IBS

Managing Irritable Bowel Syndrome & Inflammatory Bowel Disease

Irritable Bowel Syndrome, or IBS, is a problem that affects a staggering 3million people, or more, in Australia and about 20% of people world-wide. It is a condition that has baffled doctors for years. There is no single cause, no specific treatment and, as yet, no cure.

But first let’s look at some general information on IBS.

IBS is more common in women than in men and occurs more often in younger people. IBS is usually ongoing, and there are some times when symptoms are worse than other times. Having IBS does not mean you are more likely to develop colon cancer later in life.

Symptoms of IBS

Some people with IBS mainly have constipation, others have diarrhoea. Many people with IBS alternate between periods of constipation and diarrhoea.

Symptoms include:

  • Cramps and bloating in your lower abdomen, which usually get better after having a bowel motion or passing wind
  • Pain that can be a sharp or dull feeling
  • Constipation: feeling that you have not managed to empty your bowels completely, having bowel motions less often, straining to pass a motion or passing small, hard stools
  • Diarrhoea: having bowel motions too often and passing loose stools
  • Flatulence, or wind, and/or rumbling noises from your abdomen
  • Needing to rush to the toilet
  • Headaches
  • Mucus in your stools

Some of these symptoms can also be from other inflammatory bowel diseases such as Crohns disease and Ulcerative Colitis, which sometimes get categories as IBS.

But some of the symptoms above can also be part of having endometriosis and many women who are diagnosis with IBS, in fact have endometriosis. They then have all the testing for IBS, Crohn’s, ulcerative colitis etc (colonoscopy etc) as these don’t find anything and then these women are often told by doctors they are at a loss to what is happening. This is why endometriosis often takes up to 12 years for definitive diagnosis, which is terrible.

IBS triggers

The cause of IBS is not known, but certain things can trigger its symptoms, including:

  • Stress
  • Depressed mood
  • Food poisoning
  • Tummy bug
  • Virus
  • Certain foods and drinks
  • Some medication
  • Some people find avoiding alcohol, caffeine and nicotine can reduce their IBS symptoms

As said before some women suffer more acutely from symptoms of IBS just before, or during, their menstrual cycle. IBS symptoms can also mean that they have a condition called Endometriosis. Many times these conditions can be overlooked and they can be present at the same time, along with bladder issues as well.

Lactose and wheat intolerance and wheat may be a cause and needs to be assessed before permanent changes to diet are made. Wheat grains are inflammatory to the bowel anyway and they should be removed if anyone does have inflammatory bowel issues.

Treatments

There are a few medical treatments available but results can be varying. Many people with severe IBS end up on steroids to settle inflammation in the bowel. There are also other medications to slow bowel motility and reduce inflammation as well.

Dietary and lifestyle changes are a must for the treatment of IBS. See my post on what real nutrition should be food what a good diet should be like.

There is, however complementary therapies that can bring great results.

The complementary medicine unit and the University of Western Sydney ran a randomised, double blind, placebo controlled trial to determine whether Chinese Herbal medicine was of any benefit in the treatment of IBS. Chinese medicine has been used for thousands of years to treat many disease states, including inflammatory bowel conditions.

The results were stunning. More than 70% of patients taking the Chinese herbs improved. The results were published in the Journal of the American Medicine Association.

There are also other complementary therapies and treatments that can be used and combined with medical interventions, or other interventions mentioned above.

Studies have shown that strain specific probiotic bacteria have induced remission in inflammatory bowel conditions such as ulcerative colitis and IBS. But, this needs consultation with a qualified healthcare professional to treat disease properly. Self-prescribing is not an option for this disease that affects over 3 million people here in Australia alone.

With any disease state such as IBS, there needs to be an individualised approach, not a one treatment fix all approach, because everyone is uniquely difference in their symptoms they experience and what their triggers are. There also needs to be a multimodality approach because many times IBS overlaps with conditions such as endometriosis for women, and other inflammatory conditions in men.

If you have IBS or inflammatory bowel disease and need help and assistance in managing your disease better, please give my friendly staff a call and they will explain how I may be able to assist you.

Regards

Andrew Orr

-No Stone Left Unturned

-Women’s and Men’s Health Advocate

References

  1. Treatment of IBs with chinese herbal medicine -Alan Bensoussan, MSc; Nick J. Talley, MD; Michael Hing, MBBS, FRACP; Robert Menzies, PhD; Anna Guo, PhD; Meng Ngu, PhD http://jama.jamanetwork.com/article.aspx?articleid=188145
  2. VSL#3 Probiotic-Mixture Induces Remission in Patients with Active Ulcerative Colitis- (American Journal of Gastroenterology 2005;100:1-8)
  3. Investigations and treatment of Endometriosis- Royal College of Obstetricians and Gynaecologists 2008
  4. Bensoussan A, Myers SP. Towards a Safer Choice: The Practice of Traditional Chinese Medicine in Australia . Sydney, Australia: University of Western Sydney Macarthur; 1996.
  1. Yu ZX, Wang K, Li FP. Clinical trial of Chinese herbal capsule for 157 cases of irritable bowel syndrome. Chin J Integrated Tradit West Med.1991;11:170-171.
  1. Liu ZK. Chinese herbal medicine treatment for 120 cases of irritable bowel syndrome. Chin J Integrated Tradit West Med.1990;10:615.
  1. Shi ZQ. Combination treatment of Chinese and Western medicine for 30 cases of irritable bowel syndrome. Chin J Integrated Tradit West Med.1989;9:241.
  2. Chen DZ. Tong Xie Yao Fang with additions in treating 106 cases of irritable bowel syndrome. Nanjing Med University J.1995;15:924.
  3. Xu RL. Clinical realisations during the diagnosis and treatment of 55 cases of irritable bowel syndrome. Shanxi J Tradit Chin Med.1995;11:10-11.
Chill Pill

A Special Kind of Pill for Better Health and Increased Fertility

Previously I have mentioned that I was going to talk to you all about a special medicine and a special kind of pill, that can not only help you with gynaecological and other healthy issues, but it can also help with fertility and being able to fall pregnant.

I was going to post this up straight away, but then I had to think more about it, because I know when you mention this subject, people can take a message with the intention of helping the wrong way.

So what is this special pill that I am talking about and not yet available on the market?

Well, it’s called a “Chill Pill” and many of us need to be taking it often, or learning to administer it often.

Now, before anyone gets all up in arms about this and what I am about to say, I need you to listen and take the personal out of this and just hear the reasons why.

I have been on the other end of stress, where it almost killed me, literally and I know how it then affected my health and then exacerbated pre-existing health complaints I had. So I am coming from a place of understanding, but also a place of wanting to help people through my own experienced personally, but also what I see in clinical practice daily. I was one of those people who kept saying that weren’t stressed, or that I don’t feel stressed, yet all the while my body signs were saying something different.

Like any change we need to make, the first part is admitting there may be something wrong in order to enact that change.

