Diseases Of The Prostate Gland: Benign Prostatic Hypertrophy Or Hyperplasia

Posted on December 29, 2009 by David | 56 Comments

Submitted by Dr. Georgie Porgie

Click On Image To View Presentation (PDF Format)

This entry was posted in Blogging and tagged Blogging, Healthy Living, Hyperplasia, Hypertrophy, Prostate. Bookmark the permalink.

56 responses to “Diseases Of The Prostate Gland: Benign Prostatic Hypertrophy Or Hyperplasia”

Georgie Porgie | December 29, 2009 at 9:24 PM |

I have finally managed to get one of aseries of three ppts on Prostate diseases up for the nenefit of the Men as commissined by BU David.

In 2005 I had the pleasure of teaching Biochemistry and Pharmacology at a young Medical school in Curacao.

It was clear to me that there was nothing being done to help the students integrate the Basic Science subjects they were leaning.

So I got some keen students to gether and we put together some great seminars after school on Thursdays on diseases of some areas of the body.

This allowed the students to review the components of the Anatomy, Histology, Physiology, Pathology, Microbiology and Pharmacology they had learned. It also helped them to see all this came together in treating their patients when they got to begin thier clinical training.

We did three sessions on the prostate.
I hope you will enjoy and learn from these presentations, and thank BU David for being very persistent about me presenting information on this subject.

The students certainly found some good stuff online, to which we added the Pathology from “Big Robbins”, and some Pharm notes, to give a fairly comprehensive picture.
Hants | December 29, 2009 at 10:59 PM |

Thanks Georgie Porgie and David.

Useful information for a 58 year old like myself.
John | December 29, 2009 at 11:42 PM |

GP

Likewise, thanks …. 53 years old!!

Been looking at 3D representations of internal organs recently to visualise what goes on inside of me and understand what goes where and how the various parts wear out.

Never came across this particular system of the Human body displayed as it is here in 3D.

Usually it is depicted in 2D and difficult to visualise.

Got the opportunity when I was in New York recently to go to the Bodies Exhibit.

If it weren’t for my fear of blood I might have been a doctor, but I have to make do as an engineer to satisfy my love of understanding how things work.

Fascinating creation the Human Body ….. miraculous.

The guy who came up with the design is a genius!
David | December 30, 2009 at 12:53 AM |

@BU family

There is the technically minded on this subject and the layman, we are sure GP will adjust his interventions accordingly.

The first layman question: Yes men when they approach middle age should get tested BUT what are the signs the average Joe should anticipate which signals something is wrong with the P?
BAFBFP | December 30, 2009 at 1:39 AM |

@ John
“The guy who came up with the design is a genius!”

Please, please don’t start!!! Enough already!
John | December 30, 2009 at 5:41 AM |

Sorry BAFBFP … just expressing my feelings!!

Only recently started to apply my mind to the physical processes that go on inside the body.

The heart and lungs are what started it.

…. still interested in what’s outside too …

…. it has engaged my mind for as long as I can remember so just diversifying a bit!!
John | December 30, 2009 at 5:47 AM |

GP

The doctor I attend says that the digital exam can affect the results of the PSA test.

Never asked why.

Is there a reason?
Crusoe | December 30, 2009 at 6:18 AM |

BAF & John,

You both just made me crack up.

Maybe BAF thought John was being wicked, stirring the pot…..

Lol. Thanks!
20+days | December 30, 2009 at 10:08 AM |

Very interesting presentation.

Since it seems that enlargement is inevitable, could the doctor elaborate on the race factor and on the ways to reduce the risk of developing prostate cancer, i.e. tomatoes + >ejaculations.
Gerorgie Porgie | December 30, 2009 at 11:45 AM |

@ John // December 29, 2009 at 11:42 PM
Re

Fascinating creation the Human Body ….. miraculous.

The guy who came up with the design is a genius!

We are indeed fearfully and wonderfully made as taught in the Psalms.

@David // December 30, 2009 at 12:53 AM

It is thought that the prostate starts to enlarge around age 45, so that many men get symptoms by age 50.

Most men have up to this time had little need to attend the doctor, but YOUR TIME HAS COME NOW LOL!

Around age 45 we should all be checking on our doctors to have them check on our prostate—symptoms or no symptoms.

