expression

What is the Microbiota

The gut microbiota used to be called the microflora of the gut. The importance of the microbiota has been known for a long time, but now medical science is discovering just how important it is, and it is now becoming a cornerstone of preventive medicine.

The gut microbiota contains over 3 million genes, making it 150 times more genetically varied than the human body. The gut microbiota of each individual is very unique and it has a major contribution to how a person fights disease, digests food, and even his or her mood and psychological processes.

This symbiotic relationship greatly benefits humans. The presence of this normal flora includes microorganisms that are so present in the environment that they can be found in practically all animals from the same habitat.

However, while there are good bacteria found within these native microbes, some of these microbes also include harmful bacteria that can overcome the body’s defences that separate them from vital systems and organs. There are beneficial bacteria in the gut, and there are harmful bacteria that can cross into wider systems and can cause local infections of the GI tract. These infections can then cause infection and inflammation and can also worsen disease states in the body.

What is dybiosis?

The microbiome plays an important role in resisting intestinal overgrowth of externally introduced populations that would otherwise cause disease. In our microbiome, the “good” bacteria compete with the “bad,” with some even releasing anti-inflammatory compounds.

Bacterial dysbiosis produces an endotoxin called lipopolysaccharide (LPS). It is one of the most inflammatory substances known. LPS is also major contributor to the inflammation, which then drives many chronic health conditions and disease states.

These bad bacteria are called dysbiotic bacteria and cause a process called ‘dysbiosis’.

Broadly speaking, dysbiosis indicates the existence of either the wrong microbiota (e.g. overgrowth of bacteria, fungi and/or parasites) and/or the wrong numbers of the right microbiota (imbalances in composition), or either, in the wrong place.

Dysbiosis causes increased gut and intestinal permeability, which can lead to what we call leaky gut, or leaky gut syndrome. Dysbiosis can also consequent lead to up-regulation of inflammatory pathways and lead to increased inflammation in the body.

Dybiosis is implicated in many chronic diseases

Dysbiosis is very common it the western culture and bacterial dysbiosis is now being linked to causing, or exacerbating many health conditions and disease states. Research has found links between bacterial populations, whether normal or disturbed, and the following diseases:

  • Endometriosis
  • Adenomyosis
  • PCOS
  • Asthma
  • Autism
  • Auto-immune conditions
  • Cancer
  • Celiac disease
  • Colitis
  • Inflammatory Bowel Disease
  • IBS
  • Crohn’s Disease
  • Diabetes
  • Eczema
  • Heart disease
  • Malnutrition
  • Multiple sclerosis
  • Arthritis
  • Obesity
  • Metabolic Syndrome

What Causes Dysbiosis?

There are many things that lead to bacterial overgrowth, which then leads to dysbiosis. This is why many people suffer bloating, reflux, nausea, constipation, inflammatory bowel symptoms, and many other gastrointestinal symptoms daily.

Day-to-day risk factors include a western-based diet, overly hygienic living (being too sterile), alcohol, certain medications, hormones and the use of antibiotics.

Mood disorders, stress and being overly busy are also a big factors with creating dysbiosis and something that many overlook, or do not even realise. Yes, stress is a big factor in many gastrointestinal symptoms people experience daily.

With all these factors it means that almost everyone will have some degree of dysbiosis at some point in their life.

Many constantly have dysbiosis and why they often have long-standing digestive symptoms such persistent pain and bloating, constipation, alternating diarrhoea or other digestive imbalances. We also commonly see this with endometriosis and the dreaded “endo belly”

Medications Cause Dysbiosis and Significantly Affect The Microbiome

As mention already, many medications and hormones actually have a toxic affect on the microbiome and can cause dysbiosis. It is crucial to for all of us to understand the consequences of medication use in the gut microbiome. I’ll talk about this in my next post.

The good news, however, is although medications can cause a dysfunctional microbiome quite rapidly, you can begin to restore a healthy microbiome just as quickly through strategic microbiome restore.

