I have been suffering from a runny nose for years. At night it falls down my throat like a waterfall. It also makes my eyes water and I cough all the time. I have been given nasal sprays but nothing helps. What should I do?
Some people may suffer from an incessant runny nose with no apparent cause – this is called chronic non-allergic rhinitis, writes Dr Ellie.
Dr. Ellie answers: A runny nose is often caused by rhinitis, in which the nasal passages become inflamed. Colds and other infections, as well as allergies such as hay fever, also cause this.
However, some people may experience the condition without an apparent cause, which is called chronic nonallergic rhinitis.
This can last for some time and lead to unpleasant symptoms such as congestion, sneezing and nasal drip, which can cause coughing and sleep disorders.
A number of medications can cause this problem, including blood pressure pills and anti-inflammatory painkillers.
There is also a specific problem called rhinitis medicamentosa, which is strangely caused by overuse of nasal sprays and decongestants. Long-term rhinitis can even be caused by working with industrial chemicals, regularly drinking alcohol or eating spicy foods.
In some cases, the complaints can be caused by a physical problem in the nose. This may be due to tissue growths called polyps, or a deviated septum, where the wall between the two nostrils is not straight.
Any structural problem is usually discovered by looking at it with a camera. If it is caused by polyps or a deviated septum, surgical options are available. This may involve removing the polyps or fixing the shape of the septum.
In rare cases, it is also possible for chronic rhinitis to be caused by nerve damage.
I have been advised to wear compression stockings due to poor circulation. However, I have trouble putting them on, and they roll down when I walk around. Can you recommend alternatives?
Dr. Ellie answers: Compression stockings are used to treat blood circulation problems in the legs. In older people, the body sometimes has difficulty pumping blood from the feet and legs. It can lead to painful swelling in the limbs, but also increases the risk of blood clots forming.
Compression stockings – tight knee-high socks – put pressure on the blood vessels in the legs, causing the blood to rise.
Although effective, it is common for people to struggle with it. However, it is important to stick with them because they can have a great benefit – and save lives.
Fortunately, the stockings are available in different sizes and strengths, depending on how much pressure is applied. A pharmacist is usually the best person to talk to about finding the right stocking, and they can measure the legs to ensure the correct size is used.
Also consider putting on the stockings first thing in the morning, as this is when the legs are least swollen.
If a patient really has trouble putting it on, a doctor can prescribe a medical device called ActiGlide. This is a plastic sheet that is placed over the foot and leg to make it easier to put on stockings.
I am 76 and have suffered from an anal fissure for the past year. My GP has been very unhelpful. Can I do anything to relieve the pain?
Dr. Ellie answers: A fissure is a tear in the opening of the back passage that can cause excruciating pain. Patients therefore often postpone visiting the toilet and suffer from constipation.
Fissures can be caused by an infection, diarrhea or constipation. However, a new fissure can also be a sign of colon cancer. Therefore, the problem always requires an investigation. A GP can order a stool test to detect cancer and can refer patients to hospital for further checks if necessary.
For most patients with a fissure, the most important thing they need is pain relief.
Over-the-counter pain relievers such as acetaminophen or ibuprofen can help. However, many patients benefit from it
a numbing cream that can be applied to the fissure before going to the toilet. This can be prescribed by a GP.
Some people also find that sitting in a warm, shallow bath relieves pain.
If pain persists despite these approaches, a cream called glyceryl trinitrate (GTN) may be prescribed.
This is used for about two months to help the tear heal. However, it does not provide pain relief and some patients report severe headaches while taking it. GTN is also not given to patients with certain heart problems or a history of migraines.
In addition to these measures, it is very important that someone with a fissure eats fiber-rich foods or uses a laxative to keep their stools soft. This is because straining while going to the toilet can worsen cracks. It is also important to drink plenty of water, this helps with bowel movements.
- Write to Doctor Ellie. Do you have a question for Dr. Ellie Cannon? E-mail DrEllie@mailonsunday.co.uk
- Dr. Cannon cannot enter into personal correspondence and her responses must be placed in a general context.
Once rare, now scabies is everywhere
In recent years there has been a significant increase in the number of patients coming to my practice with scabies.
I did not regularly see the annoying – and painful – mite infection when I started as a general practitioner almost twenty years ago. Now I see patients every month with the telltale patchy rash and painful itching.
Last month, new data was published showing that scabies infections in Britain have quadrupled in the past fifteen years. It’s not entirely clear why this has happened, but some research suggests that the highly contagious insects are becoming resistant to existing treatments.
Whatever the cause, it is concerning because scabies spreads easily and is difficult to control. If you have recently suffered from scabies, do you know where you contracted it? Please write and let me know: E-mail DrEllie@mailonsunday.co.uk