DR ELLIE CANNON answers 50 questions we all want to ask a GP


Whatever happened to the Family Health Encyclopaedia – that tome of the threshold everyone had on their bookcase, with just about every condition you and your kids would ever get, and how to treat them?

They are written by teams of doctors and published by the Royal College of GPs, the British Medical Association and other trusted organizations. And they were a tool you could really rely on.

But today, most of them are sold out and instead we go online whenever we get a new symptom, be it a rash, bump or bump, a terrible infection or an accident, to ask Dr. Google.

In fact, eight out of ten people are now getting health information from internet search engines, and nearly half of us use it to seek specific treatment advice.

I'm afraid there will be some with serious conditions that will go undiagnosed, and others who fall into this dr Google and misdiagnose or mistreat their ailments, Dr. Ellie Cannon

I’m afraid there will be some with serious conditions that will go undiagnosed, and others who fall into this dr Google and misdiagnose or mistreat their ailments, Dr. Ellie Cannon

Despite concerns about cyberchondria (the name given to the anxiety caused by search engine self-diagnosis issues) and fake health news, I think the internet has had an amazingly positive impact on public health overall.

With a few keys on the keyboard, patients can arm themselves with up-to-date health advice and the latest medical research. This can be empowering and liberating. But there are also pitfalls. A study published earlier this month found that search engines make an “inaccurate diagnosis” about a third of the time.

And that’s a shame, as easy access to renowned health advice is more important than ever at the moment.

As I wrote last week, GP practices are very open to business and that has been the whole crisis.

Of course things are different. The majority of our appointments now go through video calls and recipes are completed online.

I was one of the first to criticize the relentless advance towards ‘digitization’ of healthcare because I feared it would leave many of my elderly or vulnerable patients behind.

But in fact, they were the most enthusiastic contractors for these changes – and are delighted to now be able to make appointments the next day, in the comfort of their own couch, rather than waiting for weeks and then waiting for hours in a busy way room.

Specialist services such as skin clinics and physical therapy have been suspended, and there is a hiatus from cervical, breast, and prostate cancer screenings.

GP practices are very open to business and have been the whole crisis (file photo of a doctor working in the office listening to a patient)

GP practices are very open to business and have been the whole crisis (file photo of a doctor working in the office listening to a patient)

GP practices are very open to business and have been the whole crisis (file photo of a doctor working in the office listening to a patient)

However, we still follow patients on the blood-thinning drug warfarin, assess sick children, and see patients with extreme abdominal pain.

And we still offer personal appointments for those who don’t have access to video conferencing or with urgent complaints.

Despite this, there is less contact with GPs across the UK. Surveys suggest that many people are reluctant to ‘harass’ their doctors and use valuable NHS resources.

This is a concern, of course, as I fear that some with serious conditions will go undiagnosed, and others will fall into the trap of Dr. Google will fall and misdiagnose or mistreat their conditions.

And with this thought – if you cannot or cannot go to the doctor – I bring the doctor.

On the next eight pages you will find my essential guide to dealing with all your family’s health problems at home.

Routine health checks are not currently taking place, making it more important than ever to make sure you are in good health (photo of an elderly woman checking her blood pressure)

Routine health checks are not currently taking place, making it more important than ever to make sure you are in good health (photo of an elderly woman checking her blood pressure)

No routine health checks are currently taking place, making it more important than ever to ensure you are in good health (file photo of an elderly woman checking her blood pressure)

This includes answers to 50 questions I get asked in the clinic most often – from how to deal with bad backs and sore knees, to recognizing the symptoms of a chest infection, treatments for painful headaches, and eye problems.

In case you are faced with an emergency, we have added an easy to follow basic first aid guide, with up to date advice to minimize the risk of Covid-19, should it be someone outside your family that you attend again.

And since there are currently no routine health checks, making it more important than ever to ensure you are in good health, we’ve provided a guide to give yourself a full MOT.

Consider this pack your own Family Health Encyclopaedia – an invaluable resource that will protect your health and the health of your loved ones.

At a time when NHS determinations seem sporadic, it is vital for every patient to know what they can do to help themselves – and of course when it is time to seek help …

HEADS AND OTHER PAINFUL PROBLEMS

It's worth knowing that dehydration and stress are both common headache triggers (shown: illustration of a person with a headache)

It's worth knowing that dehydration and stress are both common headache triggers (shown: illustration of a person with a headache)

It’s worth knowing that dehydration and stress are both common headache triggers (shown: illustration of a person with a headache)

1. Is it safe to take painkillers every day for headaches – and which is the best type?

Headaches have many causes – and often they are surprising. Morning headaches can result from jaw clenching and grinding of teeth while we sleep. Both are the result of stress.

Dehydration is another culprit, and if the headache is worse when bending over, it could indicate a sinus infection.

It’s safe to take pain medications for a few days, but if you need them every day for a week or more, you should talk to your doctor and try to find out what’s behind the problem.