Proper Microbiome Restore Protocols

When it comes to proper microbiome restore,  it isn’t just as easy as taking any old probiotic, or a combination of probiotics. Microbiome restore requires and individualised and strain specific approach and it needs to be done in stages with antimicrobials, gut repair and prebiotics as well. Dysbiotic microbes can be hard to treat effectively because they have evolved and adapted to life inside human beings. Consequently, elimination of these organisms requires a similarly evolved and adapted approach. This is all part of the microbiome restore protocol I use with my patients.

A New Understanding

When it comes to the perfect microbiome, researchers have discovered there is no ‘one size fits all’ across various populations. It is important to recognise that not all strains are created equal when it comes to their ability to rebuild a healthy microbiome.

What is now known is that there are only certain types of good probiotic bacteria that have benefit for our gut and microbiome, and that some strains of probiotic bacteria have no benefit. These new finding mean that we need to adopt a strain specific approach when repairing and restoring the microbiome.

From recent investigations and research, the best results are gained by introducing strain specific influential probiotic that have beneficial functions. These specifically influential strains are able to restore each patient’s unique microbiome by promoting the growth of key commensal (symbiotic) groups, but also by improving overall GIT function.

The Importance of Prebiotics

In addition to prescribing a specific probiotic formulation, prebiotic therapy is needed to help support and encourage the establishment of healthy microbiota by significantly increasing the numbers of beneficial bacteria. Without prebiotics, the probiotic bacteria do not grow and this is why they are essential for microbiome restore. Prebiotics are not talked about enough and many people do not realise their importance and often wonder why their probiotics are not working effectively enough.

Prebiotics are also needed to promote the growth of healthy microbiota, begin refurbishment of gut mucosa and improve gastrointestinal immunity. Prebiotics also help with inflammation and also support the integrity of the intestinal barrier, provide healthy immune responses and promote intestinal microbiome balance.

Microbiome Restore Protocols

With emerging research now highlighting the significance of developing and maintaining a healthy microbiome, it is important that everyone knows the importance of appropriate probiotic and prebiotic combinations. By supporting the restoration and repair of our micriobiome, we can all optimise our health, improve treatment outcomes and also help with reducing the risk of many chronic disease states.

If you would like to find out how to restore your microbiome properly, please give my friendly staff a call and find out how I may be able to assist you. Online and in person consultations are available. Some conditions apply.