However the symptoms to expect are stated in slides 46 & 47 thus:-

•Symptoms of bladder outlet obstruction caused by BPH include:
•Hesitancy
•Weakness of urinary stream
•Intermittent urinary stream
•A feeling of incomplete
bladder emptying and need for repeat voiding
•Bladder ‘irritability,’ as manifested by urinary frequency, nocturia, and urinary urgency

•symptoms: -nocturia (need to urinate during night)
dysuria (difficulty and/or pain during
urination)
-urgency (sudden desire to urinate)
Gerorgie Porgie | December 30, 2009 at 11:48 AM |

@ John // December 30, 2009 at 5:47 AM

The doctor I attend says that the digital exam can affect the results of the PSA test. Never asked why. Is there a reason?
WILL DISCUSS THIS WHEN WE CONSIDER the PSA test in PART 1 or part 3..stay tuned!

@ 20+days // December 30, 2009 at 10:08 AM

could the doctor elaborate on the race factor and on the ways to reduce the risk of developing prostate cancer, i.e. tomatoes + >ejaculations.

WILL DO SO IN PART 3 stay tuned! Thanks for your kind remarks about the presentation.
David | December 30, 2009 at 12:46 PM |

Thanks GP!

Sometimes some will jump to comments so bear with us if we ask obvious questions.
Gerorgie Porgie | December 30, 2009 at 1:51 PM |

Point taken David.

Note that the medical students who put this presentation together under my supervisin were laymen when they were working on this too— or virtually so (they were in their second semester). LOL

But the presentation can easily be understood.

But I have kept it at a certain level as I might one day get the chance to use these powerpoints again

So the laymen must get what they can and ask about what they cant LOL

First get an idea of the general gross anatomy of the male genitalia in slides 6-10 & 14 . I think the illustrations are very good.

Then have a good look at the Pathology in the pictures in slides 29, 30, 33-37 and 58-62.

These pictures show how the nodules encroach upon and obliterate the urethra as it passes through the prostate. they also show the result of prostate enlargement on the bladder even as far as causing stone formation in the bladder.

The layman can get sufficient from these pictures to appreciate the normal and to decide if he wants to wait to experience the abnormal……….and then decide once you are over 45, if you should or should not wait to check your doctor for advice and to monitor the situation including your PSA (on which we will put up a short presentation in a day or two- as I am quite busy.)

The more adventurous and curious or researchers like my friend Annonymous, will discuss this with his doctor friend I am sure, and also have his young friends involved in the discovery about thier impending prostate issues.

If so, then my effort and the persistent prodding of BU David would have been worth it.

Much of the Physiology and Pharmacology at the end of the presentation is quite simple to unravel really.

Basically it is these things happen in the prostate as we get older and so we use these drugs to block them from happening or we use alpha blockers to relax the area around the bladder neck where the prostate lies.

Take it slowly and you will get it. Dont let the jargon run you away. Just ask quetions about the jargon for this presentation.

But if you feel you are not too smart (layman) you can still learn a lot from the pictures. OK?
Pick Sense | December 30, 2009 at 2:11 PM |

Well presented Dr.Porgie! Sure scared the feces out of a village ram I know!Now he is anxiously awaiting Part 3 of your presentation.Incidentally after Fourteen years he is now seeing a Doctor for check ups.
Gerorgie Porgie | December 30, 2009 at 2:52 PM |

@ Pick Sense

I think that is the desired effect BU David was hoping for! LOL.

Thanks for your kind word, Sir.
Georgie Porgie | December 30, 2009 at 10:10 PM |

Fellows

Give me a day or so to edit the info I have on the PSA, and related tests, before submitting the same to the doctor. This will answer some of the questions asked above.

Meanwhile you chaps can go see your doctor for your digital rectal exam and your PSA test. LOL.

Ladies see that your men folk do this—-even if you have to pay the doctor bills. LOL
Georgie Porgie | December 30, 2009 at 10:27 PM |

Submitting to David sorry
David | December 31, 2009 at 7:42 AM |

@Dr.GP

The men seem to be frighten for this topic.
John | December 31, 2009 at 9:19 AM |

…. shy.
Georgie Porgie | December 31, 2009 at 10:36 AM |

LOL
Well even if they dont comment, and they heed the advice, we would have done our duty to our fellow Bajan men.
Technician | December 31, 2009 at 10:17 PM |

More like petrified in my case.
I had a case of kidney stones and I wouldnt wish that pain on my enemy.
I didnt sleep for 4 straight nights and when the pain got the better of my pride, I could hardly stand upright. Big man brought to his knees and crying calling mummy …*sigh*.
The passing…..well…*sigh*
John | January 1, 2010 at 2:16 AM |

Technician

I remember seeing examples of Kidney stones in the Bodies Exhibit in New York .

