Cholesterol drug gives me tummy ache. Is it time to stop taking it?
VERY high cholesterol runs in my family, and I have been prescribed statins and another drug called ezetimibe to control it. I’m now suffering stomach aches and flatulence, which are known side effects of ezetimibe. Should I stop taking it?
WE OFFER drugs to lower cholesterol – a fatty substance in the blood – to try to reduce the risk of a heart attack and stroke.
Statins work by affecting the way the liver works – stopping it producing so much cholesterol and helping to remove it from the blood. Ezetimibe, on the other hand, works by stopping the gut absorbing cholesterol from food, which is where the digestive side effects come from.
If a medication is doing what it should be but is also causing issues, doctor and patient need to have a serious conversation to weigh up the pros and the cons.
If someone is describing their side effects as mild, the benefits of the medication might outweigh the downsides. Or the reverse may be true. Only the patient knows how much the side effects impact their day-to-day life.
Digestive discomfort can be distressing, embarrassing and seriously impact quality of life.
One option could be to continue the medications if they are valuable, but add in another drug to deal with the side effects.
This is something that your GP could handle.
It’s also important to note that there are other medications that can be taken instead of ezetimibe.
I HAVE long had difficulties emptying my bladder completely. When I go, I often have a weak stream and need to go again shortly after. I was recently told I’d need a hysterectomy as, at 77, I was suffering from intermittent bleeding. Will the operation solve my bladder issue?
NOT being able to fully empty the bladder is known as urinary retention. Combined with a weak stream, in a woman this could be the symptoms of a prolapse.
This occurs when the pelvic floor muscles are weak and the structures within the pelvis, including the bladder and womb, are not supported properly, so they might squash into each other and cause urinary retention. In this scenario, if a patient is having a hysterectomy for another reason, it may improve the flow of urine.
Women can also suffer types of urinary retention if they are chronically constipated, if the womb is ‘bulky’ – for example, due to benign growths known as fibroids – or due to certain neurological conditions that may stop the bladder functioning properly, such as multiple sclerosis.
Some medications may also prevent the bladder from emptying fully, including antidepressants as well as the medications that we use to treat overactive bladder and urinary incontinence.
One concern about urinary retention is it makes women susceptible to urinary tract infections. Any treatment for urinary retention will always depend on the cause. In somebody with a prolapse, a hysterectomy is not the first treatment of choice. It would usually be pelvic floor exercises or a small operation to raise the womb out of the way of the bladder.
AT THE end of last year I fractured a vertebra in my back. I went to A&E but didn’t receive any treatment. I’m still struggling to walk or stand for more than a few minutes due to the pain. I’ve asked for another scan but I’ve been told this won’t take place until December. I’m 79. Are the doctors not taking my pain seriously because of my age?
ANYONE who suffers a fracture should be under the care of a specialist until the injury is healed.
The vertebrae are the spinal bones and can be broken just like any other bone, but patients usually won’t be offered an operation because they can heal on their own. Sometimes a spinal brace is fitted in order to keep it stable and allow the bone to heal in the correct position. Many patients are also offered physiotherapy to build up strength in the back.
However, most fracture sufferers receive a scan within three months to ensure that the bone is healing correctly.
A fracture may also be a sign of osteoporosis – a condition which thins the bones. The risk of this increases with age.
Anyone with osteoporosis should be offered medication to help prevent further fractures, as left untreated it can lead to life-threatening injuries.
Most hospitals have fracture clinics where patients can receive a DEXA scan – an X-ray which can reveal signs of osteoporosis – and then, if necessary, be referred on to a specialist for treatment.
Waiting another six months for a scan while in intense pain does not seem appropriate or safe.
It’s possible that a referral to a fracture clinic was supposed to happen, but didn’t. A GP can check the medical notes taken when you visited A&E, known as a discharge summary, to find out whether a referral was missed.