Regards

Andrew Orr

-No Stone Left Unturned

-Women’s and Men’s Health Advocate

References
  1. Walker A, et al. Phylogeny, culturing, and metagenomics of the human gut microbiota. Trends Microbiol. 2014;22:267–74.
  2. Collado MC, et al. Role of commercial probiotic strains against human pathogen adhesion to intestinal mucus. Lett Appl Microbiol. 2007;45(4):454-60.
  3. Leahy SC, et al. Getting better with bifidobacteria. J Appl Microbiol. 2005;98(6):1303-15.
  4. McFarland LV. Systematic review and meta-analysis of Saccharomyces boulardii in adult patients. World J Gastroenterol. 2010;16(18):2202-22.
  5. Jahn HU, et al. Immunological and trophical effects of Saccharomyces boulardii on the small intestine in healthy human volunteers. Digestion. 1996;57(2):95-104.
  6. Jahn HU, et al. Immunological and trophical effects of Saccharomyces boulardii on the small intestine in healthy human volunteers. Digestion. 1996;57(2):95-104.
  7. Dahan S, et al. Saccharomyces boulardii interferes with enterohemorrhagic Escherichia coli induced signaling pathways in T84 cells. Infect Immun. 2003;71:766-773.
  8. Hsieh H. Versalovic J. The human microbiome and probiotics: Implications for pediatrics. Curr Probl Pediatr Adolesc Health Care. 2008;38(10):309–327.
  9. Lam EK, et al. Enhancement of gastric mucosal integrity by Lactobacillus rhamnosus GG. Life Sci. 2007;80(23):2128-36.
  10. Seth A, et al. Probiotics ameliorate the hydrogen peroxide-induced epithelial barrier disruption by a PKC- and MAP kinase-dependent mechanism. Am J Physiol Gastrointest Liver Physiol. 2008;294(4):G1060-9.
  11. Gibson GR. Roberford M. Dietary modulation of the human colonic microbiota: introducing the concept of prebiotics. J Nutr. 1995;125:1401-1412.
  12. Fastinger ND, et al. A novel resistant maltodextrin alters gastrointestinal tolerance factors, fecal characteristics, and fecal microbiota in healthy adult humans. J Am Coll Nutr. 2008;27(2):356-66.
  13. Raninen K, et al. Dietary fiber type reflects physiological functionality: comparison of grain fiber, inulin, and polydextrose. Nutr Rev. 2011;69(1):9-21.
  14. Robison LE. Reeves S. EpiCor® and its immune effects on gut health. Embria Health Sciences, LLC. [Online]. No date. Available from: http://www.embriahealth.com/upload/pdf/EpiCor%20Science%20%20EpiCor%20and%20its%20Immune%20Effects%20on%20Gut%20Health_FINAL.pdf [Cited 16/02/13].
  15. Jensen GS, et al. Antioxidant bioavailability and rapid immune-modulating effects after consumption of a single acute dose of a high-metabolite yeast immunogen: results of a placebo-controlled double-blinded crossover pilot study. J Med Food. 2011 Sep;14(9):1002-10.
  1. Bartoli, C., Frachon, L., Barret, M., Huard-Chauveau, C., Mayjonade, B., Zanchetta, C., … & Roux, F. (2018, May 30). In situ relationships between microbiota and potential pathobiota in Arabidopsis thaliana. The ISME Journal. Retrieved from https://www.nature.com/articles/s41396-018-0152-7#article-info
  2. Berg, R. D. (1996). The indigenous gastrointestinal microflora. Trends in Microbiology, 4(11), 430-435. Retrieved from https://www.sciencedirect.com/science/article/pii/0966842X96100573
  3. Carpenter, S. (2012, September). That gut feeling. Monitor on Psychology, 43(8), 50. Retrieved from http://www.apa.org/monitor/2012/09/gut-feeling.aspx
  4. Clapp, M., Aurora, N., Herrera, L., Bhatia, M., Wilen, E., & Wakefield, S. (2017, September 15). Gut microbiota’s effect on mental health: The gut-brain axis. Clinics and Practice, 7(4), 987. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5641835/
  5. NIH Human Microbiome Project. (n.d.). Retrieved from https://hmpdacc.org/
  6. Shepherd, E. S., DeLoache, W. C., Pruss, K. M., Whitaker, W. R., & Sonnenburg, J. L. (2018, May 9). An exclusive metabolic niche enables strain engraftment in the gut microbiota [abstract]. Nature, 557, 434-438. Retrieved from https://www.nature.com/articles/s41586-018-0092-4
  7. The Human Microbiome Project Consortium. (2012, 14 June). Structure, function and diversity of the healthy human microbiome. Nature, 486, 207-214. Retrieved from https://www.nature.com/articles/nature11234
  8. Ursell, L. K., Metcalf, L., K., Wegener Parfry, L., Knight, R. (2012, August). Defining the human microbiome. Nutrition Reviews, 70(Suppl 1), S38-S44. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3426293/

Expectation versus reality with surgery and ongoing healthcare management

I have talked about expectation versus reality before but I wanted to go over this subject again. I think that many treatment plans and even surgical interventions and treatment outcomes are not explained very well.
This then leads to people not really knowing what realists health outcomes are and also what realists healing times are either.
In my latest video blog I talk about the expectation versus reality when it comes to surgery and recovery times. I also talks about being realist about time frames with treatment and results on ongoing healthcare.
I also talk about the realist time frames to help with certain conditions and also being real about healing times for pain.
Watch my latest video post to see what I am talking about and trying to explain
Regards
Dr Andrew Orr (DOAM, MRepMed, MWHM)
-No Stone Left Unturned
-Reproductive Medicines and Women’s Health Experts
-Women’s and Men’s Health Advocate
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Give us this day our daily…..Bloating

Many people do not realise that the cause of their daily bloating may in fact start with their daily consumption of bread.

