What is that health condition so embarrassing to you that you’d not freely discuss it with family or even a doctor?
Medics say cases of patients being uneasy with some medical conditions are common, leaving many at risk of severe health complications or even death because they would not step forward for help.
Paul Mitei, a medical doctor, discussed the issue with the Business Daily.
1. Anal itching
This is a common problem which may be caused by poor hygiene, anal warts — sometimes caused by human papillomavirus (HPV) — haemorrhoids, dyes or other agents in toilet paper, fungal infection, lice, or sexually transmitted infections.
The condition can also be caused by an allergy to soaps or tissue. “These are uncomfortable areas to scratch openly. The itchiness could also be a yeast infection and may be a colorectal condition.
“Seeing a doctor can solve the problem,” Dr Mitei said.
In mild cases, the itching may be controlled by improved hygiene or decreasing intake of yeast.
2. Vaginal flatulence
This involves sudden loud emission of air from the vagina and mainly happens during or after sexual intercourse, body stretches or exercise. Though the sound produced may be comparable to flatulence from the anal opening, it has no odour.
“This is a common health problem, but most women are too embarrassed to talk about it,” Dr Mitei said.
The condition is caused by loose pelvic muscles that cause vaginal muscles to expand and trap air inside.
The condition can be corrected through physiotherapy or surgery to rectify the loose muscles, Dr Mitei said.
3. Urinary incontinence
This is a common yet embarrassing condition where one loses control of the urinary bladder. People suffering from this condition report varied severity, from occasional urine leaks when they sneeze or cough to inability to hold back urine. Medics attribute the condition to weakened pelvic muscles and the urethra sphincter.
Some factors heighten chances of developing the condition including obesity, pregnancy and vaginal birth, advanced age or a history of incontinence in the family. “Pelvic exercises including kegels can strengthen muscles,” advises Dr Mitei. The condition can also be managed through dieting for weight loss or training of the urinary bladder. Surgery is also recommended for extreme cases of urinary incontinence.
4. Sexual dysfunction
Sexual dysfunction has become a common problem among Kenyan men and women, but many are too anxious to talk about it with their partners and doctors. In women, it is mainly manifested through reduced sex drive and vaginal dryness, while in men it is characterised by erectile dysfunction or premature ejaculation.
Premature ejaculation may be caused by anxiety about sexual performance, stress, unresolved issues in a relationship, or depression. It may also be due to an infection in the prostate or urethra. Tackling stress or treating infections may help deal with premature ejaculation.
“It can also be solved by putting on a condom and resuming sex only when one is ready, applying creams may also help,” Dr Mitei said.
Some men are also unable to get or keep an erection during sexual intercourse. This may be due to causes such as diabetes, high blood pressure or a heart condition.
Alcohol and hard drugs may also trigger erectile dysfunction. In women, loss of libido is mainly triggered by hormonal changes, aging, stress, anxiety and side effects of medication. Medication, psychosexual counselling as well as physical exercise can help tackle sexual dysfunction.
5. Vaginal odour
This is one of the biggest problems that women face, but many do not discuss it freely with family or doctor.
One of the greatest causes of the problem is chlamydia, gonorrhoea or bacterial vaginosis; an overgrowth occurring due to vaginal bacteria.
“The birth canal cleanses itself naturally. If you leave it to its own devices, it can naturally maintain a healthy PH and keep unhealthy bacteria at bay, but when attacked one experiences itchiness and unusual discharge which causes the odour,” said Dr Mitei.
Practising good hygiene like cleansing the area regularly using water and mild soap can wash away the smell, change underwear frequently, stay hydrated by drinking plenty of water — which is good for more than just your skin. Washing your vagina before and after intimacy helps to maintain natural bacteria levels because fluids and foreign substances like lubrication and spermicides from condoms tend to introduce bacteria.
“If the odour persists see a doctor because it could be a sign of a bigger problem like cervical cancer,” advised Dr Mitei.
6. Anal fissures
In this condition one develops cracks in the anus. This can be very uncomfortable and painful in extreme conditions.
Dr Mitei said the condition may be caused by a hard stool passed by a constipating patient, causing fissures.
Repeated episodes of diarrhoea could also cause tears on anal tissues. Softening stool or consuming high fibre food can help deal with anal fissures. Surgery may be a treatment option in severe cases.
This is a condition where one develops swellings containing enlarged blood vessels inside or around the rectum and anus. The condition does not often show symptoms but when they come, they manifest in the form of bleeding after passing a stool, an itchy anus, a lump of body tissue hanging outside the anus — which may need to be pushed back in after passing a stool, a mucus discharge, soreness, redness and painful swelling around the anus.
“Naturally, no one wants to show a doctor a swollen anus. People prefer suffering in silence and using home remedies and traditional herbs,” Dr Mitei said. The condition can be caused by straining during bowel movements, or for prolonged periods.
Too much straining on the toilet as a result of prolonged constipation, often due to lack of fibre in one’s diet, can also cause the condition. Going to the toilet promptly helps limit the condition. Eating plenty of high fibre foods (cereals, fruits and vegetables) and exercising regularly can help with digestion and limit chances of developing the condition. “Most people use warm water and a piece of cloth to massage the area for the swelling to subside.
There is a need to see a doctor for a prescription. Not seeking treatment could worsen the situation, necessitating surgery,” said Dr Mitei.
8.Bad breath/ body odour
This is caused by either tooth decay or poor hygiene whereby one does not clean the mouth and teeth well. It is common for individuals to resort to chewing gum or using mouth fresheners to deal with bad mouth odour.
Persistent bad breath may signal gum disease. Eating strong flavoured foods, such as onions and garlic, can also cause breath to smell, as can smoking and drinking alcohol. For one to improve oral health, routines such as daily flossing, brushing teeth and gums regularly and cleaning the tongue are recommended.
Dr Mitei said that bad breath can also come from lung infections and severe sinus problems. This can indicate a life-threatening condition such as poorly controlled diabetes. See a dentist for advice.
Body odour could be caused by hot weather which causes sweating. Most people are too embarrassed to discuss the condition, with some covering up the smell with perfume, which makes it worse.
The smell can also be caused by bacteria in the skin. Some of the parts that smell the most are armpits, the groin, rectum and feet. “Some interventions like taking a daily shower and using perfumed soap and body perfumes are not effective. See a doctor before it is too late. This can be a sign of a serious problem and the earlier you seek treatment the better,” Dr Mitei said.
How to handle patients with sensitive health issues
Convincing a patient with an embarrassing health problem to open up for medical assistance is not an easy matter. Medics have adopted diverse strategies to win their confidence. “The first thing I do to make patients relax is meet them in a different environment, may be a restaurant,” said Paul Mitei, an obstetrician and gynaecologist.
“The hospital environment is feared by many, more so men,” Dr Mitei said. The second point is to be prepared because some patients break down and want to share more, he said, adding that he gives them writing paper and pen.
Some are more comfortable writing than narrating, he explains. “I then develop a list of questions and encourage them to talk honestly about their condition,” said Dr Mitei .
He also makes the patient understand that not visiting a doctor could worsen the condition. “Some see the sense, but others are adamant,” he said. “We also use pseudo names in their files because their cases are confidential and we do not want others to know about them. But with all these assurances we still face resistance from some patients,” he said.
When it comes to other procedures, Dr Mitei said they have to be around to give instructions and talk to the person performing the procedure rather than the patient doing the talking.
“When we do the talking it becomes easy because they do not have to narrate their problems to third parties,” Dr Mitei said. It calls for patience and understanding to handle such patients, he said. “You don’t nag them or show that they are the cause of their problems because all they need is to get better and not lectures,” he said.