Post-nasal drip likely di­ag­no­sis

The Weekend Australian - Travel - - Health - LINDA CAL­ABRESI

I have had a cough for sev­eral years. A chest X-ray and treat­ment for asthma have not yielded any pos­i­tive re­sults. Oc­ca­sion­ally I cough up a dob of thick phlegm. Could I have post-nasal drip, even though this phlegm is thick? IT’S hard to be cer­tain of any di­ag­no­sis with­out know­ing your full his­tory and ex­am­in­ing you, but in terms of pos­si­bil­i­ties post-nasal drip would have to be high on your list of pos­si­ble di­ag­noses. This con­di­tion sim­ply in­volves the se­cre­tions from your nose or si­nuses drain­ing down the back of your throat. Th­ese can be wa­tery or thick, and it is th­ese se­cre­tions that trig­ger the cough. The di­ag­no­sis is con­sis­tent with the nor­mal chest X-ray and the length of time you have had the prob­lem. Post-nasal drip re­sults from in­flam­ma­tion of the lin­ing of your nose and/or si­nuses. It is com­mon when you have a cold or a si­nus in­fec­tion, and oc­ca­sion­ally chronic in­fec­tion will cause the post-nasal drip to con­tinue for ex­tended pe­ri­ods. How­ever, when the con­di­tion per­sists over many months it is more likely the un­der­ly­ing cause of the in­flam­ma­tion is go­ing to be al­lergy. Treat­ment of post-nasal drip is very much de­pen­dent on the cause, but may in­clude an­ti­his­tamines, steroid nasal sprays and al­lergy avoid­ance. It would be worth­while dis­cussing this pos­si­bil­ity with your doc­tor. Linda Cal­abresi is a GP and ed­i­tor of Med­i­calOb­server. Send your queries to­ I was re­cently re­ferred for an ul­tra­sound due to very heavy pe­ri­ods and pain. I am get­ting my pe­riod about ev­ery two weeks. I am 45 years of age, suf­fer­ing from anaemia, prob­a­bly due to my pe­ri­ods. I was told at the scan that I had a very lumpy uterus and the re­sults would be sent to my doc­tor. Should I be wor­ried? GIVEN your age and symp­toms, the most likely di­ag­no­sis would have to be fi­broids — which are non-can­cer­ous growths within the mus­cu­lar wall of the uterus. They are very com­mon, oc­cur­ring in about 40 per cent of women your age, al­though they can vary enor­mously in terms of size and the symp­toms they cause. Be­cause they are al­most al­ways be­nign, fi­broids are gen­er­ally only treated if they are caus­ing in­tol­er­a­ble symp­toms. There are a num­ber of treat­ment op­tions avail­able, in­clud­ing sur­gi­cal re­moval of the fi­broids, hys­terec­tomy or a newer tech­nique known as uter­ine fi­broid em­boli­sa­tion, in which the blood ves­sels sup­ply­ing the fi­broid are blocked. If the symp­toms are tol­er­a­ble, an­other op­tion is to wait un­til menopause, as fi­broids are oe­stro­gen-de­pen­dent and gen­er­ally shrink af­ter menopause. While fi­broids are the most likely di­ag­no­sis, there are other pos­si­bil­i­ties and it would be best to check with your doc­tor as soon as pos­si­ble. My 17-month-old grand­son re­cently suf­fered a seizure, which his par­ents were told was re­lated to a fever he was ex­pe­ri­enc­ing at the time. He had no ap­par­ent ill ef­fects from this fit. What are the chances this will hap­pen again? AT least two-thirds of chil­dren who ex­pe­ri­ence a sim­ple febrile con­vul­sion will only have the one. That means up to one in three will have a sec­ond con­vul­sion, but only 10 per cent will have more than this. Febrile con­vul­sions are very com­mon, with about 4 per cent of chil­dren un­der the age of five hav­ing had one at some stage. It’s worth men­tion­ing here that the chance of a febrile fit caus­ing any long-term harm is min­i­mal. As for pre­ven­tion, the gen­eral ad­vice is to keep a fever down. How­ever, febrile con­vul­sions are more re­lated to a rapid rise or fall in the child’s tem­per­a­ture rather than how high the fever gets. Of­ten th­ese fits oc­cur be­fore any­one has re­alised the child ac­tu­ally has a fever, so don’t overdo the parac­eta­mol or ibupro­fen.

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