I’ve been told I have gallstones. So why am I not being treated?

LAST year I had an ultrasound scan of my abdomen which revealed gallstones. I was told this on the phone by a locum who didn’t say much else. Do I need to do anything about them? I’m male, 75 and not overweight.

GALLSTONES are small, hardened deposits that form within the gallbladder, which is a pouch in the liver that stores the digestive juice, bile.

They are usually made of cholesterol, and eight out of ten people with gallstones will never know they have them because they don’t cause any symptoms.

If someone has gallstones with no symptoms, there would be no reason to treat them.

They usually occur in women who are over 40 and overweight and who eat a diet high in fats and processed sugars.

Strangely, they can also appear in people who quickly lose drastic amounts of weight.

Gallstones cause problems when they get stuck in the opening of the gallbladder, causing excruciating pain known as biliary colic.

They can also cause an infection or inflammation in the gallbladder and also in the pancreas, a gland that is next to it. Both of these can be very serious conditions and usually require hospital treatment.

If the stones do become troubling, the gallbladder is completely removed with an operation – generally via keyhole surgery.

If the gallbladder is removed, the liver still produces enough bile to break down fats in food, which is its main function. But instead of being stored in the gallbladder, it drips continuously into the digestive system.

Some people experience side effects such as bloating or diarrhoea after surgery, though this usually improves within a few weeks.

Since bile is released in response to eating fatty foods, opting for a low-fat diet can help to prevent biliary colic for some people.

I HAVE recently been diagnosed with something called peripheral neuropathy, which causes pain and tingling in my feet. A friend told me Vitamin B supplements might help. Is she right?

PERIPHERAL neuropathy develops due to nerve damage in the body’s extremities, such as the hands and feet. Diabetes is the most common cause, because high levels of sugar in the blood causes damage to the nerves.

Other triggers include chemotherapy, a deficiency of Vitamin B12 or folic acid, HIV medication and alcoholism.

Nerves can also be damaged through injury, viral infections like shingles and certain chronic inflammatory diseases such as lupus and rheumatoid arthritis.

Depending which nerves are affected, a range of symptoms can arise, among them pins and needles, burning pains, numbness or a loss of sensation in the hands and feet. If movement nerves are affected this would lead to muscle weakness, cramps, twitching and even paralysis. Bladder control and erectile dysfunction can also be symptoms.

Doctors do a whole host of blood tests to look for a cause of peripheral neuropathy, often alongside nerve-conduction studies. These are specialist investigations in the hospital to see which nerves are and are not functioning.

Treatment always depends on the underlying cause – for instance, improved diabetes treatment or physiotherapy to resolve any nerve damage from an injury. Vitamin B12 would normally be offered only if a deficiency was confirmed by a blood test.

IS THERE a basic diet that can speed recovery when flare-ups of irritable bowel syndrome occur?

IRRITABLE bowel syndrome, or IBS, typically causes symptoms such as stomach cramps, bloating, diarrhoea and constipation. These usually come and go over time and can last for days, weeks or months at a time.

When someone has a flare-up of IBS, it is often related to a trigger. This may be a specific food such as dairy, alcohol, caffeine or fatty food, but there can also be nonfood triggers like stress, anxiety, antibiotics or an infection.

Official guidelines recommend a 12-week course of probiotics, in order to replace any gut-friendly bacteria destroyed by infection or a food trigger.

You should speak to a pharmacist about this.

Changes to diet depend on which of the symptoms are more dominant.

For example, somebody who has diarrhoea-dominant IBS should reduce the intake of fibre such as wholemeal or highfibre bread and also reduce fizzy drinks and gassy foods like certain vegetables.

On the other hand, somebody with significant IBS constipation needs to gradually increase their fibre intake with soluble fibre such as Fybogel supplements, or gradually add oats and linseed to their food.

People with IBS may be advised to follow a low FODMAP diet. This means removing foods such as artificial sweeteners, legumes and certain green vegetables that ferment within the bowel.

It is best to undertake this diet with the supervision of a dietician. It can also be a useful process to determine which foods are particularly troublesome and causing your flare-ups.

Dr Cannon cannot enter into personal correspondence and her replies should be taken in a general context.