The Best Medications for an Overactive Bladder

September 1st, 2015

An overactive bladder (OAB) is a frequent or sudden urge to urinate. Some even experience leakage, multiple episodes of nighttime urination or urinary incontinence. For many patients, OAB interferes with their daily routine and quality of life. Luckily there are lots of treatment options, including medication. First, the physician has to find out what is causing the issue. For older men, an enlarged prostate or benign prostate hyperplasia (BPH) is often the cause. Here, ED medications are sometimes prescribed. Those who have M.S. or Parkinson’s may find OAB a symptom of their condition. Bladder stones or even cancer may also be at fault, so it’s important to see a doctor. A full examination and diagnosis must be completed before the appropriate therapy can be arrived upon. Depending on the cause, some physicians suggest trying lifestyle changes and behavioral therapy before taking medication as some people can experience side effects. Creating a bathroom schedule, keeping tabs on what you drink, watching what you drink, relaxation techniques and more can help. For some patients, a specific cause cannot be found.

If these lifestyle changes fail to curb the problem, medication is usually the next step. What are the best medications for OAB? There are generally two kinds. The first relaxes the muscles in order to allow urine to pass more easily out of the body. The second is the type that strengthens the muscles of the bladder which may have weakened over time. Anticholinergics are the most commonly prescribed class of drugs for OAB. These relax the muscles and stop the spasms which lead to urination. They do so by blocking the chemical messenger acetylcholine. Dry mouth is the most common side effect. Tricyclic antidepressants are also pretty commonly prescribed. They strengthen the muscles at the neck of the bladder helping to curb incontinence while relaxing other muscles, lowering the urge to go. Sleepiness is the most common side effect. Lastly, Botox has been used to neutralize some of the muscles in the bladder that cause OAB. Though effective, this is a new procedure and may not be covered by insurance. If you haven’t already, see your doctor and find out what is causing OAB and which treatment is right for you.

Vitamin-D and Prostate Cancer

November 19th, 2014

A new study out of the University of Colorado Cancer Center in Denver finds that vitamin-D and prostate cancer are inexorably linked. The essential nutrient regulates the gene GDF-15. But in cases of prostate cancer driven by inflammation, when vitamin-D is absent so is the gene. The peer-reviewed journal Prostate published the study. Lead author James R. Lambert, PhD. said, “When you take vitamin D and put it on prostate cancer cells, it inhibits their growth. But it hasn’t been proven as an anti-cancer agent. We wanted to understand what genes vitamin-D is turning on or off in prostate cancer to offer new targets.” The group proved that vitamin-D regulates the gene, and wanted to further prove that this particular gene was how vitamin-D affected prostate cancer. Dr. Lambert wrote in the press release, “We thought there might be high levels of GDF-15 in normal tissue and low levels in prostate cancer, but we found that in a large cohort of human prostate tissue samples, expression of GDF-15 did not track with either normal or cancerous prostate tissue.” But then they noticed something else.

Sunshine Vitamin D

The presence of GDF-15 was low in human prostate cancer tissue samples where inflammation was present. Dr. Lambert said, “Inflammation is thought to drive many cancers, including prostate, gastric, and colon. Therefore, GDF-15 may be a good thing in keeping prostate tissue healthy; it suppresses inflammation, which is a bad actor potentially driving prostate cancer.” Researchers utilized a sophisticated new technique in this study, using computer algorithms to analyze biochemical data. Gene GDF-15 was shown to inhibit NFkB, a biochemical compound which was shown to contribute to cancer growth and inflammation in previous studies. Dr. Lambert said, “There’s been a lot of work on inhibiting NFkB.” He added, “Now from this starting point of vitamin D in prostate cancer, we’ve come a long way toward understanding how we might use GDF-15 to target NFkB, which may have implications in cancer types far beyond prostate.”

Low Testosterone and Type-2 Diabetes tied to Higher Vascular Risk

November 6th, 2014

Doctors have long seen a connection between type-2 diabetes, vascular problems and erectile dysfunction. But this is the first study to connect the other two with low levels of the male hormone. This was a cross-sectional study. All participants had type-2 diabetes, low serum testosterone levels—the kind that freely roams the bloodstream, and had a greater risk of thickening of the carotid artery. This is the one leading to the brain. Blood clots in this blood vessel can cause a stroke. These participants had six times greater risk of what is known as carotid artery intima media thickness (CIMT). 31% of the participants had low testosterone which was linked to a higher risk of vascular disease, known in medical terminology as atherosclerosis. The study was conducted by the Hospital Universitario Sanatorio Guemes in Buenos Aires, Argentina, in conjunction with Emory University in the U.S. The results were published online in the peer-reviewed Journal of Clinical Endocrinology & Metabolism.Doctor-examining-patient-obese

