Posted in Health, news

Expert States Holding In Farts May Escape Through the Mouth

An Australian professor claims a fart that wants to escape rectally may find another way if tempted.

Clare Collins, a professor in nutrition and dietetics at the University of Newcastle states that if a fart is not expelled, some air may get reabsorbed by the body and exhaled through the mouth.  But more commonly it will come out as an uncontrollable fart.



In an article published in The Conversation, she states:

A buildup of intestinal gas can trigger abdominal distension, with some gas reabsorbed into the circulation and exhaled in your breath. Holding on too long means the buildup of intestinal gas will eventually escape via an uncontrollable fart. 

She and her collegues studied how baked beans and psyllium increased gas quantity.  She urges to “let it go”, rather than holding it in.

Holding in a fart can be dangerous

In 2013 Dr. Pommergaard and Rosenberg et al published a report encouraging to “let it go” when it comes to flatus on an airplane.  At high altitudes, i.e. on an airplane, air expands. Hence gastrointestinal symptoms could be exacerbated by the intestinal distention.  These include:

  • Abdominal pain
  • Bloating
  • Increased heart rate
  • Increased blood pressure
  • Heartburn

to name a few…  The authors write:

Furthermore the ability to restrain a fart may be impaired by flatus incontinence or falling asleep on the airplane. Persons susceptible to such flatus incontinence may be especially vulnerable to the effect of air holes, turbulence, coughing and sneezing.

On a more serious note, the physiological responses to distended intestine are elevated blood pressure and pulse, and reduced oxygenation of the blood, which can be serious for people already at risk for cardiovascular complications. Furthermore, flatus retention has been suggested as a major factor in the origin of sigmoid diverticular disease.

However, what hasn’t been documented is bowel perforation from holding in gas.  Bowel perforations occur from ulcerations that eat through the lining of the intestine and trauma to the wall.  A direct link to holding gas in has not been documented I believe with any case of bowel perforation.

A sneeze has force and speed that increases the air pressure.  Holding in gas that is not being expelled has significantly less pressure and therefore would be unlikely to directly lacerate tissue.

What about sitting on your farts?

Some will try to lessen the sound of the fart by expelling the gas while seated firmly.  So in this instance, air pressure in increased because the fart is being expelled by sphincter muscles and air is trapped between the anus and the chair.  This may cause damage and some back pressure, but would occur at the level of the rectum and anus and most likely spare the large intestine from injury.

What’s in a fart?

Flatus, or flatulence, is commonly called a “fart”.  Flatus is made up of multiple gases obtained from swallowing and produced by the microbes lining the intestine. These include hydrogen, nitrogen, oxygen, carbon dioxide and methane.

Flatus odor, however, is caused from minor sulfur gas components including hydrogen sulfide, dimethyl sulfide and others.



Can farts make you sick?

Studies have found that bacteria passed from flatus will grow on a petrie dish but that clothes provide a filter.  Reports of pink eye being obtained from a pillow case soiled in flatus are anecdotal.

However, nausea and headaches can happen.  The hydrogen sulfide, depending on the dose, can cause headaches, nausea, skin and eye irritation.  In toxic doses, hydrogen sulfide (which has the characteristic rotten egg odor) can cause convulsions, delirium and death.  But hydrogen sulfide comprises such a minute amount in flatus that no one would become that ill by smelling it.

Can farts be beneficial?

For the farter, yes.  It assists in movement of the stool and passing it can help prevent bloating and constipation.  However for the recipient of the smell, it may be beneficial too.

In 2014, a study from Exeter University, found the hydrogen sulfide in gas to HELP cells recover from mitochondrial damage, allowing their energy powerhouses to continue working. Researchers believe this could help repair the damage in heart disease, stroke, dementia and many other diseases.

In summary, holding in farts, or burps for that matter, may cause uncomfortable gastrointestinal symptoms but in theory should not cause serious injury to the intestines by means of perforation.  Keep in mind, however, that you only have so much control.  The air will need to escape somehow, so the next sneeze, cough or laugh during a board meeting or date may be your gas’s only time to escape.


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Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, KDWN, and iHeart Radio.