I can well imagine how much pain they can give from seeing them in an actual kidney.

In fact I had a mild bout, hours not days, and pain you cannot stand up with as you say.

Spent some time at the exhibit and tried to relate what was happening inside me with processes and equipment I have dealt with as an engineer.

Here is my very crude understanding.

According to what I can remember from the exhibit the kidneys filter a two litre pet bottle of blood every two minutes.

I was amazed at the volume of blood which pass through the kidneys and is filtered every day.

Every time the heart beats it pushes blood at them for purification.

They extract impurities from the blood and pass them as urine to the bladder below.

The bladder is the storage tank for impurities, there is no allowance for storage in the kidneys.

All the time the stone is blocking the flow of urine the heart is pushing blood at the kidney and the kidney is extracting impurities …. which it can’t store ….. and there is no way you want the heart to stop.

Something’s got to give.

Either the stone has to move to let the urine flow to the bladder or the kidney is in big trouble, ……. or the heart.

After the urine and stone get into the bladder there is the potential problem of blockage from the prostate.

An amazing design of a recirculating pumping system with filtration, optimised for minimum storage and functioning in real time with automatic disposal of filtered impurities, …..

…… and it gives little trouble and requires no maintenance for years.

Man could never build anything like it.

The longest a simple non recirculating water pumping system I built lasted without breaking down was 10 years ….

…… almost zero maintenance except for routine removal of debris from the filters

….. and to do that had to shut the system down for short periods …… no such luxury with the human body.

Extreme pain ….. extreme emergency.

Can’t imagine four days of that sort of pain.
Georgie Porgie | January 1, 2010 at 11:25 AM |

John you seem to have a reasonable grasp of the functioning of the kidneys.

Perhaps we should put up illustrations of its intricate design (gross and microscopic anatomy), then detail the physiology so that we can better show how this remarkable organ evolved ex nihilo via the big bang and other cosmic phenomenon by infrequent random unrepaired mutations of DNA! LOL ROTFLMAO!
David | January 1, 2010 at 3:31 PM |

Here is a presentation on PSA which Doc P asked to be uploaded. Have to expressed our disappointment with how scared our men folk on BU have demonstrated on this topic 🙂
Technician | January 1, 2010 at 3:52 PM |

@John..

All that
you said is true. It was explained to me by Dr.Mosely and the other doctor at the Diagnostic Clinic .
I had to take 2 tablespoons(not teaspoons) of castor oil and not eat for a day before I had to get a test (expensive) done. I spent the day on the ‘ throne’, the test w done the following morning where they injected some kind of dye into me and then too an Xray of my kidneys. when I saw the size of the stones (they were 3) I could not believe it…the size of a pin head!!
So yes, I too marvel at the human body and its functions.
David | January 1, 2010 at 4:02 PM |

Doc P

Please expand on the extract from slide 10.

However, some treatments for prostate cancer can cause complications, such as the inability to control urination (incontinence) or the inability to have an erection (erectile dysfunction). Therefore, some men may reasonably choose not to treat prostate cancer if it is detected. These men do not need a PSA test.
David | January 1, 2010 at 4:50 PM |

Dr. P is feeding the information fast and furious!

Here is another presentation, this time covering the PSA Rectal Examination.
Georgie Porgie | January 1, 2010 at 4:57 PM |

The test is done for screening, to assist diagnosis or to monitor treatment……not to determine treatment.
The PSA is indicated for these reasons.

In a person with complications of the disease all ready, there is no need to do the test because you are neither screeing him; no know the diagnosis, and the test is not used to determine treatment. So why do the test unecessarily?

Perhaps you are more interested in the complications.

Two complications of a prostatectomy are urinary incontinence and erectile dysfunction.

Prostatecomy was one of the few treatments available in the good “ole” days for treating BPH. In which the prostate was enucleated from its ( false) “capsule”

Today there are other proceddures which might be preferred, that are less invasive.

Our local doctors are certainly competent enough to elaborate thereon.
Georgie Porgie | January 1, 2010 at 5:02 PM |

LOL One of the female teachers from Suriname had been given a British ESLB edition of Hamilton Bailey’s Signs & Demonstrations in Clinical Surgery.

And the students scanned the relevant pages and projected it in the seminars.