The sad fact is that 9 out of 10 people report being stressed and 41% of people feel they experience unhealthy levels of stress. Stress and the body’s response to it, can affect people in different ways. Small amounts of stress that are easily resolved can help to keep us motivated and achieve our goals.

The difference with long term or chronic stress is that it can affect the whole body in a negative way. It is the long grade, low grade stress (or busyness) that often creeps up on us and causes issues. Many people do not even know they are stressed, or that stress is a big factor in their current health issues, because they are either so used to it, or their health issues takes over and they cannot even begin to see the correlation.

The harsh reality of many problems in life is that we are ultimately responsible for our own well-being. Not all people will want to accept this, as it is so much easier to blame someone or something else for our dilemmas.

Nearly every problem we experience in life may have an element of stress to it bought on by ourselves and our busy lives, with many of us not consciously knowing it is at play. That means everything from a common cold to a long-standing illness. Everyone reading this will be by now squirming in his or her seats as the harsh reality of such a statement hits home. But the real problem with this is that it is true. I know I had to face this reality with my own health issues. We can and do cause many of our own health problems, or exacerbate them, either consciously, or subconsciously.

The problem with any health matter is getting people to become responsible for their own self. So much illness is completely preventable if we would just take responsibility for our own actions. It is so much easier to blame someone, or something else with comments such as “ I have tried everything”, “That didn’t work for me”, or “I’ve been everywhere and nothing can help me”.

The problem with many of these blanket statements is that they are all just excuses not to take responsibility for our actions. Maybe it isn’t that the methods you are trying aren’t working. Maybe it is simply a matter of nothing will ever work unless we make that all important change for ourselves first.

Sure, some disease states are hereditary, or someone have a predisposition for them, but even so, once the illness, or disease is expressed in the body, it is our responsibility to do what we can to control it.

Yes, sometimes it doesn’t seem fair, I get that, but sometimes you just have to admit there is an issue that isn’t going away in a hurry, or keeps being flared up, because you need to make some changes in your life to better manage this issue.

I know this is something I had to learn myself. Boy did I fight the reality of this in the beginning too. But, I also acknowledge that some people have seen some pretty shitty healthcare practitioners who have missed and dismissed their issues too. It all compounds and just makes everything seem so much worse. But, at the end of the day you can also find good practitioners who can help you too.

Stress is also a major factor in many couples not being able to conceive. Stress affects cortisol levels and the adrenals and this then has an effect on testicular and ovarian function.

Stress can affect both sperm and egg quality and high stress levels also affects our hormones and our immune system. Stress also has an effect on the uterine environment, which can affect implantation, affect circulation in the uterine lining, and also increase the risk of miscarriage. High stress levels also exacerbate, or fuel many gynaecological and men’s reproductive health issues too.

Looking for the ‘Off ’ Butt on

Stress can affect each of us differently. Perhaps you are suffering from anxiety, feeling worried, depressed or irritable; even feeling exhausted and overwhelmed can indicate you are under stress. As well as affecting your ability to cope, stress may also be causing a disruption to your health. When under stress for a length of time, you may be more susceptible to tension headaches, high blood pressure, frequent colds and flus, digestive disorders or a worsening of an existing condition.

So you can see, there are many reasons why it is so important to manage your stress now, take that “Chill Pill” before it starts impacting your health and wellbeing.

How Resilience Begins

Some people seem to deal with stress better than others. That doesn’t mean that the rest of us need to continue suffering. The ability to increase your resilience to stress is something that can be learned and helped with talking to a counsellor, or psychologist etc.

There are supplements, nutrients, and vitamins to support your body’s individual stress response system too. Many people are lacking key nutrients because of our highly processed diets now and we also know that gut health, and a healthy microbiome is integral to psychological wellbeing and our moods.

Taking a strain specific probiotic and a prebiotic daily can improve gut health and improve your immune system and psychological wellbeing. Omega 3 oils, multivitamins, melatonin, St John’s wort, passion flower, chamomile and many other herbs and nutrients can assist with coping with stress and its impact on the body.

Don’t buy vitamins or supplements off the shelf at the chemist or supermarket as these are so inferior and contain lots of fillers and additives that aren’t good for you. Always see a qualified healthcare practitioner to get proper advice on what nutrients and supplements are needed for your health complaint.

By the way, Dr Google is banned in my clinic. Dr Google is not a reliable way to find out about healthcare products and illnesses. Only a trained healthcare professional should be giving you that advice. But, in saying that, researching where to find a good practitioner is great and also developing and understanding of ones health issues is great too, as long as it doesn’t become an obsession and that is all you focus on. It is about a balance. There is nothing wrong with trying to be informed. But, trying to self diagnose, or self prescribe is not a good thing at all.

Some people may be in such a bad state that medication may be needed to get them over their first hurdles and develop some resilience and coping skills. This should always be done in conjunction with talk therapy as well. To be honest, most of us could do with talking to a good counsellor or psychologist to get some coping strategies to deal with work, business, health, or life better.

Lifestyle Tips to Help Manage Stress

Managing your stress is essential for long-term health and vitality. With proper support, a variety of stress relief techniques can be introduced, in conjunction with a

healthy eating plan to help assist you in stressing less. These may include:

  1. Exercise: Daily movement is essential for brain health. Aerobic exercise including running, swimming or walking is proven to decrease stress hormones. Resistance exercise is also great for stress relief, burning fats, increasing lean muscle and keeping you healthy.
  2. Enjoy the benefits of spending some time in the sun. Being in nature for 30 minutes per day can help reduce stress hormones and assist recovery after a stressful situation.
  3. Meditation and/or yoga can help to increase relaxation whilst benefiting not just the mind, but also the body. Learning to unwind is important for reducing stress.
  4. Favourite pastime: create time for YOU! Do something that you love, like listening to music, enjoying a candle lit bath, watching a movie, or starting a creative project – these fun activities can help you become more tolerant of everyday stress.
  5. Get creative and express yourself in as many different ways as feels good; singing, dancing, and art projects are but a few ways to do this.
  6. Eat seasonally, fresh and organic as much as possible. Include protein at every meal with a variety of fruit and vegetables.
  7. Include good fats such as omega 3s from fish, nuts and seeds, and olive oil to help with brain health and mood regulation.
  8. Drink plenty of water, a minimum of eight glasses per day and avoid excessive alcohol, caffeine, sugar and salt.
  9. See a counsellor, or psychologist to get some coping strategies in place.
  10. Acupuncture has been shown to be as effective as medications for stress and equal to the effects of talk therapy in several major studies.

Stress Less for Good Health

Our modern lifestyle is inescapable. The stress of it however, is manageable. This is why I mentioned the magic “Chill Pill”. All people have to do is take the advice and administer it often.

You aren’t born stressed and being stress isn’t a part of you. It is a learnt behaviour that can be changed. You can become more resilient to the symptoms and long term effects of stress through the aid of individualised lifestyle and dietary changes, together with nutrients, supplement and in some cases medicines that your healthcare providers can help you with.

Talk therapy such as counselling and psychology is an integral part of leaning to cope with stress and dealing with it better too. Mindfulness and meditation can also assist with stress.

