Health
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| Urinary Incontinence |
Urinary incontinence (UI) is the accidental leakage of urine.
Over a lifespan, there are gender differences in the frequency
of urinary incontinence. In childhood, girls usually develop
bladder control at an earlier age than boys, and bedwetting
(nocturnal enuresis) is less common in girls than in boys.
However, adult women are far more likely to experience
urinary incontinence because of the anatomy of their urinary
tract and the stresses caused by pregnancy and childbirth.
Nevertheless, men may experience urinary incontinence as a
result of prostate problems, and both men and women can
experience nerve damage that leads to urinary incontinence.
Its prevalence increases with age, but it is not an inevitable
part of aging.
The four forms of urinary incontinence are [1] temporary or
reversible incontinence related to urinary tract infection,
constipation, or delirium [2] tress incontinence caused by
weak pelvic and sphincter muscles [3] urge incontinence
caused by damaged or irritable nerves [4] overflow
incontinence that results when an individual is unable to
empty the bladder.
What causes urinary incontinence in men?
For the urinary system to do its job, muscles and nerves
must work together to hold urine in the bladder and then
release it at the right time.
Nerve Problems Any disease, condition, or injury that
damages nerves can lead to urination problems. Nerve
problems can occur at any age. Man with spinal cord injury,
diabetes, stroke, Parkinson's disease, multiple sclerosis and
overactive bladder may develop urinary incontinence.
Prostate Problems The prostate is a male gland about the
size and shape of a walnut. It surrounds the urethra just
below the bladder, where it adds fluid to semen before
ejaculation.
BPH The prostate gland commonly becomes enlarged as a
man ages. This condition is called benign prostatic hyperplasia
(BPH) or benign prostatic hypertrophy. As the prostate
enlarges, it may squeeze the urethra. The bladder wall
thickens and becomes irritable, and the bladder begins to
contract even when it contains only small amounts of urine.
This results in more frequent urination. BPH rarely causes
symptoms before age 40, but more than half of men in their
sixties and up to 90 percent in their seventies and eighties
have some symptoms of BPH. The symptoms vary, but the
most common ones involve changes or problems with
urination, such as a hesitant, interrupted, weak stream;
urgency and leaking or dribbling; more frequent urination,
especially at night; and urge incontinence.
Radical prostatectomy The surgical removal of the entire
prostate gland—called radical prostatectomy—may be
recommended to treat prostate cancer. The surgery may lead
to erection problems and UI, although nerve-sparing
procedures in the abdominal approach may make these side
effects less likely.
External beam radiation: This therapy uses an x-ray machine
to deliver radiation to the prostate gland. The treatment can
cause loss of bladder control as well as fatigue, skin redness
and irritation, rectal burning or injury, diarrhea, inflammation
of the bladder wall (cystitis), blood in the urine, loss of sexual
function, and loss of appetite.
How is UI diagnosed?
Medical History Your general medical history, including any
major illnesses or surgeries, and details about your
continence problem and when it started will help your doctor
determine the cause. Voiding Diary You may be asked to keep
a voiding diary, which is a record of fluid intake and trips to
the bathroom, plus any episodes of leakage. Physical
Examination A physical exam will check for prostate
enlargement or nerve damage. EEG and EMG An
electroencephalogram (EEG), a test where wires are taped to
the forehead, can sense dysfunction in the brain. An
electromyogram (EMG) measures nerve activity in muscles
and muscular activity that may be related to loss of bladder
control.
Ultrasound For an ultrasound, or sonography, a technician
holds a device, called a transducer, that sends harmless
sound waves into the body and catches them as they bounce
back off the organs inside to create a picture on a monitor.
Urodynamics Urodynamic testing focuses on the bladder's
ability to store urine and empty steadily and completely, and
on your sphincter control mechanism. It can also show
whether the bladder is having abnormal contractions that
cause leakage.
How is UI treated?
No single treatment works for everyone.
Behavioral Treatments For some men, avoiding incontinence
is as simple as limiting fluids at certain times of the day or
planning regular trips to the bathroom—a therapy called
timed voiding or bladder training.
Some people with nerve damage cannot tell whether they are
doing Kegel exercises correctly or not. If you are not sure,
you may still be able to learn proper Kegel exercises by doing
special training with biofeedback, electrical stimulation, or
both. Biofeedback uses sensors to detect muscle activity and
create a visual or audio signal when the appropriate muscles
are being used.