Painkillers every day can actually make the problem worse – a condition called headaches from drug overuse.

Alternate between acetaminophen, ibuprofen and aspirin and try to rest without painkillers to keep things from getting worse.

Ibuprofen and aspirin can irritate the stomach, so if you take them regularly, make sure it’s with the meal.

It’s worth knowing that dehydration and stress are both common headache triggers.

2. Can I use ibuprofen and acetaminophen together for my arthritis pain?

Paracetamol and ibuprofen can be taken safely together.

The usual daily dose for acetaminophen is 1 g (two tablets) four times a day. For ibuprofen, it’s 400 mg (usually two tablets) three times a day with food for an otherwise healthy adult.

Paracetamol and ibuprofen can be taken safely together. The usual dose of paracetamol is 1 g (two tablets) four times a day (shown: file photo of paracetamol tablets)

Paracetamol and ibuprofen can be taken safely together. The usual dose of paracetamol is 1 g (two tablets) four times a day (shown: file photo of paracetamol tablets)

Paracetamol and ibuprofen can be taken safely together. The usual dose of paracetamol is 1 g (two tablets) four times a day (shown: file photo of paracetamol tablets)

Combining medications is a sensible way to control pain, and taking it regularly when you have a flare-up is a good way to keep moving, which is also vital.

In addition to pain relievers, applying ice to joints is a great way to ease the pain, especially if they’re also swollen, as well as using pharmacy rub-in treatments.

3. I have a terrible toothache, but the dentist is closed. What should I do?

Toothache usually clears up within a few days without treatment. Take pain killers regularly for a few days and maintain strict oral hygiene with chlorhexidine mouthwash and regular brushing. Ibuprofen or aspirin are good for toothaches.

Currently, dental services are available at 111: the dentist can consult by phone or video. They may be able to prescribe and treat you remotely.

4. I keep getting random nosebleeds. What is the best way to stop them?

Most nosebleeds are not a sign of something serious and can be treated at home. Sit down and squeeze your nose just above the nostrils and hold for ten minutes. Try to lean forward to prevent blood from flowing back down your throat.

Once the bleeding has stopped, stay upright – don’t lie down, as this will increase blood pressure in your nose – and put a bag of frozen peas on the bridge of your nose. This causes the blood vessels in the nose to contract, preventing new bleeding.

The lining of the center of the nose is fragile and can break and bleed, especially in nose blowing, dry rooms or if you are taking blood thinners. Often new nosebleeds are caused by an infection in the inside of the nose. To treat that, a prescription antibiotic cream is needed. If they occur regularly, contact your doctor. It’s rare, but they can be a result of high blood pressure, so it’s worth taking your blood pressure at home.

5. Which cream should I apply to a painful burn?

No. If your burn is light enough to be treated at home, you don’t need to use a cream, as these can irritate your skin – not what you want next to the burn.

Run the burn under cold water for 20 minutes and cover with cling film to keep it clean. Do not wrap it as this can narrow the burn and it will hurt more.

Run the burn under cold water for 20 minutes and cover with cling film to keep it clean

Run the burn under cold water for 20 minutes and cover with cling film to keep it clean

Run the burn under cold water for 20 minutes and cover with cling film to keep it clean

You can keep the cling film in place with a bandage.

To treat pain, you can use acetaminophen or ibuprofen.

Most minor burns heal within one to two weeks with minimal scarring. Do not break blisters.

COUGHS, COLDS AND HOW TO TACKLE A FEVER

6. How long does it take to recover from a cough or cold, and when do you need antibiotics?

At this point, any new cough, high temperature, or loss of sense of smell should be treated as a warning sign for coronavirus, and the advice is to isolate itself for seven days, or longer if symptoms persist.

Patients should also go to the NHS 111 website, because a Covid-19 test may be appropriate. But overall, one of the most (if not the most common) things I see in the clinic is someone concerned that a cough, runny nose, and excess mucus won’t go away after two weeks. A bad upper respiratory infection often takes two weeks or more to disappear and to feel normal again.

In any case, antibiotics are rarely prescribed. These drugs kill bacterial infections, not the viral ones responsible for most coughs and colds.

Instead, ask your pharmacist for advice on effective cough medications – and state if your cough is dry or heavy. Otherwise, the best remedies are boring but effective: plenty of rest and plenty of fluids. But if you start to have breathing problems, call your doctor. Occasionally, a persistent cough indicates an underlying condition or secondary infection, so call your doctor if you still have a cough after three weeks, just in case.

7. What color is your mucus if you have a breast infection?

Forget the widely held belief that green slime means you need antibiotics. A change in the color of the mucus doesn’t say anything about your infection unless you have chronic lung disease. It simply means that the immune system fights the infection by deploying many hunter cells, which vary in color.

The only way to diagnose a breast infection is through a family doctor examination or a chest X-ray. Blood or a brown spot in the mucus can indicate both a serious infection and other problems. Call your doctor if you have a stain of this color.

