Under The Angsana Tree: Constipation and Urinary Incontinence

08/05/2024

Constipation and Urinary Incontinence

What Is Constipation?

Bloating and cramps are two common symptoms of constipation

Being constipated means your bowel movements are tough or happen less often than normal. You might be constipated if you have less than three bowel movements per week.

Constipation is very common. Around 2.5 million people visit their doctor each year in the U.S. because they are constipated. It's usually not serious, and home remedies can get you back on track. How often should you poop? The normal length of time between bowel movements varies from person to person. Some people have them three times a day. Others have them just a few times a week.

But going longer than 3 days without one is usually too long. After 3 days, your stool gets harder and more difficult to pass. Constipation Symptoms You may have:

Few or no bowel movements
Trouble having a bowel movement (straining to go)
Hard or small stools
A feeling that everything didn’t come out
Belly bloating
A feeling like your rectum is blocked
A stomachache or cramps

Constipation

Constipation occurs when your bowel movements become less frequent and stools become difficult to pass. It happens most often due to changes in diet or routine, or due to inadequate intake of fiber. You should call a healthcare provider if you have severe pain, blood in your stool or constipation that lasts longer than three weeks.

Having fewer than three bowel movements a week is, technically, the definition of constipation. But how often you poop varies widely from person to person. Some people poop several times a day while others only poop one to two times a week. Whatever your bowel movement pattern is, it’s unique and normal for you — as long as you don’t stray too far from your pattern.

Regardless of your bowel pattern, one fact is certain: The longer you go before you poop, the more difficult it becomes for poop to pass. Other key features that usually define constipation include:

Your stools are dry and hard.
Your bowel movements are painful, and your stools are difficult to pass.
You have a feeling that you haven’t fully emptied your bowels.

Constipation

Constipation is where you have changes to how you poo, including not pooing as often or finding it hard to poo. It's common and it affects people of all ages. You can usually treat it with simple changes to your diet and lifestyle.

Check if it's constipation:

you have not had a poo at least 3 times during the last week or you're pooing less often than usual
the poo is unusually large or small and is dry, hard or lumpy
you are straining or in pain when you have a poo
you feel like you haven't fully emptied your bowels

You may also have a stomach ache and feel bloated or sick. If you're caring for someone with dementia or an older person, constipation may be easily missed. Look out for any behaviour changes such as confusion, as it might mean they are in pain or discomfort.

Constipation

Constipation is a problem with passing stool. Constipation generally means passing fewer than three stools a week or having a difficult time passing stool.

Constipation is fairly common. A lack of dietary fiber, fluids and exercise can cause constipation. But other medical conditions or certain medicines may be the cause. Constipation is usually treated with changes in diet and exercise or with nonprescription medicines. Constipation may require medicines, changes in medicines or other treatments prescribed by a health care professional. Long-term constipation, also called chronic constipation, may require treating another disease or condition that can cause or worsen constipation.

Symptoms of constipation include:

Fewer than three stools a week.
Hard, dry or lumpy stools.
Straining or pain when passing stools.
A feeling that not all stool has passed.
A feeling that the rectum is blocked.
The need to use a finger to pass stool.

What You Should Know About Constipation

Constipation means having hard, dry bowel movements or passing stool fewer than three times a week. It can be caused by things like your diet, medications, whether you are pregnant, or just a change in your routine.

Each person’s bowel habits are different. Some people go three times a day, while others go three times a week. However, you may be constipated if you experience the following symptoms:

fewer than three bowel movements a week
passing lumpy, hard, or dry stools
straining or pain during bowel movements
a feeling of fullness, even after having a bowel movement

The National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)Trusted Source recommends seeking medical advice if symptoms don’t go away or if you notice the following:

bleeding from the rectum
blood in your stool
persistent abdominal pain
pain in the lower back
a feeling that gas is trapped
vomiting
fever
unexplained weight loss
a sudden change in bowel movements

Constipation Relief: Tips and Treatments

Lately, you've been feeling a little -- to put it delicately -- backed up. You're not "going" as often as you should, and you feel bloated and uncomfortable.

A lot of Americans, more than 4 million by some estimates, deal with constipation on a regular basis. Women have constipation more often than men. This may have to do with the slower movement of food through a woman's intestines, as well as with the effects of female hormones on the gastrointestinal (GI) tract.

