Post-nasal drip likely diagnosis
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 firstname.lastname@example.org 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.