She is also a Board Certified Family Physician and Assistant Professor at Touro University Nevada


Posted in Health, marijuana, news

Cannabis Coke Could Soon Be a Reality

Reports have surfaced that Coca-Cola is eyeing a deal with Aurora Cannabis, which may result in the production of a cannabis-infused cola drink.

The talks between the Canadian cannabis company and the famous Atlanta-based cola corporation was reported by Bloomberg.

They write:

“We are closely watching the growth of non-psychoactive CBD as an ingredient in functional wellness beverages around the world,” Coca-Cola spokesman Kent Landers said in an emailed statement to Bloomberg News. “The space is evolving quickly. No decisions have been made at this time.” 

Cannabis-infused foods have been a favorite in legalized markets where consumers wish to avoid inhaling the plant.

A legalized market coupled with a high demand for such a beverage could send shares “flying.”

However its safety, such as when mixed with alcohol, raises concerns.

This is a developing story.

Marijuana Medical Benefits are Strain Specific

Cannabis plants produce cannabinoids, or chemicals that can induce an effect on the body. When cannabinoids are produced by a plant they are called phytocannabinoids.  Humans produce their own cannabinoids, called endogenous cannabinoids.  Laboratory  or synthetically produced cannabinoids are called synthetic cannabinoids.

The human body has a very intricate endocannabinoid (endogenous cannabinoid) system, with receptors throughout our brain, organs, glands, and immune system. Hence a wide variety of physiological responses, occur when these receptors are stimulated by cannabinoids.  These include responses to sleep, memory, appetite, pain, immune response, mood, and cell damage repair and death, Research is currently investigating what endogenous chemicals the human body produces, but the majority of medical discussions surrounding cannabinoids includes the phytocannabinoids.

Cannabis plants produce many phytocannabinoids, but the most well-known and studied include CBD (cannabidiol) and THC (Tetrahydrocannabinol).  The latter is psychoactive, meaning it can give the user a feeling of euphoria.   The former, CBD, in non-psychoactive and researched more than others for its medicinal benefits.

Now plants, just like animals, are classified from Kingdom (Plantae) down to Genius and species.  Cannabis comes in a variety of species, including the major ones:  C. sativa, C. indica and C. ruderalis. 




C. ruderalis is less popular as it has a lower THC content. However it has “autoflowering” qualities, making them useful to cultivators, and if bred with C. sativa or C. indica could enhance the new hybrid in its reproduction.

C. sativa has a higher THC/CBD ratio, hence can provide more euphoria.  It reportedly helps decrease anxiety, treat depression and increase appetite.  It’s been touted to increase energy and boost creativity.  Its also used to help manage attention deficit disorder.  Although not approved yet in the US, an oral spray, nabiximol, has been developed and sold in multiple countries to treat neuropathic cancer pain.  Its brand name is sold, by prescription, as Sativex® .

C. indica has a higher CBD content and has been used for its sedative properties.  Its also used to help anxiety and induce appetite, but will additionally be used to treat pain and muscle spasms.


Epidiolex has received FDA approval to treat some seizures.  Its high CBD component is credited for its anti-seizure activity.

There are multiple other strains, each touted to have their own unique properties. provides the below table.




The challenge, however, is the lack of medical research in each of the different strains.  And when a study does come out discussing the medical advantages or disadvantages to using cannabis medicinally, the specific strain may not be mentioned or easily found in the report.

I believe that various strains do have unique properties and there is an art to the field of medical marijuana but more research needs to be done and quickly to avoid random use of cannabis products for treatment of medical conditions.


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Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, KDWN, and iHeart Radio.

She is also a Board Certified Family Physician and Assistant Professor at Touro University Nevada

Posted in Health, news, weather

Hurricane Florence Death Toll Rises: How You Can Help

The Category 1 hurricane that hit the Carolinas on Friday is expected to cause “widespread devastation” to multiple states for weeks to come.

19 people, including an infant, have been reportedly killed in the hours and days following Hurricane Florence’s landfall.

Torrential downpours are expected to continue and power outages, floods, raging waters, and the potential for tornadoes threaten coastal and inland residents.