I always used to comment that when I was in travelling through Asia and eating all the great fresh foods over there, that I was feeling really good. I never got that bloated feeling that most people often get each day.

On arriving back home, I would always suddenly start to get stomach cramps and bloating for no reason. I find this quite ironic as most people have a perception that you are going to get food poisoning etc if you go overseas. I have never ever been sick in all the years of travelling there. Actually it is always the opposite, I always feel better when I eat the foods there.

Having ruled out bugs and parasites etc, I was starting to go a bit crazy as to what was going on. Then one day I didn’t get the bloating anymore.

What did I do that day?

Was it a virus just getting out of my system, or was it a food that I missed that day?

Then it all dawned on me that I had not eaten bread that day. I’m not a big bread eater anyway, but the next day I tried out my theory and ate some bread. Bingo!

I had bloating and pains all day again. So much for supposedly being a healthy staple food. While travelling in Asia, I didn’t have bread or many refined foods at all and that is probably why I always feel better when I go there.

Many people suffer bloating caused by bread

Actually many people suffer from bloating each day, caused by bread, and some suffer it quite severely. Some to the point that they actually look pregnant with it. Many people’s bloating and weight issues are caused from over consumption of bread and other refined flour foods. Many people lose weight just by giving up bread alone. The sad fact is many people continue to eat bread even when they know it is causing them bloating and pain etc.

When you look at the average Australian diet, we live on the stuff. Toast in the morning, sandwiches at lunch and sometimes we have bread with our dinner too. In this day and age, there is no reason to eat as much bread as we do. There are so many more healthy food alternatives available to us today, but we all go for the gut filler and bloater every chance we get. It’s quick and it makes you feel full, temporarily anyway.

Bread is just a filler to help you fill full

Actually if you look at the history of bread, it was born through poverty. It was born out of necessity when there was no other foods around and it gave the perception of being full. The trouble is the first breads were semi good for you as they were very dense and full of whole grains. Not this refined rubbish, full of chemicals and additives, that make it last for weeks. These days, weevils won’t even live in it and some kids can even get hyper on it because it can be laced with that many preservatives.

Gluten, yeast and other additives

Besides all the additives in bread today, there are two main ingredients that make many people have digestive issues. One is gluten and the other is yeast. Yeast is a rising agent and it can surely make the stomach bubble and rise too. Then the refined grains containing gluten also causes inflammation in the system. The other disturbing thought about bread it that it is really just flour and water. Flour and water makes glue and that’s why it clogs so many people’s bowels up each day. The gluten can also cause loose bowels for some people too.

Many people also have a misconception about the different types of bread too. Many people choose brown bread over white thinking it is a healthier option. Wrong!

Brown bread is just white bread with a tiny bit of wheat germ added and a splash of colouring to make it brown. Even when you do find a semi decent option, with the many breads out there, it still really isn’t a really healthy option. Again it is just a filler and there are many more foods out there with much more nutrition, and again it won’t make you bloated. We also now know how bad refined grains are for you.

Gluten free does not mean healthier

Don’t think for a moment that Gluten free is a healthier option, because it isn’t. It is still refined grains, minus the gluten. It is still inflammatory due to lectins and leptins and other things in the grains. Many gluten free products also contain a lot more sugars and emulsifiers too. It is best to go grain free than go gluten free.

Eating other foods instead of bread

I must admit that there is nothing quite like the smell of freshly baked bread, but that doesn’t make it good for you. The other hard thing about it is it is really hard not to give it to our kids, especially if they are going to school.

