RIGHT now it might feel like everyone you know has a cough. There’s lots going round.
If you are struck down with one too, there is no need to visit your GP unless your cough becomes persistent for more than three weeks, your immune system is compromised, you are struggling to breathe or have chest pain.
Dr Zoe Williams answers questions sent in by readers
You should see a GP urgently if you are coughing up blood.
Otherwise, coughs are annoying but treatable at home with rest and lots of fluids, including hot honey and lemon for anyone over the age of one. You can also chat to your pharmacist about cough sweets and medicines that might help.
Try to avoid mixing with other people, especially if you have a temperature. Within a few weeks, your cough should be on the mend.
Here is what readers have been asking me this week.
Q) SHOULD a 43-year-old woman with recurring haemorrhoids visit her GP, and will they have to look?
A) Haemorrhoids, or piles, are swellings that develop around the anus. They are swollen veins and the overlying tissue, and some are internal while others are external.
They often don’t cause any problems but when they do, they can be painful and bleed.
If you are confident they are piles, you can ask your pharmacist to recommend an ointment or suppositories.
But if you are not sure, or the symptoms do not get better with this treatment, definitely see your GP.
They are recurring, which suggests they come and go, so I would advise speaking to your doctor.
You can request a female doctor, or a nurse chaperone, or take someone along if you feel more comfortable with that.
If none of those options appeal, start with an e-consult, where you explain everything online.
No doctor will ever force an examination. If you don’t feel comfortable, just say so, but please remember we have seen it all before and it is a very normal part of our job.
We do not completely know what causes piles. The anus has lots of tiny blood vessels in it and it is thought that increased pressure, caused by straining when we go to the toilet, can cause them.
There are four grades of piles, from grade one, which cannot be seen outside the anus as they are small swellings in the anal canal, through to grade four, which hang down “prolapsed” and are visible outside the bottom and often painful.
There are risk factors for piles and these include being overweight, constipation, eating a low-fibre diet, being pregnant, heavy lifting and getting older. In some cases they are hereditary.
There are many lifestyle changes you can make, including eating lots of fibre, drinking plenty of fluids, making sure you go to the toilet frequently so you do not have to strain, and exercising regularly.
Medical solutions include creams, ointments or suppositories, sometimes containing corticosteroids.
Sometimes, a referral may be necessary for a procedure called banding, which is done as an outpatient and involves using a rubber or elastic band to cut off the blood supply to the pile, which means it will die and fall off without any pain.
It is effective in eight out of ten cases, but if this does not work, there are more specialised procedures, including surgery.
Q) I HAD my colon removed and I’ve had a colostomy bag for 18 months. I now go to the toilet probably 50 times a day. Sleep is awful.
I’ve tried every medication known to man to try to slow things down but I don’t want a permanent colostomy bag again. Any ideas what I can do to improve my predicament?
I am so sorry to hear you are going through that.
I can only imagine the huge impact this must be having on your quality of life, not just the symptoms directly associated with such a high frequency of visits to the toilet but also your sleep and energy levels. It must make venturing out of the house very difficult, if not impossible.
I’m afraid I am limited in how much I can help because this is such a specialist situation.
Your surgical team, especially the specialist nurses, would be your best source for advice on what your options are.
It may also be useful to start considering what life might be like with a permanent stoma, and perhaps a list of pros and cons.
I know several people who felt just like you, but were actually able to get their lives back to normal living with the stoma, and never looked back. Colostomy UK is a charity that helps support people like yourself.
They have Facebook groups and a befriending service so you can connect with others who are experiencing similar predicaments.
Crohn’s and Colitis UK also have some great resources on “living with a stoma”.
You have not mentioned your age or gender, but just in case you are a young woman, there is a podcast called Inside Out By Amber that might interest you too.
Good luck and I do hope you can find a solution you are happy with.