Risks of drowning, crush injuries, infection, malnourishment, chemical exposure, hypothermia are just a few of the grave issues residents are facing.


Many of those who did prepare for the storm may not have stored plenty of food, especially healthy fresh food.  Those trapped in their homes may find the food they did store contaminated by flood water.

Greater Baton Rouge Food Bank 2016


Infectious disease

The World Health Organization states that floods bring water-borne diseases such as cholera, typhoid fever, leptospirosis and Hepatitis A.  Vector-borne diseases include Zika, malaria, dengue hemorrhagic fever, yellow fever, and West Nile.




Mosquitos initially get washed away during the storm, but the resulting puddles of water take weeks to dry and make ideal breeding grounds for insects.

The water gets dirty pretty quickly.  People touching the flood water need to wash their hands thoroughly before eating or preparing food.

Moreover due to the moisture that seeped into walls and floors of houses, mold can grow and cause a variety of respiratory issues among other physical ailments.  Massive disinfecting needs to take place before coming home to flood water contaminated residencies.




Chemical exposure

Chemicals from garages and fuel seeping into flood water expose victims to many compounds such as benzene, toluene and xylene that can cause a multitude of health effects including those that affect breathing, skin, the gut, balance, thought, and memory.



Multiple looters in North Carolina have already been arrested.  During Hurricane Harvey, a Cajun Navy rescuer told CNN that looters fired shots at him and his comrades, trying to take their rescue boat, which had actually broken down.

Panic fuels dangerous behavior and those without resources may try to take from those who prepared.

Sexual assault crimes can rise as predators find the chaos and lack of video surveillance ideal conditions to find victims who can’t yell for help.



When one loses their home, neighborhood, income, treasured belongings and more, its devastating.  Post-traumatic stress disorder may ensue.

To combat these risks, medical personnel and the CDC are preparing.  Among food, shelter and clothes, paper products, sanitizer, cleaning supplies, tetanus vaccinations and counselors will be needed is mass quantities.




Hurricane Florence, although weakening, is expected to hover over the next few days bringing more deadly conditions.


How can we help?

Army Emergency Relief is taking donations here to help victims of natural disasters.

Save the Children‘s Hurricane Florence Children’s Relief Fund site can be found here.

Blood supplies will be needed as residents who routinely donate have evacuated the area. Donating blood at your local blood bank may be shipped to the area in need.

United Blood Services have locations throughout the country that can accept your blood Donation. Contact UBS here.

The American Red Cross is accepting monetary and blood donations. Financial donations can be given here or on their website at Moreover one can call 1-800-RED-CROSS or text the word REDCROSS to 90999 to make a $10 donation.

The Salvation Army is also accepting donations online here and by calling 1-800-SAL-ARMY (725-2769).

The Red Cross and Salvation Army may also need local volunteers to help set up shelters.  Contact the above numbers.

Local volunteers are asked to donate supplies to nearby recreation centers for housing evacuees.

Supply drives in out-of-state locations may not be accepted directly but could help local charities who need to ship supplies to the affected area.


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Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, KDWN, and iHeart Radio.

She is also a Board Certified Family Physician and Assistant Professor at Touro University Nevada

Posted in Health, medications, news

Second Possible Carcinogen Found in Recalled Blood Pressure Medication

Regulators are investigating a second possible carcinogen in three lots of a common blood pressure drug.

The FDA globally expanded the recall of valsartan this summer due to an “impurity”, N-nitrosodimethylamine (NDMA) that is known to cause cancer in animals.  Now they are concerned, having additionally found traces of N-nitrosodiethylamine (NDEA).

Although originally manufactured and patented by Norvatis Pharmaceuticals, trade name Diovan, the recall involves multiple generic versions of the drug.  Batches made from Zhejiang Huahai Pharmaceuticals, Teva Pharmaceuticals, AvKARE, Torrent, Northwind,  Solco Healthcare and Proficient Rx LP are included in the recall.

The comprehensive list of recalled medications can be found here.

According to Reuters, the MHRA, Medicines and Healthcare Products Regulatory Agency, located in the UK, said the appearance of the impurity, N-nitrosodimethylamine (NDMA), came after a change in the process for making valsartan at one facility owned by Zhejiang Huahai Pharmaceuticals, a company in Linhai, China.

