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Alexa Fleckenstein M.D.

Blog: On Health. On Writing. On Life. On Everything.

The Role of Your Neck in Urge Incontinence

February 21, 2011
Tags: order, Alzheimer's, bladder, childbirth, diapers – adult, food allergies, gluten intolerance, idiopathic, incontinence - urinary, inflammation - local, mitochondria, MS, Multiple Sclerosis, muscular strength, neck, nerve – pinched, neurogenic, observations – medical, overflow incontinence, Parkinson’s, posture, spina bifida, stress incontinence, stroke, urge incontinence, Wikipedia
As a physician I sometimes make observations that strike me as plausible – but I don’t have the wherewithal or time to scientifically check on them. Writing a blog might be one method to test an idea, and find out if others made similar observations. So, here is my first one, pertaining to urge incontinence. Wikipedia defines urge incontinence as “involuntary loss of urine occurring for no apparent reason while suddenly feeling the need or urge to urinate.” What really happens is the patient makes it to the stall but then goes before she has a chance to pull down her pants. Or she hears water tinkling, and tinkles herself. The two other forms of urinary incontinence are stress incontinence and overflow incontinence. Stress incontinence comes from weak pelvic floor muscles – when you sneeze or run or laugh, you suddenly can’t hold your urine. Overflow incontinence is a constant dribbling of urine – as if the faucet can’t be shut off. All three forms are common in people of a certain age – therefore the hilarious TV ads for adult diapers. But according to my patients, incontinence is no laughing matter. People thus afflicted (women are in the majority here, probably because of what childbirth can do to one’s organs) are on the constant lookout for the nearest restroom. The interesting part of Wikipedia’s definition of urge incontinence is “for no apparent reason.” Urge incontinence has been linked to stroke, Alzheimer’s, spina bifida, multiple sclerosis (MS), Parkinson’s – they all can lead to urge incontinence. All are neurogenic causes (stemming from the brain and the nerves) – we lump them in one group, but still they are poorly understood. And then there is “idiopathic” urge incontinence. Idiopathic means: Doctors have no clue at all. But they think it has to do with local inflammation around the bladder. Years ago a patient with urge incontinence told me that she could make the urge disappear (at least long enough to make it to the bathroom), if she stretched her neck. For a while I was not sure if any sudden distraction – like clapping your hands or hopping up and down – would do the same. But lately I returned to my first hypothesis, namely that the stretching of the neck works best. Because I have observed that the condition occurs more often in people with less than stellar posture, especially the ones whose head is slightly bent most of the time. Standing tall and erect, at least for a moment, seems to release the urge. As for the mechanism – are certain spinal nerve fibers pinched when the head is bent? We need more research on that. Poor posture is more common in people with gluten intolerance and food allergies – it seems as if they don’t have the muscular strength to keep their heads straight on their shoulders – perhaps on the basis of poorly functioning mitochondria (this is all speculation on my part; I would be happily disproved). If urge incontinence is your problem, try this out – nod a bit, stretch your neck - and write me if it works for you! Perhaps one day a peer-reviewed study will be done. Read More 
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Gluten-Related Symptoms and Diseases

September 24, 2010
