The Sunday Post (Inverness)

THE DOC REPLIES

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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 stoneand-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. 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.

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

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