In animals, NDMA is known to cause liver and lung cancer.  In humans its carcinogenic risk is unknown, however the CDC states it may cause liver function impairment and cirrhosis.

With NDEA, data is limited, but due to its classification as a nitrosamine and its prevalence in tobacco smoke it is classified as a probable human carcinogen.

According to New Jersey Department of Health’s website, NDEA has been linked to liver, lung and gastrointestinal tract cancer in animals.

The director of FDA’s Center for Drug Evaluation and Research states, “We have carefully assessed the valsartan-containing medications sold in the United States, and we’ve found that the valsartan sold by these specific companies does not meet our safety standards. This is why we’ve asked these companies to take immediate action to protect patients.”

Doris Stenved, the chief physician at the Danish Medicines Agency, told the DR Nyheder, “There is no acute health threat to patients, but we know from trials with animals that it can cause cancer.”  She continues, “We don’t know if it has the same effect on humans, we just know it’s a substance that should not be in the medicine.”

Now a recent study published in the BMJ reports no short term cancer risk with NDMA. However it did not comment on long term cancer risk.  Dr. Kasper Kristensen of the University of Southern Denmark states, “We found no evidence of an increase in short-term risk of cancer from exposure to NDMA-contaminated valsartan products in this study of all adult valsartan users in Denmark.”

Valsartan is a medication in the class of angiotensin receptor blockers (ARBs) used for high blood pressure and congestive heart failure.

Although the recall was initially, Europe-wide, it has extended to the US and Americans should check with their pharmacist and/or medical provider to ensure their tablets are not included.


On the FDA’s website the following has been posted:

Like N-Nitrosodimethylamine (NDMA), which was found in the recalled valsartan products, NDEA is also formed from a specific sequence of manufacturing steps and chemical reactions. In addition to the FDA’s testing, the agency will post a preliminary method for detecting NDEA. Manufacturers and global regulators can use this method to screen other products for the potential presence of this impurity.

Additionally, the agency will update the list of products included in the recall and the list of products not included in the recall as products are tested for NDEA and as more information becomes available. If you are taking a valsartan product, be sure to check the lists, as they may change.

The FDA reminds patients taking valsartan from a recalled lot to continue taking their current medicine until their doctor or pharmacist provides a replacement or a different treatment option. Any patient taking valsartan from a recalled lot who has not yet spoken to their pharmacist or doctor should do so promptly. At this time, the FDA’s testing supports the conclusion that not all valsartan products contain NDMA or NDEA, so pharmacists may be able to provide a valsartan medication not affected by the recall, or doctors may prescribe a different medication that treats the same condition.


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Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, KDWN, and iHeart Radio.

She is also a Board Certified Family Physician and Assistant Professor at Touro University Nevada

Posted in Beauty, Health, news

Vampire Facials Are a Bad Idea

Warning: Graphic Content Below

A spa in Albuquerque, New Mexico has been shut down by the NM Health Department when a client contracted a blood-borne pathogen after undergoing a “vampire facial.”


What Is A Vampire Facial And What Are The Benefits by Barbies beauty bits



During a “Vampire Facial”, blood gets taken from the client (venipuncture) and then centrifuged to isolate the platelets, clotting factors, creating Platelet Rich Plasma (PRP.)  PRP is then reinjected into the client’s face with fillers as part of a “rejuvenation treatment”, or rubbed directly on the face after a microdermabrasion or micro-needle facial treatment.



Customers of VIP Spa who received this type of service have been urged to get tested for HIV, Hepatitis B and Hepatitis C.

PRP has been used by multiple specialties to help speed up tissue healing in tendon, ligament and muscle injuries.  The Platelet Rich Plasma also has been found to reduce inflammation and pain associated with injuries.  Some cite it may help hair growth which makes we wonder why women would want to add it to their face.



Kim Kardashian most famously had one but then stated in an interview how she regretted it due to it being “the most painful thing ever!”

Blood borne pathogens maybe be bacteria or viruses that enter the blood stream during a venipuncture or injection procedure.  These can be deadly and avoidance of unclean needles or poor sterile procedure is paramount to being protected.