8. I don’t have a thermometer. How do I know if I have a fever – and what should I do about it?

If your forehead feels warm or you have pink, flushed cheeks and a faster-than-normal wrist, these are signs that you have a high temperature. It is your body’s response to common infections, including flu, tonsillitis, urinary tract infections, and natural coronavirus.

It is clear that these are also accompanied by a general feeling of being unwell: tired and not yourself.

That said, having a thermometer is a very good idea – especially now that persistent high temperature can be a warning sign that Covid-19 is not getting any better. Choose a digital one because they are more accurate. Most fever – a temperature above 37C – disappears after a few days. Rest, plenty of fluids, and acetaminophen or ibuprofen are the main treatments. Symptoms that get worse or new ones that develop are signs that you should seek help.

Fever in children and stomach problems

9. What is the best way to deal with my toddler’s fever?

An ailing child with a fever can be extremely worrying. But it is a very common problem and in most cases it is not serious.

My first advice is: don’t panic. Most children have high temperatures three times a year – over 37.5 ° C. And the fever can even last for a few days.

If the child seems happy and drinks enough fluids to stay hydrated, it is probably okay.

Most children have high temperatures of over 37.5 ° C three times a year

Most children have high temperatures of over 37.5 ° C three times a year

Most children have high temperatures – over 37.5 ° C three times a year

The main treatment is a liquid paracetamol to lower the temperature, but it is not essential.

So how do you know if it has turned into something more serious? See how often they drink and go to the toilet. If they don’t drink or urinate and are drowsy or limp, call NHS 111 – this could be more serious. Other red flags are headaches accompanied by pale, cold, or blotchy skin, dislike bright light, and irritability. These can indicate meningitis.

Parents often think that a rash that disappears when a glass is rolled over it is the main sign of meningitis – but by the time this happens, the infection may already be quite advanced.

And what about dreaded abdominal pain? Usually the problem is constipation and related to food. Add plenty of water or juice, plenty of dried fruit, and whole wheat bread to get them moving.

Less common are occasional bouts of diarrhea, which you should keep an eye out for.

Keep a food diary for a few weeks to see if there are any triggers. Rarely, abdominal pain is accompanied by weight loss, a swollen belly, poor appetite, or persistent diarrhea – call your doctor in these cases.

If the pain is sudden and moves from the center to the right, call NHS 111 – this is the telltale sign of appendicitis.

10. What is the best way to manage vomiting in adults?

The most common cause of vomiting in adults is a stomach virus, which will be bacterial or viral.

It usually stops after one or two days. Drink small amounts of clear liquid or rehydration liquids, which you can buy from a pharmacist.

Once the vomiting has stopped, try some bland foods, such as a dry plain biscuit or toast, after about 12 hours. Vomiting insects can be contagious, so be sure to thoroughly clean any areas that have come into contact with vomiting.

11. What should I eat to reduce nausea?

Ginger is a known remedy for nausea, so you can try drinking ginger tea and taking small pieces of ginger biscuits.

Everyone in your household should also take extra care with hygiene and wash hands. Vomiting can be a sign of something serious like meningitis, and if vomiting lasts for more than an hour, doesn’t provide relief, or is accompanied by a severe headache, call your doctor.

12. What should I do with tonsillitis?

Tonsillitis, an infection in the throat, is quite easy to spot – look for the telltale white spots on the two fleshy tubercles on either side of the back of the throat. These nodules, the tonsils, are bright red when infected. It can be painful to swallow and you probably also have a fever.

Paracetamol or ibuprofen will help manage the pain and gargling with salt water – a natural anti-inflammatory – will help.

Gargling with soluble aspirin for three to four minutes can also provide relief and can be used alongside other pain killers, but be careful not to swallow it.

If tonsillitis persists, the antibiotic penicillin can be prescribed.

13. How often should I update my asthma inhaler prescription?

Make sure you use the inhaler correctly ¿useful videos can be found on the Asthma UK website (file photo of a Ventolin inhaler)

Make sure you use the inhaler correctly ¿useful videos can be found on the Asthma UK website (file photo of a Ventolin inhaler)

Make sure to use the inhaler correctly – useful videos can be found on the Asthma UK website (file photo of a Ventolin inhaler)

Symptoms are the best guide to the strength of medication you need. If you use a blue inhaler every day – for immediate relief of symptoms – it’s probably time for an update. This also applies if you cannot exercise for as long as usual without running out of breath.

But before making any changes, make sure you use the inhaler correctly – helpful videos can be found on the Asthma UK website.

14. I take an antihistamine tablet every day for my hay fever. Is this safe?

Patients don’t believe me when I tell them they can take antihistamines every day of the year.

For those with severe hay fever and other year-round allergies, these daily tablets can be life-saving.

If someone stops working, switch to another over-the-counter type – the pharmacist can help. I would also recommend buying a salty nasal spray from your local pharmacy as the pollen washes away.