Medications Medicines can affect bladder control in different
ways. Some medicines help prevent incontinence by blocking
abnormal nerve signals that make the bladder contract at the
wrong time, while others slow the production of urine. Still
others relax the bladder or shrink the prostate.
Alpha-blockers: Terazosin (Hytrin), doxazosin (Cardura),
tamsulosin (Flomax), and alfzosin (Uroxatral) are used to
treat problems caused by prostate enlargement and bladder
outlet obstruction. They act by relaxing the smooth muscle of
the prostate and bladder neck, allowing normal urine flow and
preventing abnormal bladder contractions that can lead to
urge incontinence.
5-alpha reductase inhibitors: Finasteride (Proscar) and
dutasteride (Avodart) work by inhibiting the production of the
male hormone DHT, which is thought to be responsible for
prostate enlargement. These 5-alpha reductase inhibitors
relieve voiding problems by shrinking an enlarged prostate.
Imipramine: Marketed as Tofranil, this drug belongs to a class
of drugs called tricyclic antidepressants. It relaxes muscles
and blocks nerve signals that might cause bladder spasms.
Imipramine is also used to treat bedwetting in children.
Antispasmodics: Propantheline (Pro-Banthine), tolterodine
(Detrol LA), and oxybutynin (Ditropan XL) belong to a class
of drugs that work by relaxing the bladder muscle and
relieving spasms. Their most common side effect is dry
mouth, although larger doses may cause blurred vision,
constipation, a faster heartbeat, headache, and flushing.
Catheters Clean intermittent catheterization: If you have
problems emptying your bladder because of an enlarged
prostate or because of nerve damage, you may use a
catheter at regular times, or as needed, to drain urine and
prevent overflow incontinence.
Condom catheter Some men may prefer a drainage system
that fits over the penis like a condom.
Urethral injections. Adding bulk to the tissue around the
bladder opening helps keep the urethra closed.
Urethral Injections Another method to help keep the urethra
closed is to inject a fat-like substance, e.g., collagen into the
area that surrounds the opening of the bladder into the
urethra. A variety of bulking agents are available for injection.
Your doctor will discuss which one may be best for you.
Artificial Sphincter Some men may eliminate urine leakage with
an artificial sphincter, an implanted device that keeps the
urethra closed until you are ready to urinate.
What are the types of incontinence in women?
Stress Incontinence If coughing, laughing, sneezing, or other
movements that put pressure on the bladder cause you to
leak urine, you may have stress incontinence. Physical
changes resulting from pregnancy, childbirth, and menopause
often cause stress incontinence. It is the most common form
of incontinence in women and is treatable.
Pelvic floor muscles support your bladder. If these muscles
weaken, your bladder can move downward, pushing slightly
out of the bottom of the pelvis toward the vagina. This
prevents muscles that ordinarily force the urethra shut from
squeezing as tightly as they should. As a result, urine can
leak into the urethra during moments of physical stress.
Stress incontinence also occurs if the muscles that do the
squeezing weaken.
Stress incontinence can worsen during the week before your
menstrual period. At that time, lowered estrogen levels might
lead to lower muscular pressure around the urethra,
increasing chances of leakage. The incidence of stress
incontinence increases following menopause.
Urge Incontinence If you lose urine for no apparent reason
while suddenly feeling the need or urge to urinate, you may
have urge incontinence. The most common cause of urge
incontinence is inappropriate bladder contractions.
Involuntary actions of bladder muscles can occur because of
damage to the nerves of the bladder, to the nervous system
(spinal cord and brain), or to the muscles themselves.
Multiple sclerosis, Parkinson's disease, Alzheimer's disease,
stroke, and injury—including injury that occurs during
surgery—all can harm bladder nerves or muscles.
Functional Incontinence People with functional incontinence
may have problems thinking, moving, or communicating that
prevent them from reaching a toilet. A person with
Alzheimer's disease, for example, may not think well enough
to plan a timely trip to a restroom. A person in a wheelchair
may be blocked from getting to a toilet in time. Conditions
such as these are often associated with age and account for
some of the incontinence of elderly women in nursing homes.
Overflow Incontinence If your bladder is always full so that it
frequently leaks urine, you have overflow incontinence. Weak
bladder muscles or a blocked urethra can cause this type of
incontinence. Nerve damage from diabetes or other diseases
can lead to weak bladder muscles; tumors and urinary stones
can block the urethra. Overflow incontinence is rare in women.
