All the answers to the things you never dared ask!
...and all the other questions it’s too embarrassing to ask
If you suffer incontinence, limit your chocolate intake as it contains theobromine – a mild diuretic
TYPE the words ‘Is it normal to…’ into Google and you’ll be presented with a host of suggestions based on millions of previous searches. Top of the list include variations on ‘… go for a wee every hour’ and ‘… not go to the toilet for a day’. These are questions that nearly half of all Britons would rather punch into a computer, than voice to a doctor, according to studies.
The worry is, when you ask the internet, you could end up with a cyber-diagnosis that gives false reassurance or undue worry.
With this in mind, we’ve spoken to the experts about all those so-called embarrassing ailments, to give you the facts and, hopefully, dismiss fears, demystify symptoms, and arm you with the information you need, or the courage to actually visit your GP.
Last week we provided a no-nonsense guide to sex-specific problems.
Now we turn to some of the problems that can bother any one of us at any time…
THE NASTY GUT BUGS THAT MAKE YOU GASSY
BREAKING wind is perfectly normal, but some days you can be more gassy than others. So when should you be worried? Even the experts can’t agree what is ‘normal’.
The NHS, says it means breaking wind roughly 15 times a day, but according to digestive health charity Guts UK, anything up to 40 is healthy.
‘Frequency isn’t so important,’ says Dr Rehan Haidry, consultant gastroenterologist at The London Clinic.
‘But if it is very smelly and comes with bloating and pain in the tummy, it’s concerning.’
WHAT’S CAUSING IT?
Even in healthy people, foods such as onions, garlic and beans generate a lot of gas, as do carbonated drinks. But some suffer more than others, and feel pain, bloating and a change in bowel habits.
‘The most common cause of excess flatulence is an overgrowth of bacteria in the small bowel, called SIBO,’ says Dr Haidry.
‘These bacteria release gases as they react with compounds in foods. And because the small bowel is small and narrow, the gas gets squeezed out.
‘It often results in bloating and pain, too.’
The condition, diagnosed using either a food diary or breath test, is considered to be a type of irritable bowel syndrome.
But GP Sasha Green warns: ‘If there are multiple symptoms, more serious problems such as lactose intolerance, coeliac disease, inflammatory bowel conditions and bowel cancer may be to blame.’
WHAT CAN BE DONE?
Dr Green recommends trying the over-the-counter medication simethicone, which can help some people as it breaks up gas bubbles in the stomach.
As for SIBO, antibiotics usually kills the nasty gut bug within a month, stopping symptoms, says Dr Haidry. ‘Reduce foods such as beans, onions, garlic, cabbage and artificial sweeteners – those prone to SIBO find these particularly difficult to digest,’ he adds.
Dr Green adds: ‘A study has shown that underwear made with charcoal absorbs smell.’ These are available online.
THE SIMPLE WAY TO SMELL YOUR BAD BREATH
BAD breath, or halitosis, can be mortifying – especially as it’s so hard to detect it yourself. But the Oral Health Foundation suggests that one way involves licking the inside of your wrist and sniffing – those with a chronic problem will detect a strong stench, similar to rotten eggs.
WHAT’S CAUSING IT?
Halitosis is almost always caused by bacteria in the mouth. These bugs release strong-smelling gases called volatile sulphur compounds. And the one in three Britons with gum disease, who have high levels of bacteria, suffer the most. Here, the bugs coat the teeth, gums and tongue, and get stuck in tiny gaps.
If it’s not gum disease, clues can be found in the type of smell. If it is acidic, and even vomit-like, this may be a sign of acid reflux.
This is where acid in the stomach flows back up the oesophagus, reaching the back of the throat.
If the stench is reminiscent of acetone – sweet and similar to nail varnish – it’s likely to be caused by the release of chemicals called ketones.
These are expelled when the body burns fat, because it doesn’t have enough glucose – the main source of fuel for energy, converted from carbohydrates. If you’re on a lowcarb diet, you may get so-called ketone-breath.
Dr Green says: ‘This smell could also be a sign of type 1 diabetes, because of the uncontrolled levels of sugar in the blood.