ACHY JOINTS, BAD BACKS AND BROKEN BONES

15. My knee is in pain! Is it because I started jogging or could it be something serious?

Knee pain is common – and there are a variety of causes. It can be related to an injury, including damage to the soft tissues in and around the joint, which is easy to do if you plunge yourself into a new exercise regimen.

This type of pain is often one-sided.

It is often small. Resting and using a cool compress – an ice pack or a bag of frozen peas wrapped in a tea towel – will help. Try to keep your bad knee up as this means that the circulatory system doesn’t have to work against gravity, which means that swelling is kept to a minimum.

Intense pain when moving or resting, instability and swelling that doesn’t go away with a few days of rest can indicate a problem that needs medical attention.

Knee pain can also be a symptom of osteoarthritis, but this is more common on both knees and will usually get worse in the morning.

This is also common from middle age and can be tricky to treat – being overweight is a big worsening factor, so weight loss and, paradoxically, staying as active as possible are the best ways to reduce pain.

16. I cannot move my right shoulder, it is too painful. What have I done?

This is what is known as a frozen shoulder: it will be sore and stiff all the time, especially when trying to reach. It happens when the capsule around the joint thickens and tightens, limiting movement.

We’re not sure why it happens, but it’s more common in the over-40s and two-thirds of patients are women.

Keep moving and use anti-inflammatory tablets and ice packs to ease the pain. Learn how to sit properly, not lanky and with your shoulders gently back (file photo)

Keep moving and use anti-inflammatory tablets and ice packs to ease the pain. Learn how to sit properly, not lanky and with your shoulders gently back (file photo)

Keep moving and use anti-inflammatory tablets and ice packs to ease the pain. Learn how to sit properly, not lanky and with your shoulders gently back (file photo)

Diabetics are more likely to have a frozen shoulder – again, we don’t know why – as well as those who have recently had arm surgery or fracture.

Physical therapy is central. You can refer locally locally through the NHS, through your family doctor or go private. You can also find the right exercises online – the charity versusarthritis.org has a comprehensive booklet on shoulder pain. Keep moving and use anti-inflammatory tablets and ice packs to ease the pain. Learn to sit well, not lanky and with your shoulders gently back.

17. I have had lower back pain for two weeks now. Will it ever disappear?

Low back pain happens to almost everyone, and for most, it disappears without medical attention.

As with knee pain and all other joint problems, it can occur after a single incident, twisting or lifting something, or simply building up over time.

The trick is to keep moving, so try doing gentle exercises that you can find online at versusarthritis.org. You have to stick to doing them every day for weeks, ideally even if your symptoms are gone.

If it’s bad, take pain killers every day so you can move normally. Immobility or unnatural movement – what we call compensatory movements – to avoid pain can make things worse. Combine that with heat packs or rub the area. Any leg weakness, numbness, or changes in your bowel or bladder are an urgent reason to seek medical attention. Simple back pain usually starts to improve within two to three weeks.

18. I have noticed that my hearing is much worse in one of my ears. What is the best way to clean them up, and may they need syringes?

Wax that blocks the ear is a common cause of hearing loss on one side – and can be quite annoying.

Never use cotton swabs that get caught in it. Instead, try a wax-removing drop from the pharmacist – they contain oils or hydrogen peroxide, both of which soften the wax, causing it to pass out naturally.

If you have a stuffy ear, never insert anything ... no matter how much you desire

If you have a stuffy ear, never insert anything ... no matter how much you desire

If you have a stuffy ear, never insert anything … no matter how much you desire

One caveat: it can take up to two weeks.

If it persists, the two options are ear irrigation, a newer, safer version of syringes that involve a machine, or microsuction, which gently sucks out the wax. Not all GPs offer these, so you may need to go private.

19. I have twisted my ankle and can barely walk. What shall I do?

Twisting an ankle pulls the ligaments into the joint, damaging them and causing pain and swelling.

The answer is rest, ice, compression and height.

Rest as much as possible on the joint with little or no weight. Ice the joint four times a day for 15 minutes with frozen peas or an ice pack. Press it together with a bandage from the pharmacy to support it. Keep it up as much as possible to reduce swelling.

Paracetamol is best for pain in the first few days after a twist.

20. Why do I get leg cramps at night?

Leg cramps are normally harmless and we often find no reason for it. Calf muscle stretching exercises can help prevent them – good instructions are available online at nhs.uk.

Leg cramps can be due to aging, too little or too much movement, or dehydration. Making sure you drink enough water is a good idea.

Cramps can also be a side effect of medication – especially water tablets (diuretics) for heart disease and statins.

Leg cramps are normally harmless and we often find no reason for it. Calf muscle stretching exercises can help prevent these (file photo)

Leg cramps are normally harmless and we often find no reason for it. Calf muscle stretching exercises can help prevent these (file photo)

Leg cramps are normally harmless and we often find no reason for it. Calf muscle stretching exercises can help prevent these (file photo)

21. I have a terrible feeling of breaking a finger. Should I stick it on the tape next to it or just leave it?

If you think you have a broken finger, you should go to a minor injury or emergency department. While the treatment is often to attach it to another finger to stabilize it, this will only work if the bone and joint are still aligned. The finger may need to be stretched or molded. Complex fractures may even require surgery.