There are a few effective constipation treatments. Some people naturally have a bowel movement a few times a day, while others go just a few times a week. You don't need constipation treatments unless you're going to the bathroom a lot less often than usual. But if you do, there are a lot of options for constipation treatment. What you choose will depend on why you’re blocked, and whether it’s a new or a long-term problem for you.

The Best Foods to Relieve Constipation

Eating foods high in fiber, like certain fruits and vegetables, may help relieve constipation. These foods may soften, accelerate, and increase your stool frequency.

Constipation can be painful and uncomfortable and may happen to anyone. Nearly 16 in 100 adults in the United States experience constipation, which may have symptoms like:

passing stools less than three times per week
straining, lumpy, or hard stools
feeling blocked
being unable to pass a stool

Increasing your dietary fiber intake may be a natural and effective remedy to help relieve your symptoms of constipation. Here are 4 foods that could help relieve constipation divided into categories:

Fruit
Vegetables
Legumes and seeds
Grains and dairy

Urinary incontinence

Urinary incontinence is the loss of bladder control — is a common and often embarrassing problem. The severity ranges from occasionally leaking urine when you cough or sneeze to having an urge to urinate that's so sudden and strong you don't get to a toilet in time.

Though it occurs more often as people get older, urinary incontinence isn't an inevitable consequence of aging. If urinary incontinence affects your daily activities, don't hesitate to see your doctor. For most people, simple lifestyle and dietary changes or medical care can treat symptoms of urinary incontinence.

Many people experience occasional, minor leaks of urine. Others may lose small to moderate amounts of urine more frequently. Types of urinary incontinence include:

Stress incontinence. Urine leaks when you exert pressure on your bladder by coughing, sneezing, laughing, exercising or lifting something heavy.
Urge incontinence. You have a sudden, intense urge to urinate followed by an involuntary loss of urine. You may need to urinate often, including throughout the night. Urge incontinence may be caused by a minor condition, such as infection, or a more severe condition such as a neurological disorder or diabetes.
Overflow incontinence. You experience frequent or constant dribbling of urine due to a bladder that doesn't empty completely.
Functional incontinence. A physical or mental impairment keeps you from making it to the toilet in time. For example, if you have severe arthritis, you may not be able to unbutton your pants quickly enough.
Mixed incontinence. You experience more than one type of urinary incontinence — most often this refers to a combination of stress incontinence and urge incontinence.

Urinary Incontinence

The experience of uncontrollably leaking urine can be an embarrassing issue for many people. Urinary incontinence is a loss of bladder control that’s commonly seen in older adults and women who have given birth or gone through menopause. Urinary tract infections (UTIs), pelvic floor disorders and an enlarged prostate are other causes.

What is incontinence? Urinary incontinence is a condition that impacts many people’s lives. When you have incontinence, you may experience bladder control issues and leak urine. This leakage is often uncontrollable and can negatively impact your life. Your urinary system is made up of the kidneys, ureters, bladder and urethra. These parts do several jobs. They filter, store and remove waste from your body. Your kidneys are the filters of your body. Waste products are removed from your blood by the kidneys, creating urine. The urine then moves down through two thin tubes called the ureters. The ureters connect to the bladder, where the urine will collect until it’s time to leave the body. Your bladder is like a storage tank — once the bladder is full, the brain sends a signal that it’s time to urinate. Urine then leaves the bladder when a muscle opens up (sphincter), allowing the urine to flow freely out of the body through the urethra.

When this system is working smoothly, you usually have time to get to a bathroom before needing to urinate and you don’t experience any leakage of urine. Urinary incontinence can happen when these parts don’t operate as they should. This can happen for many different reasons throughout your life. Many people think that incontinence is a normal part of aging that can’t be helped. While it is true that your risk of incontinence increases as you get older, there are also treatments available to help you manage this condition. Incontinence doesn’t have to disrupt your life and keep you from being active.

