Wednesday, April 20, 2016

Pelvic Floor Dysfunction - Do I have it?

by Dr. Urszula May, MHSc, ND

Have you suffered with stress incontinence, urinary urgency/frequency, painful bladder syndrome or painful intercourse?  What about pelvic organ prolapse, prostatitis, heaviness in the vaginal or rectal area, constipation, fecal or gas incontinence?  These are a few of the conditions that are related to pelvic floor dysfunction and that can be addressed through pelvic floor treatment.  

What is the Pelvic Floor?

The pelvic floor is a sling-like structure that sits between the hips and has several important functions.  It's made up of muscle and connective tissue that:
  • support internal organs 
  • allow sexual functions
  • relax during urination, defication and birth
  • act like a pump moving blood and lymph from our lower body back to our heart
  • and provide stability for the body as a whole. 

What Causes Pelvic Floor Concerns?

The pelvic floor is a crucial component of your anatomy and can be damaged in a number of ways.  Falls, traumas, infections, childbirth and surgeries are some of the most common reasons patients end up with pelvic floor dysfunctions.

When damaged, the muscles, tissues and joints of the pelvis can become too tight or too loose, or both.  Tissues that are too tight can pull on the structures in their neighbourhood, like the bladder for example, leading to urge incontinence or painful intercourse.  When these tissues are too loose, pelvic organ prolapse or stress incontinence can result.

Many pelvic floor issues arise slowly over time. Also, they can wrongly be associated with aging in general and misdiagnosed as hip and / or low back pain.  Pelvic floor dysfunctions can tremendously impact a person's quality of life. They often result in people spending more time at home and avoiding social outings due to concern with bladder control or pain management. Painful intercourse can also dramatically affect a person's relationship with their sexual partner. 

How is Pelvic Floor Dysfunction Diagnosed?

Pelvic floor dysfunction is diagnosed using hand-on assessment of both internal and external structures.  An initial visit includes an examination of:
  • posture 
  • gait
  • flexibility
  • skin
  • muscle tone and trigger points

Often stress, anxiety and perceptions of pain are related to incontinence and pelvic pain, and those, too, are discussed and evaluated.  An internal examination (rectal for men, vaginal and rectal for women) can be differed depending on patient comfort level and body need.  When the external structures are significantly tight, it's important to relax them prior to moving deeper into the body. 

What's the Treatment?

Pelvic floor treatment is a combination of in-office visits and self-care exercises. Self-care is the most important aspect of any pelvic floor treatment plan. Stretching, massage, deep breathing and bathing become part of a daily routine that maintains the progress made during office visits.  

What's exciting about this type of therapy is how well it works for people who thought they were stuck living with their symptoms for the rest of their lives. With the proper instruction and guidance, the results of pelvic floor therapy are life-long. 
Dr. May is one of the few naturopathic doctors in Canada with special training in Pelvic Floor diagnosis and treatment. If you feel you may benefit from a pelvic floor assessment, or would like more information to see if pelvic floor therapy is right for you, please feel free to contact Dr. May.

Oral Health - 5 Common Concerns

by Dr. Leena Athparia, ND

Does an apple a day keep the dentist away? If only it were that easy to maintain oral health.  Brushing, flossing, tongue cleaning & eating healthy are important steps to preventing cavities, gum disease and other conditions that affect the mouth, teeth and gums. Yet, in today’s world, maintaining optimum oral health is becoming more challenging despite daily oral hygiene.

The mouth is, quite literally, the opening to the entire digestive tract.  What you put into your mouth, chew and swallow is what will be passed through the metres of digestive tract – through the esophagus, stomach, small & large intestines and to the rectum.  A healthy oral cavity sets the environment for a healthy digestive tract, which in turn is linked to all the systems in the body. 

Just like your gut, your mouth is filled with bacterial microorganisms which feed off undigested food and secrete by-products. These bacteria proliferate with foods such as refined sugars, carbohydrates, acidic foods and tobacco. Over time, accumulation of these bacteria in the mouth can lead to bad breath, gingivitis, periodontitis and cavities. When gut flora is imbalanced further down in the digestive tract, you may experience gas & bloating, cramps and discomfort.