SORE EYES, WATERY EYES … AND BLOCKED EARS

22. What is the best way to get rid of a stye?

A stye is a painful bump in the eyelid – normally caused by a blocked eyelash pouch or oil canal that is infected, inflamed, and often filled with pus.

The best treatment is a home remedy. Soak a flannel in hot water and use as a warm compress on the eyelid until cool. Repeat two to three times so you have heat on the stye for 20 to 30 minutes. Do this three times a day.

The compress helps to gently melt and loosen the oils responsible for the blockage, draining the shit. It may take a week for the stye to disappear. At that time, avoid contact lenses and makeup. If the swelling worsens, call a doctor immediately as it could be a sign that the infection is spreading.

23. How do I know if I have an ear infection?

Ear infections are often thought of as a child’s problem, but are also common among adults.

Symptoms include ear pain or pressure, swollen glands behind or under the ear, oozing from the ear or a temperature. They can occur after a bad cold or can be caused by water getting into the ear while swimming or by wearing earplugs.

Some ear infections can be treated with a spray from the pharmacist, but in most cases the infection will clear up in a few days and acetaminophen or ibuprofen will control the discomfort.

24. My eyes don’t stop tears. Will drops help, and what kind?

When looking at screens, we blink less, which leads to dehydration of the eye surface

When looking at screens, we blink less, which leads to dehydration of the eye surface

When looking at screens, we blink less, which leads to dehydration of the eye surface

Oddly, watery eyes are usually dry eyes.

Dry eyes that give a lot of water are common, especially in certain environments: air conditioning, excessive use of computer screens (we blink less when looking at screens, which leads to dehydration of the eye surface) and windy weather are all causes.

Use an artificial tear product from the pharmacist: these can be drops, gel or ointment, but gels and ointments stay in the eye longer and can therefore be better than drops.

25. What can cause my dizziness?

Dizzy spells are common and can occur for a variety of reasons. They can indicate anemia or a problem with your heart, blood pressure, or your ears. Therefore, if you are dizzy for more than a week, contact your doctor.

If you know your blood pressure and pulse, it is helpful to have the doctor on hand. Short-term dizziness, especially after a cold, is usually labyrinthitis – a viral inflammation of the parts of the balance of the ear. It settles on its own and it helps to stay well hydrated and well rested.

Do not drive if you feel dizzy.

26. Ik ben mijn reukvermogen kwijt, maar voel me verder prima. Zou het Covid-19 kunnen zijn?

Het verliezen van je reukvermogen, dat bekend staat als anosmie, vooral als je geen verstopte neus hebt, kan een teken zijn van coronavirus en je moet zeven dagen isoleren. Mogelijk merkt u ook een verandering in smaak.

U heeft misschien geen andere symptomen: u moet nog steeds isoleren en online een zelftest bestellen.

Het is normaal om je reukvermogen om andere redenen te verliezen, vooral met een verstopte neus door sinusitis, hooikoorts of verkoudheid.

RASHES, FLAKY BITS EN ANDERE HUIDKLACHTEN

27. Mijn handen zijn vreselijk droog en pijnlijk – ik denk dat het komt door al het wassen. Wat kan ik doen?

Ik zoek hier veel van, niet verwonderlijk. Handeczeem of dermatitis is veel erger bij veel handen wassen. Water en zeep verwijderen de natuurlijke zuurgraad van de huid.

Vraag uw apotheker naar een op paraffine gebaseerde zeepvervanger of een eczeemcrème om als handwas te gebruiken: het reinigt net zo goed en er is genoeg om uit te kiezen.

Handeczeem of dermatitis is veel erger bij veel handen wassen. Zeep en water verwijderen de natuurlijke zuurgraad van de huid (foto van een vrouw die haar handen wast)

Handeczeem of dermatitis is veel erger bij veel handen wassen. Zeep en water verwijderen de natuurlijke zuurgraad van de huid (foto van een vrouw die haar handen wast)

Handeczeem of dermatitis is veel erger bij veel handen wassen. Zeep en water verwijderen de natuurlijke zuurgraad van de huid (foto van een vrouw die haar handen wast)

Wrijf minstens vier keer per dag op paraffine- of haverextractcrème en vooral ‘s nachts, zodat het in de handen kan trekken. Gebruik altijd afwashandschoenen bij het schoonmaken. Wasmiddelen, zeep en doekjes zijn erg irriterend voor de handen.

28. Ik heb een klein stukje ruwe, rode huid aan de zijkant van mijn neus die niet zal verdwijnen. Moet ik een dokter zien?