Other Types of Incontinence Combinations of incontinence—
and this combination in particular—are sometimes referred to
as "mixed incontinence." "Transient incontinence" is a
temporary version of incontinence. It can be triggered by
medications, urinary tract infections, mental impairment,
restricted mobility, and stool impaction (severe constipation),
which can push against the urinary tract and obstruct outflow.
How is incontinence evaluated?
To diagnose the problem, your doctor will first ask about
symptoms, medical history, your pattern of voiding and urine
leakage straining and discomfort, use of drugs, recent
surgery, and illness, tumors that block the urinary tract, stool
impaction, and poor reflexes or sensations.
Your doctor will measure your bladder capacity and residual
urine for evidence of poorly functioning bladder muscles. Your
doctor may also recommend Stress test—You relax, then
cough vigorously as the doctor watches for loss of urine.
Urinalysis—Urine is tested for evidence of infection, urinary
stones, or other contributing causes. Blood tests—Blood is
taken, sent to a laboratory, and examined for substances
related to causes of incontinence. Ultrasound—Sound waves
are used to "see" the kidneys, ureters, bladder, and urethra.
Cystoscopy—A thin tube with a tiny camera is inserted in the
urethra and used to see the inside of the urethra and
bladder. Urodynamics—Various techniques measure pressure
in the bladder and the flow of urine.
How is incontinence treated?
Exercises Kegel exercises to strengthen or retrain pelvic floor
muscles and sphincter muscles can reduce or cure stress
leakage. Women of all ages can learn and practice these
exercises, which are taught by a health care professional.
Electrical Stimulation Brief doses of electrical stimulation can
strengthen muscles in the lower pelvis in a way similar to
exercising the muscles.
Biofeedback Biofeedback uses measuring devices to help you
become aware of your body's functioning.
Timed voiding (urinating) and bladder training are techniques
that use biofeedback. In timed voiding, you fill in a chart of
voiding and leaking. From the patterns that appear in your
chart, you can plan to empty your bladder before you would
otherwise leak. Biofeedback and muscle conditioning—known
as bladder training—can alter the bladder's schedule for
storing and emptying urine. These techniques are effective
for urge and overflow incontinence.
Medications Medications can reduce many types of leakage.
Some drugs inhibit contractions of an overactive bladder.
Others relax muscles, leading to more complete bladder
emptying during urination. Some drugs tighten muscles at
the bladder neck and urethra, preventing leakage. And some,
especially hormones such as estrogen, are believed to cause
muscles involved in urination to function normally.
Pessaries A pessary is a stiff ring that is inserted by a doctor
or nurse into the vagina, where it presses against the wall of
the vagina and the nearby urethra. The pressure helps
reposition the urethra, leading to less stress leakage.
Implants Implants are substances injected into tissues
around the urethra. The implant adds bulk and helps to close
the urethra to reduce stress incontinence.
Surgery Most stress incontinence results from the bladder
dropping down toward the vagina. Therefore, common
surgery for stress incontinence involves pulling the bladder
up to a more normal position. In rare cases, a surgeon
implants an artificial sphincter.
Catheterization A catheter is a tube that you can learn to
insert through the urethra into the bladder to drain urine.
Content Source NKUDIC
Over a lifespan, there are gender differences in the frequency
of urinary incontinence. In childhood, girls usually develop
bladder control at an earlier age than boys, and bedwetting
(nocturnal enuresis) is less common in girls than in boys.
However, adult women are far more likely to experience
urinary incontinence because of the anatomy of their urinary
tract and the stresses caused by pregnancy and childbirth.
Nevertheless, men may experience urinary incontinence as a
result of prostate problems, and both men and women can
experience nerve damage that leads to urinary incontinence.
Its prevalence increases with age, but it is not an inevitable
part of aging.
The four forms of urinary incontinence are [1] temporary or
reversible incontinence related to urinary tract infection,
constipation, or delirium [2] tress incontinence caused by
weak pelvic and sphincter muscles [3] urge incontinence
caused by damaged or irritable nerves [4] overflow
incontinence that results when an individual is unable to
empty the bladder.
What causes urinary incontinence in men?
For the urinary system to do its job, muscles and nerves
must work together to hold urine in the bladder and then
release it at the right time.
Nerve Problems Any disease, condition, or injury that
damages nerves can lead to urination problems. Nerve
problems can occur at any age. Man with spinal cord injury,
diabetes, stroke, Parkinson's disease, multiple sclerosis and
overactive bladder may develop urinary incontinence.
