Evening Telegraph (First Edition)
MANAGING COELIAC DISEASE Q
AI have just been diagnosed with coeliac disease and I am worried about how I will cope with having to change what I eat. While there is no cure for coeliac disease, there are changes you can make to your routine and eating habits that will help you live well with the condition. The treatment is to follow a lifelong gluten-free diet. Living with coeliac disease can be challenging, but the right support and information mean it can become very manageable. NHS Inform has information on all aspects of understanding the illness and managing it, including: ■ See a dietician and get a step-by-step plan for removing gluten from your diet. ■ Learn which foods are naturally gluten-free. ■ Talk to other people with coeliac disease.
YOU may have heard of benign prostate enlargement but are you clear on exactly what it is? First of all, the prostate is a small, walnut-shaped gland located in men’s pelvic regions. It sits between their bladder and penis and surrounds the urethra (the tube that passes urine out of the body). Benign prostate enlargement (BPE) is a condition where the gland becomes enlarged, often causing symptoms likes having to pee more frequently and urgently. It’s not medically serious but can be a nuisance, sometimes having a significant impact on a man’s general health and wellbeing, and quality of life. It’s important not to self-diagnose, though, as the symptoms can be very similar to those of prostate cancer, so you should always get things checked by your GP if you notice any chances in your toilet habits, or any pain, discomfort or swelling in that area. There’s also a lot that can be done to help treat and manage symptoms caused by prostate enlargement, so there’s no need to just put up with it. With 40% of men over 50, and 70% of those in their 70s, affected according to the NHS, it’s pretty common and nothing to be embarrassed about. So what do you need to know? Here, GP and Media Medics founder Dr Paul Stillman debunks five common myths about benign prostate enlargement:
TO PEE AT NIGHT IS ONLY SYMPTOM
It’s true that the most common symptom of an enlarged prostate is “nocturia” – or needing to pee at night. However, this isn’t the only symptom to be aware of. Dr Stillman says: “When the prostate gland enlarges, it constricts the urethra, impeding the easy flow of urine from the bladder. “This can cause difficulty and hesitancy starting to urinate, with a weak flow and an after-feeling that there is more to come. You may also return to urinate minutes after having finished.” He adds: “Until properly treated, nocturia may be an inevitable part of BPE. An obvious point to note is that the more you drink, especially just before bedtime, the more frequent nocturia becomes – so restricting drinks, especially alcohol a or caffeine, for a few hours before hitting the hay will help.” It t’s also a good idea to empty your bladder immediately before bed and keep the lights low when you do have to go, to encourage gettiingbacktosleepquickly.
FINE TO IGNORE THE SYMPTOMS AS THEY’RE NOT SERIOUS
First and foremost, as mentioned, th he symptoms of benign prostate enlargement can be similar to th hose of prostate cancer – the most m common male cancer in the UK. Prostate cancer can often be successfully treated but early diagnosis is vital, so it is advisable to get any symptoms or unusual changes checked by your doctor. If cancer is ruled out and BPE is diagnosed, although not lifethreatening, the condition can still have a big impact on a man’s physical and mental health if left unchecked. “For the majority of men, a BPE is a nuisance, an inconvenience,” says Dr Stillman – but it can have a hefty effect, particularly if the need to urinate becomes very urgent and difficult to control. “Incontinence issues can be common in men with BPE, especially if it is not possible to find a toilet when required,” he says. “If the frequency extends into the night, it can often result in poor sleep quality, too, which will have a knock-on effect on energy levels.” Some men may find a negative effect on their sex life too. Dr Stillman says: “There is a link between prostatic enlargement and erectile dysfunction, although the cause is not clear. Problems of urinary frequency, disrupted sleep and associated anxiety can upset the delicate mechanism that results in sexual performance and satisfaction.”
WITH BPE ARE MORE AT RISK OF PROSTATE CANCER
“BPE is not caused by prostate cancer and men with an enlarged