Types of Urinary Incontinence

Urinary incontinence -- when you accidentally leak urine -- is a problem that affects millions of Americans, most of them women. There are several different types, causes, and treatments:

Stress Incontinence - With this type, urine leaks due to weakened pelvic floor muscles and tissues. It can happen when pressure on your bladder increases -- such as when you exercise, laugh, sneeze, or cough. Pregnancy and childbirth can stretch and weaken a woman’s pelvic floor muscles. Other things that can lead to stress incontinence are being overweight or obese, neurological conditions, trauma to the urethral sphincter muscle, taking certain medications or, in men, having prostate surgery
Urge Incontinence - This is also called overactive bladder (OAB). With this type, you have an urgent need to go to the bathroom and may not get there in time.
Overflow Incontinence - If you can't empty your bladder, you may have overflow incontinence. This means you may dribble urine.

Managing Incontinence

Incontinence means you have trouble controlling when you pee or poop. This can happen for many different reasons. It can be occasional and mild, or it can seriously interfere with your daily life.

With urinary incontinence, pee might leak when you laugh or cough. You could wet the bed or be unable to make it to the toilet in time. Bowel incontinence can range from sometimes releasing a little poop when you pass gas to having sudden and uncontrollable urges to poop.

While incontinence can feel embarrassing, it's important to talk to a doctor if it happens to you. They can recommend the most effective ways to treat and manage it. Often, simple treatments like changes in your diet and exercises to strengthen certain muscles can improve your symptoms.

8 helpful tips for managing urinary incontinence

Urinary incontinence is the unintentional loss of urine. It is a common problem among all age groups, though it occurs more frequently in older people, and women are affected more than men.

It can be caused by physical problems such as weak bladder or neurological disorders, or it can be the result of certain lifestyle habits and conditions. Treatment for urinary incontinence will depend on the type and severity of your condition, but may involve lifestyle adjustments, medications, surgery or devices like catheters.

The most common signs and symptoms of urinary incontinence include:

Unexpected or frequent leakage of urine while coughing, sneezing, laughing, exercising or engaging in other activities
Difficulty making it to the bathroom in time
A strong and sudden urge to urinate followed by an involuntary loss of urine
Inability to control the release of urine
Urinating frequently (more than 8 times a day)
Small amounts of urine being released with no warning or sensation
Waking up several times at night to urinate
Leakage during sexual intercourse (especially for female patients)

Why Am I Experiencing Urinary Incontinence?

Urinary incontinence can be caused by weakened bladder muscles, damage to the pelvic floor, enlarged prostate, menopause, or bladder cancer. Some medications or neurological conditions can also cause urinary incontinence.

Urinary incontinence happens when you lose control of your bladder. In some cases, you may empty your bladder’s contents completely. In other cases, you may experience only minor leakage. The condition may be temporary or chronic, depending on its cause. According to the Urology Care Foundation, millions of adults in the United States experience urinary incontinence. Urinary incontinence affects women more often than men in a 2-to-1Trusted Source ratio. However, this condition can affect anyone and has many different causes. As you age, the muscles supporting your bladder tend to weaken, which can lead to urinary incontinence.

Many different health problems can also cause the condition. Symptoms can range from mild to severe and can be a sign of cancer, kidney stones, infection, or an enlarged prostate, among other causes. If you experience urinary incontinence, make an appointment with a healthcare professional. Urinary incontinence can interfere with your daily life and lead to potential accidents. A healthcare professional can also determine if a more serious medical condition may be the cause. They may also be able to treat the cause.

Constipation

Constipation in a young child seen on X-ray. Circles represent areas of fecal matter (stool is white surrounded by black bowel gas)

Constipation is a bowel dysfunction that makes bowel movements infrequent or hard to pass. The stool is often hard and dry. Other symptoms may include abdominal pain, bloating, and feeling as if one has not completely passed the bowel movement. Complications from constipation may include hemorrhoids, anal fissure or fecal impaction. The normal frequency of bowel movements in adults is between three per day and three per week. Babies often have three to four bowel movements per day while young children typically have two to three per day.

Constipation has many causes. Common causes include slow movement of stool within the colon, irritable bowel syndrome, and pelvic floor disorders. Underlying associated diseases include hypothyroidism, diabetes, Parkinson's disease, celiac disease, non-celiac gluten sensitivity, vitamin B12 deficiency, colon cancer, diverticulitis, and inflammatory bowel disease. Medications associated with constipation include opioids, certain antacids, calcium channel blockers, and anticholinergics. Of those taking opioids about 90% develop constipation. Constipation is more concerning when there is weight loss or anemia, blood is present in the stool, there is a history of inflammatory bowel disease or colon cancer in a person's family, or it is of new onset in someone who is older.