Supporting a healthy stress response will allow you to feel more energised, resilient and ready to tackle life, so you can maintain the state of health and wellness that you deserve.

I hope that helps everyone and please remember to take off those superwoman/superman capes regularly, allow space to just breath and shut off the mind and just have some you time. It is OK to just sit there and not feel guilty about it. People need to learn to switch off the “busyness” and close down the 100 boxes they have open. It is Ok just to sit in peace and quietness and not feel guilty about it. Actually, your body needs to do this to maintain your inner health, but also your psychological health.

Every persons health, or disease state is different and while stress may not be the cause of ones particular issue, it can certainly exacerbate it. This is why it is so important to look at every aspect of ones life, not just a small isolated portion of it.

When was the last time you allowed yourself the space to just be, just take some quite time and let the world pass by for a little while without worrying about it?

Take care and relax and don’t work too hard. We work to live, not live to work.

Regards

Andrew Orr

-No Stone Left Unturned

-Women’s and Men’s Health Advocate

Stress, Distress and De-Stress

Knowing the difference between stress, distress and de-stress.
Many people do not realise that being constantly busy and being stressed slowly creeps up on them and can one day cause major health issues for them. Being busy for for the sake of being busy is a very common issue these days. We actually refer to it as “The Disease of Being Busy”.

Too many people run their lives and their social status around this term. It is not a badge to be worn with pride at all. When people say that they don’t know how to slow down and relax, this isn’t good. They actually need to learn and retrain the body how to relax and what it feels like to relax.

Being too “Busy” causes stress on the body and can lead to disease, or exacerbate diseases that are already there. It also makes pain worse too.

Life is too short to be busy all the time and just being busy being busy. There is always time in a 24 hour day to take at least 1 hour for self. It is OK to leave emails, leave the washing etc and just be.

At my clinic I help people with learning how to relax and also giving ones body time out with many different forms of treatments. I also work in with counsellors, psychologists, and mindfulness practitioners,  who can teach people coping skills of how to slow down and enjoy life more.

Life is not a race and it is important that we teach children that being too busy is not OK either. It is OK to say “No” to everyone and just take time for self.

Stress and distress can not only cause physical symptoms, such as pain, but it can also cause emotional and psychological issues too. Stress can also kill you.

Symptoms of stress can accumulate over a long period of time and then present with acute symptoms, which can then become chronic. This is why I talk about learning to put yourself first and put your oxygen mask on before attending to others.

It is important to be aware of stress levels and also learning coping strategies and learning that being busy for the sake of being busy, may one day catch up with you and slow you down for good.

Have a listen to my latest video post about stress, distress and de-stress.

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

01 Dr Andrew Orr 1

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The Importance of Following Through With Advice, Treatments & Change

I see so many people who have been ‘missed’ and ‘dismissed’ and who have suffered in silence with their disease state.

But the biggest shame is when those that are offered real help, then do nothing with that advice and continue on the vicious, merry-go-round cycle of their disease.

My motto is “No Stone Left Unturned” and I apply that to every patient that I see. My initial consults are usually 1-2 hours in length and I also do lots of preliminary work prior to see a patient as well. I make sure all my patients are now only sent health appraisal questionnaires, but are also evaluated with mood and stress questionnaires for their mental health too.

I really want to delve into every fine detail of a persons life to see what may be driving their disease state and symptoms. It is to also help with diagnosing those that have not been properly diagnosed either. I then write up a comprehensive report for all my patients, with everything they need to do, the changes they need to make, the medicines they need to take, the investigations and testing they need to have and all their step by step health management moving forward. It really is a matter of ‘No Stone Is Left Unturned’ as I mentioned before.

As I mention in this video blog is that the greatest shame is those that come to get the advice and help and then do nothing with it. Just remember that if you do not change anything, or do the work needed, then nothing changes. The key to real change is actually within you.

If you so need help with a particular health issue, or you just aren’t getting the right answers and care, then please book in a time to see me and let me be your guide to better health and getting your life back to normal.

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Poor Diet, Stress and Sedentary Lifestyle ups Risk of Developing PCOS

Polycystic Ovarian Syndrome (PCOS) is a hormonal/endocrine/reproductive issue  and is on the rise due to unhealthy food habits, low physical activity and high stress levels, a new study has found.

It has long been known that insulin resistance and poor dietary and lifestyle habits increase the risk factors for developing PCOS. While being overweight is a risk factor for PCOS, women can be of any body type and still develop PCOS. Women of all body shape can still have poor dietary and lifestyle habits and this is every increasing in our modern world.

Increased refined foods, increased refined grains, increased refined sugars and a sedentary lifestyle are big factors in developing PCOS and also other health conditions such as Diabetes and Heart disease.

We also know that high stress levels can lead to high cortisol levels and high inflammation in the body and then also be drivers of PCOS and many of the conditions that go with this disease state.

What is PCOS?

Polycystic ovary syndrome (PCOS) is the most common hormonal/endocrine/reproductive disorder among women of reproductive age. Symptoms can include include

  • Irregular or absent menstrual cycle
  • facial hair growth and excess body hair (hirsutism)
  • Acne
  • Increase weight and increase body fat (all body types can have PCOS)
  • Infertility and difficulty conceiving

The condition has many physiological implications as well. It also results in emotional and psychological agony in affected women. For more information on PCOS, have a read of my page about “Polycystic Ovarian Syndrome”

A recently concluded study published on the 12th January 2019, has revealed that uncontrolled or untreated PCOS can raise the risk of diabetes, heart disease and infertility. It has also been concluded that psychological issues such as anxiety and depression can also be the consequence of untreated PCOS. This study fits in with many other recent studies and has prompted changes to PCOS guidelines.

The study was conducted on two groups — one group of 150 patients with untreated/uncontrolled PCOS and the other group of 150 women who had controlled PCOS. The study found that those affected with PCOS followed a poor lifestyle, consumed excessive junk food, had no or low physical activity, more intake of refined carbohydrates and high stress levels.

The study also discovered that there was lack of awareness among the affected women and about 40 per cent were seeking information online. This is a major cause of concern as there is a lot of misinformation on the internet and this is leading to women trying to self-diagnose and go off recommendations of friends and internet groups, rather than healthcare professionals who specialise in this area.

During the study, one group was taking probiotics along with maintaining good lifestyle, while the other group was only maintaining good lifestyle. While both groups showed improvement, the group taking probiotics had additional improvement.

Good gut health and restoring the microbiome is something that I have always promoted in women, not only with PCOS, but other gynaecological/reproductive issues as well. New research has shown that healthy levels of good gut bacteria not only help with restoring the microbiome and gut and digestive health, but also help with reducing inflammation, helping with a healthy immune system and helping with psychological health and wellbeing as well.

Women with PCOS need to be properly diagnosed first and then treatments require a multimodality approach with diet and lifestyle interventions as well. Women with PCOS also need to be properly monitored and managed by a healthcare professional and not go off self-diagnosis and recommendation of untrained people.