Prostate Problems The prostate is a male gland about the
size and shape of a walnut. It surrounds the urethra just
below the bladder, where it adds fluid to semen before
ejaculation.
BPH The prostate gland commonly becomes enlarged as a
man ages. This condition is called benign prostatic hyperplasia
(BPH) or benign prostatic hypertrophy. As the prostate
enlarges, it may squeeze the urethra. The bladder wall
thickens and becomes irritable, and the bladder begins to
contract even when it contains only small amounts of urine.
This results in more frequent urination. BPH rarely causes
symptoms before age 40, but more than half of men in their
sixties and up to 90 percent in their seventies and eighties
have some symptoms of BPH. The symptoms vary, but the
most common ones involve changes or problems with
urination, such as a hesitant, interrupted, weak stream;
urgency and leaking or dribbling; more frequent urination,
especially at night; and urge incontinence.
Radical prostatectomy The surgical removal of the entire
prostate gland—called radical prostatectomy—may be
recommended to treat prostate cancer. The surgery may lead
to erection problems and UI, although nerve-sparing
procedures in the abdominal approach may make these side
effects less likely.
External beam radiation: This therapy uses an x-ray machine
to deliver radiation to the prostate gland. The treatment can
cause loss of bladder control as well as fatigue, skin redness
and irritation, rectal burning or injury, diarrhea, inflammation
of the bladder wall (cystitis), blood in the urine, loss of sexual
function, and loss of appetite.
How is UI diagnosed?
Medical History Your general medical history, including any
major illnesses or surgeries, and details about your
continence problem and when it started will help your doctor
determine the cause. Voiding Diary You may be asked to keep
a voiding diary, which is a record of fluid intake and trips to
the bathroom, plus any episodes of leakage. Physical
Examination A physical exam will check for prostate
enlargement or nerve damage. EEG and EMG An
electroencephalogram (EEG), a test where wires are taped to
the forehead, can sense dysfunction in the brain. An
electromyogram (EMG) measures nerve activity in muscles
and muscular activity that may be related to loss of bladder
control.
Ultrasound For an ultrasound, or sonography, a technician
holds a device, called a transducer, that sends harmless
sound waves into the body and catches them as they bounce
back off the organs inside to create a picture on a monitor.
Urodynamics Urodynamic testing focuses on the bladder's
ability to store urine and empty steadily and completely, and
on your sphincter control mechanism. It can also show
whether the bladder is having abnormal contractions that
cause leakage.
How is UI treated?
No single treatment works for everyone.
Behavioral Treatments For some men, avoiding incontinence
is as simple as limiting fluids at certain times of the day or
planning regular trips to the bathroom—a therapy called
timed voiding or bladder training.
Some people with nerve damage cannot tell whether they are
doing Kegel exercises correctly or not. If you are not sure,
you may still be able to learn proper Kegel exercises by doing
special training with biofeedback, electrical stimulation, or
both. Biofeedback uses sensors to detect muscle activity and
create a visual or audio signal when the appropriate muscles
are being used.
Medications Medicines can affect bladder control in different
ways. Some medicines help prevent incontinence by blocking
abnormal nerve signals that make the bladder contract at the
wrong time, while others slow the production of urine. Still
others relax the bladder or shrink the prostate.
Alpha-blockers: Terazosin (Hytrin), doxazosin (Cardura),
tamsulosin (Flomax), and alfzosin (Uroxatral) are used to
treat problems caused by prostate enlargement and bladder
outlet obstruction. They act by relaxing the smooth muscle of
the prostate and bladder neck, allowing normal urine flow and
preventing abnormal bladder contractions that can lead to
urge incontinence.
5-alpha reductase inhibitors: Finasteride (Proscar) and
dutasteride (Avodart) work by inhibiting the production of the
male hormone DHT, which is thought to be responsible for
prostate enlargement. These 5-alpha reductase inhibitors
relieve voiding problems by shrinking an enlarged prostate.
Imipramine: Marketed as Tofranil, this drug belongs to a class
of drugs called tricyclic antidepressants. It relaxes muscles
and blocks nerve signals that might cause bladder spasms.
Imipramine is also used to treat bedwetting in children.
