From farting when walking to urinary infections – Dr Zoe Williams answers your health questions

WE can all feel embarrassed sometimes, but one place where you really never need to feel awkward is in front of your GP.

Of course, this is easier said than done when you are worried about something, especially a problem affecting an intimate body part.

Dr Zoe Williams answers some common questions sent in by readers

But I want you to know that we GPs aren’t squeamish.

We’re used to seeing bodies of all shapes and sizes.

If you are anxious about seeing your GP, you can always specifically ask for a male or female practitioner – whichever you feel most comfortable speaking to – and surgeries will do their best to accommodate this.

You can also take someone along with you to the appointment, or request a chaperone.

Whatever you do, please don’t let embarrassment get in the way of seeking help.

Here are some of the questions readers asked me this week . . . 

Q) I AM 76 and a widow for the last 18 months. I’m on Calceos and alendronic acid. I suffer terrible wind as I walk or move and it can happen at any time.

I get a lot of exercise walking the dog twice a day, gardening and I’m always on the go. I have always eaten plenty of fruit and veg and I don’t drink fizzy drinks.

After looking online, I have stopped chewing gum. I have swapped Fruit & Fibre for two boiled eggs for breakfast.

I have given up greens, onions and such like. I stopped eating beef stew and soup and anything with lots of veg.

I don’t know what else to do as I have always eaten healthily. I have even tried not eating before I go anywhere. I have taken Alka-Seltzer, settlers and such like.

The doctor gave me omeprazole and Busco-pan which have done no good. I have also done blood tests, and a stool sample was all clear.

I wonder if you can throw a light on this as now I avoid going anywhere in case I am shown up.

A) It’s always lovely to hear from people who are so clued up in their own health. You have taken a lot of positive steps, done your own research and got your GP on board early too.

However, I would advise you to reintroduce the vegetables now, especially as a trial of reducing them has not helped.

I understand why you tried a low fibre diet, as sometimes dieticians will recommend this in patients with irritable bowel syndrome, but this is usually only advisable when the IBS diagnosis is confirmed and there is dietician support because fibre is so important for so many aspects of health.

So, what’s the next plan with your GP now they’ve ruled out anything concerning with blood and stool tests?

They may look at potential side-effects of your medication.

Alendronic acid and omeprazole can both cause flatulence, so it’s worth chatting to your GP to see if they think it would be ok to have a trial period without these, to see if they might be contributing to the problem.

Have you tried reducing your meal sizes but increasing the frequency? This can help with wind.

Eating slowly and thoroughly chewing your food can help with digestion too, as can peppermint tea or peppermint oil capsules.

Fizzy drinks and chewing gum are both ways in which people swallow air without realising — leading to wind — but it’s possible you are swallowing air while you’re sleeping too, which is difficult to avoid. It’s worth remembering it’s not uncommon to pass wind around 15 times a day.

I’d encourage you to continue exploring the issue with your GP though.

You’re still very recently widowed and it’s important you don’t let your social circle reduce in size — your mental health is vital. Please continue to pursue a solution and keep in touch to let me know how you get on.

Q) I’VE been having lots of urine infections and itchiness inside my urethra.

Now my foreskin has retreated inside and I’m unable to pull it back.

I’ve had antibiotics and cream but still nothing works.

A) Thank you for writing in. I see patients   in clinic who have let genital issues get worse because they are embarrassed, but doctors are not phased by it.

You sound like you could have phimosis, which is the inability to retract the foreskin around the head of the penis.

Infection, inflammation and a condition called lichen sclerosus are all possible causes of these symptoms.

It is important to update your GP about the foreskin becoming stuck, as this should likely prompt a referral to a specialist.

It’s also important to send a urine sample and do tests for STIs too.

Big prostate a problem?

Q) I HAVE a benign, significantly enlarged prostate.

I have a PSA blood test every six months and the results vary, which I am told is to be expected.

Last year I also had an MRI scan.

My urologist says if the readings rise at the next blood test in October, I should have another scan and maybe a biopsy.

My question is, is it inevitable that sooner or later this will become malignant? And also, is there anything I can do to prevent this?

A) Benign prostatic hypertrophy, also known as hyperplasia, is very common, and prevalence increases with age. It is estimated that it may affect three in four men in their sixties.

BPH does not develop into cancer, but you can have an enlarged prostate at the same time as having areas in the prostate gland that contain cancer cells.

When a PSA (prostate specific antigen) blood test is raised, this could be due to BPH or prostate cancer (or both), or it could be caused by inflammation or infection.

An elevated PSA result usually leads to either active surveillance or further investigations (MRI and/or biopsies of the prostate gland).

The main risk factors for getting prostate cancer are age and genetics, but a healthy diet and regular exercise might help lower your risk of being diagnosed with advanced or aggressive prostate cancer.

Your urologist sounds like they are doing everything they should do and having BPH does not mean you are more likely to get prostate cancer, so try not to worry.

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