Q ASK THE DOC
This month, surgeon and lecturer Dr Sarah Rayne tackles crippling social anxiety, digestive issues and the possible causes of bad breath.
Q: I’m so self-conscious of my body that I often avoid social situations – it’s affected my job, relationships and my health. What is wrong with me?
A: Humans have an innate desire to connect. Feelings of anxiety, embarrassment or self-consciousness, whether real or imagined, can leave us feeling isolated. Although medicine classifies conditions in a yes/no way, patients often experience a spectrum of symptoms that may fit into different disease categories, and there are several clinical conditions that could develop and cause some of the feelings you describe.
It sounds as if you have social anxiety, which might be the result of how you feel about your body or could be what’s causing you to focus on your body. Social anxiety is more than just shyness – it’s a persistent, intense fear of being observed or judged by others, and it can affect up to one in eight adults.
It doesn’t have to be normal for you to feel like this. I think you’d benefit from seeking specialist help from a psychiatrist or psychologist. Talking therapies and sometimes medication can help you to manage these feelings and reconnect with those who love you.
Q: My mother is 74 and suffers from bad breath. It seems to have come out of the blue.
Is it related to old age, and should I be worried?
A: This isn’t unusual, as nearly half of all adults complain of bad breath at some point in their lives.
Obviously eating pungent foods such as garlic or onions can cause temporary bad breath, but more commonly, the cause of long-term bad breath is bacteria living in your mouth. These feed off food particles left in your mouth, which is why it’s important to brush your teeth well, twice a day.
As you get older, these bacteria can more easily collect under the gums and result in periodontal (gum) disease; symptoms include inflammation, loosened teeth and bad breath. This affects more than 70 percent of older adults but brushing, flossing and regular dental visits will remedy this. Saliva is your friend as it has bacteria-killing properties, so chewing gum helps. Check your mom’s medication too, as some can cause a dry mouth. And remember, dentures and bridges need cleaning too!
Q: I suffer from crippling abdominal pains and have to rush to the loo 20 minutes after a meal, with diarrhoea. It’s impossible to leave the house. I even keep extra underwear in my bag when I go out. What could be the cause of this?
A: You need to see a doctor. Over-the-counter medication is useful for many conditions, but this sounds like more than a little diarrhoea.
A common cause of chronic diarrhoea is irritable bowel syndrome (IBS). This is characterised by symptoms like stomach cramps, diarrhoea and constipation that come and go over days or weeks. It seems to be related to food travelling too quickly or too slowly through the gut, and is also related to nerves in the gut and your state of mind – it gets worse with stress.
One of the most important ways to diagnose IBS is to rule out other causes of diarrhoea such as infections, inflammatory bowel disease and cancer. Once these have been eliminated, there are diet and lifestyle changes, along with some types of medication, that could help you get back control.
There are a few red flags to look out for: if you have any blood in the stool, fevers with the diarrhoea and if you’re losing weight unintentionally, visit a doctor immediately. Also if you have severe, prolonged cramps, don’t delay having this seen to.