Paisley Prescriptions - July 2018

Your Bodily Fluids and the Story they Tell


The human body is a well-built machine offering warning signs just like your car. While these signs are not flashing lights, they are easy to detect by just paying attention. Obviously aches and pains are  warning signs indicating something is wrong. Another warning sign is your bodily fluids. That’s right, the stuff most of us think is gross, like poop, pee, discharges and blood, actually are magnificent storytellers about what’s going on inside our bodies. Here’s what we found out:

Give us the low down on down under.
What do we need to be concerned about?
A woman’s pelvis includes parts of the urogenital system along with the rectum and colon. Your OB-Gyn or personal physician should guide you regarding your care. Changes in your normal state can include unexpected bleeding, discharge, UTI symptoms (itching, burning, urge to urinate, etc), mucous discharge vaginally or rectally, and abnormal growths, such as warts or hemorrhoids. There is also concerns that reduce quality of life and may be relatively asymptomatic. These include vaginal atrophy and pelvic relaxation issues, such as urinary incontinence and sexual dysfunction.

Most things can be screened for on a routine pelvic exam. The frequency of this exam is based on your age, findings on exam, and standard recommendations. Follow your physician’s advice on this.

Non-invasive treatment is available for quality of life issues that are detected early on. The entire pelvic floor can be strengthened by treatments with the BTL EMSella chair, which treats female urinary incontinence. (Georgia Coast Surgical currently has the EMSella in Georgia) Sexual dysfunction can be treated by radiofrequency devices. (Our BTL UltraFemme 360 device requires 8 minutes for interior vaginal rejuvenation.) External treatments for the vulva are available, too.

What bloody concerns should I have?
Your physician will probably order labs on you during a routine exam, or when you have certain symptoms.

Some general recommendations include monitoring lipids (cholesterol and triglycerides), checking for HIV and monitoring blood sugars (often with the addition of hemoglobin A1c in patients with a family history of diabetes) for patients in their 20s. In addition to these labs, a complete blood count (CBC) and complete metabolic panel (CMP), which checks for liver and kidney function as well as protein and calcium levels, are ordered fairly frequently.  

Over the age of 30, thyroid function should be checked. Hepatitis C screening is frequently recommended due to its prevalence, and current recommendations are that HPV (human papilloma virus) should be checked periodically.

Due to the frequency of heart and vascular disease, CRP should be checked in women in their 40s and 50s. In addition to this, homocysteine and Lipoprotein A may be checked to further identify cardiac risk factors.  Vitamin D levels should also be checked since a significant percentage of the population has low levels which can lead to an increased risk of osteoporosis. There can be a role for testing estradiol and testosterone as women age if they experience decreased energy or libido.   kent

Harold L. Kent, MD, FACS, is Board-Certified with the American Board of Surgery, Past-President of Georgia Society of American College of Surgeons and President of the American Society of General Surgeons. He is owner of Georgia Coast Surgical and Med Spa, 3226-F Hampton Avenue, Brunswick, GA. 912-264-9724.

What does the color of our urine tell us?
Urine is made as your kidneys filter excess salts, fluids and waste products like urea from your body. The average person urinates about every 3-4 hours, so approximately 6-7 times a day.

Urine frequency, volume, color and odor varies from person to person, day to day, depending on fluid intake. A pale yellow to gold color is typical. Fluid needs vary, but remember, it is estimated that the human body is about 60 percent water. Good hydration is important. It is generally recommended for the average adult to drink eight 8-ounce glasses of water each day (about 2 liters or 1/2 gallon). You may need more if you exercise or work outside. Nope, wine and coffee don’t count.

Color and odor are affected by fluid intake, as well as the foods we eat, and the medications, vitamins and supplements we take. For example, asparagus and B vitamins often cause a strong odor. 

At present, there is no specific recommendation for urine testing for preventive care in an otherwise asymptomatic healthy adult. However, if you have a significant change in the frequency or volume of urine, check with your health care provider. For example, increased urination may indicate infection, or can be a symptom of diabetes, while urinating a lot less could indicate dehydration, or a blockage. If better hydration doesn’t help, or there’s pain or other symptoms, it is always reasonable to check with your health care provider.

What’s the latest scoop on poop?
Ask a hundred people about their bowel habits, you’ll get a hundred different answers.  Television ads make it sound like you should have the same sized, perfectly sculpted poo at the same time every day. Truth is, it can be just as normal to have three stools a day as it is to have a bowel movement three times a week.

Color, texture, frequency and volume can vary largely depending on what we eat and drink. Even exercise, or lack of, can affect stool habits. Good hydration and a healthy balanced diet rich in fiber are important.

Know what is normal for you. You don’t have to study the toilet every day but be aware of your stool patterns. If you have a persistent change in your bowel habits, whether it’s a different color, consistency, size, shape, volume or frequency, it is wise to discuss with your health care provider.
Blood in the stool is never “normal.” Though it may be something simple like a small hemorrhoid, it could indicate something serious. Likewise, black stool is something to discuss with your health care provider. Perhaps it is easily explained by a new supplement with iron, but black tarry stool can come from internal bleeding. It never hurts to get it checked out, but it could be a problem if ignored.
The American Cancer Society recently advised lowering the age of colon cancer screening to 45 for asymptomatic low-risk people. Talk with your provider about screening options.Carter

Margaret Carter, M.D., is a board-certified family medicine physician with Southeast Georgia Physician Associates- Primary Care, a strategic affiliate of Southeast Georgia Health System; 7000 Wellness Way, Ste. 7210, SSI. 912.466.5985.

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