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Corner Clinic: Our Experts Answer Your Health Questions

This month we talk about the prostate, superfoods and back pain

By UC San Diego Health System Experts   |   November 07, 2014
  1. I’ve got benign prostatic hyperplasia. Should I be worried?
  2. Is there any such thing as a superfood?
  3. Is bed rest good for back pain?

I’ve got benign prostatic hyperplasia. Should I be worried?

Mike Hsieh

T. Mike Hsieh, MD, assistant professor, Division of Urology and program director, UC San Diego Male Fertility and Sexual Health Program

A healthy prostate is about the same size and shape as a walnut and is located below the bladder surrounding the urethra. The main function of the prostate is to produce ejaculatory fluid.

Benign prostatic hyperplasia (BPH) is a common condition associated with aging and caused by the non-cancerous enlargement of the prostate. It affects 50 percent of men in their 50’s and 90 percent of men in their 80’s. Besides age, other risk factors for developing BPH include obesity and a family history of BPH.

A common symptom associated with BPH is frequent urination, especially at night. BPH can also result in a weak urinary stream, dribbling of urine, or needing to strain to urine. All of these symptoms are caused by the enlarged prostate squeezing the urethra.

An evaluation for possible BPH consists of a thorough medical history, physical exam (including digital rectal exam) and a urine test. If indicated, your doctor might also suggest a study of urine flow, a measurement of post-void residual urine volume or a test for a prostate-specific antigen. A man should see a doctor if he is bothered by a previously mentioned symptom, and he should see a doctor immediately if he has blood in the urine, pain or burning with urination or is unable to urinate.

An enlarged prostate alone is not reason enough to get treatment. BPH only needs to be treated if the enlarged prostate is causing significant irritation or complications. Men with mild urinary symptoms may be treated by simply changing their current medications and diet with supervision from a physician. Medications may help shrink the prostate or relax the prostate’s smooth muscle, improving urine flow. Surgery is reserved for men whose symptoms are not responding to other treatments or who have complications related to BPH, such as kidney damage, frequent urinary tract infections, blood in the urine, bladder stone, or inability to urinate. Before starting a treatment for BPH, a man should consult with a physician to better understand the pros and cons of his treatment options.

Is there any such thing as a superfood?

Melanie Fiorella

Melanie R. Fiorella, MD, assistant clinical professor Department of Family and Preventive Medicine and Department of Reproductive Medicine

From superheroes to supermodels, our culture is fascinated by all things “super” so it is no wonder many of us are drawn to the idea of superfoods.

In reality, though, there are no scientific criteria for determining which foods are worthy of the title and it is virtually impossible to consume the amount of food needed to reap the specific health claims, such as a lower risk of heart disease or dementia, associated with some superfoods in daily life.

The approach to dietary guidance is also very individualized and what might be a superfood for one person could be something akin to poison to someone else, depending on the circumstances. A person suffering from high cholesterol and high blood pressure, for example, might be counseled to eat plenty of garlic; but this would not be advised for someone with heartburn.

I like the term superfood as a highlight to the fact that real, whole foods are a stark contrast to “junk foods" or processed foods loaded with calories, sugars and fats with minimal nutritional value. Superfoods, typically, are nutrient-dense, meaning lower in calories and higher in vitamins, antioxidants and/or fiber. In addition, the superfood label has helped educate the public about the health benefits of various natural foods beyond calories, carbohydrates and fat.

Do “superfoods” really exist? Yes! A superfood is simply one of the many nutritious and delicious natural whole foods enjoying their 15 minutes of fame and helping us feel a little more super ourselves.

Is bed rest good for back pain?

Amy Leu

Amy Leu, DO, primary care physician and
assistant director, Primary Care Sports Medicine Fellowship

We all have had patients who have thrown out their back doing something as simple as bending over or lifting or moving something that didn’t seem heavy, and we often hear patients say they have been on bed rest for a week without improvement. In general, prolonged bed rest is never good for back pain. For run-of-the-mill back injuries that do not have progressive numbness and tingling down the legs, we typically encourage our patients to keep moving to some degree.

Bed rest for three days after injury is reasonable. Beyond that, in the absence of red flags, prolonged bed rest can result in increased stiffness and back pain. Typically, injured back muscles will go through an acute phase, involving pain and loss of range of motion, followed by recovery or improvement over a period of a few weeks. The key during this phase is to keep moving to prevent your back from becoming stiff and weak. This can be done with heat, massage, gentle stretching and exercises to regain range of motion.

You then want to begin retraining injured back muscles so that you can go back to the activities you enjoyed previously. This can be done with anything from gentle stretching, simple home-exercise programs, yoga and Pilates, or formal physical therapy and strength training, depending on your pre-injury or desired activity level. No matter which method you choose, the important thing to remember is that in sports medicine we say "motion is lotion!" That is the cornerstone of recovery.

Related Specialties

Family Medicine

Men's Sexual Health

Sports Medicine