Is a virus to blame for my upset tum?
Q HOW can you tell the difference between a winter vomiting bug such as the norovirus and food poisoning?
A NORO VIRUS causes sudden severe vomiting and watery diarrhoea. Some people also have bad stomach cramps, a slight fever, headache and aching limbs, a bit like flu. The symptoms appear two days after being infected and usually last for two to three days.
Although food poisoning typically causes stomach cramps and diarrhoea and may also cause vomiting, symptoms vary with the bug responsible. Some bacteria cause vomiting within a few hours of eating infected food and may not cause diarrhoea, while some bacteria cause only diarrhoea that may not start until a week after being infected.
In practice, though, the symptoms may be very similar and it can be difficult to tell the difference between the two. However the treatment is the same, stay hydrated by sipping fluids and take care with hygiene to avoid infecting others.
Q LAST year I ended up in A& E having suffered a rather serious nosebleed which the doctor had to cauterise. Since then I have suffered from sinus problems, hay fever and allergies. I wondered if the cauterisation might have caused this?
A NOSEBLEEDS are generally caused by widened blood vessels in the nose and most commonly occur from the middle part of the nose just inside the nostril.
Cauterisation involves sealing the bleeding vessels with heat and should not affect the lining of the nose. Nosebleeds are more likely if you have inflammation in your nose which means you blow your nose a lot and they are common in people with hay fever and other types of allergic rhinitis.
I suspect you had problems with your nose before you had the cauterisation procedure but by coincidence they have become worse since. However, there is no reason for the two to be connected.
Q I HAVE scalp psoriasis and have been using steroid cream and Alphosyl medicated shampoo very successfully for some years but now the problem is getting worse and I have had to stop using both treatments. My scalp is very itchy and I get little sleep. Can you help?
A PSORIASIS causes an increased production of skin cells leading to a build up of flaking, crusty areas of skin covered with silvery scales. If the scalp is affected it can give the appearance of severe dandruff. It is an autoimmune disorder, where the body’s own immune system attacks the deep layer of skin, triggering it to become inflamed. Steroids can help by preventing inflammation and may also help reduce the excess skin production but, sadly, there may be a rebound effect when they are stopped and the condition can become worse.
Creams and lotions containing coal tar such as Alphosyl, can also help reduce flaking and itching but how they work isn’t known. More effective are products containing chemicals similar to vitamin D, known as vitamin D analogues, which can help slow the production of skin cells. They include calcipotriol and tacalcitol and are available for the scalp as well as the skin and are certainly worth a try.
Creams containing tacrolimus and pimecrolimus are slightly different and can help reduce the activity of the immune system and can be effective for psoriasis, although they can sometimes cause skin irritation. Both of these groups of products
are available on prescription only, so you need to make an appointment to see your GP.
READERS RESPOND
IN response to your column ( February 9) in which a correspondent complains of tinnitus, I began to suffer from this condition suddenly at the age of 55. I had a course of acupuncture which cured it completely. I am now 76 and I have had no recurrence. I was sceptical of acupuncture until then but desperation made me try it. I would recommend anyone who has tinnitus to try this form of treatment.
Liam Queally, by email After reading the question and answer from the reader who was suffering from an itchy scalp ( February 2) I felt I had to tell you of my experience. For many months I had dreadful itching all down my arms and thighs. Doctors prescribed cream after cream which had little or no effect. After seeing another doctor who suggested yet another cream, I said it would be a waste of time.
I told him I thought that my tablets for high blood pressure could be the cause of my itching and I would stop taking them to see what happened.
He said that would not be a good idea and advised I take Amias ( candesartan) instead. Within three days the itching stopped and after two years has not returned. This might work for your reader.
Philip Witherow, Devon
If you have a health question for Dr Rosemary please write to her in confi dence at The Northern & Shell Building, 10 Lower Thames Street, London EC3R 6EN or email health@ express. co. uk
Dr Rosemary’s reply will appear in this column. She regrets that she cannot enter into personal correspondence and that, due to the volume of letters, she cannot reply to everyone. Find out more about Dr Rosemary at drrosemaryleonard. co. uk