The long term consequence of mismanaged, or unmanaged PCOS can be damaging on many levels many patients are not aware of this. The problem these days is that everyone wants a quick fix, or a magic pill, and when things don’t seem to be working, they get impatient and either change treatments, or opt advice from untrained people, or friends and this can be very dangerous.

While self-education is very important, self-management can also be detrimental as conditions such as PCOS requires constant motivation, guidance and proper healthcare management. This was also highlight as part of this recent study.

The study also highlighted that the top 3 issues with PCOS were irregular periods, hirsutism and weight issues. Irregular periods, or absent periods affect about 7 in 10 women with PCOS. Hirsutism or the extra hair on face or other parts of body are seen in 70 per cent cases, while 70 per cent to 80 per cent of women with PCOS are either overweight or obese.

But, women of all body types can have PCOS so this also needs to be noted. Many women put off being investigated for symptoms of PCOS because they believe they need to be overweight to have this condition. There also older healthcare practitioners who still believe this to be the case and this is why it often takes up to 3 years for a woman to be properly diagnosed with PCOS.

There are also other symptoms of PCOS that are often overlooked. Acne, dark patches on the skin on back of neck and others areas, skin tags, hair loss, anxiety, depression, difficulty in getting pregnant, recurrent miscarriages and sleep apnoea are other symptoms that a woman may have PCOS.

What the study concluded

Besides the known factors such and diet and lifestyle, the study highlighted that many women with PCOS suffered in ignorance and isolation. Many women with PCOS are often take up to 3 years to be diagnosed and many are misdiagnosed on the way.

The study also showed that many women with PCOS were unaware of the long term fertility and health consequences, and many hardly have any information given to the about this disease. Many women with PCOS are dependent on internet, friends, other people with the disease etc, as their main source of information.

The study also showed that while routine treatments for PCOS are needed, they can be expensive and less effective than proper dietary and lifestyle control.  Poor diet and lifestyle and increased stress levels are a major reason for the rising prevalence of the disease.

In the study diet and lifestyle changes had a comprehensive impact in controlling other health problems like insulin resistance, diabetes, and hypertension. When women were overweight, or obese, and they reduced body fat, there was also improvement in the symptoms and their testing reports.

Probiotic supplementation also had an overall additional benefit in reducing the abdominal fat, LH:FSH ratio, total testosterone, LPS level, menstrual regularity and also preserving the gut and digestive function. The addition of probiotics to any treatment regime for PCOS needs to be looked at as it could be a new PCOS treatment modality in future.

There are many things women can do to help PCOS and the associated symptoms and the short term and long term health consequences of the disease. While diet and lifestyle interventions needs to be part of this and is the number one treatment for PCOS, women with PCOS do need to be carefully monitored by a qualified healthcare practitioner. This then ensures proper care, management and also accountability and also ensures the disease in properly monitored along with any other changes in symptoms. It also helps with monitoring future fertility and future health issues as well.

If you do need help, or assistance with PCOS, please give my friendly staff a call and find out how I may be able to assist you.

Regards

Andrew Orr

-No Stone Left Unturned

-The PCOS Experts

-The Women’s Health Experts

References

-https://doi.org/10.3389/fendo.2019.00346

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But what do I do and who is going to help me?

Many years ago I was asking this same question, “But what do I do?” and “Who is going to help me?”

Like so many others, I know all too well about having a chronic health condition and living with that daily.

Yes, I too have a chronic disease state and I also know what it is like to live in that chronic disease state. That is why I understand what many of you go through daily. I may not know what it is like to live with your disease state, but I know what it feels like to live in chronic disease state and have to live with the consequences of that disease.

I also know what it is like sitting there thinking that nobody seems to be able to help me and one seems to be getting nowhere with this. Then the vicious cycle of then doing nothing, because one believes that nothing works and nobody can help, and then nothing gets done and the symptoms continue and then you get even more and more frustrated.

Yes, I have been there too. This is why I do what I do now and why I want to help others get out of their rut, and help them overcome their disease and learn to manage their disease better to then have a better life.

But unlike many others, I do know the power of positivity and know that once I put my mind to something and commit to it, then I’ll do as best I can and it also helps get the process going.  I also know that in order for something to change, that I also had to be proactive and make things change. It is that old saying “If you don’t change anything, then nothing changes”

So one day I sat down and said “Right, let’s just forget about whom I have been seeing, forget the blame game etc and let’s just really look at this objectively. What do (I) need to do to create a change?” and “Can I do all these changes on my own?”

Sometimes asking these sorts of questions about yourself can be quite confronting and when you do, you also need to be completely honest with yourself and have those around you be honest with you also.

Then you have to take that advice, listen to what people are saying and then go about finding someone to help you and then actually make the necessary changes that are needed. But, finding someone to help can be really hard too.

Like every other profession, or industry, or workplace etc, there are good and bad people in what they do. Unfortunately finding the good people to help can often be hard, but it doesn’t mean they are not out there.

There are good people out there, and people who are excellent at what they do, but it also means not being sceptical and also having an open mind, otherwise you will just give up and not do anything again. Then you end up being in the vicious ‘poor me’ cycle again and that isn’t going to help anyone. This is where a good counsellor or psychologist can help and be impartial and be objective in what you need to do to move forward.

Then I also learnt that I had to stop the blame game and had to learn to stop making excuses. I know all too well that it was much as it is easy to blame others and blame things for not working, but at the end of the day we are all in charge of our own health, our own lives and what happens to our body too.

Well, to a point anyway. I do know that sometimes you just can’t help genetics and hereditary disease, but at the same time, these disease states can be managed “If” you get proper care.

I remember a good friend sitting me down and talking to me about what I should do and also some of the questions this friend asked me. Some of the things he said to me and insights he shared with me were things like these.

  1. “Are the people you are seeing good at what they do?”
  2. “Have you noticed any changes after the treatments they have prescribed?”
  3. “How long have you been seeing these people for?”
  4. “What are your expectations around the treatments they have prescribed for you?”
  5. “Have you actually been doing the treatments they have prescribed”
  6. “Have you been taking the prescribed treatments and advice seriously and doing it properly?”

This friend of mine said to sit there for a minute or so and really reflect on what he was asking and be completely honest with myself.

He said to me “You know how some people come to see you and then they go away and then don’t take on any of the recommended changes and don’t do the treatments and then expect for things to miraculously changes and you to somehow just fix them without them having to do anything….. are you one of those people too?”

Not something I wanted to hear, but I did appreciate the honesty. I could relate to what he was saying because if one doesn’t do the necessary recommendation, or do the treatment, then one isn’t going to get better and then you can’t blame the person you are seeing if it all goes pear shaped.

Then he said to me “You can’t keep doing the same thing over and over again. If it isn’t working, you can’t then expect a different outcome each time, or just hope that all of a sudden it works.”

He then went on to say “I’ll put it to you this way. If you keep running into a brick wall and then it hurts and you fall over and then get back up again and try to do it again thinking it might not hurt this time, and expect a different outcome, when you know it is going to hurt, then you need to start asking yourself some serious questions”

Then he said to me “Let’s really look at expectation versus reality. You have had this disease state for a really long time, but in your own mind you want it fixed straight away, or after a few days, or after a few weeks.  The thing is… it isn’t going to happen.”