Treatment of constipation depends on the underlying cause and the duration that it has been present. Measures that may help include drinking enough fluids, eating more fiber, consumption of honey and exercise. If this is not effective, laxatives of the bulk-forming agent, osmotic agent, stool softener, or lubricant type may be recommended. Stimulant laxatives are generally reserved for when other types are not effective. Other treatments may include biofeedback or in rare cases surgery.

Urinary incontinence

Anatomy of the lower urinary tract and genital system. The top diagram shows the female urinary system, and the bottom shows the male urinary system

Urinary incontinence (UI), also known as involuntary urination, is any uncontrolled leakage of urine. It is a common and distressing problem, which may have a large impact on quality of life. It has been identified as an important issue in geriatric health care. The term enuresis is often used to refer to urinary incontinence primarily in children, such as nocturnal enuresis (bed wetting). UI is an example of a stigmatized medical condition, which creates barriers to successful management and makes the problem worse. People may be too embarrassed to seek medical help, and attempt to self-manage the symptom in secrecy from others.

Pelvic surgery, pregnancy, childbirth, and menopause are major risk factors. Urinary incontinence is often a result of an underlying medical condition but is under-reported to medical practitioners. There are four main types of incontinence:

Urge incontinence due to an overactive bladder
Stress incontinence due to "a poorly functioning urethral sphincter muscle (intrinsic sphincter deficiency) or to hypermobility of the bladder neck or urethra"
Overflow incontinence due to either poor bladder contraction or blockage of the urethra
Mixed incontinence involving features of different other types

Treatments include pelvic floor muscle training, bladder training, surgery, and electrical stimulation. Behavioral therapy generally works better than medication for stress and urge incontinence. The benefit of medications is small and long-term safety is unclear. Urinary incontinence is more common in older women

Symptoms, causes & treatment of gas in stomach

Stomach gas can cause issues ranging from burping and flatulence to heartburn and indigestion

Symptoms of stomach gas - According to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)Trusted Source, the most common symptoms of gas in the stomach include:

burping
flatulence
bloating
abdominal pain or discomfort

Causes:

person swallows more air during the following:
eating or drinking too fast
chewing gum
sucking on hard candy
drinking carbonated drinks, such as soda, sparkling water, and beer
smoking
wearing ill-fitting dentures that reduce chewing efficiency

Treatments for stomach gas:

Home remedies
Lifestyle changes
Herbal remedies
OTC medications

Hematochezia: Blood in Stool

Advice About Bright Red Blood in Stool

Blood is supposed to stay in your body. Seeing blood in your bowel movement is very frightening. It is an indication that something is not working right, but it is not always a herald of colon cancer. Rectal bleeding has many causes, but only one of them is colon cancer.

When You Note Blood in the Stool - The best action you can take now, to advocate for yourself, is to pay attention to this symptom and be prepared to discuss it with your doctor. Ask yourself these questions:

Was the blood in the stool, toilet bowl or on the toilet paper?
Was the blood bright red or dark red?
Approximately how much blood did you see? (Keep in mind, a drop of blood in a toilet bowl will turn all of the water red.)
Did you have to strain to pass the bowel movement?
How frequently do you have bowel movements?
Do you have other symptoms?
When was your last colon screening exam or colonoscopy?
Do you have a history of polyps or a family history of polyps?

Causes of Blood in the Stool:

Hemorrhoids
Inflammatory Conditions
Colon Polyps
Constipation
Bowel Infections
Colon Cancer

Hematuria: Blood in urine

Hematuria is the presence of red blood cells in the urine. If there are enough red cells, the urine can become bright red, pink or cola colored. Often, however, the urine appears completely normal because there is not enough blood to cause a color change. In this case, the condition is called "microscopic" hematuria. There are many possible causes of hematuria, including:

Urinary tract infection — Hematuria can be caused by an infection in any part of the urinary tract, most commonly the bladder (cystitis) or the kidney (pyelonephritis).
Kidney stones
Tumors in the kidney or bladder
Exercise — Exercise hematuria is a harmless condition that produces blood in the urine after strenuous exercise. It is more common in males than females.
Trauma — Traumatic injury to any part of the urinary tract — from the kidneys to the urethral opening (the connection between the bladder and the outside world) — can cause hematuria.
Drugs — Hematuria can be caused by medications, such as blood thinners, including heparin, warfarin (Coumadin) or aspirin-type medications, penicillins, sulfa-containing drugs and cyclophosphamide (Cytoxan).
Glomerulonephritis — Glomerulonephritis is a family of illnesses that are characterized by inflammation of the glomeruli, the filtering units of the kidneys. Glomerulonephritis is a rare complication of certain viral and bacterial infections (including strep throat). It can also occur in people with certain auto-immune diseases, systemic lupus erythematosus (lupus or SLE) and vasculitis. Sometimes there is no identifiable cause.
Bleeding disorders — This includes conditions such as hemophilia and von Willebrand's disease.

Nocturia: Excessive Urination at Night

Nocturia is a condition that causes you to wake up during the night to pee. This condition is also called nocturnal urinary frequency — having to pee more often at night. Nocturia becomes more common as people age (usually older than 60) and occurs in all genders and sexes, sometimes for different reasons. It can be common for people to wake up once during the night to pee, but peeing more frequently may be a sign of an underlying condition or problem.

When a person pees too much during the daytime, but can limit the amount of trips to the bathroom at night, it’s referred to as frequent urination. Nocturia is strictly using the bathroom multiple times after bedtime and before you wake up in the morning. Whether it’s happening due to an underlying medical condition or something else, it can leave you feeling tired because your regular sleep cycle is disrupted.

How common is nocturia? Nocturia is a common condition affecting more than 50% of adults after age 50. It’s more common in men and people assigned male at birth (AMAB) after age 50. Before 50, nocturia is more common in women and people assigned female at birth (AFAB). It affects up to 1 in 3 people over the age of 30.

Pneumaturia: Gas in urine

What Is Pneumaturia? Having small bubbles in your urine is called pneumaturia. It isn’t a diagnosis on its own but can be a symptom of certain health conditions. Common source causes for pneumaturia include urinary tract infections (UTIs) and passageways between the colon and the bladder (called fistula) that don’t belong.

If you have pneumaturia, you’ll feel gas or a bubbling sensation interrupting your urine stream. Your urine may appear to be full of small air bubbles. This is different than urine that looks foamy, which is usually an indicator of too much protein in your urine. Since pneumaturia is a symptom of other conditions and not a condition all by itself, you may want to look out for other symptoms that sometimes come along with it, such as:

burning sensation while urinating
difficulty urinating
feeling the need to “go” all the time
discolored urine

All of these symptoms could indicate an infection in your urinary tract. Common causes:

One common cause of pneumaturia is infectious bacteria. Pneumaturia can indicate a UTI, as the bacteria create bubbles in your urine stream.
Another common cause is a fistula. This is a passage between organs in your body that doesn’t belong there. A fistula between your bowel and your bladder can bring bubbles into your urine stream. This fistula can be an outcome of diverticulitis.
Less often, deep sea divers will have pneumaturia after a period of time underwater.
Sometimes pneumaturia is a symptom of Crohn’s disease.

Acupressure Points for Constipation

Acupressure can help in relieving constipation symptoms such as abdominal pain, bloating and gas by applying pressure to specific points on the body. The following are the commonly used acupressure points to relieve constipation that you can do on your own. Instead of pressing with your fingers, you can also use acupressure stick:

Tianshu (ST25) - Tianshu can improve digestion. You can place three fingers parallel and alongside the centre of the belly button. Tianshu is located at the edge of the last finger, away from the belly button. Use your thumb or forefinger and apply pressure or you can do circular motion with finger.
Guanyuan (CV4) - Guanyuan is used for relieving abdominal pain and diarrhea. It is located at 3 inches below your belly button. Use your thumb or forefinger and apply pressure or you can do circular motion with finger.

Zhigou (TE6) - Zhigou is an effective pressure point for relieving chronic constipation. It is located at 3 inches up the back of your arm from the crease of your wrist. Use your thumb and apply pressure or you can do circular motion with thumb. This procedure should have been repeated for the other wrist.
Zusanli (ST36) - Zusanli can strengthen the digestive system. It is located on the outer calf, about four finger widths under the knee bone. Use your thumb or forefinger and apply pressure. This procedure should have been repeated for the other foot.

