As a GP, I always hope there's nothing my patients won't say to me - no matter how embarrassing for them, I've seen it all before. But all too often patients leave the issue they're worried about until they're on their way out of the door. And surveys suggest people often suffer in silence with wind, incontinence and a host of other issues for years, when simple lifestyle changes can make a world of difference.
Flatulence - no matter what your disapproving grandma told you - is completely normal. Gas down below is largely a function of what we eat, and the bacteria in our guts that help us digest it. That nose-wrinkling smell is down to small amounts of sulphur (also responsible for the smell of rotten eggs, so you get the picture!).
Our guts contain trillions of bacteria - together they make up your gut microbiome - and we wouldn't be able to digest food without them. But some are 'friendlier' than others and where wind is concerned, you're better off if you can keep the proportion of gas-producing bacteria down by topping up your good bacteria.
Diet makes a difference - the wider the variety of foods you eat the better, particularly if veg and fruit feature heavily. You can also improve your gut microbiome by providing food good bacteria thrive on, including fermented foods like sauerkraut, natural live yoghurt, naturally produced cheese and tofu.
Where supplements are concerned, there are two options. You can take a prebiotic (which provides a food source which favours these good bacteria). Or you can use a probiotic, which tops up your good bacteria and allows them to out-compete the gas-producing ones. There is limited evidence they help in cases of offensive wind, but they have been shown to make a difference in gut conditions such as irritable bowel syndrome, where wind can be a prominent symptom.
Some kinds of non-absorbable carbohydrates are resistant to being broken down and digested in the stomach and small bowel, so they reach the large bowel (colon) essentially unchanged. Here the bacteria get to work, producing wind as they digest them. Beans are the classic culprits, but peas, broccoli, parsnips, raisins, prunes and slimming foods containing sorbitol all have the same effect. Try substituting other veg - cutting down on fibre too much leads to constipation, which can also make wind worse.
Burping is also largely to do with what you swallow, including air. We all swallow some air when we eat, but gulping food or gum chewing increases this. Fizzy drinks add gas which often comes up rather than goes down; large meals swell your stomach, which relieves the pressure by letting wind out; and mints, tomatoes and onions can relax the valve at the bottom of your gullet, allowing gas to escape upwards.
Burps associated with burning pain in the top of your stomach are a common combination of symptoms in indigestion. In this case, treating the underlying cause of indigestion may help.
We all worry about bad breath sometimes, and it's usually due to the state of your teeth and oral health. Using dental floss to remove trapped food as well as brushing; chewing gum to increase saliva flow (although too much can increase wind!), and getting regular dental check-ups will all reduce the risk. Everyone knows spicy foods, garlic and onions can come out on your breath, but crash diets can also lead to halitosis. And since bacteria in your mouth thrive on sugary foods, it's worth cutting down on sugary foods and fizzy drinks.
Dry mouth makes you more prone to bad breath - this can be a side-effect of medication, so check with your pharmacist. Mouth-breathing from a blocked nose dries your mouth out, and nasal sprays from your pharmacist or GP can solve this if allergy is the cause.
It's estimated that as many as one in three women over 40 suffer from urine leaks when they cough, sneeze, laugh, run or jump. This is stress incontinence, the most common form of the condition.
Don't be embarrassed to see your doctor; there are plenty of options available nowadays. The first step will likely be focusing on strengthening your pelvic floor. You might be referred to a specialist physiotherapist who will help you identify your pelvic floor muscles and take you through the exercises to strengthen them. Eight out of 10 women find their problem significantly improves after seeking help in this way.
Body odour, as you probably know, comes mostly from armpits. We have sweat glands all over, but most of them only produce salty water. Those in your armpits, by contrast, produce a thicker liquid that contains proteins and fats. Bacteria thrive on these, and mostly it's the bacterial feeding frenzy that causes BO. Having said that, some foods like garlic and spices can get into sweat, so cutting down on these may help.
Getting rid of sweat frequently with regular washing stops the bacteria having time to do their work. But avoiding sweating from your armpits can be even better. Choose an antiperspirant (rather than just a deodorant); keep cool and wear cotton, breathable fabrics. If the problem persists, speak with your pharmacist about a deodorant containing aluminium, which is more effective than normal deodorants.
Thanks to My Weekly where this piece originally appeared.