Dr Rosemary

Medical adVice cOlUmNiST OF THe YeaR

dogs and some foods (especially pepper and other strong spices).

WHAT causes swollen ankles? Over the past month mine have started swelling about an hour after I get out of bed and remain like that all day.

My doctor says it is nothing to worry about. What do you think?

aOCCASIONALLY swollen ankles can be a side-effect of medication, particularly drugs known as calcium channel blockers, such as amlodipine. In the warm summer months it can just be a sign of slightly leaky tiny blood vessels.

However persistent swollen ankles usually indicate a problem with your circulation.

In young people defective drainage in the lymphatic system can be to blame but in older sufferers puffy feet and legs can be a sign that the heart is not pumping as efficiently as it used to. So apart from the fact that you probably find it difficult to get your shoes on, it may be a sign of a significant underlying problem and you are right to be concerned.

When I see a patient with swollen ankles I check their blood pressure and cholesterol and renal function levels and also arrange for then to have both an electrical recording (an ECG) and an ultrasound (echo) examination of their heart.

In the past, swollen ankles were often treated with diuretic (water) tablets and although these are sometimes used now, it is often more effective to use tablets that improve the heart’s muscle action such as ramipril.

So go back to your GP and if necessary, take along a friend for support. In the meantime do regular exercise to boost your circulation and when relaxing, keep your feet up, preferably above the level of your hips. Q a A HIATUS hernia occurs when the upper part of the stomach pushes up into the lower chest. This can happen

WHAT is the best treatment is for a hiatus hernia?