I have had an itchy bottom for months, especially at night. Scratching only seems to make it worse. I regularly wash the area and have tried hydrocortisone cream but to no avail. What could be the cause?
Dr Ellie replies: This could be a sign of parasitic threadworms, which are found in poo and lay eggs around the anus.
They are more common in young children, but can also spread to adults who are in close contact with them, such as parents or nursery workers.
Usually threadworms can be spotted in poo – and look like pieces of white thread.
Treatment involves taking a tablet called mebendazole.
Other causes of itching in this area are fungal and yeast infections. Since the bottom is often moist and warm, it can be an ideal place for them to form.
It can normally be treated with an antifungal cream called clotrimazole alongside hydrocortisone, which helps calm the skin inflammation and reduce itching.
An itchy bottom could be a sign of parasitic threadworms, which are found in poo (file image)
In order to prevent further infections, it is important to keep the bottom dry. One way to do this is with a barrier cream, such as Sudocrem, which is the opposite of a moisturiser – it keeps skin dry and has the added benefit of preventing chaffing.
Some patients also find that an antihistamine, an allergy tablet, can help reduce itching.
An examination from a GP would be helpful, as they can help work out the cause of the itch. A pharmacist can help recommend over-the-counter treatments.
I’ve just found out I have high cholesterol – my score is 7.4. But because I’m otherwise healthy, my GP says I don’t need to take statins. I’m worried I could have a heart attack. What should I do?
Dr Ellie replies: High cholesterol increases the risk of suffering a heart attack or stroke.
Cholesterol is a waxy, fat-like substance which builds up in the blood vessels, eventually causing life-threatening blockages.
Since high cholesterol is often linked with poor lifestyle, GPs will usually recommend that patients get more exercise and improve their diet – avoiding red meat and processed foods, and instead eating more vegetables, fruit, pulses and fish.
If these measures fail, doctors will typically recommend a statin – daily tablets that are highly effective at lowering cholesterol levels.
Statins are very safe and have few side effects, though in rare cases they cause muscle pains.
In the past, anyone with high cholesterol would have been given a statin. However, there is a growing understanding that this should not be the case, because it can be found in people who are not overweight, eat healthily, regularly exercise and have no underlying issues.
These people tend to have a genetic form of high cholesterol – meaning it is inherited from their parents – which does not respond to diet and exercise.
If they are doing everything they can to stay healthy then they are at a low risk of heart disease, regardless of their cholesterol score. However, this does not mean they cannot take a statin. Anyone with raised cholesterol – which is a score over five – who is concerned about it should talk to their GP.
While it wouldn’t be standard practice to give these patients a statin, the drug is low-risk and cheap, meaning doctors may offer it to those who are worried about their score.
I’ve been taking the heartburn drug omeprazole for 15 years. However, in the past two weeks my symptoms have got worse. But my diet hasn’t changed, so what could be causing it?
Dr Ellie replies: Anyone taking omeprazole for a long period should be seen by a GP regularly to ensure it is still needed.
Omeprazole is type of tablet called a proton pump inhibitor, or PPI, which suppresses the acid produced in the stomach.
It is an effective treatment for heartburn – also known as acid reflux – where acid in the stomach rises into the windpipe, triggering uncomfortable symptoms including coughing, bad breath, an unpleasant sour taste in the mouth and a burning sensation in the chest.
Heartburn is often triggered by being overweight, smoking, pregnancy, stress, a stomach ulcer, anti-inflammatory tablets, a bacterial infection in the stomach or a hiatus hernia – where part of the stomach pushes through the diaphragm and up into the chest.
However, omeprazole is not designed to be taken long term, because is has a number of worrying side effects, including kidney problems and the bone-thinning disease osteoporosis.
If the heartburn symptoms appear to be getting worse, this might suggest the underlying issue driving the problem may be also progressing. For example, a hiatus hernia may have grown or a stomach infection may have returned.
This is why it’s important to speak to a GP about a long-term omeprazole prescription. Not only will they be able to decide whether patients should keep taking the tablets, they may be able to identify the cause of the heartburn and treat that instead.
TV chef Jamie Oliver’s new documentary explores his own undiagnosed dyslexia
Diagnosed with dyslexia as an adult, like Jamie?
I was moved by Jamie Oliver’s new documentary about his own undiagnosed dyslexia and how thousands of children with the learning difficulty are going undiagnosed.
Dyslexia is a common condition which means patients struggle with reading, writing and spelling. In Jamie’s case, the TV chef’s dyslexia meant that he did not read a book until the age of 33.
While the condition cannot be cured, a diagnosis means children can receive specialist help to improve their learning skills.
Yet, as the new Channel 4 show highlights, dyslexia is often missed at a young age – meaning undiagnosed children are written off as simply unintelligent.
In the past decade, I’ve seen a big rise in patients coming to my surgery who believe they have ADHD – the attention deficit condition – but I rarely ever see those who believe they have dyslexia, even though studies show it is more common.
I wonder how many patients have lived with undiagnosed dyslexia for decades. Did you find out late in life that you have dyslexia? Did a diagnosis help? Write and let me know.
A supplement with real success
I’ve always been sceptical of health supplements that claim to work wonders, but I believe I may have found an exception: those designed to help combat urinary tract infections (UTIs).
The bladder infections are often painful and trigger a sensation called urination frequency, where patients feel the need to pee all the time.
For many patients, UTIs can become chronic, meaning they keep returning, even after treatment with antibiotics.
A health supplement is an over-the-counter product that, while it may have some benefits, its effects are not strong enough for it to be considered a medicine.
But it seems that some of my UTI patients are seeing real improvements taking products like D-mannose, a daily tablet which contains a sugar thought to help combat urination frequency.
While these supplements will never be a replacement for medicine, it is good news that some UTI patients appear to benefit.
Have you tried any bladder supplements to help combat UTIs? Did it help? Let me know via my email.
Do you have a question for Dr Ellie Cannon? Email DrEllie@mailonsunday.co.uk. Dr Cannon cannot enter into personal correspondence and her replies should be taken in a general context.