15 signs your stomach is functioning badly

A queasy feeling in the pit of your stomach, dreading even the idea of food, and having to constantly run to the washroom; these are all unpleasant symptoms of stomach issues. There are all sorts of reasons why you may have a poorly functioning stomach. Sometimes, it’s from food poisoning or a gastro bug going around; however, if your stomach is chronically upset, it might be a sign of a bigger problem. If you are experiencing any of these 15 signs that your stomach is functioning badly, be sure to make an appointment with your healthcare provider:

Frequent and chronic diarrhea
Blood in your stool
Severe cramps after eating
Chronic constipation
Frequent heartburn
Difficulty swallowing
Loss of appetite
Unexplained weight loss
Sudden intense abdominal pain
Feeling full after eating a small portion
Swollen abdomen
Anemia
Fatigue and weakness
Frequent vomiting
Skin issues

What your poop tells you about your health

5 Things Your Poop Can Tell You About Your Health

Having a bowel movement is a critical part of digesting the food we eat. Stool formed by the large intestine is the body's way of getting rid of waste.

While you should talk to your doctor about any concerns, changes in poop color and consistency could show what is happening inside your digestive system:

Rocks and Pebbles - Poop that is hard and shaped like tiny rocks or pebbles is likely just a sign of constipation. You can still be considered constipated even if you are able to pass a small amount of stool. The large intestine helps to concentrate waste by absorbing water. If muscle contractions in the large intestine are not working properly, waste left in the colon becomes even more concentrated, resulting in harder stool.
Color Changes - A change in stool color is one of the most common concerns patients ask about. The foods you eat and the kind of bacteria living in your colon can both cause such changes, and added food colorings are frequent culprits. This is one reason why patients preparing for a colonoscopy are instructed to avoid food and beverages with certain added colors the day before. Doctors note that when they perform a colonoscopy, they can actually tell what color the beverage was that the patient drank during their preparation for the procedure. Most changes in the color of stool are not cause for concern. The exception is poop that appears black or bloody, which could signal other problems with the digestive system.
Black and Tarry - The most common cause of black and tarry poop is taking iron supplements or a medication containing bismuth, such as Pepto-Bismol. However, it could mean you're losing blood somewhere in your gastrointestinal tract, such as in the stomach or small intestine.
Oily or Greasy Stools - If you have poop that appears oily, has a greasy consistency and is difficult to flush, it could be a signal that your body is not able to properly digest fat. The consistency changes could be caused by an infection, nutrients not being digested due to celiac disease or a problem with the pancreas, such as pancreatic cancer or pancreatitis.
Pencil Thin - Stool that is only occasionally very thin is not a cause for concern. It is likely due to muscle contractions in the large intestine as it helps to concentrate waste. If there is a sudden and consistent change in your stool always being thin, it could mean there is a blockage in your colon, and you should see your doctor.

Diabetes: Early Signs & Symptoms

Diabetes mellitus refers to a group of diseases that affect how the body uses blood sugar (glucose). Glucose is an important source of energy for the cells that make up the muscles and tissues. It's also the brain's main source of fuel. The main cause of diabetes varies by type. But no matter what type of diabetes you have, it can lead to excess sugar in the blood. Too much sugar in the blood can lead to serious health problems.

Chronic diabetes conditions include type 1 diabetes and type 2 diabetes. Potentially reversible diabetes conditions include prediabetes and gestational diabetes. Prediabetes happens when blood sugar levels are higher than normal. But the blood sugar levels aren't high enough to be called diabetes. And prediabetes can lead to diabetes unless steps are taken to prevent it. Gestational diabetes happens during pregnancy. But it may go away after the baby is born. Diabetes symptoms depend on how high your blood sugar is. Some people, especially if they have prediabetes, gestational diabetes or type 2 diabetes, may not have symptoms. In type 1 diabetes, symptoms tend to come on quickly and be more severe.

Some of the symptoms of type 1 diabetes and type 2 diabetes are:

Feeling more thirsty than usual.
Urinating often.
Losing weight without trying.
Presence of ketones in the urine. Ketones are a byproduct of the breakdown of muscle and fat that happens when there's not enough available insulin.
Feeling tired and weak.
Feeling irritable or having other mood changes.
Having blurry vision.
Having slow-healing sores.
Getting a lot of infections, such as gum, skin and vaginal infections.