He then continued “You know all too well that if you have had a disease state for years it isn’t going to fix overnight and that it is going to take months, or may even take a year or more to fully get on top of it, depending on the severity and what is going on”

This friend also said to me “Sometimes pain levels and symptom and all a matter of expectation versus reality too. Sometimes you think you aren’t getting better, when in fact you actually are. If someone where monitoring you properly you may have started out at 10/10 pain and may now be 5/10, which is an improvement. But, because you are still in pain, you won’t see it as such until someone points out the difference. It is all relative to what you believe versus what is actually happening ”

Lastly he then put it rather bluntly to me “Who the bloody hell have you been seeing and are they any good?” then he added “Because we all know there are people out there you wouldn’t send your dog to and the good ones are few and far between. Btw, who sent you there in the first place?”

He then added one more thing in “You can’t try and do this yourself, or try and treat yourself because that isn’t going to work and this is not your area of expertise. Go and see someone for advice and help and don’t be like many others and try and (Dr Google), or try and self-manage your own disease. That will end in tears”

So, after my brutally honest, but helpful, conversation with my friend, I did have a big conversation with myself and realised some things. These same things I now share with my own patients.

  1. Not everyone you see is good at what they do and if someone isn’t helping you, then you need to find someone that will. This is why now I always say to people that never underestimate the power of a second, or tenth opinion. Never give up until you find someone who will listen and then really help you.
  2. When you get a referral to someone, do your research and make sure the person you are seeing is well qualified to be helping you and your condition. You need to ask them the big questions and don’t be scared in asking the big questions. If they don’t seem qualified to help you, then find someone else. Also make sure your surgeon is advanced trained, if one is needed and also specialises in your disease state.
  3. Look at who is referring you. Look at what their knowledge of the area you need help with. It is your friend referring that may have no idea? Is it mum, or dad referring? Make sure the person referring you has a good knowledge base of the person they are referring to and also has a good understanding of your disease. Sometimes the people referring you have no idea and then refer you to someone mediocre. It is all about perception and sometimes perception of who is good and who isn’t might be a little distorted.
  4. Look at how long you have had a disease for and look at what your expectations are around how long it may take to see some changes? Then ask the person you are seeing for an honest opinion about how long they would expect to see some changes happening. No long term health issues fixes overnight and the longer you have a disease for, the longer it is going to take to help it and see some real changes.
  5. If you are asking to make changes and do a certain treatment and management plan, then make sure you do it 100%. For changes to happen you have to follow the advice given and stick to it.Forget what Dr Google says. If a professional with years of training tells you to follow their advice, then make sure you give it a chance and actually do it.

    You also need regular follow-up consultations and regular management to oversee those changes and also talk about any concerns and also talk about changes as they happen. You need to document changes and actually be managed properly.

    If a treatment isn’t helping, or you perceive it isn’t helping, then have a chat with your healthcare practitioner about this.

    If something really isn’t working, then you need to change something, or change the person you are seeing until you find someone who can help you.

  6. Pain levels and symptoms and healing times can sometimes be distorted when you are in pain. When you are in pain, or have bad symptoms sometimes you don’t always realise you have had changes, because you are still in pain and have symptoms.As my friend mentioned to me, sometimes you may have started at 10/10 pain, or symptoms, but now you may actually be 5/10 pain and symptoms. That is actually a big change and means you are getting better, but because you are still in pain, or have symptoms, you may not be able to see this until it is pointed out.

    As long as you are progressing and moving forward then this is good and something to give you hope that your treatment is working.

  7. You are always going to have bad days. Even with the best treatments and best management, everyone will have bad days and these are the days you need to be careful about and not get negative about.Shit happens. Bad days happen for everyone and we all have to be aware that while the bad days will happen, as long as you are moving forward, even if it is step by step, then this is a good thing. Like they say “Two steps forward, one step back”, which still means you are one step ahead of where you were.
  8. Don’t try and treat yourself. It is good to be educated and good to be informed etc, but relying on Dr Google, or friends advice etc, can be a bad thing too.We don’t try and cut our own hair, or fix our own car, or make our own medicines etc, so we shouldn’t try and fix ourselves either. We need someone who can be objective and someone who is actually qualified in the area that we need help with to get the best results.
  9. Many disease states need a ‘team’ or multimodality approach to give you the best results possible. We know that despite the best medical treatments, that many people are still in pain etc and it isn’t until they incorporate other therapies, that they then start getting positive results. Be open to trying new therapies and new things that may help you.
  10. If you do ever need to go to the emergency department for your disease, just remember that the emergency department isn’t there to fix your chronic disease. They are there to stabilise your pain and stabilise your symptoms and once that is done, they are more than likely to send you home, if you aren’t in any medical danger. If so they will admit you. But part of critical care should be making sure you are referred to someone who can manage you clinically moving forward. The reality is that sometimes this doesn’t always happen.
  11. Never ever let the disease own you. You are not the disease and it does not own you and we need to be careful of not buying into the label and then letting the disease and the label consume us. Take back your power and be positive and use that to help you overcome the disease and being owned by the label.
  12. Be kind to yourself. That means eating good foods, exercise, lifestyle changes and getting out into the sunshine daily. Many foods that we eat are inflammatory and only add to the inflammatory disease process you are dealing with already. Create good gut health to build up your reserves of health gut bacteria to help your body and help your immune system. Get the body moving and get the circulation and blood flow moving to nourish the body too.
  13. Last but not least, never underestimate the power of the mind, or how emotions can be a big part of a disease state and some of those disease states symptoms.We check in our tax to the accountant, we check in our health with the GP, we check in our hair to the hair dresser, but when do we actually check in our emotions and our thought processes.

    Never underestimate the power of talk therapy and seeing a counsellor etc. The body mind connection is a big part of many diseases. Never underestimate the power of stillness and mindfulness and bringing the body to rest and being mindful of your life and what may be needed to help your health. There are people who can help you with mindfulness and meditation and creating that positivity in your life

Having lived with a chronic disease state for most of my life, I do know how challenging it can be for people and to find that strength and courage to actually get up and do something about your health.

It can also be disheartening when the people you have seen have missed and dismissed your disease too. It all just compounds and adds to the daily burden of what you are going through.

But, never let those things stop you from finding someone who can help, or finding the strength to get up and make the necessary changes you need to make a better life for you.

I think that having a disease is sometimes like learning to ride a horse. You may fall off many times, but you need to just get straight back on again until you master the art of staying on and being a good rider and being in control. But even the best rider is going to fall of every now and again, and that is ok too.

Just remember that there is always help out there and there are people who will listen and who do specialise in the area you need help with.

Lastly, for you to get better, it also needs for you to be a big part of the driving force behind that and actually do the work needed. Don’t just sit there in ‘poor me’ mode. Get up and get yourself out there and do what you need to do for you.