Dr. Javier Mauricio Farias was the lead author of the study. Emory’s Dr. Guillermo E. Umpierrez co-authored. Umppierrez said in a statement, “Several cross-sectional studies have reported that about one-third of adult patients with obesity and type 2 diabetes have low serum testosterone.” He added, “Our study indicates a strong association between cardiovascular disease and low testosterone but does not prove causation.” The authors note that few studies have looked at a link between low testosterone, atherosclerosis and type-2 diabetes, before. Doctors say that the choice to administer testosterone replacement therapy, in hopes of saving men with these combined conditions, is controversial and up to their physician’s discretion. The researchers wrote, “Prospective randomized studies are needed to assess the clinical significance of our findings and the clinical impact of testosterone replacement on cardiovascular risk factors in diabetic patients with low total testosterone.” The role of testosterone replacement therapy (TRT) was not included in this study. However Dr. Umpierrez noted, “In elderly patients with evidence of atherosclerosis, testosterone replacement has not been shown to be of benefitand may even increase the risk of cardiovascular events.”

Pains You Should Never Ignore

July 15th, 2014

A “thunderclap” headache 

Could be: An aneurysm, which is a balloon-like area in an artery

Fix it: If you experience head pain that comes on suddenly and is severe, call 911. (You may also get dizzy and notice blurred vision.) Bleeding in the brain due to a ruptured aneurysm isn’t all that common, but when it does happen, swift action is key. Surgeons can save your life by sealing off the weakened spot. Photo By Getty Images

Tooth pain that wakes you up

Could beTeeth grinding

Fix it: Frequent clenching can cause the nerve within the tooth to become inflamed and the protective enamel to wear away. You might even end up cracking teeth down to the root, which leads to extraction. Call your dentist so he or she can figure out the problem. The complications from grinding, which is often brought on by stress, can be prevented by wearing a night guard.

Dull stomach pain that gets sharper as it moves lower to the right of your abdomen

Could be

Fix It: If you feel this sensation, go straight to the ER. (Usually it gets more intense over a 24-hour period as it shifts location.) You’re likely going to need surgery-soon. If the appendix bursts, bacteria from the colon can leak into the abdomen, which is dangerous.

Mid-back pain coupled with fever

Could be:
 A kidney infection

Fix it: Don’t assume that your temperature, nausea and back pain are just a stomach bug. This condition develops when bacteria that infiltrate the urinary tract spread to the kidneys, making the infection much more severe. (You might start with UTI symptoms, like pain during urination, but some people don’t notice anything until later.) You’ll likely need antibiotics ASAP, so call your doctor.

A tender spot on your calf

Could be
Deep vein thrombosis (DVT)

Fix it: If one small area of your leg is painful, you could have DVT, a blood clot in the deep veins. (The spot may also be red and warm to the touch.) DVT is more likely if you use birth control pills or recently took a long car or plane ride. Unless your leg is very swollen or the pain is getting worse rapidly, you can probably wait a day to see your doctor instead of going to the ER, but don’t delay any longer. The clot could increase in size-or break off, move toward the lungs and stop blood flow.

Menstrual cramps that don’t get better with medication

Could be: Endometriosis

Fix it: If meds like Advil aren’t helping, this condition-in which tissue grows outside the uterus-might be to blame. Endometriosis impedes fertility, and it’s common (40% to 60% of women whose periods are very painful may have it). Unless you’re trying to conceive, your doc can start you on oral contraceptives. If pain persists, you may need to have the tissue surgically removed.

An unexplained ache between your shoulder blades 

Could beA heart attack

Fix it: About 30% of people who have heart attacks don’t get the classic chest pressure. Pain between shoulder blades is common in women, as is jaw pain, shortness of breath and nausea. If you have these symptoms (you’ll likely have more than one), you need care ASAP. If you think you’re having a heart attack, don’t ask someone to drive you to the hospital-call 911. Emergency responders provide care the moment they reach you.

SOURCES: Alice G. Boghosian, DDS, consumer advisor spokesperson, American Dental Association. Rebekah Gross, MD, clinical assistant professor, NYU Langone Medical Center, New York. Sharonne N. Hayes, MD, professor of medicine and cardiovascular diseases and founder of the Women’s Heart Clinic, Mayo Clinic. Mary Jane Minkin, MD, clinical professor of obstetrics, gynecology and reproductive sciences, Yale School of Medicine.


Birth Control Works in Long-Term Acne Treatment, Study Says

June 6th, 2014


More effective than previously thought

Birth control pills are as effective as antibiotics for treating women’s acne in the long term, according to a new review of clinical studies.

The dermatological study shows that antibiotics are more effective than the Pill for the first three months of treatment, but are equally successful after six months.

“This confirms that birth control pills are a good solid treatment for acne, and they’re probably underutilized,” Dr. Steven R. Feldman, a dermatologist at Wake Forest University School of Medicine, toldReuters. “Given the desire to minimize antibiotic resistance and exposure, hormonal birth control could be a good alternative.”

Birth control pills may soon be the more benign alternative to some of the antibiotics and harsh topical gels used in acne treatment. Dermatologists are already recommending low doses of birth control for female acne patients, Feldman said.