De neus is een zeer typische plek voor seborrheic dermatitis – rode, schilferige huidontsteking. Het kan ook voorkomen in de wenkbrauwen, hoofdhuid en rond je haarlijn. Het wordt veroorzaakt door een overgroei van gist en u heeft een crème van de apotheker nodig die clotrimazol of miconazol bevat: ze kunnen veilig worden gebruikt als langdurige behandeling. Als het na een maand niet beter is, laat het dan aan uw arts zien.

29. De huid tussen mijn tenen is onlangs begonnen te breken en te bloeden. Welke crèmes moet ik kopen?

Dit klinkt als atletenvoet, een veel voorkomende schimmelinfectie die verergerd wordt door warme, vochtige voeten. Een antischimmelcrème, spray of poeder zoals miconazol van de apotheker moet er vanaf. Het kan weken duren om op te ruimen, dus wees geduldig.

Houd je voeten droog door na het wassen grondig met een handdoek te deppen en draag schoenen met open teen zonder sokken zodat ze niet zweterig worden. Deel geen handdoeken.

30. Ik krijg steeds zweren in mijn mond. Wat kan dit veroorzaken – en wat moet ik doen?

Mondzweren zijn kleine laesies die zich ontwikkelen in de normale voering van de mond, tandvlees of tong. Ze worden veroorzaakt door een hele reeks dingen, waaronder schade van het bijten van uw wang, poetsen of slecht passende kunstgebitten of beugels tot hormonale problemen – en het is niet altijd duidelijk.

They normally clear up on their own within ten days and pharmacy treatments can help ease the pain: use simple painkillers or painkilling mouth gel or lozenges.

Repeated ulcers usually happen as a reaction to the ingredient SLS in toothpaste or from stress and overtiredness.

Less commonly they can be a sign of underlying disease such as bowel disease or B12 deficiency.

Always show your doctor or dentist if you have one for more than three weeks, as it could be mouth cancer.

If you’re desperate to quit smoking, now’s the perfect time to do it

31. How do I finally stop smoking – for good?

There has never been a better time to quit smoking – and I’ve had a fair few patients contact me looking for help, spurred on by Covid-19 worries.

Triggers such as pubs and the company of smoker friends are out of the equation, so there’s every chance you’ll succeed.

Smoking increases your chances of catching the virus by a quarter and makes you two-and-a-half times more likely to have serious complications if you do.

You’re four times more likely to quit for good with support from your local NHS Stop Smoking Service or your GP. And both services are still very much available.

I’ve had a fair few patients contact me looking for help, spurred on by Covid-19 worries, writes Dr Ellie Cannon (file photo of a woman using a nicotine patch)

Your local Stop Smoking service can be found via the nhs.uk website, or a GP receptionist over the phone. It offers online support groups and telephone and video calls from healthcare practitioners.

You can also use an over-the-counter aid such as nicotine gum or a patch, above. The strength of gum or patch you need depends how heavily you smoke. If it’s 20-a-day, opt for a gum containing roughly 4g of nicotine.

And if you smoke within half an hour of waking up, you’ll need a patch that lasts 24 hours.

Another option is to take medication that stops cravings. A GP can prescribe this and send it to your local pharmacist.

Or you could try vaping. It’s 95 per cent safer, in terms of health risks, than normal cigarettes. You can get a vaping device easily from many stores online, and your Stop Smoking Service adviser will be able to recommend one.

HEARTBURN, BLOATING AND DIGESTIVE DISTRESS

32. I keep getting heartburn – what’s the best thing to deal with it?

Heartburn is a burning feeling in the chest caused by stomach acid travelling up towards the throat.

Also known as acid reflux, it’s common and usually not serious. Consuming spicy food, chilli, coffee, alcohol and medicines such as ibuprofen, as well as smoking, are triggers.

Other symptoms are an intermittent cough that keeps coming back, a hoarse voice, and bad breath.

Sleeping propped up and eating smaller meals can help, as can avoiding eating in the last few hours before bed.

You can try a range of things from the pharmacist including thick alginate liquids, calcium carbonate tablets or esomeprazole.

Try them in turn to see which one works, alongside avoiding the triggers.

It’s rare, but heartburn can be a sign of cancer, so if it is persisting for more than a few weeks, consult your doctor.

33. I find that I’m rushing to the loo a lot, especially after mealtimes. Could I be allergic to something?

Rushing to the loo is rarely a sign of a food allergy. It can be a feature of lactose intolerance, which is a reaction to the sugar in milk and dairy.

More often it’s due to what we call irritable bowel syndrome, or IBS. Tummy pain and bloating are other common symptoms.

Keep a diary to see what foods make it worse or make it better, as IBS typically has food triggers.

A stool test from the doctor can be done to ensure that the diarrhoea is nothing serious, such as bowel cancer.

34. I am normally regular as clockwork, but find my system is very sluggish at the moment. Should I worry?

Constipation is usually a reaction to changes in diet, lack of fluids or even stress or holidays. Bowels can start moving with the help of plenty of water, dried fruit and plenty of fibre in the diet, along with exercise.

Over-the-counter laxatives are available – some, such as senna, get the bowels moving; others, such as docusate, soften the stool. Ask your pharmacist which one you need.