Conventional dentistry unfortunately is not always enough to protect you from developing cavities, gum disease and other conditions that affect the oral cavity.  Modern dentistry addresses the overt symptoms by drilling and filling.   However, it does not address flora imbalance, acidity and long-term inflammation which are factors leading to these oral conditions. Below are some of the most common conditions affecting oral health.

Common Oral Health Concerns

  • Cavities: It is a well-known fact that sugar is the primary cause of cavities.  Sugar consumption has skyrocketed over the last few decades, and cavities are the most common dental concern in children.  Sugar (or any carbohydrate) fuels bacteria in your mouth, such as Streptococcus mutans which form acid and promote tooth decay. Salivary pH also plays an important buffering role in preventing or promoting cavities. The reason why some people are more susceptible to cavities than others, despite similar diets, is connected to oral flora and the overall pH of a person's system. 
  • Mercury Fillings: Heavy metal toxicity due to years of mercury fillings is a growing concern. Mercury is a heavy metal which, as a cavity breaks down, results in mercury deposits in the tissues, especially in the nervous system. If you have had amalgam fillings - which contain mercury - it is important to have them removed properly if they are old or breaking down. Holistic dentists are trained in removing mercury fillings, but concurrent naturopathic heavy metal detoxification is critical to prevent mercury re-circulating and depositing in other organs.
  • Receding or bleeding gums: If your gums bleed when you floss or you notice your gums are receding, this is a sign of chronic inflammation (gingivitis).  If not addressed properly over time, this inflammation can progress into periodontitis (gum disease) where food debris & bacteria build up and begin to damage gums & bones, eventually leading to tooth loss.  When gums begin to recede, they can expose the enamel leading to sensitivity. In addition to daily oral hygiene and regular dental checkups, there are many naturopathic options that can support gum health, decrease inflammation and prevent or treat receding or bleeding gums.
  • Sensitive Teeth: Teeth become sensitive when enamel becomes thin. Acidic food that is directly in contact with teeth erodes tooth enamel over time.  Beverages such as soda pop - which is rich in phosphoric acid and sugar - not only erode tooth enamel and cause cavities, but also promote demineralization in the body.  When there is a deficiency of minerals, just like in bones, the body is unable to replenish enamel without the building blocks. If you have sensitive teeth, sensitivity toothpaste may bring temporary relief but it is likely that your mineral levels also need to be addressed. A lesser known fact is that mechanical issues (such as teeth grinding or TMJ issues) can add significant pressure on teeth, causing weakness in tooth enamel. Teeth grinding can be due to an active mind when you are sleeping or can be linked to the presence of parasites (such as worms in children) or to tension in the jaw from long-term stress.  A naturopathic doctor can help you identify contributing factors to sensitive teeth and address them from the root cause.
  • Bad breath: Mouthwashes and conventional products may kill the bacteria causing odour, but they do not address the real causes of bad breath.  If you are struggling with bad breath, keeping oral hygiene is a must, but it is also important to identify other contributing causes of bad breath – conditions such as diabetes, digestive issues, imbalanced gut bacteria and h. pylori.  If you have bad breath, this likely indicates toxic build-up in your mouth, and could indicate toxicity in the entire body which can be improved with customized diet, lifestyle changes and naturopathic therapies.

Teeth & gums are living tissue like your bones and other tissues and need to be treated with care. You only have one set of adult teeth so ensure you take the time to take care of your oral health with daily oral hygiene.  Since oral health is intimately linked with our bodies, it is also important to seek professional care to identify the root cause and to support contributing factors such as diet, digestion, medications & stress. 

Stay posted for Oral Health Part II where we will discuss more about oral health.

Dr. Leena Athparia, ND is a naturopathic doctor with an interest in chronic health concerns. If you are interested in a naturopathic assessment with a focus on oral health and treatment customized to your constitution, please contact Naturopathic Foundations at 905-940-2727 or email to book an appointment with Dr. Leena Athparia ND.