THE DOC REPLIES

CAN you tell me if it’s worse to have low or high blood pressure?

The latter is potentially dangerous. There aren’t always symptoms and it increases the risk of blood vessel disease and, in particular, strokes and heart problems. If it is sustained over a number of years the risks increase. For this reason we treat high blood pressure when it is noted. Low blood pressure is complicated but in general terms is not as important. A lot of young, healthy, active people have low blood pressure, as do pregnant women and some elderly, frail people. It can make patients a little bit light-headed when rising or moving quickly but in general it’s not a problem.

I’M on Tegretol – is it possible it’s causing the burning sensation I’m now experiencing in my legs? I’m 79 and am a type two diabetic.

Tegretol, or carbamazepine, is a drug which is used for epilepsy and nerve problems such as neuralgia. Drugs often have many potential sideeffects and in this case there is a lengthy list. A possible, if rare, complication of carbamazepine is that it can aggravate the sensations you describe.

HOW effective are St John’s Wort tablets? Are there any side-effects?

St John’s Wort is a medicinal herb. In clinical trials it has been shown to be more effective than a placebo. It is generally quite well tolerated but can cause nausea, pain and loss of appetite. It may interact with some prescribed medications so, if you are taking any, it is worth asking your doctor what he thinks. It might be the case that he or she could prescribe something more appropriate for you. St John’s Wort interacts with warfarin and can also make the combined contraceptive pill less effective.

I’VE got a long-haul flight to Australia coming up soon. Is there any way to avoid jet lag?

Make sure you are well rested before you travel and stay well hydrated during the flight. It is best not to drink too much alcohol as it can make you groggy and cause dehydration. When you arrive in Australia it is best to establish a new routine, eating and sleeping at the right hours for your new time zone. Although you may be tired after the energy-sapping journey, it is best to avoid going for a nap before the “local” bed-time. Spending time outdoors will help, as natural daylight helps you adjust to your new surroundings.

MY dad has diverticulitis. What is it and how is it treated?

Diverticular disease refers to formation of pockets within the large bowel. In most cases these do not cause any symptoms. Diverticulitis occurs when these pockets become inflamed or infected. Common symptoms include lower abdominal pain and feeling a bit bloated. Sometimes patients might have a temperature and experience altered bowel habits, often with diarrhoea or more frequent movements. A high-fibre diet often helps tackle the symptoms of diverticular disease, while paracetamol can be used to relieve the pain. Most mild cases of diverticulitis settle but sometimes antibiotics may be required.

MY teenage grandson has developed an ulcer in his stomach. Surely he’s too young to develop such a condition?

Although you feel your grandson is not old enough to have suffered this, ulcers do occur among children and teenagers. In many cases, ulcers form due to an infection with Helicobacter pylori. This germ can weaken the protective mucus in the stomach, making it more likely to be damaged from acid. In some cases, ibuprofen can cause inflammation in the stomach. Sometimes the condition can be inherited. Smoking increases the chances of getting an ulcer and many teenagers do smoke, even if their families are unaware.

Unfortunately The Doc can’t directly reply to individual letters. When in doubt speak to your GP