If something isn’t working then change it. Just remember that in order for a change to take place, something has to change. Something that means you changing your belief and your thinking too. It might also mean changing the healthcare provider you are seeing too.

As someone who has been there, I hope this helps you all get the help you so desperately deserve. Just remember that if you don’t know what to do, or where to get help, please know I am here to help you as well. You can always book in a consult (in person, or via online) and I can help assist you with your health, and also point you in the right direction too.

Regards

Andrew Orr

-No Stone Left Unturned

-Women’s and Men’s Health Advocate

Cancer Pregnancy Endometriosis

Why am I getting bleeding between my periods?

Vaginal bleeding between periods can be common and is not generally a cause for concern. Most of the time women will get just very light pink coloured watery flow, or just some spotting.

There can be many reasons why a woman would be getting bleeding between periods, which includes hormonal changes, injury, or an underlying gynaecological, or health condition.

While bleeding between your periods may not be cause for concern, on one level, the ideal situation is to not have any form of bleeding at all and if you do get bleeding between your cycle, it is a good idea to have this investigated, just to be on the safe side.

What a proper menstrual cycle should be like

I have done quite a few posts on what a proper menstrual cycle should be like, but I will go over this again just briefly

A proper menstrual cycle should be between 26-32 days in length and really only have about 3-5 days flow. Any longer than this can be too long and put a woman at risk of being low in iron, especially if this happens all the time.

The blood flow should be a nice red consistency, no clots, with no stopping and starting, and women shouldn’t have too many digestive disruptions, and really, a woman should not be getting pain with her cycle.

A little bit of distention and knowing the period is coming is fine, but there should not be pain at all. If you have to reach for the pain killers and the heat pack, or are doubled up in pain, this is not normal and you need to get this checked out.

What are the causes of bleeding between periods?

As mentioned before, there can be a variety of reasons for breakthrough bleeding, some of which are no cause for concern at all. Some however do need to be investigated.

Below are some of reasons for bleeding between periods:

Ovulation

When an egg is released from the ovary, it does create a tiny wound, through which the egg will then travel through the tubes and prepare to make its way to be fertilised, or then shed with the menstrual flow. At ovulation, this tiny wound can also create a tiny amount of bleeding, which can be seen as spotting during the ovulatory phase of a woman’s cycle.

Implantation bleeding

When an embryo implants into the uterine lining and begins to grow, many women experience spotting around this time. This is called implantation bleeding. They may also experience some slight cramping at the same time and all of this is quite normal. Some women may then experience some lighter bleeding as the embryo grows further. They usually get some light spotting, which can be a light pink, or a brown colour. Sometimes it can be more like fresh blood. While this is normal, it is a good idea to get this checked out just to be on the safe side and to also put the pregnant mothers mind as ease too.

Miscarriage

Bleeding between menstrual periods can be an early sign of a miscarriage. Many women may not even know they are pregnant and may be completely unaware they are having a miscarriage.  While it is generally thought that once a woman reaches twelve weeks gestation everything is generally going to be ok, miscarriages can occur at any time during pregnancy.

Termination

After having a termination women can bleed for some time after the procedure, or taking the medication to start the abortion process. If bleeding continues and is very heavy, women need to seek medical advice.

Polyps 

Polyps are small growths that can develop in the uterus or on the cervix. They are often a cause for unexplained bleeding between the cycles. Polyps do need to be removed as they can prevent implantation happening and they can also turn cancerous if left behind. Polyps are a very common cause of bleeding between periods.

Fibroids

Fibroids, or myomas (also known as leiomyomas, or fibromyomas) are growths, or benign (non-cancerous) tumours that form in the muscle of the uterus. Up to 40% of women over the age of 40 years have fibroids and as many as 3 out of 4 women develop fibroids in their lifetime.

Fibroids can cause heavy bleeding, extended bleed and painful periods. They can also cause infertility, miscarriage and premature labour. In many women, they will not cause any problems at all. Fibroids are a very common cause of bleeding between the cycles.

Polycystic Ovarian syndrome (PCOS)

Polycystic Ovarian Syndrome (PCOS) is a very common condition that can cause irregular periods, absent periods, and can also cause bleeding between periods. PCOS can also cause other issues such as acne, weight gain, infertility and hormonal and emotional disturbances.

Endometriosis or Adenomyosis

One in ten women are diagnosed with endometriosis and many more do not even know that they have it. Endometriosis and Adenomyosis are very closely related, with endometriosis usually being more superficial disease and not confined to the uterus,  and adenomyosis being deep within the uterine tissue. Chronic conditions such as endometriosis and adenomyosis, can cause bleeding or spotting between periods.  These conditions may also cause heavy or painful menstrual periods and cramps between periods. Adenomyosis will usually cause more bleeding symptoms along with pain etc.

Sexually transmitted infections (STIs)

Some sexually transmitted infections (STIs) can cause pain, vaginal bleeding and spotting. If you do suspect you may have a STI, you need to see your doctor for investigation and treatment.

Injury to the vaginal wall

During sexual intercourse the tissue of the vagina can be damaged and this can then cause bleeding. If the vagina is too dry, lack of arousal, and not lubricated enough this is more likely to happen. It can also happen if there is atrophy in the vaginal tissue as well. This is called atrophic vaginitis.  This is more likely to be seen when a woman is going into menopause, or undergoing cancer treatments, or has diabetes.

Menopause or perimenopause

The menopausal stage of life and especially the perimenopause stage, can be a cause of irregular menses and irregular bleeding. It can also cause spotting, or heavy bleeding too. Perimenopause is the period leading up to menopause. This stage of a woman’s life can last for up to 10 years as hormone levels in the body change and can be unstable.

Hormonal contraceptives

Hormonal contraceptives are a common cause of bleeding between periods. They can also cause irregular bleeding and this can be quite usual in the first 3 months of using the contraceptive. If a woman misses takin her oral contraceptive, it can also cause irregular bleeding, or a withdrawal bleed.  Intrauterine Devices (IUD’s) like the Mirena, will often cause irregular periods and irregular bleeding in the first 3 months after it have been inserted. If bleeding lasts for longer than 3 months on any contraceptive, it is a good idea to seek medical advice and get investigated and managed properly.

Emergency contraception

The morning after pill, or emergency contraceptives, may also cause bleeding. If bleeding persists, you should seek medical advice.

Certain cancers

Vaginal bleeding between periods can also be a sign of gynaecological cancers in women. Most bleeding that women get is not serious, but it still needs to be checked.  Cervical cancer can affect women of any age. Bleeding between the cycle, or after intercourse, and pain after intercourse, or unpleasant smelling discharge can be symptoms of cervical cancer and these all need to be checked by your doctor, or gynaecologist.

Uterine cancer tends to occur in women over 50 year of age. One of the early symptoms of uterine cancer can be vaginal bleeding. Uterine cancer mostly affects women are in the menopause and no longer have periods, so this is why any bleeding after menopause needs to be investigate and seen as not being normal.

Stress

Yes, stress can cause abnormal bleeding and also interfere with a woman’s cycle. Increased levels of stress can interfere with hormones and this can lead to bleeding, irregular cycles, or pain with cycles too.