Prolonged constipation can be a sign of IBS or thyroid disease. It is rarely a sign of serious bowel disease.

36. My nose is always running – how do I stop it?

Take a daily anti-histamine, which treats allergies and wash the nose our regularly with a salt water solution.

35. How long does food poisoning last, and what should I do to treat it?

Most food poisoning contracted in the UK goes away with no treatment. Diarrhoea, stomach cramps, vomiting, nausea and exhaustion are all symptoms. Alongside making sure you are hydrated, diarrhoea can be slowed by eating bananas, white rice and dry toast.

It usually lasts for about 48 hours but can last a week. Remember to stay off work or school to protect others.

ANXIETY, STRESS AND MENTAL HEALTH ISSUES

Am I suffering from depression... and how do I stop panic attacks? (pictured: a man hiding his face behind a blue balloon with a smiley face drawn on it)

Am I suffering from depression... and how do I stop panic attacks? (pictured: a man hiding his face behind a blue balloon with a smiley face drawn on it)

Am I suffering from depression… and how do I stop panic attacks? (pictured: a man hiding his face behind a blue balloon with a smiley face drawn on it)

37. I am tired all the time. Am I ill?

Feeling tired all the time is one of the most common symptoms reported by patients. Poor sleep, stress, lack of exercise and not eating properly are all causes. But it also comes from illnesses: anaemia, thyroid disease, heart disease and arthritis, to name just a few.

Tiredness can often be related to mood and is a typical symptom of depression. Look at your lifestyle first, but if you have significant tiredness, ask your doctor for blood tests to rule out illness. Tiredness also comes from many medications – even paracetamol has this side effect.

38. I think I had a panic attack the other day. I don’t want to have another. What can I do?

Panic attacks are frightening. Symptoms include a racing heart, dizziness, fast breathing and an overwhelming sense of nausea. Some people think they’re having a heart attack – but, despite being horrible, they’re not harmful in themselves.

Anxiety causes a spike in stress hormones and other chemicals in the body, and the panic attack is an acute physical result of this.

Learning to deal with attacks is key. Breathing slowly in and out while counting to five can calm the panic and slow your heart rate. Focusing on marching on the spot while breathing slowly can also help.

You can learn relaxation and breathing techniques to prevent attacks at mentalhealth.org, and there are panic attack apps, such as Beat Panic, that you can download from the NHS app library.

39. How do I know if I have depression?

Symptoms of depression include a low mood, unhappiness, feeling unmotivated or hopeless, waking up very early in the morning or oversleeping and a lack of interest in eating, seeing friends or things that you usually enjoy.

Symptoms of depression include a low mood, unhappiness, feeling unmotivated or hopeless, waking up very early in the morning or oversleeping (file photo)

Symptoms of depression include a low mood, unhappiness, feeling unmotivated or hopeless, waking up very early in the morning or oversleeping (file photo)

Symptoms of depression include a low mood, unhappiness, feeling unmotivated or hopeless, waking up very early in the morning or oversleeping (file photo)

Difficulty concentrating and feeling worthless, as well as thinking about hurting yourself or suicide are also signs.

If you are having any of these feelings, talk to a close friend or relative and try to diarise your symptoms. It is important to talk to your doctor or seek online help at nhs.uk.

40. My teenage daughter is a very picky eater. How do I know if it’s actually an eating disorder?

Many children and teenagers are fussy, and this isn’t a mental health problem.

But it is crucial, if you do feel there is something more going on, to get help as early as possible, so have the conversation. Anorexia, bulimia and binge-eating disorder are not about food but about feelings and distorted views of your body and control.

Signs can be weight loss, secret eating, meal avoidance, or complaining of being dizzy or of light-headedness. Start an open and calm conversation on her terms with no talk of weight or size.

The BEAT UK helpline is open every day and can talk you through how to do that. Visit beateatingdisorders.org.uk.

41. I’m cleaning obsessively – could I be a bit OCD?

The mental health condition obsessive compulsive disorder is far more complicated – and serious – than a bit of excessive hand-washing or cleaning.

It is not a case of having ‘a bit’ of the illness – you either do or you don’t.

The condition can be debilitating for sufferers, with troubling thoughts you can’t stop repeating over and over.

This induces a feeling of anxiety, which makes you repeat actions compulsively. It can be anything from checking locked doors, touching objects repeatedly, hoarding or cleaning a certain number of times.

The illness convinces the sufferer that if they don’t perform these rituals, something bad will happen. This takes over normal thoughts and normal life.

Cognitive behavioural therapy is a good treatment – you can explore online through a service called IAPT, which helps patients access specialist therapy.

42. I can’t sleep. What are the best remedies?

It is vital to explore sleep hygiene and a good sleep routine. Sleep hygiene creates the best situation for good sleep – get used to sleeping in a cool, dark room that’s quiet (use ear plugs if necessary) and don’t take your phone to bed.

