THERE are health conditions that get scoffed at, or which people laugh off and try to ignore.
Batteries is one of them.
But avoiding talking about such issues could mean we don’t have the information we need, and can end up worrying that what’s going on with us is wrong or is a sign there’s an underlying problem.
Well, let me reassure you.
Batteries are very common and if you are worried, us GPs do not get embarrassed talking about anything happening down there.
Here are this week’s reader questions. .
Q) WHEN should I worry about batteries?
HAS) Piles, or haemorrhoids, are swollen veins in your anus and lower rectum.
They are very common in the developed world and can occur at any age.
Common symptoms include anal itch, anal pain and bright red bleeding, usually when wiping after a poo.
You may also feel a lump at the anal opening if they are external piles.
The most common cause is constipation, closely linked to our Western diets, which are too low in fiber.
Interestingly, haemorrhoids are uncommon in developing countries.
They are also common during pregnancy, or after childbirth when there is extra pressure on the veins in the lower body due to the growing fetus.
Mostly they can be treated with topical ointments or suppositories from the pharmacy.
Longer term, it’s important to address the underlying issue where possible, such as making lifestyle changes to prevent constipation and straining, for example.
However, if they are persisting, getting larger, or causing extreme pain, then it is important to get them checked by your GP.
A GP may refer to a colorectal surgeon if the diagnosis is unclear, symptoms are very severe or if they don’t respond to primary care treatment.
Q) Why do I keep getting a fluttering noise in my ear?
HAS) Tinnitus is the name for hearing noises that are not caused by sounds coming from the outside world.
It’s common and not usually a sign of anything serious, but occasionally it can be, so should be checked by your GP if persisting for more than a few weeks.
It might get better by itself and there are treatments that can help.
There are a number of potential causes of tinnitus and often no cause is found at all.
The clue you have given here is with your description of “fluttering”.
This specific type of sound makes it more likely that the cause is due to unnecessary contractions of the middle ear muscles.
Sometimes people describe it as like a butterfly flapping its wings.
While this in itself is not harmful or dangerous, it can be very annoying and cause distress.
It can make us fixated on what is causing this sensation in the ears, often distracting us from other things in life.
So if not resolved, please speak to your GP via a routine appointment within the next few weeks.
Q) I HAVE a family member who suffers from peripheral neuropathy and no one, including her GP, can say for sure how to tackle this condition or offer relief.
My family member is in excruciating pain, morning to night. It breaks my heart that I am unable to help. Can you suggest anything that can help relieve the constant pain?
HAS) Peripheral neuropathy means damage to the nerves that connect the brain and spinal cord (central nervous system) with the rest of the body.
The treatment for peripheral neuropathy varies, depending on the underlying cause, the symptoms and which nerves have been damaged.
Diabetes is the most common cause of peripheral neuropathy in the UK.
Higher-than-normal concentrations of glucose in the blood can cause damage to the nerves.
So when this is the cause, gaining better control of blood glucose levels is important.
But there are many other causes, ranging from vitamin B12 deficiency to medication side-effects, to traumatic injury, which would all need to be treated differently.
And not all of the underlying causes of neuropathy can be treated.
Sometimes the main focus is treating the symptoms and even supporting the person to be able to have a good quality of life despite the symptoms.
There is a long list of possible symptoms of peripheral neuropathy, and it sounds as though nerve pain is effectively causing suffering for your relative.
Nerve pain may be treated with prescribed medicines called neuropathic pain agents, such as gabapentin, amitriptyline and pregabalin.
If these have been tried and are not helping, your relative may benefit from referral to the local pain specialist clinic, which may consider medications, therapies such as acupuncture and even psychological therapies.
However, the waiting times can be quite long. The British Pain Society has helpful information at britishpainsociety.org.
Q) I AM diabetic and suffer from very bad fungal thrush, vaginally, to the extent I scratch myself until I bleed. What can I do to ease it?
HAS) I’m so sorry to hear this. Vaginal thrush is so unpleasant.
Thrush is caused by a type of yeast infection. Yeast and other types of fungi love warm, moist conditions.
They also feed on glucose, so if the blood glucose level is raised, as in diabetes, they can thrive even more.
In the short term, this requires treatment with antifungal medication.
First off, a pessary (vaginal tablet) and an antifungal cream if the vulva (the external genitalia) is also affected.
This resolves the issue for most people and your pharmacist can supply both.
My guess would be that you have already tried this and either it did not work, or it came back quickly afterwards.
The next treatment would be oral antifungal medication.
Usually a single dose of 150mg of fluconazole will do the job. Again, your pharmacist can provide this as long as there are no interactions with other medication that you are taking.
If you are still having problems then it’s time to speak to a GP as you may require a course of antifungal tablets, and sometimes this can be for several months.
Longer term, in your case, it will be important to try to get the blood sugars as well controlled as possible as the higher the glucose, the happier the fungus.