What Your Bathroom Habits Might Be Telling You, with Alexander Kandabarow, M.D.

Alexander Kandabarow, M.D.

Credit: X.com

Talking about bathroom habits might feel awkward, but your health could depend on it. In an interview with The Educated Patient, Alex M. Kandabarow, M.D., a board-certified urologist with VHC Health Urology – West Alexandria, discusses why symptoms like blood in the urine or changes in urinary flow should never be ignored, how to overcome embarrassment around these topics, and what simple, minimally invasive tests can reveal serious health issues like bladder cancer or kidney disease.

Kandabarow emphasizes that seeking help early not only could improve your quality of life but might even save it.

Why do you think so many people ignore or feel embarrassed to talk about changes in their bathroom habits?

Alex M. Kandabarow, M.D.: Across cultures, discussions around bathroom habits are discouraged and shamed from a young age. It is very common to carry these biases into adulthood, making people less likely to seek care for bathroom-related health issues.

How can we break the stigma around symptoms like blood in the urine or changes in bowel habits?

AK: Though doctors and patients are more rushed for time than ever, it is so important to collaborate with your care team to proactively broach these topics to help you get the care you deserve. During a visit, it is easy to skip uncomfortable bathroom habit discussions when there are other pressing health issues to cover, but you are your best advocate, and ultimately only you know what your symptoms are and how you feel. I promise, your care team has heard it all before!

What kinds of changes should never be ignored, even if they seem small or go away on their own?

AK: Blood in the urine (hematuria), even if only seen once or only detected once on a urinalysis, should always prompt a visit to a urologist. Bladder cancer or kidney cancer can cause blood in the urine. There are not yet reliable ways to screen for these cancers, so doing an appropriate workup when these bleeding episodes occur may be our only chance to catch these cancers early.

Additionally, men who experience a weaker urinary stream, go to the bathroom frequently day and night, and feel like they’re not emptying their bladder well could have an enlarged prostate. While that’s not dangerous itself, over the long term it could lead to urinary tract infections, bladder stones, kidney failure and lifelong dependency on catheters.

What screening tests or evaluations do you typically recommend for someone experiencing these symptoms?

AK: Blood in the urine requires looking inside the bladder with a camera, a procedure called a cystoscopy. This can be done in the office without anesthesia. Imaging of the kidneys, such as a CT scan or ultrasound, should be performed as well.

For bothersome urinary symptoms, a urologist may perform a urinary symptom questionnaire, a urinalysis, a urine flow and bladder emptying test, a cystoscopy and a prostate ultrasound to better understand why you’re having urinary symptoms. These are all minimally invasive, quick and easy tests.

What’s your advice for someone who’s noticing changes but feels too embarrassed to bring the issue up with their doctor?

AK: You should seek help with these changes not only because they could be signs of more serious medical issues but also to be less bothered by these symptoms and more fully enjoy life.

What’s the biggest message you want readers to take away when it comes to listening to their body and speaking up about bathroom changes?

AK: Many people think worsening of urinary symptoms is a normal part of aging and don’t seek treatment. There are easy, safe and effective steps that you and your physician can take to help. Worsening of your eyesight is a normal part of aging too — you’re still going to get glasses, aren’t you?