All Three to four weeks I have severe stomach pain, along with illness and other digestive issues. I’ve had tests done, but it’s back to normal. I’ve tried liquid diets, but they don’t help. What could be wrong?
Bowel symptoms that come and go are likely to be caused by irritable bowel syndrome, or irritable bowel syndrome as it is also known. The problem is very common, and it is often related to eating certain foods. Abdominal pain, as well as constipation, diarrhea, and bloating can be experienced by sufferers.
Irritable bowel syndrome can only be officially diagnosed after other, more serious culprits have been ruled out by tests. Therefore, scans that look at the gut and upper stomach, called endoscopy and colonoscopy, and blood tests, are usually the first port of call.
Special diets are not likely to help. Instead, professionals advise trying to identify and avoid trigger foods. Doctors may recommend a nutritional plan called the FODMAP diet, which has been shown to help reduce IBS symptoms.
Bowel symptoms that come and go are likely to be caused by irritable bowel syndrome, or irritable bowel syndrome as it is also known. The problem is very common, and it is often related to eating certain foods. Those with abdominal pain, as well as constipation, diarrhea, and bloating can suffer
It involves eliminating foods that interact with the microbes in the gut to cause excess gas – and then reintroducing them to identify triggers. Medications are also available to help treat stomach pain and disease.
Another possible cause of these types of symptoms is a digestive problem called SIBO.
Here, bacteria grow in the wrong part of the intestine, causing intermittent bloating, pain, and changes in bowel habits.
Because the problem is bacterial, it responds to a course of antibiotics, which are usually prescribed by a hospital specialist.
SIBO tests are available on both the NHS and the private sector.
Another thing doctors might consider is endometriosis. This is a condition in which tissue similar to the lining of the uterus begins to grow in other places, such as the ovaries, fallopian tubes, and other pelvic organs. Besides pain, this can lead to symptoms in the gut every month, around the time of your period.
I’ve started leaking water in my underwear – is this just a normal part of being a 67 year old woman? I am overweight and have undergone breast cancer treatment.
People often think that incontinence is just a normal part of aging. In fact, no amount of leakage is acceptable and normal. If the problem is affecting a patient’s quality of life, then doctors must deal with it.
More from Dr. Ellie Cannon for The Mail on Sunday…
There are two types – stress incontinence and urge incontinence. The stress type causes leakage from sneezing, coughing, laughing or running.
Those with urge incontinence feel a sudden urge to pass water that usually cannot be stopped.
But people can suffer from both types, and persistent incontinence, which is a constant loss of urine.
It may be related to being overweight and getting cancer treatment – hormones given to stop tumors from growing put pressure on the female hormone estrogen, which can weaken and damage the pelvic floor, allowing urine to pass very easily. Doctors should test for diabetes, kidney function, urinary tract infections, prolapse and problems with pelvic floor strength.
The GP should also talk about lifestyle factors that could make the problem worse, such as caffeine, alcohol, medications, and your pregnancy and birth history.
Constant leakage of urine may be a sign of what is called a fistula. This occurs when damage to the bladder causes an opening to form between the bladder and the vagina.
Urine can constantly leak through the vagina without control.
In most cases, surgery is required to repair damage to the bladder and close the opening.
My husband is 70 years old and takes tablets for high blood pressure. Last year, his readings were a bit high, and the doctor suggested increasing his dose without seeing him in person. Now they say he should take a statin, because he has a 28 percent chance of having a stroke or heart attack in the next 10 years. How would a GP know that?
Before doctors prescribe drugs for heart attacks and strokes, they calculate the degree of risk using a specialized computer program.
It’s called Qrisk — and it takes into account a host of factors including smoking, waist size, medical problems, family history, and even your zip code.
If the calculator determines that you have a 10 percent or greater chance of having a stroke or heart attack, doctors’ guidelines advise prescribing statins to lower the risk.
Controlling blood pressure is important, but statins also help by reducing a type of fat called LDL, or low-density lipoprotein — a harmful form of cholesterol — in the blood.
Blood pressure control is important, but statins also help by reducing a type of fat called LDL, or low-density lipoprotein — a harmful form of cholesterol — in the blood.
The risk score of 28 percent is considered high – so it’s worth taking seriously. Doctors expect such a risk to occur in patients with diabetes or smoking. But we also make mistakes, and incorrect calculations are always possible, so it’s worth discussing.
The majority of my statins are doing perfectly fine and don’t experience any side effects. We monitor patients closely with blood tests, and advise them to stop taking statins if there is a problem.
There are also other important non-pharmacological interventions that would reduce the risk of heart disease, such as exercise, maintaining weight, and reducing salt intake.
Do you have a question for Dr. Elie?
Email DrEllie@mailonsunday.co.uk or write to Health, The Mail on Sunday, 2 Derry Street, London, W8 5TT.
Dr. Elie can only answer in a general context and cannot respond to individual cases or give personal responses. If you have a health problem, always see your doctor.
My verdict on the great controversy over antidepressants
Like many GPs, I was concerned by claims last week that antidepressants don’t work. This came after the publication of a review that concluded that depression is not caused by an imbalance in the mood-boosting serotonin after all. Commentators have jumped to say that this is evidence that common antidepressants – which boost serotonin – are useless. I appeared this morning on ITV, along with review author Professor Joanna Moncrieff, to argue that people were jumping to the wrong conclusion.
The fact that a lack of serotonin may not be the only cause of depression does not mean that increasing its levels cannot help treat it. I take paracetamol to help with headaches – but headaches are not caused by a lack of paracetamol.
We are front-line GPs, treating mental illness in our clinics, day in and day out. We see life-changing benefits in our patients who take medication. They don’t care how it works, as long as it works. As long as clinical trials show it to be safe and effective – which many do – I will continue to prescribe it.
Like many GPs, I was concerned by claims last week that antidepressants don’t work. This came after the publication of a review that concluded that depression is not caused by an imbalance in the mood-boosting serotonin after all. Commentators have jumped to say that this is evidence that common antidepressants – which boost serotonin – are useless. Appearing this morning on ITV, along with review author Professor Joanna Moncrieff, pictured left, to argue that people were jumping to the wrong conclusion (Dr. Ellie Cannon, pictured, right)
Do not panic about the risk of dementia
I’ve received a number of letters from readers concerned that their thyroid problems could cause them to have dementia, after reading a story about this link in our Health section.
I want to address concerns. Studies like this are important, because they help us build a picture of how diseases develop — and who might be at risk. But, as we reported, the study did not show that the relationship was well-defined. While the researchers found a strong association between people with thyroid disease and dementia, they did not clarify whether one caused the other. When it comes to thinking about your risks, it is much more useful to focus on facts we know for sure: smoking, high blood pressure, and excessive alcohol intake are all factors that increase these risks. These are things you can do something about.
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