I remember these seminars fondly. The school then started a revision course for the senior students based thereon….. after I left.

Certainly very detailed and graphic. LOL

GO SEE YOUR DOCTORS FELLAS! LOL!
John | January 1, 2010 at 5:15 PM |

Technician

The doctor sent me for ultra sound … expensive test.

I got a CD ROM with images which showed some evidence of kidney stones … or so I was told.

I looked after on my own but to be quite honest, did not understand what I was looking at.

I suppose on my own I could convince myself that what I was shown was the right kidney and evidence of stones.

The pain was so bad at one time in the lower part of my right side abdomen that I thought for sure it was appendicitis and curtains for me.

The doctor said if it was appendicitis the pain would get worse (unimaginable for me), but it got better.

My sister put me on Cranberry Juice which I buy when I remember.

Amazing though how completely the pain disappeared.

One added benfit of the test was that the ultrasound also showed up my prostate in the picture and the doctor could opine on whether it looked bad or not ….I asked, he didn’t express any concern so presume it was ok as far as the measurements and appearance went.

Good thing also about the test is that it is a data point which provides a reference for the future, like past PSA values.

As an engineer I can appreciate the use of the test and data to monitor the performance of a pretty complex machine.

… and that’s why after I got the opportunity to go to the Bodies Exhibit in NY I made it my business to spend some time inspecting the kidneys and relating their location and connections to where I had the pain.
David | January 1, 2010 at 6:22 PM |

Here is a presentation of a URINARY TRACT OBSTRUCTION. Perhaps of interest to John.

From Doc P.
Georgie Porgie | January 1, 2010 at 6:33 PM |

John I asked David to put this ppt up especially for you. Unfortunately the animation in slides 24 & 25 does not work in pdf.
John | January 1, 2010 at 7:36 PM |

David, GP

Thanks.

I went through it quickly just now. Will study shortly and relate the pictures I have on the CD ROM.
Technician | January 1, 2010 at 8:03 PM |

@ John…

Can you still see that Bodies Exhibit in NY?
If so, can you direct me as to where and when?
John | January 1, 2010 at 10:31 PM |

Technician

Check this link

http://www.bodiestheexhibition.com/
Technician | January 1, 2010 at 10:48 PM |

@ John…

Thanks much for that info, will be going next week.
Makaveli | January 2, 2010 at 12:06 AM |

Abdominal ultrasound is not ideal, and does not rule out prostate pathology. If there is suspicion the preferred imaging test is a transrectal ultrasound…yep you know where the probe goes.

PSA is not a very good test for much of anything but an icebreaker… a way of working up to the DRE, and getting men into the health system and involved in their prostate’s health. PSA can vary for so many reasons and just because is called prostate specific antigen does not mean the prostate is the only source of PSA. PSA test can scare you over nothing or make you complacent when something could be lurking… Beware!
Sargeant | January 2, 2010 at 12:44 AM |

GP

Thanks for the information on the Prostate and PSA screening I hope that the males who see the slides take action and the females who view the slides also encourage their partners to take care of their bodies as appropriate. I don’t know if the view still holds in Barbados but I’ve found that many men from the Caribbean are reluctant to have a rectal examination because of the perception that it may be harmful to their sexuality. This fear may account for some premature deaths.

I’ve had the rectal examination and I have an annual PSA test done, a few years ago I also had a Cystoscopy, my doctor said I’m as likely to die with Prostate cancer as to die from it, when my grandfather died at 92 he had prostate cancer but it was the fall which broke his hip that finally sent him to Paradise. One of my close relatives recently had his Prostate removed in the USA however although he had a relatively low PSA count the specialist relied on the Gleason Score to make the decision to operate. What is your opinion on this diagnostic tool?

If this series is to continue may I suggest that you do a post on the benefits of a Colonoscopy for men and women.

http://www.prostate-cancer.org/education/staging/Dowd_GleasonScore.html
David | January 2, 2010 at 3:13 AM |

Sometime ago in discussion with a Doctor on the colonoscopy the issue of a tear or damage while inserting the probe came up. Perhaps to add to Sargeants request to list benefits etc Doc P might address.
Dictionary | January 2, 2010 at 7:53 AM |

GP:

You all need to develop a relatively non-invasive, reasonable screening test.

Pushing for “digital” examinations, and the like based on annual checkups is not going to hack it, long term.

Any progress?