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Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, KDWN, and iHeart Radio.

She is also a Board Certified Family Physician and Assistant Professor at Touro University Nevada


Posted in Health, news

Physician Burnout Rates Based on Specialty

A recent article published in AMA Wire breaks down burnout rates based on physician specialty.

Study authors surveyed 15,000 physicians in 29 specialties regarding their prevalence of burnout factors. As expected, close to half reported burnout and 15% admitted to symptoms of depression.

They report:

For the most stressful medical job, the highest percentages of burnout occurred among these medical specialties:

  • Critical care: 48 percent.
  • Neurology: 48 percent.
  • Family medicine: 47 percent.
  • Obstetrics and gynecology: 46 percent.
  • Internal medicine: 46 percent.
  • Emergency medicine: 45 percent.

Physicians in these medical specialties reported the lowest rates of burnout:

  • Plastic surgery: 23 percent.
  • Dermatology: 32 percent.
  • Pathology: 32 percent.
  • Ophthalmology: 33 percent.
  • Orthopedics: 34 percent.


A study last year from the American Medical Association (AMA), the Mayo Clinic and Stanford University finds 1 in 5 physicians plan to cut back their hours next year and 1 in 50 will leave the profession completely within the next 2 years.

Burnout is cited to be the main cause and is one of the biggest threats to healthcare today.

How Doctors Can Prevent Burnout


According to AMA President Dr. David Barbe, “An energized, engaged, and resilient  workforce is essential to achieving national health goals.”

And burnout affects all fields of medicine, surpassing 50%, in those including primary care and specialties such as gynecology, neurology, urology, emergency medicine, anesthesiology, cardiology and critical care to name a few.

Patients are at risk because if doctors aren’t at the top of their game, things get missed.  Moreover the keen instinct of a clinician is imperative to diagnosing correctly, and this gets blunted when one is emotionally fatigued, or burned out.

Why are Doctors Burning Out?

A variety of factors can lead to physician burnout but the following appear to be the most cited:

  1. Electronic medical records – these are time-consuming to learn and implement, take time away from patients and may be financially burdensome due to their cost and lack of revenue for those who struggle to type and work with computers.
  2. High patient insurance deductibles – with insurance companies not paying until patients reach their deductible, it forces doctor’s offices to work harder to collect the income needed to run a practice.  Physicians do not want to get into the financial aspect of patient collections and it adds undue stress on an already stressful field.
  3. Red tape – ICD 10 code changes, insurance authorizations, referral forms turn the average day of a physician to less patient care and more bureaucracy.
  4. Less respect – in the old days, doctors were considered heroes and revered greatly.  Today they are frequently blamed for issues such as rising healthcare costs and the opioid epidemic.
  5. Malpractice suit fears – doctors are human and can only combat nature so much.  When one is diagnosed with cancer a physician has to fear that one will accuse him of not diagnosing it “quickly enough”.  When a lab gets ordered, the clinician has to hope that his staff is ensuring that every lab value comes across his desk.  When a prescription gets written, he has to hope that the correct medicine gets dispensed, works effectively and does not cause an adverse reaction.  And when a referral is made to a specialist, he has to hope all the above issues go well with the second physician or he can be sued for the referral.  And since a doctor sees thousands of patients a year, the odds that he will be sued for something is higher than any other profession.  Moreover, one lawsuit is a enough to bankrupt him.  Pretty darn stressful.


What are the signs of burnout?

In any profession, the following may be signs of burnout:

  • Apathy
  • Exhaustion
  • Poor sleep
  • Negative attitude at work
  • Absence from work
  • Being irritated
  • Feeling empty
  • Dreading going to work
  • Feeling underappreciated
  • Feeling you don’t matter
  • Blame others for mistakes
  • Low energy
  • Thinking about quitting





How to prevent burnout?