Routine before bed should be no screens and no work or food. Wind down with a bath or a book, and set a clear bedtime and wake-up time that you stick to.

If your mind is racing, put a pen and pad by your bed and write down your worries as they appear so they can be ‘parked’. Sleeping tablets are rarely the answer.

YOUR AGE, HORMONES… OR SOMETHING ELSE?

43. My husband seems to keep getting up in the night to use the toilet. Is it just his age, or could something be wrong?

In men, waking up to pass water in the night is usually a sign of benign prostate problems. Alongside changes in urine stream, dribbling and the need to pass water more often, they can be an indicator of an enlarged prostate.

Reducing caffeine and alcohol intake, and avoiding fizzy drinks and sweeteners may help. These can all irritate the bladder and make it worse. Your husband should also avoid drinking anything two hours before bed. Constipation should be treated, if that’s a problem, as it can worsen bladder symptoms. And he should ask his doctor or pharmacist for a PSA test, a blood test that can flag up prostate problems.

Memory loss doesn’t mean dementia

44. How do you spot the first signs of dementia? What do I do about it?

Dementia is memory loss but in its early stages it is hard to differentiate from normal, age-related troubles with memory.

Difficulty concentrating, getting confused with money or words, struggling to follow a typical task or conversation or being confused about the time or where you are may be signs, especially if these symptoms are consistent, worsening or ongoing over weeks and months.

Dementia is memory loss but in its early stages it is hard to differentiate from normal, age-related troubles with memory (file photo of nurse comforting a senior man)

Dementia is memory loss but in its early stages it is hard to differentiate from normal, age-related troubles with memory (file photo of nurse comforting a senior man)

Dementia is memory loss but in its early stages it is hard to differentiate from normal, age-related troubles with memory (file photo of nurse comforting a senior man)

Walking into a room and forgetting what you came in for is common, and not a sign of dementia; walking into a room and forgetting what the room is, would be. If the problem has been going on for a while, see a GP for blood tests to explore all possibilities – confusion can also be due to the medication side effects, stress and other emotional issues.

If you’re concerned about yourself or a loved one, you could try a standard cognitive test (detailed in our health MOT feature opposite) which would flag up classic signs of dementia.

45. There is a painless, squishy lump that’s appeared in my groin – and I’m scared about what it could be. Do you have any advice?

It could be a hernia – a soft protrusion from the inside of the body, popping out between the muscle fibres of the abdomen. If it is soft and painless, it is not a concern. But if it causes pain or grows, surgical treatment may be needed.

46. Does the NHS back mental health apps?

Yes, the NHS backs many of these, such as apps for stress, sleep, psychotherapy and positivity. Find them on nhs.uk.

Lumps in the groin can also be glands or lymph nodes – these become painful and enlarged if there is an infection in the lower part of the body. I would always advise that any new lumps are examined by a doctor if they persist for more than two weeks.

47. I’m suffering hot flushes and find it hard to sleep. I’m in my early 50s, so I expect it’s the menopause. What are my options?

Hormone replacement therapy, or HRT, is a great option – it treats all the symptoms with one medication, and there are few risks. It can be given as a patch, gel or daily tablet, and has to be prescribed by a doctor.

But many women choose not to take HRT. Instead they rely on exercise, yoga and meditation and avoiding triggers such as spicy foods, caffeine, and alcohol – all lifestyle measures that reduce symptoms.

A cool bedroom and light bedclothes help with sleep problems.

You can also find treatment in the pharmacy for vaginal dryness and remember to take enough calcium for strong bones. Black cohosh and St John’s wort are easy-to-get-hold-of herbal remedies that may reduce hot flushes.

48. What should I do if I think I’m suffering from a urine infection?

Symptoms of a urine infection, or UTI, include painful urination, going more often than normal and passing very little amounts. You may also pass blood.

First, ask your pharmacist for an over-the-counter UTI treatment – these are sachets of granules that you dilute and drink – and make sure you’re well hydrated.

If that is no help, call your doctor for antibiotics. They can prescribe these over the phone with no urine sample. If symptoms persist, have a urine test. Cranberry juice cannot treat a UTI but may relieve some discomfort.

49. Are lumps in the breast always cancer?

Breast lumps are more likely to be benign than cancer, particularly in a woman under 50. But if a lump lasts more than a week or two, or throughout your cycle, you should always be examined by your doctor. Breast lumps that are hard or feel fixed are always a worry. Get used to how your breasts look and feel, including the skin and the nipple so any change is clear to you.

50. I know that men are not supposed to lose interest in sex, but I have. Do I need Viagra?

Viagra doesn’t help revive a libido – it helps to maintain an erection. Loss of libido can be from relationship issues, stress, depression or lower levels of the sex hormone testosterone.

If you are having erectile problems, Viagra would help.

Antidepressants and high blood pressure pills can affect libido, and so can drinking regularly too much. Look closely at what could be causing the issue and if it remains even after plenty of relaxation, have a chat with your doctor.

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