D
Bonny Peppa | January 2, 2010 at 7:56 AM |

Off topic:
Dr.Porgie, what are the benefits/dangers of a colonic cleanse? I mean when they insert a tube in the rectum and flash out the faeces. It lasts as much as 30-45 mins.
Makaveli | January 2, 2010 at 8:18 AM |

By the time samples are being sent to a pathologist, there is a suspicion of malignancy. The Gleason Score is used more to guide therapy decisions, but it is operator dependent and one pathologists 7 maybe another’s 8, some studies of prognosis and survival may group some of the scores and stratify e.g group 4 gleason 7+8 and group 5 gleason 9+10. So even if the numbers are discrete they really represent a continuum of tissue pathology.
Bonny Peppa | January 2, 2010 at 9:15 PM |

Dr.Porgie
I ask you a question man. wah happen?

Makaveli
You can answer my question for me too cause you seem to know your ‘onions’.
Pat | January 2, 2010 at 10:07 PM |

@ Bonnie Peppa

What you are asking a bout is an enema. You have them before delivery and colonoscopy.
Pat | January 2, 2010 at 10:11 PM |

@ Dr. Georgie Porgie

With regard to impotence in men, who still want to do the business, can you elaborarte/indicate, using probably the opening slide, where they place the two rods in the penis?

What would it be like for a man walking around all day with a “hard” penis. Is it also true that an impotent man’s penis extends (is longer than normal).
Bonny Peppa | January 2, 2010 at 10:38 PM |

Pat
No, not an enema. I had children man. I know an enema.
I talking about a colonic where a tube is placed in the rectum and flushed with some sort of warm liquid and it flushes out all the ol faeces. I had a few done before long long after I had my children. Coming to the end of the exercise, the first time I had it done,I became very nauseous and the second time around, I was made to lie on my side and I was ok.
But some question the safety of this, hence the question to the good ol Dr. Porgie.
Pat | January 4, 2010 at 5:16 PM |

@ Dr. Porgie

I am still awaiting a response to the question above. Or is this thread only for men? If so, I am a man, Patrick, today! lol.
Bonny Peppa | January 4, 2010 at 6:35 PM |

Pat
wah I khan undastan. Dr.Porgie like he jus put we pun ‘ignore’.
You is Patrick today an I is Bobby Peppa. Lol
Terence M. Blackett | January 4, 2010 at 10:50 PM |

Recent research into the use of “NATURAL PROGESTERONE” as a tool to treat prostate problems is well documented….

Far too many Bajans are coming down with this disease – many are dying for a lack of knowledge…

If we can get pass the blinding science and the big-headedness of doctors who have taken a “Hippocratic” oath but in reality are “hypocrites”, liars and extortioners who sacrifice innocent people’s on the altar of ignorance at the behest of the pharmaceutical lobby and the massive drug companies who have their cronies masquerading as legitimate healers…

It’s all a BLOODY JOKE!!!!

Folks need to study for themselves and by putting their own health into a proper context and in turn taking complete responsibility for their own well-being – doctors won’t be able to fleece us of our children wealth and the drug companies would have to rethink their insidiously diabolical strategies to chemicalize the world at any cost….

Here is 200 odd links to Prostate info and how best we can empower ourselves as men with the right knowledge to stay fit and healthy – sexually and otherwise…

http://search.mercola.com/Results.aspx?k=prostate%20cancer
Terence M. Blackett | January 4, 2010 at 11:02 PM |

The last 50 years of medical technological growth has also been “shadowed” by a ninja-like medical holocaust which has caused million of lives due to the use of so-called legitimate drugs licensed and patented by companies sanctioned by governments and peddled by “white-collar” drug dealers….

Heck, don’t take my word for it – read someone else’s take on it:-

http://www.naturalnews.com/001298_drugs_doctors_drug_companies.html
John | January 5, 2010 at 8:02 AM |

I hate to take pills and so far, thank God, I have kept good health and avoided them.

For a period a while back the Dr. had me on Pravachol for cholesterol but stopped it when it started to affect the liver enzymes.

Around the same time I was in training for a hike overseas, drinking plenty water and exercising regularly with 40 pounds on my back.

For a period back then I was a lean mean machine!!

My cholesterol level sunk to below the lowest level of the range of numbers the Dr. was using.

The Dr. could only rush in during the check up and ask me what I did because I was no longer on the medication and getting results way beyond his expectation.

He nodded his head when I told him and told me “keep it up”.