When to see a doctor

If vaginal bleeding between periods is heavy, persistent, or unusual then a woman should go and see a specialist, or a gynaecologist, who is a specialist in this area of medicine. As mentioned previously, while some causes of bleeding are not serious, some are and need to be properly investigated and properly managed medically.

Treatment and prevention

All women should keep a record of their menstrual cycle and when the period starts and how long it lasts for. Any abnormal bleeding should be recorded so that you can show your healthcare specialist if need be. Any abnormal bleeding should be investigated and the treatment will depend on what the underlying cause is.

Women should try and see their healthcare specialist for regular pap smears and regular check-ups for gynaecological health.

If women are getting small tears and bleeding caused from dryness in the vagina, then there are water based lubricants that can be used to help with lubrication and to moisturise the surrounding tissue.

There is no cure for gynaecological and reproductive issues such Endometriosis, but these disease states can be treated and managed to give women a normal life.

Proper treatment of these issues needs a “Team”, or multimodality approach using medical options, surgical interventions, pelvic floor specialists, complementary therapies, hormone therapies, and diet and lifestyle changes. It is about using what works for the individual and not a blanket one treatment fits all approach.

Last but not least, all women should know that period pain is not normal and that irregular bleeding really isn’t normal either. While most causes of bleeding are not life threatening, they still need to be investigated and checked out properly. Never ever put off seeing a medical specialist if you have abnormal bleeding.

If you would like to book in a consultation with me and find out how I can assist you with women’s health conditions, please give my friendly staff a call and they will be able to assist you.

Regards

Andrew Orr

-No Stone Left Unturned

-Women’s and Men’s Health Advocate

disease 4392164 1920

Could You Be Suffering With Interstitial Cystitis?

Interstitial cystitis (IC) is a chronic inflammatory bladder condition in which there is persisting chronic pelvic pain, urinary frequency and urgency, bladder pain or pressure, and it can also resemble the symptoms of a urinary tract infection, but there will be no infection present. The pain can range from being mild to severe.

Worldwide Interstitial Cystitis affects up to 100 million people and it can affect both men and women, regardless of age. IC is also known as painful bladder syndrome (PBS), bladder pain syndrome (BPS) and chronic pelvic pain (CPP)

Women with interstitial cystitis may experience many of the same symptoms as those with endometriosis. Women can have both Interstitial Cystitis and endometriosis at the same time. Some people with IC may also have irritable bowel syndrome (IBS), Fibromyalgia and other pain syndromes

People with IC have chronic symptoms in the urinary tract that last more than 6 weeks in duration. Infection has not been identified as a cause of IC. Physical and emotional stress can worsen the symptoms of IC.

Interstitial Cystitis can cause the following symptoms:

  • Chronic pelvic pain that lasts 6 months or more
  • Symptoms affected by the menstrual cycle
  • Pain, pressure, discomfort or unpleasant sensation that may worsen as the bladder fills
  • Urinating often alleviates the pain and may give a temporary sense of relief;
  • Suprapubic pain or discomfort
  • Pelvic pain (lower abdominal pain), sometimes extending to the lower part of the back, the groin and thighs
  • In women there may be pain in the vagina and vulva
  • In men, pain in the penis, testicles, scrotum and perineum
  • Both men and women may have pain in the urethra and rectum
  • Pain with sexual intercourse in both men and women (dyspareunia)
  • Pain on ejaculation in men
  • Pain may worsen with specific foods or drinks
  • A frequent need to urinate (frequency), including at night (night-time frequency or nocturia)
  • An often urgent or compelling need to urinate (urgency)

The pain may be experienced as discomfort or tenderness or irritation or burning sensation in the bladder, in the form of spasms in or around the bladder, or stabbing or burning vaginal pain or simply a feeling of pressure on or in the bladder or a feeling of fullness even when there is only a little urine in the bladder.

In many people, the pain is relieved temporarily by urination, while other people may also feel strong pain following urination.

The pain or discomfort may be constant or intermittent. It may also be felt throughout the pelvic floor, including the lower bowel system and rectum. In some patients the pain may be very severe and debilitating.

Other people, particularly in the early stages, may have milder frequency with/without urgency and without a true sensation of pain. What they may experience, however, is a feeling of heaviness, fullness, discomfort or pressure.

Diagnosis

During the evaluation of potential IC, several tests may be completed to make a diagnosis. These tests may include taking a full medical history, completing a bladder diary, pelvic examination, including a neurological exam and urinalysis to rule out or diagnose an infection

Other diagnostic tests that can be carried out include:

Cystoscopy: This is performed inserting a tube, with a camera attached, into the bladder to evaluate the lining and to look for inflammation and signs of disease. A specialist may also evaluate the bladder capacity with a cystoscopy.

Urodynamics: The bladder is filled to test its capacity by measuring the pressure during filling and voiding. These tests evaluate the function of the bladder, urethra, and sphincter muscles.

Biopsy: During a cystoscopy, a biopsy may or may not be taken to rules out cancer or other inflammatory bladder conditions that can cause pain similar to IC.

Potassium sensitivity test: This is a test in which potassium and water are instilled into the bladder. In healthy bladders, pain is not felt with either solution. In cases of IC, however, pain is typically experienced when the potassium is instilled.

Diet

People with IC may be sensitive to certain foods and beverages. There is a range of items a person may need to excluded from their diet after receiving an IC diagnosis. This will be different for each individual but there are certain foods and drinks that an individual with IC should be aware of potentially needing to avoid. There are food and drinks such as:

  • tea and coffee
  • Soft drinks and soda (including diet drinks)
  • alcohol
  • citrus, citrus drinks and cranberry
  • artificial sweeteners
  • spicy food

Some people with IC may need to a food elimination diet over several weeks to see which specific foods and drinks may be exacerbating their symptoms. There are many foods that do not have an irritating effect on the bladder and contain vital nutrients to help fight disease. This is why elimination diets and specific dietary requirements need to be done under the guidance of a healthcare professional.

People with IC should also give up smoking if they are a smoker, as the chemicals can affect this condition too.

Treatment

The treatment of interstitial cystitis is complex and needs a multimodality approach to treat it effectively. It may require treatments such as:

  • Urodynamic Therapies
  • Physiotherapy with a specialised pelvic floor physiotherapist
  • Pelvic Floor Therapy (Kegels, Yoni eggs, Ba Wen Balls, internal TENS)
  • Surgery, including laser surgery
  • Neuromodulators, such as electrical nerve stimulators
  • Injections, such as Nerves blocks, Antispasmodics and Botox therapy
  • Pain medications- including narcotics, NSAIDS, Anti-inflammatories,
  • Hormone therapy, both oral and intravaginal
  • Antidepressants
  • Acupuncture
  • Pilates and Yoga
  • Exercise
  • Herbal Medicines, including Chinese Herbal Medicines
  • Amino acids, vitamins and antioxidants
  • Sex Therapy and counselling
  • Mindfulness
  • Adopting health sleeping habits

Your specialist or healthcare provider will discuss the best forms of treatment for your individual case. People with IC should also be referred to a Urodynamic and Pelvic Floor Specialist who specialises in this area.

