Jiahui brushes her teeth every morning and evening. She cleans her mouth thoroughly with a mouth rinse, and chews mint gum regularly. But all these fail to get rid of her bad breath, or halitosis. The 45-year-old trading company executive from Hong Kong feels terrible when her boyfriend drops a subtle hint and asks her to chew gum, and finds it most embarrassing when her friends or even complete strangers notice her bad breath. “I must do something about it,” she told herself.

Almost everyone has, at some point, experienced an embarrassing health problem or another – leaking urine, smelly feet or bad breath that won’t go away. Although not life threatening, such problems can affect quality of life. What many don’t realise is that they can be cured or managed. Yet people often feel too self-conscious to speak to a doctor – and suffer in silence – even though doctors have heard it all before and are able to deal with these problems.

BAD BREATH

As well as causing stress, bad breath can be exacerbated by stress. It can also be caused by throat and sinus infections or periodontal disease. Breath can also become foul from smoking, drinking alcohol an eating foods such as garlic.

But ‘BACTERIA in mouth is the major cause of bad breath,” says Anne Bosy, clinical and research director of the Fresh Breath Clinic in Toronto, Canada. “And some bacteria can cause odour that can be smelled from metre or so away.”

Jiahui is troubled by her bad breath. Although she has not refrained from social interactions altogether, she has become particularly sensitive about other people’s body language. “When it is because of my bad breath,” she says. “I feel a bit paranoid and keep a certain distance from others.”

All it took was a visit to her dentist to find that she suffers from severe periodontal disease – a chronic bacterial infection that affects the gums and bone supporting the teeth. Now Jiahui carries a toothbrush and toothpaste with her, and takes the time to brush after every meal.

“I’ve consulted Chinese herbalists. I drink plenty of water, eat simple foods, cut down on spicy and fried food, and get plenty of sleep,” she says. “When my condition improves I’ll feel a little more relaxed.”

“It’s important to practise good oral hygiene,” Bosy says: “But once some bacteria set in, the problem may require antimicrobial mouthwashes, such as those containing zinc – which can alter the metabolism of the bacteria and prevent them from producing sulphur, which has a distinct odour – or those containing chlorhexdine, which destroys bacteria.”

One day six years ago, Mei Fong wet herself in a busy street in Tsim Sha Tsui, Hong Kong. She was horribly embarrassed. Mei Fong, now 55, first suffered from dribble incontinence after childbirth. Urine would dribble out each time she laughed, sneezed, coughed or even ran.

Incontinence, defined as an involuntary leakage of urine, is a problem that affects both genders, although women are affected approximately twice as often as men. Pregnancy, childbirth and age are the primary culprits. But men, women and children weak pelvic-floor muscles, birth defects and strokes.

According to Dr Nor Azhari Md Zam, from the Department of Urology at Singapore General Hospital, the most common types of urinary incontinence are stress incontinence – where the patient has a sudden urge to void and is unable to get to the toilet in time. “Urge incontinence is not a disease itself. It is a symptom of several diseases, hence an evaluation by a urologist is necessary,” says Dr Azhari.

Urge incontinence is normally related to an overactive or oversensitive bladder. Some patients may relate the triggering of symptoms or worsening symptoms to specific irritants such as certain foods, drinks or the environment, such as cold water.

Coffee, chocolate and cola drinks contain caffeine, which is diuretic that can increase urine production, and this may worsen the symptons in patients overactive bladders.

“Treatment for overactive bladders includes lifestyle changes or behavioural therapy and medications,” says Dr Nor Azhari. “The latest therapy is the injection of botox into the bladder, making the bladder less sensitive.”

Mei Fong developed urinary incontinence probably because she didn’t do urethra-contracting exercises after childbirth. So three years ago, she began following her doctor’s instruction to do regular pelvic exercises and her condition has improved markedly.

“Now, I go dancing regularly without fear of urinary incontinence,” she said happily.

Unlink Mei Fing, many are ashamed to seek help for their embarrassing problem even though, as Dr Azhari stresses, “urinary incontinence is treatable and curable.”

SWEATY FEET

Your feet contain about 250, 000 sweat glands and are capable of producing 250 millilitres (one cup) of sweat a day. The smell comes from bacteria on the skin that break down the sweat, excreting offensive-smelling waste. According to the president of the Canadian Podiatric Medical Association, Dr Robert Chelin, the amount of a person’s feet sweat depends on their genetic makeup and activity level.

Luckil, there are some simple home and over-the-counter treatments that can help. The basics include washing feet daily and drying them thoroughly, using odour-absorbing insoles to control smelly shoes and choosing socks – cotton or a mix of cotton and synthetic – that contain moisture-escape panels.

For more persistent problems, soak your feet once a day in water containing drying agents such vinegar or salt. Spray feet with rubbing alcohol every morning and use an absorbent powder, such as baby powder or cornstarch, in shoes.

“If you have a problem, see a professional for guidance,” suggests Chelin. “It’s better to deal with a small problem right away than to let it become a big issue.”

Sweating is necessary as it helps maintain our body temperature and prevents us from over-heating, explains Dr Koh Chuan Keng from the Dermatological Society of Malaysia. “But excessive sweating can be a major cause of embarrassment,” says Dr Koh. Clothes can become drenched and there can be a strong body odour as well. In extreme cases, it can lead to dehydration.

To control excessive sweating, medical treatments include antiperspirants of varying strengths, but these are only effective on the area they are applied to. Antiperspirants can be overriden by the body’s need to sweat and can cause skin irritation.

Another way to deal with excessive sweat is by electrical stimulation of the skin to inhibit localised excessive sweating. Called iontophoreses, it’s been around since the 1950′s but has become more widely available in the last 30 years.

More recently, Botox injections have been used to locally prevent sweat release. This is a very effective treatment but can be expensive and painful, and the effects can wear off in four to six months. Surgery to cut used in extreme cases.

So if you have any of the above problems, don’t suffer in silence. And don’t let embarrassment keep you from living life to the fullest!

By Paula Wild
With additional reporting by Siti Rohani & Dandy Wong.