Diet and exercise beat pills anyday.

I am not so strict in diet as anyone looking at me would know but try to get strenuous exercise regularly, or just any exercise.

Side effects are associated with most medications and sometimes they are harmful.

I have noticed the ads for various medicines on the TV in the US and often wonder how the drug companies get sales because every ad contains a list of harmful side effects as required by law ….

eg for medicines to help with erectile disfunction the ad warns you that “you should consult a Dr. for any erection lasting more than four hours”

… and for others “this medicine has been known to cause heart attacks or strokes in patients suffering from ….”

….. how I interpret what I hear when I listen to them is “if you take so and so medicine you will die”!!

So, I’ll try and avoid pills as long as possible but I accept that there are situations where they do help.
Bonny Peppa | January 5, 2010 at 9:48 AM |

Pat
nabody in fartin pun we. ya realize? stupseeeeeeeeeeee
Georgie Porgie | January 5, 2010 at 2:16 PM |

Dear Bobby the peppery one

I have no plans to fart on either you or Pat(rick) LOL.

Re Dr.Porgie, what are the benefits/dangers of a colonic cleanse? I mean when they insert a tube in the rectum and flash out the faeces. It lasts as much as 30-45 mins.

I have a cousin who graduated from Ross Medical school in Dominica, but who practices alternative Medicine, who does them and swears by them.

One major nenefit of regularly flushing out the bowels is that it prevents stasis of the bowel contents in the colon. Such stasis especially if there are carcinogens in the faeculent material at this stage can possibly lead to cancer of the colon.

As you know, we Bajans grew up with the regular use of Epsom salts, or senna pods in sea water , castor oil etc which were used to “purge ya”. Was that a stupid practice? Probably not? Unpleasant perhaps, but sound.

The disadvantages of these pratices could be losing a lot of fluid from the body. But this could be overcome by drinking extra fluids.

In recent times I found by chance that sweetening my home made ginger beer/ginger tea with zylitol sent me to the toilet just as regularly as using Epsom salts in the good old days.

A major complication of the colonic would be tearing of the mucosa if the operator is not careful.

Hope this helps.
Georgie Porgie | January 5, 2010 at 2:30 PM |

Dear Pat(rick) for a day

Sorry for the delay.

Pat // January 2, 2010 at 10:11 PM
@ Dr. Georgie Porgie
With regard to impotence in men, who still want to do the business, can you elaborate/indicate, using probably the opening slide, where they place the two rods in the penis?

A penile prosthesis is another treatment option for men with erectile dysfunction. These devices are either malleable or inflatable. The simplest type of prosthesis consists of a pair of malleable (bendable) rods surgically implanted within the erection chambers of the penis. With this type of implant the penis is always semi-rigid and merely needs to be lifted or adjusted into the erect position to initiate sex. Today, many men choose a hydraulic, inflatable prosthesis, which allows a man to have an erection whenever he chooses and is much easier to conceal. It is also more natural.
A penile implant is usually used when there is a clear medical cause for ED and when the problem is unlikely to resolve or improve naturally or with other medical treatments. Sometimes a penile prosthesis is implanted during surgery to reconstruct the penis when scarring has caused erections to curve (Peyronie’s disease).
OK referring to the opening slide, the rods would be placed in the areas in red

Re What would it be like for a man walking around all day with a “hard” penis.
Aparently the penis is always semi-rigid and merely needs to be lifted or adjusted into the erect position to initiate sex. However, I have never performed the proceedure, seen it done, or had it done to me, so I cant speak with authority on how it “feels” LOL

It appears, however, that the chaps get along quite fine. And the presence of the implants are not noticeable to their peers in the rest room.

Re Is it also true that an impotent man’s penis extends (is longer than normal).

NO it is not.

Hope this answers your questions.
Bonny Peppa | January 5, 2010 at 8:03 PM |

Thank you very much Dr. Porgie. I still use epsom salts at least once a month. Haven’t had a colonic in recent times. A lubricant is used to guide/slide the instrument into the rectum so I don’t think that any tearing is likely to occur.I will try the zylitol with my ginger-tea if available here in the health shop.
Thanks again.
Yours truly
Bobby Peppa alias Bonny.
LOLllllllll

Pat
That procedure seems very painful to me. I would prefer to see de sex n leff it bosey. LOL
Pat | January 6, 2010 at 4:35 PM |

@ Dr. Porgie

Thanks a million. You always comes through for me.

Pat.