‘This is usually coupled with weight loss, excessive thirst and going to the toilet more often than usual.’
WHAT CAN BE DONE?
A full dental check-up is essential, as is maintaining excellent oral hygiene.
Brush the tongue and use dental floss daily to pick out lingering bacteria between the teeth. Try antibacterial mouthwash – look for zinc, chlorhexidine and cetylpyridinium chloride on the label.
If the problem persists for more than two weeks, or you suspect an underlying condition such as reflux or diabetes, talk to the GP.
THE INTIMATE ITCH THAT MILLIONS ARE HIDING
A STAGGERING one Briton in four struggles with discomfort in the back passage – in fact, itching, pain, swelling and bleeding in the bottom are among the most common health concerns in people of all ages.
WHAT’S CAUSING IT?
If itching comes with pain and/or swollen lumps in the anal area, it’s likely to be haemorrhoids – or piles, as they’re commonly known.
They are the leading cause of rectal pain and bleeding, and happen when blood vessels in the back passage become swollen and inflamed, forming a lump.
Pregnancy can bring them on, as can constipation and straining when going to the toilet.
If children are complaining of an itchy bottom, the cause may be
threadworms – a parasitic infection as common as nits.
WHAT CAN BE DONE?
If it is haemorrhoids – which are often identified by finding bright red blood in the toilet – creams or suppositories containing hydrocortisone can ease the pain.
‘The itching usually vanishes on its own after a while,’ says Dr Green. ‘It’s only in rare cases that surgery is needed to remove piles, if painful.
‘If you see blood in the toilet, always talk to the GP for a consultation, just in case.’
In the meantime, preventing constipation by eating more fibre – found in wholegrain cereal and bread – will help.
If one member of the household has threadworms, everyone needs treatment with over-the-counter medicine called mebendazole.
TREAT FOOT FUNGUS FAST – OR YOU’LL REGRET IT
DO YOU suffer from flaky patches of skin – usually between the toes – and discoloured, cracked toenails? It’s not normal, so don’t ignore it.
WHAT’S CAUSING IT?
It is most likely the common fungal infection athlete’s foot.
Yeasts and other fungal spores usually live harmlessly on the skin. But they flourish in warm, moist conditions and can grow out of control, spreading into and destroying skin tissue.
If left untreated, the fungus – usually picked up in communal showers or changing rooms – can spread to the toenails.
WHAT CAN BE DONE?
‘Once the fungal infection has penetrated the nail, it is much tougher to treat, so catch it before this point,’ says Dr Green.
‘A pharmacist can prescribe anti-fungal creams such as miconazole and clotrimazole, which quickly reduce inflammation in the skin. If you need to treat the nail, an over-the-counter nail lacquer called amorolfine can be used in the early stages. You might need to take anti-fungal tablets prescribed by the doctor.’
For sweaty feet with no infection, pharmacists advise spritzing the soles with deodorant, throwing out old shoes and changing socks twice daily.
BAD BODY ODOUR? IT MIGHT BE THE MENOPAUSE
A THIRD of Britons avoid social situations due to worries about how they smell, according to a recent poll.
While most of us will emit some body odour when sweating, for some the problem is noticeably strong for most of the day.
WHAT’S CAUSING IT?
Most cases of strong body odour, known medically as bromhidrosis, are a result of excessive sweating. But millions suffer a condition called hyperhidrosis, where sweating is chronically extreme whatever the temperature.
Commonly, a change in hormones – which trigger the activity of the sweat glands – is the underlying culprit. The menopause, for instance, can spark the problem, as a drop in oestrogen triggers excess sweating.
And conditions such as diabetes and an overactive thyroid cause changes in sweat production too.
WHAT CAN BE DONE?
‘Ask the pharmacist for a deodorant with a high level of aluminium chloride,’ says Dr Green.
‘This is the active agent in most deodorants, but some have higher concentrations. And avoid common triggers such as alcohol and spicy foods.’
In extreme cases, GPs may refer you to a specialist who might offer injections of Botox into the sweat glands, reducing their activity.
If the menopause is to blame, ask your GP about hormonereplacement therapy.