Is tummy pain due

QHOW can you tell the difference between food poisoning and a stomach bug? I was ill for several days this week and I’m still unsure whether something I ate upset my stomach or if it was caused by a virus. No one else I know was unwell.

AGASTROENTERITIS is the medical term for inflammation of the stomach and the intestines, which in turn can lead to symptoms that can include nausea, vomiting, abdominal pain and diarrhoea.

Gastroenteritis can be caused by viruses such as norovirus, which are spread from person to person, or by bacteria or their toxins in food, for example campylobacter or salmonella.

If several people who work together but eat separately become ill then a viral infection is likely to be to blame. If a group of people who have eaten the same meal all start being sick then food poisoning is more likely. However symptoms of food poisoning can take a week or more to become evident, which can make it difficult to pinpoint the exact culprit. In practice it’s often impossible to know what has caused stomach upsets and in most cases it doesn’t really matter as most people get better in a few days.

Having said that I always tell people with gastroenteritis to think back to what they have eaten and where and to check if any of their eating companions have been affected as well. It is only in this way that food that has been contaminated, from either a supermarket or a restaurant, can be tracked down.

I HAVE had shingles for seven weeks and it has been terrible. How can I ease the pain?

ASHINGLES occurs when the chicken pox virus, herpes zoster, re-activates and travels down a nerve from the spinal cord to the skin.

Not only does this cause the characteristic blisters in the area supplied by the nerve but the nerve itself also becomes inflamed, causing severe pain.

Unfortunately this pain can continue after the blisters have healed, a condition called post-herpetic neuralgia.

Standard painkillers such as ibuprofen, paracetamol or codeine often barely take the edge off this. Far better are painkillers that help stop the pain impulse travelling down the nerve. Carbamazepine is the one that is used most often but gabapentin and amitriptyline can also be effective. Unlike other painkillers these don’t work straightaway but rather take up to a week to become effective and have to be taken regularly, either once or twice a day. To keep side effects (such as drowsiness) to a minimum it’s best to start with a low dose which is slowly increased over several days. They are available on prescription so see your GP.

A RECENT X-ray showed an ache in my lower back caused by wear and tear, which is only eased when I sit or lie down. I’ve been prescribed co-dydramol.

Can you suggest other ways of easing the pain? I am 82.

ADOCTORS use the term “wear and tear” for changes that occur in the spine with age. The joints and cartilage between the individual bones grow worn, deformed and thinner. This can create pressure on the nerves as they leave the spinal cord.

This tends to be worse when you are upright, when your lower spine is carrying the weight of your body, which is why the pain eases when you are sitting or lying down. Spasm of the muscles that support the back