But I also know that with cooler packs now, there are many other options that we can give our children to take to school. Moderation is the key here. Have a look at some of the health snack options you can use instead of bread and refined flour products.

All of us need to cut back on the stomach glue (bread) and start eating some healthier foods such as salads, lean proteins, nuts, seeds, veggies and fruit. It isn’t all that hard.

Instead of eating that meat and salad sandwich tomorrow, how about just having the meat & salad. It is a much healthier option and it won’t bloat you either. Some nice sliced ham off the bone, or tuna, or chicken, and a lovely Greek salad and hey presto, we have a great healthy lunch option.

Other foods that may cause bloating

There are other may other things in our diet that cause bloating such as alcohol, oats, sugars, chocolate, fermented bean paste (miso) etc that people also need to be aware of. Overindulgence in all of these things can all lead the stomach to overload and cause bloating and pain.

One more thing, “no”, you just can’t take medicines and supplements to make the bloating go away and still eat the foods that cause bloating.  It doesn’t work that way. You have to remove the cause, otherwise the problem will continue no matter what you do.

So next time you look like you have added two clothe sizes,  with a stomach full of wind, remember that it may just be from the bread that you have just eaten beforehand. If you are getting bloating each day, it is a good idea to talk to your healthcare provider about this and look into the cause of your issues. There are simple testings for food allergens and your healthcare provider is trained to know what to test for and look for in your diet as well. There may also be an underlying disease state being missed as well.

Take care

Regards

Dr Andrew Orr

-No Stone Left Unturned

-Women’s and Men’s Health Advocate

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Foods That Can, and Do, Cause Constipation

Many people have trouble moving their bowels on a daily basis and are none the wiser as to why this happens to them. Many do not realise how bad for their health it is not to move your bowels daily and many people just think it is normal for them to not need to get things moving each morning.

Of course some people have conditions, that cause constipation, and these need to be ruled out too.

Conditions such as Endometriosis, Pelvic Inflammatory disease, IBS and other bowel disorders can all cause chronic constipation and inflammation in the bowel

But for most people the clogging of the back passage is caused by what they are eating and lack of foods that contain real fibre and water to keep the bowels moving.

Lack of proper hydration and stress is also a factor too. But when it comes to proper fibre, many people are just eating the wrong foods. Many of the foods people are having on a daily basis, thinking it is fibre, are actually closer to being cardboard and the effects on the bowel are just as bad.

So what are the foods that are causing a blockage in peoples elimination pipes.

1.Fast Or Prepared Foods

Those ready made meals and takeaway meals may be convenient, but they could cause a backup. Most are low in fiber, which you need to help food move through your system.

2.Fried Food

Fried foods are full of fat, lack fiber and are hard to digest. When food moves through your colon slowly, too much water can be taken out of it. That makes for a hard, dry stool.

3.Cakes, Sweets and Pastries

Pastries, cookies, and other treats with refined sugar are low in fiber and fluids, and high in fat. Many people think that because they contain grains, that they are good for you. But nothing could be further from the truth. Wheat grains are actually inflammatory and cause disruption to the digestive system. There is actually more fiber in whole foods such as fruit and vegetable. Grains are refined grains are not good if you’re having trouble keeping things moving. Satisfy your sweet tooth with some fresh fruits and yogurt. Your tummy will thank you for it.

4.Breads

Bread is basically made from flour and water and what does flour and water make? Glue that’s what it makes! That is what it turns to in your stomach and bowel too. Plus refined flours are made from inflammatory grains and these cause disruption to your digestion and bowel too. Too much bread will give you hard, dry stools and also mess with your digestion. It’s also made with low-fiber flour. The whole grain variety may be a little bit better, but not much. If your digestive system is shot and you are having trouble getting things to move, time to ditch the bread. We don’t need to eat it anyway.