Tags: order, abdominal pain, acanthosis nigricans, Addison’s disease, ADHD, Alcoholism, alkaline phosphatase (bone) elevated, allergic rhinitis, alopecia areata (patchy hair loss), amenorrhea (absence of menstrual period), anemia, anemia – iron deficiency, anemia – refractory, anemia - vitamin B12 deficiency, anti-endomysium antibodies (EMA), anti-gliadin antibodies (AGA), anti-tissue-transglutaminase antibodies (tTG), antiphospholipid syndrome (frequent miscarriages and other problems), anxiety, aortic vasculitis, apathy, aphthous ulcers, appetite – poor, arthritis, arthritis – enteropathic, arthritis - juvenile idiopathic, asthma, ataxia, ataxia - progressive myoclonic, atherosclerosis, Attention Deficit Hyperactive Disorder (ADHD), Autism, learning disorders, autoimmune cholangitis, autoimmune diseases, autoimmune hepatitis, autoimmune thyroid disease, balding – premature, bipolar disorder, Bitot’s spots (foamy patches on whites of eye), bleeding – unexplained, blepharitis, bloating, blurred vision, bone fracture, bone pain, brain atrophy, brain fog, bronchiectasis, cachexia (general wasting), calcium – low, cancer - small cell of the esophagus, cancer (adenocarcinoma) of the small intestine, cancer of the esophagus, cancer of the pharynx, Candida infections – recurrent, cardiomegaly, casein intolerance, cataracts, cerebral perfusion abnormalities, cheilosis (cracked lips and corners of mouth), cholesterol – low, chorea, chronic bullous dermatosis, chronic fatigue syndrome, colitis, common variable immunodeficiency, complications during pregnancy – labor - delivery and post-partum period, congenital anomalies, constipation, copper deficiency, coronary artery disease, cortical calcifying angiomatosis, cow mill “allergy”, cutaneous vasculitis, cutis laxa, cystic fibrosis, dairy intolerance, delusions, Dementia, depression, dermatitis herpetiformis, dermatomyositis, diabetes type I, diabetes type II, diarrhea, disorientation, Down syndrome, dry eyes, duodenal ulcers, dysmenorrhea (painful menstrual periods), dyspareunia (painful sexual intercourse), dysphagia (difficulty swallowing), early menopause, easy bruising, ecchymosis, eczema, edema, Enteropathy Associated T-cell Lymphoma (EATL), epilepsy, erythema nodosum, esophageal motor abnormalities, eyes – dry, eyes – bloodshot, erythema elevatum diutinum, failure to thrive, fatigue, fatty liver, folic acid (folate) deficiency, food allergies - blood-mediated and cell mediated, food cravings, gall bladder – impaired motility, gas, gastric emptying – delayed, gastritis, GERD - Gastro-Esophageal Reflux Disease, glucose abnormalities - too low or too high, gluten, Gluten-Related Symptoms and Diseases, Grave’s Disease, growth retardation, gums – bleeding and swollen, hair loss, hallucination, headache, Heartburn, heart disease, hemochromatosis, hemosiderosis - idiopathic pulmonary, hepatic granulomatous disease, high blood pressure, homocysteine elevated, hyperactivity, hyperkeratosis – follicular, hyperparathyroidism, hypertension, hyperthyroidism, hypocalciuria, hypogonadism, hypoparathyroidism, hyposplenism (atrophy of spleen), Hypothyroidism, hypotonia, ichthyosis – acquired, pulmonary hemosiderosis – idiopathic, IgA deficiency, IgA nephropathy, impotence, inability to concentrate, infertility, insomnia, intrauterine growth retardation, iron deficiency anemia in pregnancy – severe, irritable bowel syndrome, keratoconjunctivitis sicca, keratomalacia, kidney stones, lactose intolerance, lassitude, late menarche (late start of menstrual periods), leaky gut syndrome, liver enzymes elevated, loss of memory, lymphadenopathy, lymphoma - B-cell non-Hodgkin’s, lymphoma - cryptic intestinal T-cell (refractory sprue), lymphoma – non-Hodgkin, macroamylasemia, macrocytosis (red blood cells larger than normal), macrolipasemia, magnesium - low, malabsorption, melanoma, memory loss, migraine, miscarriage, monoarthritis – recurrent, multiple sclerosis (MS) – a possible link, muscle pain and tenderness, muscle spasms and cramps, muscle wasting, muscle weakness, nail problems, nausea, nervousness, neuropathy – peripheral, neutropenia (low white blood cells), nightblindness, nosebleeds – unexplained, obesity, occult blood in stool, ocular myopathy, osteitis fibrosa, osteomalacia, osteomalacic myopathy, osteonecrosis, osteopenia, osteoporosis, pancreatic insufficiency (poor digestion), panic