Antispasmodics: Propantheline (Pro-Banthine), tolterodine
(Detrol LA), and oxybutynin (Ditropan XL) belong to a class
of drugs that work by relaxing the bladder muscle and
relieving spasms. Their most common side effect is dry
mouth, although larger doses may cause blurred vision,
constipation, a faster heartbeat, headache, and flushing.
Catheters Clean intermittent catheterization: If you have
problems emptying your bladder because of an enlarged
prostate or because of nerve damage, you may use a
catheter at regular times, or as needed, to drain urine and
prevent overflow incontinence.
Condom catheter Some men may prefer a drainage system
that fits over the penis like a condom.
Urethral injections. Adding bulk to the tissue around the
bladder opening helps keep the urethra closed.
Urethral Injections Another method to help keep the urethra
closed is to inject a fat-like substance, e.g., collagen into the
area that surrounds the opening of the bladder into the
urethra. A variety of bulking agents are available for injection.
Your doctor will discuss which one may be best for you.
Artificial Sphincter Some men may eliminate urine leakage with
an artificial sphincter, an implanted device that keeps the
urethra closed until you are ready to urinate.
What are the types of incontinence in women?
Stress Incontinence If coughing, laughing, sneezing, or other
movements that put pressure on the bladder cause you to
leak urine, you may have stress incontinence. Physical
changes resulting from pregnancy, childbirth, and menopause
often cause stress incontinence. It is the most common form
of incontinence in women and is treatable.
Pelvic floor muscles support your bladder. If these muscles
weaken, your bladder can move downward, pushing slightly
out of the bottom of the pelvis toward the vagina. This
prevents muscles that ordinarily force the urethra shut from
squeezing as tightly as they should. As a result, urine can
leak into the urethra during moments of physical stress.
Stress incontinence also occurs if the muscles that do the
squeezing weaken.
Stress incontinence can worsen during the week before your
menstrual period. At that time, lowered estrogen levels might
lead to lower muscular pressure around the urethra,
increasing chances of leakage. The incidence of stress
incontinence increases following menopause.
Urge Incontinence If you lose urine for no apparent reason
while suddenly feeling the need or urge to urinate, you may
have urge incontinence. The most common cause of urge
incontinence is inappropriate bladder contractions.
Involuntary actions of bladder muscles can occur because of
damage to the nerves of the bladder, to the nervous system
(spinal cord and brain), or to the muscles themselves.
Multiple sclerosis, Parkinson's disease, Alzheimer's disease,
stroke, and injury—including injury that occurs during
surgery—all can harm bladder nerves or muscles.
Functional Incontinence People with functional incontinence
may have problems thinking, moving, or communicating that
prevent them from reaching a toilet. A person with
Alzheimer's disease, for example, may not think well enough
to plan a timely trip to a restroom. A person in a wheelchair
may be blocked from getting to a toilet in time. Conditions
such as these are often associated with age and account for
some of the incontinence of elderly women in nursing homes.
Overflow Incontinence If your bladder is always full so that it
frequently leaks urine, you have overflow incontinence. Weak
bladder muscles or a blocked urethra can cause this type of
incontinence. Nerve damage from diabetes or other diseases
can lead to weak bladder muscles; tumors and urinary stones
can block the urethra. Overflow incontinence is rare in women.
Other Types of Incontinence Combinations of incontinence—
and this combination in particular—are sometimes referred to
as "mixed incontinence." "Transient incontinence" is a
temporary version of incontinence. It can be triggered by
medications, urinary tract infections, mental impairment,
restricted mobility, and stool impaction (severe constipation),
which can push against the urinary tract and obstruct outflow.
How is incontinence evaluated?
To diagnose the problem, your doctor will first ask about
symptoms, medical history, your pattern of voiding and urine
leakage straining and discomfort, use of drugs, recent
surgery, and illness, tumors that block the urinary tract, stool
impaction, and poor reflexes or sensations.
Your doctor will measure your bladder capacity and residual
urine for evidence of poorly functioning bladder muscles. Your
doctor may also recommend Stress test—You relax, then
cough vigorously as the doctor watches for loss of urine.
Urinalysis—Urine is tested for evidence of infection, urinary
stones, or other contributing causes. Blood tests—Blood is
taken, sent to a laboratory, and examined for substances
related to causes of incontinence. Ultrasound—Sound waves
are used to "see" the kidneys, ureters, bladder, and urethra.
Cystoscopy—A thin tube with a tiny camera is inserted in the
urethra and used to see the inside of the urethra and
bladder. Urodynamics—Various techniques measure pressure
in the bladder and the flow of urine.
