THE DOC REPLIES

My wife recently died and it said on my her death certificate that it was because of intra-abdominal sepsis and cerebrovascular disease. Can you explain this to me in layman’s terms?

I am sorry to hear the sad news about your wife. Intra abdominal sepsis essentially means she will have suffered from a condition that would cause severe infection in the abdomen or tummy area. Sometimes, this can be caused by a hole in the bowel or sometimes abscesses or inflammation. The cerebrovascular disease means your wife will have suffered from narrowing of the arteries in the brain. This can lead to strokes but not necessarily always.

I’ve been on Bisoprolol for several years – but recently I’ve experienced freezing feet. My dose has been cut, but will my foot problems disappear?

Bisoprolol is a beta blocker. It is one of the newer generation of betablockers that we say is more “cardio specific”, which means it acts mainly in the heart and has less side effects compared to more old-fashioned betablockers. But some people still do get side effects around the body and cold feet could be one of these problems. Reducing your dose may improve your freezing feet but this cannot be guaranteed. I am sure that your doctor will be keeping an eye on you in this regard.

I’m 84 and have lost a stone-and-a-half in the past six months. I have diagnosed with diverticulitis – would that have something to do with it?

We would always take that much weight loss in six months seriously unless you have been dieting, exercising and trying to lose this amount of weight. I assume your doctor has investigated this. Your diverticulitis could possibly cause you to lose weight. Diverticulitis is very common in the western world. It is essentially small pouches in the bowel and often these can get inflamed and cause a variety of symptoms like constipation or indeed diarrhoea. It can also cause abdominal pain. It’s possible that weight loss could have been caused by this and I am sure your doctor has looked into all other aspects of your weight loss.

I have endometriosis, but recently the monthly pain I had has disappeared. Could it have cleared up by itself?

Endometriosis as you say can frequently cause cyclical or monthly pain. It is good the pain has disappeared and we quite often see this with patients where they go through a spell where the pain does settle itself down. However, it is possible this may return at some point. If it does and your symptoms are severe you should see your doctor again.

I have something called costochondritis and was given Ibuprofen. What is it and will it clear up?

Costochondritis is inflammation of the cartilages in the chest wall. The cartilages connect the rib bones to the breast bone. It can arise for no particular reason, it can also be caused by certain viruses that can cause inflammation in the cartilages. It can also be caused by posture or repeated movements of the thorax and upper body. In most cases it clears up fairly quickly and Ibuprofen is an anti-inflammatory that can certainly help with the symptoms and help to take inflammation down in the

cartilages.

What is diclofenac?

Diclofenac is part of the NSAID or non steroidal anti-inflammatory medication. It is similar to Ibuprofen. We use it frequently for things like back pain and it is good at taking inflammation down – but it also acts as a pain killer at the same time. There are potential side effects with this class of drugs such as stomach problems like indigestion, heartburn, reflux and more severe problems like gastritis or even ulcers. In most people, long-term use of this is not recommended as there are potential risks to the heart but in most people short use can be very useful.