attacks, parathyroid carcinoma, penicilllin V impaired absorption, phosphorus – low, pityriasis rubra pilaris, plasma proteins low, Plummer-Vinson Syndrome, PMS, pneumococcal septicemia, pneumonia – recurrent, polyglandular syndrome, polymyositis, potassium - low, premenstrual syndrome, primary biliary cirrhosis, primary sclerosing cholangitis, progressive multifocal leukoencephalopathy, prolactinemia, prothrombin time prolonged, prothrombinemia, prurigo nodularis, psoriasis, psoriatic arthritis, puberty – delayed, purpura – idiopathic thrombocytopenic, rhabdomyolysis – hypokalemic, rheumatoid arthritis, rickets, sarcoidosis, Schizophrenic Spectrum Disorders, scleroderma, seborrhea, short stature, Sjögren’s syndrome, skin rash – itchy, small intestinal bacterial overgrowth, smell - loss of, sperm abnormalities, spina bifida, sprue – refractory (see: gluten), steatorrhea (pale, malodorous, floating, hard-to-flush stools), stomach ulcer, stroke – premature, sugar intolerance, swelling, Systemic Lupus Erythematosus (SLE), taste - loss of, tetany, thrombocytopenic purpura – idiopathic, thyroid disease - juvenile autoimmune, tongue – red and/or burning, tremors, tuberculosis - increased susceptibility to, Turner’s syndrome, urinary tract infections – recurrent, urticaria - chronic hives, uveitis, vaginitis, vasculitis, vasculitis of the CNS (Central Nervous System), vitiligo, volvulus (twisted intestines), vomiting, weight gain – unexplained, weight loss – unexplained, xerophthalmia (dry eyes), zinc – low
Nearly one in one hundred people have gluten intolerance (gluten enteropathy, sprue, celiac sprue). In only fifty percent of them does the disease show with gastro-intestinal symptoms - the rest has non-intestinal symptoms. Be aware that many of these symptoms can also have other causes - this list does not replace a doctor who sees you! • Abdominal pain • Acanthosis nigricans • Addison’s disease • Alcoholism • Alkaline phosphatase (bone) elevated • Allergic rhinitis • Alopecia areata (patchy hair loss) • Amenorrhea (absence of menstrual period) • Anemia • Anemia – iron deficiency • Anemia - refractory • Anemia - vitamin B12 deficiency • Anti-endomysium antibodies (EMA) • Anti-gliadin antibodies (AGA) • Anti-tissue-transglutaminase antibodies (tTG) • Antiphospholipid syndrome (frequent miscarriages and other problems) • Anxiety • Aortic vasculitis • Apathy • Aphthous ulcers (mouth sores) • Appetite – poor • Arthritis • Arthritis – enteropathic • Arthritis - juvenile idiopathic • Asthma • Ataxia • Ataxia, progressive myoclonic • Atherosclerosis • Attention Deficit Hyperactive Disorder (ADHD) • Autism, learning disorders • Autoimmune cholangitis • Autoimmune diseases • Autoimmune hepatitis • Autoimmune thyroid disease • Balding – premature • Bipolar disorder • Bitot’s spots (foamy patches on whites of eye) • Bleeding – unexplained • Blepharitis • Bloating • Blurred vision • Bone fracture • Bone pain • Brain atrophy • Brain fog • Bronchiectasis • Cachexia (general wasting) • Calcium – low • Cancer - small cell of the esophagus • Cancer (adenocarcinoma) of the small intestine • Cancer of the esophagus • Cancer of the pharynx • Candida infections – recurrent • Cardiomegaly • Casein intolerance (cow mill “allergy”) • Cataracts • Cerebral perfusion abnormalities • Cheilosis (cracked lips and corners of mouth) • Cholesterol - low • Chorea • Chronic bullous dermatosis • Chronic fatigue syndrome • Colitis • Common variable immunodeficiency • Complications during pregnancy, labor, delivery and post-partum period • Congenital anomalies • Constipation • Copper deficiency • Coronary artery disease • Cortical calcifying angiomatosis • Cow mill “allergy” • Cutaneous vasculitis • Cutis laxa • Cystic fibrosis • Dairy intolerance • Delusions • Dementia • Depression • Dermatitis herpetiformis • Dermatomyositis • Diabetes Type I • Diabetes Type II • Diarrhea • Disorientation • Down syndrome • Dry eyes • Duodenal ulcers • Dysmenorrhea (painful menstrual periods) • Dyspareunia (painful sexual intercourse) • Dysphagia (difficulty