Why do I suffer miscarriages?

Dear Doctor: I want to have a child but I always get miscarriages. I am fertile and conceive easily. I have visited several gynaecologists who have not been helpful. Please advise.

Anita
Dear Anita: Fertility is not about getting pregnant alone, but also carrying the baby to a successful delivery.

When a woman gets consecutive miscarriages at about the same time, it is likely to be from the same cause, and apart from leading to stress, the fear of never being able to carry a pregnancy to term is high. Though there are several causes of recurrent spontaneous miscarriages, some may not be treatable or easily identified even after thorough investigation.

Identifiable causes may include womb swellings (fibroids), excessive size of womb opening, problems within the substances contained in the sperms or ova, especially in advanced maternal age, hormones (thyroid, diabetes) and abnormal body immune substance production.

Instead of using several gynaecologists, you need to stick to one for effective management of the problem. You should visit a doctor now when you are not yet pregnant, to see how the problem can be addressed. Stress can be managed by seeing a counsellor.

Dear Doctor: I find myself in an embarrassing situation. Whenever I ejaculate, I pass gas. This happens a lot after taking whiskey. But even when I do not drink, the problem has persisted. Even my wife has the same problem. Is there a remedy?

John
Dear John: Everyone needs to pass gas occasionally. But passing gas of passion can be embarrassing. The gas we pass results from either the air we swallow, or is produced during food digestion and the activity of intestinal bacteria on the food or from waste.

If the gas is not passed, it can cause discomfort and distress. However, it should be passed appropriately, otherwise, doing so uncontrollably (gas incontinence) can be embarrassing. When gas reaches the rectum and needs to be expelled, a person relaxes the anal sphincter muscle and it is passed out through the anus. This sphincter is controlled through spinal nerves and the brain.

Damage or injury to the sphincter muscle, especially when related to childbirth may cause a person to pass gas uncontrollably. Some injuries may be recognised immediately after childbirth, while others may only cause problems later in life.

Some people experience loss of strength in the anal muscles as they age, which affects the control system. A minor control problem in a younger person may also become more significant later in life. So your wife may have developed gas incontinence just like you did, either due to childbirth-related issues or age.

Health conditions such as Crohn’s disease or ulcerative colitis (inflammatory bowel disease), irritable bowel syndrome, effects of drugs especially regular and long-term use of laxatives may weaken bowel muscles and cause loss of control.

People may have problems controlling gas, but may be lucky it happens without other people noticing, except during sexual intercourse.
Some men may pass gas while ejaculating because of the pressure applied on the abdomen. It is likely that over-relaxation of several muscles, together with pressure on the abdomen, renders the anal sphincter unable to hold on to gas in the rectum.

This problem can be prevented by reducing the number of routine episiotomies (surgical incision) during childbirth and strengthening the muscles of the pelvis that support the anal sphincter through routine floor exercises (kegels). Daily whole body exercises to keep the bowels active, regularly passing stool and inevitably gas before sex can also be helpful.

Dear Doctor: I often watch television (TV) from my bedroom, especially when I fail to get sleep. However, when I switch the TV on, my eyes fail to see for a while. I have undergone tests and been told my eyes are normal. What could be the problem?

Bambeiha Katesigwa

Dear Bambeiha: Eyes produce discharge made up of mucus, oil, skin cells and other debris throughout the day. When a person blinks, the discharge is flushed out before it hardens in the eyes.

When a person is asleep and not blinking, the same eye discharge collects and accumulates, only to appear at the corner of the eyes when the person wakes up. Also, crusts may be seen at the eye corners or eyelids, which need to be washed off to keep the eyes clean.

This kind of discharge, which is also produced by the nose and mouth, is called rheum. It may interfere with sight when a person wakes up, until the act of blinking and tears (that do not occur during sleep) wash it away to clear the vision.

Several conditions, including eye allergy may cause an increase in the production of rheum, which prevent a person from opening their eyes when they wake up without prior cleansing.

Children naturally produce a lot of rheum, which is always seen at the corners of eyes. Too much rheum increases the time the eyes take to have clear vision.

Since the doctor said your eyes were normal, you do not need to do anything about them except to always blink fast enough for them to clear. It is also not advisable to have a TV in your bed room because it interrupts sleep.