ASK THE DOC
Surgeon and lecturer Dr Sarah Rayne answers your questions. This month, they’re about stomach cramps, insomnia, and becoming more sunburn-prone.
Q: I’ve been getting extremely painful stomach cramps lately. I recently started a new job; do you think it could be as a result of stress?
A: There are many reasons why you may have developed painful cramps, but you’ve already noticed a relationship between the cramps and your stress, so it sounds as though you’re developing Irritable Bowel Syndrome: a collection of problems such as abdominal pain, bloating and changing bowel habits which go on for at least six months. It’s very common but not welldiagnosed, as there is no test to confirm it – diagnosis is based on symptoms. Some of the characteristics are that the pain is helped by going to the toilet and made worse by eating. Stools can be hard, soft or mucus-y (never bloody – see a doctor immediately if you pass blood). Also see your doctor to rule out other causes of gut problems such as cancer or thyroid disease. If it is IBS, changes in lifestyle can really help, such as reducing stress, increasing exercise, drinking lots of fluids and avoiding processed foods. Sometimes reducing your fibre or fruit intake can help, but it’s best to start altering your diet in conjunction with your doctor. Taking a probiotic or peppermint oil for cramps can also be helpful in the meantime.
Q: Most nights I struggle to fall asleep, and when I do, I struggle to stay asleep. I don’t want to take sleeping pills. Are there other options?
A: Having a bad night’s sleep is a horrible experience, but it’s very common: one in four people have chronic sleep problems. There are many reasons why you may have started sleeping badly. First try and treat any new causes, and then work on your ‘sleep hygiene’. Stress, shift work and young children can all lead to disrupted sleep, as can psychological problems such as anxiety, grief or depression. Also look at any new medicines you’re taking – could they be contributing?
Before you resort to sleeping tablets, correct your sleep hygiene: establish a regular bedtime routine and only use your bedroom for sleeping – no eating and especially no screen time (TV or phone). Relax before bed with a bath or warm shower, reading or a nonalcoholic, non-caffeinated drink (and no smoking!). If these don’t help, keep a sleep diary monitoring your sleep quality. The SA Society of Sleep Medicine website (www.sassm.org) is also a great source of advice. Q: This summer I’ve really struggled with sunburn and break out in a red rash whenever I go in the sun. I have fair skin, but this has never happened before.
A: The South African sun can be very harsh, especially if you have fair skin. The most common reaction is sunburn, where the skin is damaged by UV rays. Less common is the type of reaction you describe, which sounds like ‘photosensitivity’ – a reaction to the sun that results in an allergic rash. Very rarely, this can be caused by your immune system’s response to the sun, but more commonly it is due to the sun reacting with a chemical or medication you have used. There are many medications that can cause sensitivity, such as doxycycline (sometimes taken for malaria prevention), but medications for bladder infections, heart disease, diabetes and depression can also cause a reaction in areas of your body exposed to the sun. Have a think about any new body products you’ve been using this year, as they may be the cause. In the meantime, these reactions only happen when UV penetrates the skin, so wide-brimmed hats and long sleeves will give you some reprieve.