swallowing) • Early menopause • Easy bruising • Ecchymosis • Eczema • Edema • Enteropathy Associated T-cell Lymphoma (EATL) • Epilepsy • Erythema nodosum • Esophageal motor abnormalities • Eyes – dry • Eyes - bloodshot • Erythema elevatum diutinum • Failure to thrive • Fatigue • Fatty liver • Folic acid (folate) deficiency • Food allergies - blood-mediated and cell mediated • Food cravings • Gall bladder – impaired motility • Gas • Gastric emptying – delayed • Gastritis • GERD - Gastro-Esophageal Reflux Disease • Glucose abnormalities - too low or too high • Grave’s Disease • Growth retardation • Gums – bleeding and swollen • Hair loss • Hallucination • Headache • Heartburn • Heart disease • Hemochromatosis • Hemosiderosis - idiopathic pulmonary • Hepatic granulomatous disease • High blood pressure • Homocysteine elevated • Hyperactivity • Hyperkeratosis - follicular • Hyperparathyroidism • Hypertension • Hyperthyroidism • Hypocalciuria • Hypogonadism • Hypoparathyroidism • Hyposplenism (atrophy of spleen) • Hypothyroidism • Hypotonia • Ichthyosis - acquired • Pulmonary hemosiderosis - idiopathic • IgA deficiency • IgA nephropathy • Impotence • Inability to concentrate • Infertility (in both sexes) • Insomnia • Intrauterine growth retardation • Iron deficiency anemia in pregnancy - severe • Irritable bowel syndrome • Keratoconjunctivitis sicca • Keratomalacia • Kidney stones • Lactose intolerance • Lassitude • Late menarche (late start of menstrual periods) • Leaky gut syndrome • Liver enzymes elevated • Loss of memory • Lymphadenopathy • Lymphoma - B-cell non-Hodgkin’s • Lymphoma - cryptic intestinal T-cell (refractory sprue) • Lymphoma – non-Hodgkin • Macroamylasemia • Macrocytosis (red blood cells larger than normal) • Macrolipasemia • Magnesium low • Malabsorption • Melanoma • Memory loss • Migraine • Miscarriage • Monoarthritis – recurrent • Mouth sores • Multiple sclerosis (MS) – a possible link • Muscle pain and tenderness • Muscle spasms and cramps • Muscle wasting • Muscle weakness • Nail problems • Nausea • Nervousness • Neuropathy - peripheral • Neutropenia (low white blood cells) • Nightblindness • Nosebleeds – unexplained • Obesity • Occult blood in stool • Ocular myopathy • Osteitis fibrosa • Osteomalacia • Osteomalacic myopathy • Osteonecrosis • Osteopenia • Osteoporosis • Pancreatic insufficiency (poor digestion) • Panic attacks • Parathyroid carcinoma • Penicilllin V impaired absorption • Phosphorus - low • Pityriasis rubra pilaris • Plasma proteins low • Plummer-Vinson Syndrome • PMS (premenstrual syndrome) • Pneumococcal septicemia • Pneumonia – recurrent • Polyglandular syndrome • Polymyositis • Potassium - low • Primary biliary cirrhosis • Primary sclerosing cholangitis • Progressive multifocal leukoencephalopathy • Prolactinemia • Prothrombin Time prolonged • Prothrombinemia • Prurigo nodularis • Psoriasis • Psoriatic arthritis • Puberty - delayed • Purpura – idiopathic thrombocytopenic • Rhabdomyolysis - hypokalemic • Rheumatoid arthritis • Rickets • Sarcoidosis • Schizophrenic Spectrum Disorders • Scleroderma • Seborrhea • Short stature • Sjögren’s syndrome • Skin rash – itchy • Small intestinal bacterial overgrowth • Smell - loss of • Sperm abnormalities • Spina bifida • Sprue - refractory • Steatorrhea (pale, malodorous, floating, hard-to-flush stools) • Stomach ulcer • Stroke – premature • Sugar intolerance • Swelling • Systemic Lupus Erythematosus (SLE) • Taste - loss of • Tetany • Thrombocytopenic purpura – idiopathic • Thyroid disease - juvenile autoimmune • Tongue – red and/or burning • Tremors • Tuberculosis - increased susceptibility to • Turner’s syndrome • Urinary tract infections - recurrent • Urticaria - chronic hives • Uveitis • Vaginitis • Vasculitis • Vasculitis of the CNS (Central Nervous System) • Vitiligo • Volvulus (twisted intestines) • Vomiting • Weight gain – unexplained • Weight loss – unexplained • Xerophthalmia (dry eyes) • Zinc - low I will add to this list as I come across new links –keep checking! Read More 
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