  1. Find the humor – As Milton Berle once said, “Laughter is an instant vacation”.  Watching a comedy or taking a 10 minute break to watch some funny You Tube clips offers immediate relief and energizes you.  A day without laughter is a day wastedCharlie Chaplin
  2. Take care of yourself – how can one heal others when he himself needs healing?  So what can you do?  Try Massage, Meditation, Yoga, Exercise, Stress diary, Sleep, Mini vacations, Staycations but most of all…..Take breaks!!
  3. Learn to say “No” – It’s OK to take a day off. Why not take off early on Friday’s?  Or better yet, work a half day on Wednesday to break up the week?  Learn the 4 D’s…..Deflect, Defer, Deter, Delegate…..
  4. Make small goals – too many times we burnout because we failed to meet a goal that was unattainable in the first place.  So we toil for years to become “promoted”, or “wealthy”, or “slim”, or “married”, or “see the world”.  Instead, make smaller attainable goals (find a partner, open auxiliary office, lose 10 lbs, take a trip).
  5.  Quit comparing yourself to others – we watch Shark Tank and then wonder what we are doing wrong, not being millionaires.  It’s unrealistic to think you should be “rich by now”.  We will always be inferior to someone else.  So get over it and love who you are and what you’ve accomplished.
  6. Have fun at work – contests, pot luck lunches, lunch room decorating, accent days, dress up days, and end of the week happy hour can spice things up at work.  Plus it increases morale among coworkers and staff.
  7. Be charitable – Doing community service is so rewarding and energizing that having a pet project helping out a local charity may be just what this doctor orders.  You can choose a cause, fundraise, attend charity events or walks, or even create a campaign.
  8. Get a hobby – tap into your artistic side by writing a book, song, article; paint; cook; build; teach; sing; dance; or even ride.
  9. Work on your bucket list – whether its going to a foreign country, learning to speak a new language, buying a vacation property, or even starting a second business, don’t let job burnout deter you.  This may give you the energy and perspective you need.

Finally, be around others and have a Bitch and Moan session – it feels so good to complain and gripe. Find others in similar situations as you and you’ll realize that you may have it better than you think.

Remember you have to come first and doing so will make you more of a help to others.  Feel great and you’ll make others feel great!


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Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, KDWN, and iHeart Radio.

She is also a Board Certified Family Physician and Assistant Professor at Touro University Nevada

Posted in Health, marijuana, news

Olivia Newton-John Battles Stage 4 Cancer, Uses Traditional and Alternative Treatments

The 69-year-old singer and actress recently reported she’s using both traditional and alternative medications to treat her metastatic breast cancer.

After successfully keeping the cancer at bay, it returned for a third time last year and metastasized to her sacrum, a part of the low back.




In addition to her current medical regimen the Australian native grows cannabis at her Santa Barbara, California home and uses its oil to help with the pain.  She states, “My dream is that, in Australia soon, it will be available to all the cancer patients and people going through cancer that causes pain.”

In 1992, Newton-John first battled breast cancer by undergoing chemotherapy and by having a modified radical mastectomy (removing the breast and lymph nodes).  She immediately had breast reconstruction and included yoga, acupuncture and massage in her treatment regimen.

In 2013, after a minor car accident, a lump in her left shoulder revealed it was breast cancer.

In an interview with the Susan G. Komen Foundation, she shared her personal story.  “I meditated every day, did yoga, used homeopathy, ate well—I boosted my inner strength as much as I could. When bad thoughts came in, I pushed them right out. I had what’s called a modified radical mastectomy with reconstruction done to my breast immediately—a woman can be traumatized waking up with nothing there.

She remained cancer free for years.

In a recent interview with People Magazine, she states she believes she will win “over it,” but adds, “I don’t go there. I’d be lying if I said I never go there. There are moments, I’m human. So If I allow myself to go there, I could easily create that, you know, big fear.”





Breast cancer is one of the few cancers that spreads to the bone. Other cancers that may rear its ugly head in the bone include thyroid, kidney, pancreas and the liver.

According to the American Cancer Society Stage 4 Breast Cancer (spreading to other parts of the body) has a 5 year survival rate of 22%, as opposed to Stage 3, who’s 5 year survival rate is 72%.  Treatments today are improving survival rates.


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Daliah Wachs, MD, FAAFP is a nationally syndicated radio personality on GCN Network, KDWN, and iHeart Radio.

She is also a Board Certified Family Physician and Assistant Professor at Touro University Nevada