ASK THE DOC Specialist surgeon and lecturer Dr Sarah Rayne answers your questions

Specialist surgeon and lecturer Dr Sarah Rayne answers your questions. This month, they’re about multivitamins, itchy ears and fibroids.

Q: I am now over 30 – should I be taking a multivitamin, or any other supplement in particular? Or would it be better to focus on making sure my meals are healthy and contain all the nutrients required?

A: I think you’ve answered your own question! Research recommends that nutritional needs should be met primarily through foods in a nutrient-dense form (i.e. healthy foods). I’d add that the money you save on packaged multivitamins can rather be used for natural vitamins like those found in fruits, smoothies and other foods.

More than 40% of people use some kind of multivitamin regularly, making their manufacturers a booming R2.9 billion every year in South Africa alone. Health-conscious people often believe that vitamins can make them healthier, but actually, most scientific studies of diet and vitamin intake have shown that more than 75% of participants have adequate vitamin intake from food alone. The US Preventative Service Task Force found that taking multivitamins did not reduce cancer or heart disease either.

Where vitamins are useful is in specific groups of people who need a little help: folic acid and iron in pregnancy; calcium and vitamin D to assist with bone density; and older people may benefit from vitamin B12. If you think you might not be getting everything you need from your diet, talk to your doctor, or a dietician who will advise you on a healthy (and cost-saving!) complete diet.

Q: My husband always complains that his ears are itchy. He tries very hard not to use earbuds to relieve the itch, but eventually gives in. What is causing this, and how can he stop the itch in the long term?

A: Itchy ears are a common irritation, and usually due to skin irritation inside the ear canal. The most common reasons can be a lack of wax (or too much), an irritation due to water in the ear, or dry skin. The problem with putting earbuds in there is that they continue to dry out the canal and remove the lubricating wax the body produces (it does have a purpose!) Earbuds can also damage the skin, which can lead to infection, which can be severe. If there is pain associated with the itching, your husband could have an infection and should see his GP or an ENT specialist.

Simple good measures to help with itching are to soothe the ear with a natural oil like olive oil, or over-the-counter ear drops. Avoid too much water in the ears by covering them in the shower or when swimming. Ear sprays with acetic acid in them can also be useful as an antibacterial. If none of these help, steroid eardrops can be prescribed to reduce the inflammation.

Q: I’ve been diagnosed with fibroids. What are they, and what can I do about them?

A: Fibroids are a non-cancerous growth in the womb that unfortunately cause pain and increased menstrual bleeding. They’re a common problem for women as we get older, particularly black women. There’s an old adage among gynaecologists that goes: ‘First children, then fibroids, then hysterectomy.’ But nowadays, because women often delay having children, they can suffer from fibroids before they ever get pregnant.

Fibroids themselves do not increase your risk of cancer, although they should be monitored. If you have no symptoms you don’t need to do anything about them – they can stay where they are. In some, fibroids cause pelvic pain or heavy bleeding, or the womb to grow abnormally large. In these cases they can be medically controlled with hormones to limit their growth, or they can be removed surgically.

Surgery either leaves the womb intact, which is an option for women who still want children, or women can choose to have a hysterectomy if their family is complete and their symptoms are bad. A new option is a keyhole technique to stop the blood supply to the fibroid, which causes it to shrink, though fibroids can recur. Most gynaecologists see loads of women with fibroids, so chat to your gynae about the best way to manage your individual diagnosis.