How is incontinence treated?
Exercises Kegel exercises to strengthen or retrain pelvic floor
muscles and sphincter muscles can reduce or cure stress
leakage. Women of all ages can learn and practice these
exercises, which are taught by a health care professional.
Electrical Stimulation Brief doses of electrical stimulation can
strengthen muscles in the lower pelvis in a way similar to
exercising the muscles.
Biofeedback Biofeedback uses measuring devices to help you
become aware of your body's functioning.
Timed voiding (urinating) and bladder training are techniques
that use biofeedback. In timed voiding, you fill in a chart of
voiding and leaking. From the patterns that appear in your
chart, you can plan to empty your bladder before you would
otherwise leak. Biofeedback and muscle conditioning—known
as bladder training—can alter the bladder's schedule for
storing and emptying urine. These techniques are effective
for urge and overflow incontinence.
Medications Medications can reduce many types of leakage.
Some drugs inhibit contractions of an overactive bladder.
Others relax muscles, leading to more complete bladder
emptying during urination. Some drugs tighten muscles at
the bladder neck and urethra, preventing leakage. And some,
especially hormones such as estrogen, are believed to cause
muscles involved in urination to function normally.
Pessaries A pessary is a stiff ring that is inserted by a doctor
or nurse into the vagina, where it presses against the wall of
the vagina and the nearby urethra. The pressure helps
reposition the urethra, leading to less stress leakage.
Implants Implants are substances injected into tissues
around the urethra. The implant adds bulk and helps to close
the urethra to reduce stress incontinence.
Surgery Most stress incontinence results from the bladder
dropping down toward the vagina. Therefore, common
surgery for stress incontinence involves pulling the bladder
up to a more normal position. In rare cases, a surgeon
implants an artificial sphincter.
Catheterization A catheter is a tube that you can learn to
insert through the urethra into the bladder to drain urine.
Content Source NKUDIC
| MEDICAL NOTES |
urinary frequency—
urination eight or more
times a day or two or
more times at night
urinary urgency—the
sudden, strong need to
urinate immediately
urge incontinence—urine
leakage that follows a
sudden, strong urge
urination eight or more
times a day or two or
more times at night
urinary urgency—the
sudden, strong need to
urinate immediately
urge incontinence—urine
leakage that follows a
sudden, strong urge
DISEASES AND
CONDITIONS
Acidosis
Acne
Acromegaly
Addison's Disease
Adrenal Crisis
Age. macular degn
Alzheimer's disease
Autoimmune
Hepatitis
Barrett's Esophagus
Cancer
Constipation
Colon Polyps
Crohns Disease
Cushing's Syndrm.
Diabetes
Erectile Dysfunction
Fecal Incontinence
Gallstones
Gastritis
Gastroenteritis
Gastroesophageal
Reflux (GERD)
Growth Hormone
Def.
Heartburn
Hemochromatosis
Hemorrhoids
Hyperparathyroidism
Hypertension
Inflam. Bowel Dis.
Kidney Stone
Liver Cirrhosis
Migraines
Multiple Sclerosis
Obesity
Osteorithritis
Osteoporosis
Pancreatitis
Parkinson's Disease
Peyronies' Disease
Prolactinoma
Psoriasis
Sprain and Strain
Stroke
Ulcerative Colitis
Urin. Incontinence
Vitiligo
CONDITIONS
Acidosis
Acne
Acromegaly
Addison's Disease
Adrenal Crisis
Age. macular degn
Alzheimer's disease
Autoimmune
Hepatitis
Barrett's Esophagus
Cancer
Constipation
Colon Polyps
Crohns Disease
Cushing's Syndrm.
Diabetes
Erectile Dysfunction
Fecal Incontinence
Gallstones
Gastritis
Gastroenteritis
Gastroesophageal
Reflux (GERD)
Growth Hormone
Def.
Heartburn
Hemochromatosis
Hemorrhoids
Hyperparathyroidism
Hypertension
Inflam. Bowel Dis.
Kidney Stone
Liver Cirrhosis
Migraines
Multiple Sclerosis
Obesity
Osteorithritis
Osteoporosis
Pancreatitis
Parkinson's Disease
Peyronies' Disease
Prolactinoma
Psoriasis
Sprain and Strain
Stroke
Ulcerative Colitis
Urin. Incontinence
Vitiligo