5.Caffeine

A couple cups of teas coffee makes some people race to the bathroom, but it can have the opposite effect, too. The caffeine in coffee and tea are diuretics and soft drinks can keep your body from holding onto water, and you need water to stay regular. If you’re constipated, check how much tea and coffee you might be drinking and make sure you drink plenty of water after each cup of caffeine.

6.Alcohol

Alcohol can definitely dehydrate the body make it hard for your body to hang onto water. This can then cause gastrointestinal inflammation, upset the liver function and then cause constipation.

7.Eggs

Eggs are really good for us and they are high in protein but low in fiber. But, you don’t have to stop eating them though. Just add some high-fiber foods into the mix. Add some greens with them when you eat them. Try an omelet with fresh spinach and tomatoes.

8.Well Done Meat

Meat is a great source of protein but when its well-done and over cooked, it is lacking in fiber, that juicy steak needs to be a little less cooked (medium rare) and balanced with a side of nice green veggies, or salad. This will help get it comfortably through your digestive system.

 

Some Fiber Facts.

Veggie and whole Fruits (not dried fruits) have more fiber than cereals and grains and as they contain water and other nutrients needed to keep the bowel hydrated and moving properly. Time to ditch the cereals and start eating some more whole foods instead.

Oh… and don’t forget the prebiotics and probiotics to keep healthy gut flora/microbiome and keep the digestive system functioning properly.

Of course we should drink plenty of water and also make sure you get some electrolytes into your diet daily too. This will help keep your bowels working the way they should work, rather than the way they have been.

If you are having trouble with chronic constipation and getting your bowels to move daily, then give my clinic a call and book in a consultation where we can help you get your digestion back on track again.

Take care

Regards

Dr Andrew Orr

-No Stone Left Unturned

-Women’s and Men’s Health Expert

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Western Diet Permanently Alters the Immune System & Alters Gene Expression

For many years we have been trying to explain to people how their diet is a major factor in their current health and how a poor diet can actually cause expression of many inflammatory disease states within the body. There is now research which shows how the western diet permanently alters the immune system and alters gene expression.

New research has shown that our immune system responses to the Western diet very similar to how it reacts to infection by dangerous bacteria. The research was led by the University of Bonn in Germany and published in the journal Cell.

One of the disturbing results of the study is that the longer we consume a high GI, highly refined foods, and Western diet, that it can make the immune system become hyper-responsive to inflammation triggers. We know that a diet in highly processed foods and refined carbohydrates actually causes high inflammation in the body.

The longer we eat this way, these long-term changes may contribute to type 2 diabetes, arteriosclerosis, inflammatory bowel conditions, cancers,  gynaecological conditions,  and several other conditions wherein inflammation is thought to play a part, and which have been linked to consumption of a highly refined Western based diet.

The Western diet altered gene expression

The new research showed that just after just 1 month, there were changes throughout the bodies that are similar to the strong inflammation reactions that occur in bacterial infections. The researchers showed that an unhealthy high GI/highly refined diet led to increases in certain immune cells, which were a sign of inflammation and an infection like process. They also found that the Western diet had switched on many genes in the body that would also express many disease states and inflammatory processes in the body.

The researchers concluded that  findings highlight the dramatic impact that the wrong kind of food can have, and that they have important implications for society, especially for children who grow up with this highly inflammatory based diets and consume them longer.

The researchers concluded that adults and children have a choice of what they eat every day. We should enable everyone, especially children,  to make conscious decisions regarding their dietary habits. The new research also highlighted that dietary habits and the foundations of what a healthy diet is, need to become more prominent in our education system and it needs to start at a younger age. We also need to re-educate adults on what a healthy diet is as well

At my clinic, we can help people to know what a healthy diet is and this education is also passed onto people we help with inflammatory disease states.

We always promote a Primal/Low GI/grain free diet to all our patients so that they can be healthier, have less inflammation in their bodies and live longer and happier lives.

Regards

Dr Andrew Orr

-No Stone Left Unturned

-Women’s and Men’s Health Expert

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