ASK THE DOCTOR
QI am struggling with smoking and would very much like to quit. Is nicotine replacement therapy safe, and would you recommend it? C.V., Vic. Ideally, try to quit without nicotine replacement therapy (NRT). If you can’t manage that, NRT is generally safe for most people, certainly safer than smoking cigarettes. You will need to understand the side effects and the potential for addiction to nicotine in NRT. It is most successful combined with counselling on quitting with your GP or a psychologist.
QI love eating fruit but am wondering if I have fructose malabsorption as I often have bloating and gas after I eat. Are the breath tests reliable? Or is it better to give up fruit, or some types of fruit by way of elimination and see what happens? B.B., NSW.
The breath test is not particularly reliable for fructose malabsorption. If you have symptoms after eating fruit, it may be fructose malabsorption or intolerance to FODMAPs (a collection of natural sugars found in food that are poorly absorbed in the gut). Polyols, one type of FODMAP, is found in some fruits such as apples and apricot. It is important not to give up any major food groups without the advice of a dietician.
QI have heard that psoriasis is made worse by sun exposure, but that a small amount of sun is helpful. What amount of sun is best for this condition and what else is recommended to help treat it? T.M., Qld. Ultraviolet therapy is one of the ways of treating psoriasis. In many cases, psoriasis improves dramatically with sun exposure, but not sunburn. UV radiation slows down the overproduction of skin cells, reducing inflammation and psoriasis plaque formation. Sun exposure (as well as oral vitamin D) also helps to maintain adequate vitamin D levels, which is important in managing psoriasis.
QWhat is the cause of glue ear and can it be fixed without having grommets put in? H.G., SA. Glue ear (or serous otitis media) can follow a middle ear infection. It is a build-up of thick fluid or pus behind the ear drum. The condition may resolve with time or with antibiotics, if there is an active infection. However, grommet surgery may be needed to drain the fluid and restore hearing.
QWhat are the dangers of using antihistamines over time? How long are they safe to use and are there any side effects? J.M., WA. Many people with chronic allergies need to take antihistamines long-term. Make sure it is a nonsedating type and take the recommended dose. It is considered safe and they do not lose their effectiveness.