Complications

Complications from IC can vary between individuals and why there is no one treatment fix all approach to this conditions. IC can affect a person life on so many levels. It can affect their bladder volume, their quality of life, their sex life, their libido and have an affect on sexual intimacy and it can also cause them emotional distress. It is a complex condition that can affect every aspect of a person’s life both physically and mentally and why a multimodality treatment approach is needed.

Causes

The exact cause of IC is not known, but there are several theories as to what triggers the condition. Some possible causes include:

  • Damage due to previous surgery
  • Defects in the lining of the urinary bladder that cause irritation
  • Overstretching of the bladder due to trauma
  • Pelvic floor muscle dysfunction
  • Autoimmune disorders
  • Spinal cord trauma
  • Genetics
  • Allergy

IC is a chronic inflammatory condition that affects many people world wide. It cannot be fully cured and requires close clinical management and care. A multimodality treatment approach needs to be adopted that is suited to the individual. When this is done properly, people with IC can still have a good quality of life.

Recommended treatment usually involves diet and lifestyle changes, stopping smoking, drinking less before bedtime, and scheduling planned toilet breaks to ensure the bladder does not get too full.

If you do need assistance with Interstitial Cystitis, please call my friendly staff and find out how I may be able to assist you.

Regards

Andrew Orr

-No Stone Left Unturned

-Women’s and Men’s Health Advocate

-The Women’s Health Experts

Bladder Endometriosis

What is Bladder Endometriosis?

Endometriosis is a condition where tissue resembling the uterus lining grows outside the uterus, such as on the ovaries or fallopian tubes. Endometriosis can spread to every organ in the body and can grow inside, or on the outer surface of the bladder.This is what is known as Bladder Endometriosis.

To learn more about endometriosis and to learn about the symptoms of this disease, you can click on this link to find out more (Click Here)

If endometriosis forms in, or on the bladder, it that can cause severe discomfort and pain. It can also make a woman want to urinate more and also with urgency, pain, burning and frequency.

There are other bladder conditions with the same, or similar symptoms, but endometriosis can also aggravate these conditions, or be present at the same time as well. I will discuss the other forms of bladder pain and interstitial cystitis, which can have similar symptoms to endometriosis affecting the bladder, or bladder endometriosis.

Prevalence

Bladder endometriosis is not common. Reports state that around 2 percent of women with endometriosis may have endometrial growths in their urinary system, with endometriosis growing in, or on the bladder. But even if endometriosis isn’t on, or in the bladder, it can still cause issues with the bladder and cause associated symptoms.

What are the Symptoms of Endometriosis in, or on the bladder?

One of the main symptoms bladder endometriosis is pain when the bladder is full and a woman needing to urinate more frequently. It can also cause symptoms resembling a urinary tract infection, but no infection will be found to be present.  Women do need to be aware that a significant portion of women with endometriosis are asymptomatic (meaning no symptoms) and may not be aware that they have endometriosis until they have investigations for another reason, such as not being able to fall pregnant.

Some women are more likely to notice symptoms of endometriosis around the time they are due to have their menstrual cycle.

Other symptoms of bladder endometriosis may include the following:
• More frequent need to urinate
• Needing to urinate urgently
• Feeling pain when the bladder is full
• Stinging and burning or painful sensations when passing urine
• Seeing blood in the urine
• Experiencing pelvic pain
• Having lower back pain, more on one side of the body

Diagnosis

The definitive diagnosis for endometriosis is via a laparoscopy as this is the gold standard investigation for investigating disease states inside the pelvic cavity. A biopsy is usually taken at the same time to check the microscopic implants of endometriosis, which cannot be seen visually. Normal ultrasound, transvaginal or abdominal, cannot diagnose endometriosis. Blood tests cannot diagnose endometriosis either.

If Endometriosis has spread inside the bladder a cystoscopy would be needed also. A cystoscopy is where a small scope is inserted into the bladder and the specialist can then see if there is endometriosis, or other inflammatory disease in the bladder lining.

The specialist will then see what stage the endometriosis is at. This is a staging system from 1-4, but this is only to let the surgeon know how much of the disease is present. The staging system does not have anything to do with pain levels, as pain levels “are not” related to the extent of the disease. A woman with stage 1 endometriosis could have more pain than someone who is stage 4, and someone who is stage 4, may not have any pain, or associated symptoms at all.

Treatment

There is no current cure for endometriosis. However, the condition can be managed through a multimodality approach that involves surgery, hormones, pain medication, physiotherapy, herbal medicines, acupuncture, yoga, pilates, diet, lifestyle changes, counselling and an individualised approach. Women with endometriosis need a team approach.

Surgery, via a laparoscopy, is the most common treatment, and definitive diagnosis, for those with endometriosis. If endometriosis had been found in the bladder transurethral surgery will be done at the same time. This involves a scope inside the bladder to cut away any endometriosis in the bladder lining. Sometimes a partial cystectomy is needed to remove an affected part of the bladder.

While surgery is a much-needed part of the treatment and diagnosis of endometriosis, it is not a cure. Endometriosis can, and often does, grow back again, even with the best medical forms of treatments and interventions.

Fertility

Bladder endometriosis does not have any effect on a woman’s fertility. However, endometriosis does grow in other parts of a woman’s body and reproductive system such as the ovaries, which may affect a woman’s likelihood of conception. But, endometriosis does not always affect fertility.

The Difference Between Bladder endometriosis interstitial cystitis
When endometriosis gets in the bladder it can cause very similar symptoms to another bladder condition called interstitial cystitis. This can often make it very hard to differentiate on symptoms alone.

It is also very possible to have both interstitial cystitis and endometriosis present at the same. This is why further investigations are needed to definitively diagnose both these conditions.

I do have a separate post on interstitial cystitis so that people know more about this inflammatory condition that affects the bladder.

Outlook for Women With Bladder Endometriosis

At present there is no real known cause of endometriosis and only speculation as to what the true cause is. We know that endometriosis is estrogen driven (not from estrogen dominance), but the most likely cause is probably due to genetic reasons and being a hereditary condition passed on through the parental mode of inheritance and then expressed into the body. The how, when and why will hopefully be answered in the not too distant future hopefully.

Women with endometriosis in the bladder do need to be careful and managed properly as it can cause kidney damage. There is also some research to show that endometriosis in the bladder can lead to cancer in the bladder, but this is thought to be very rare.

For now, anyone with endometriosis needs to be clinically managed properly through a multimodality team approach mentioned before. Let’s get more education out there so that women with this horrible disease have a voice and we end the silence for these women as well. Hopefully through education, funding and further research, this leads to the cure that women with endometriosis so desperately deserve.

If you do need help with endometriosis, please call my clinic staff and find out how I may be able to assist you. I do have a special interest in endometriosis and am very passionate about women receiving the right care and health management moving forward.

Regards

Andrew Orr

-No Stone Left Unturned

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-The Endometriosis Experts