I am 85 years old and have had severe itching all over my body for the past three weeks. In some areas there is a slight rash, but the itching is equally strong where there is no rash. The doctor prescribed prednisolone and some lotion, neither of which made any difference. The GP then added fexofenadine, again to no effect. Should I order a blood test?
It is not uncommon for people to visit their GP complaining of itchy skin, often without a rash appearing. It can be caused by many different skin problems, such as eczema and psoriasis, allergic conditions such as hives, or infestations such as scabies.
But many people who get itchy don’t have visible skin problems. Non-skin conditions account for about a quarter of itch patients and are more likely in older patients.
It may be the result of kidney or liver disease, both of which can be detected in a blood test. Thyroid problems and blood disorders can also trigger itching. Although unlikely, it may be a symptom of a type of blood cancer, such as multiple myeloma or Hodgkin’s lymphoma. That’s why it’s crucial to get blood work done as your first port of call.
Today’s reader is 85 years old and has developed severe itching on his body for the past three weeks. She has asked the doctor what is the possible cause of her problem and if it can be fixed.
Itching can also be a side effect of various medications, including blood pressure medications, diuretics, heart medications such as digoxin, statins, and opioid pain relievers.
Hydroxyzine, an antihistamine available by prescription, can help stop itching, and watery creams containing menthol can soothe the skin. Steroids like prednisolone are unlikely to help unless there is an allergic or inflammatory problem.
Wash in cold water without bubble baths or scented products. If the heating is on, a house can have very dry air, so placing a wet towel on a radiator can help moisten and add moisture to the skin.
After having stomach problems for a decade, I had a scan that showed my intestine was narrow in one area. A follow up scan showed that one of my valves is not closing all the way. The GP prescribed omeprazole but it did not help. I tried over the counter medications, herbal supplements, and avoided certain foods, but nothing worked. Please help. I can’t sleep because of the constant gurgling and stomach ache. By the way, I also suffer from irritable bowel syndrome.
More from Dr Ellie Cannon for The Mail on Sunday…
ACID reflux is very common. It occurs when acid and food debris from the stomach back up into the food tube, causing a burning sensation in the chest and indigestion. This happens when a valve at the top of the digestive system that connects the food tube and the stomach doesn’t close properly. Omeprazole is used to reduce acid in the stomach and therefore lessen irritation caused by rising stomach contents. So if the problem is a faulty valve, the tablets will not solve it.
The worst thing you can do is lie down in bed, as food travels in the wrong direction when you’re lying flat. Try to sleep more upright, or on your side, rather than lying flat. You can also ask your GP if they would suggest over-the-counter medicines like Gaviscon.
Irritable bowel syndrome (IBS) is a separate condition from reflux. It affects the lower part of the digestive system and usually involves pain, constipation, or loose bowel movements.
There is no cure, but there are specific treatments, such as peppermint oil capsules for swelling or antispasmodic medications for pain.
The guidelines recommend trying a daily probiotic for a month to see if it helps with any symptoms.
I have type 2 diabetes which is treated with gliclazide. The morning dose keeps my blood sugar levels at acceptable levels throughout the day, but my readings before breakfast are always high. Is it the wrong medicine?
Treatment for type 2 diabetes is aimed at preventing long-term complications, such as heart disease and kidney damage. Instead of using daily blood sugar targets, it is recommended that type 2 diabetics have their blood tested every three to six months to look for levels of something called Hba1C.
This tells us about blood sugar control over the long term, rather than on a specific day.
Regular blood sugar checks are not recommended for type 2 diabetics unless they are taking insulin or have regular episodes of low blood sugar (hypoglycemia).
Gliclazide is a diabetic aid known as a sulfonylurea. It helps the pancreas to produce more insulin to lower the level of glucose in the blood. It also helps the body’s cells to use insulin more effectively.
Sulfonylureas would typically be given as a secondary medication along with metformin or as an initial starter medication. If there are problems with gliclazide, such as not keeping blood sugar levels stable or causing side effects, there are other options.
Metformin is the most frequently offered drug; it is usually given first, depending on other health problems. There are also other sulfonylurea tablets.
Diabetes care also involves regular checks of the eyes, kidneys, and feet, all of which are taken into account when evaluating which medication is most effective.
Direct GP referrals save lives
Starting this month, GPs will be able to refer patients directly for exams and cancer scans, bypassing specialists and speeding up diagnoses.
It’s a brilliant idea and one that should have come into effect a long time ago.
For a long time I thought it was time to redefine the role of GPs amid increasing demand in almost all areas of healthcare.
Many appointments with patients’ GPs are relatively pointless, a waste of time for us and for them. Often we are simply an intermediary, connecting them with specialists who can offer tests. Or we see patients with coughs, colds, aches and pains about whom we can do little, the professional they need is usually a pharmacist or a physiotherapist.
Therefore, anything we can do to speed up diagnosis and treatment of patients, and save valuable time for the GP, is a success.
STIs don’t just catch young people…
Do you have a question for Dr. Ellie?
Email DrEllie@mailonsunday.co.uk or write to Health, The Mail on Sunday, 2 Derry Street, London, W8 5TT.
Dr. Ellie can only respond in a general context and cannot respond to individual cases or give personal answers. If she has a health problem, she always consults her own GP.
Would it surprise you if I told you that sexually transmitted infections are increasing among those 65 and older? Well they are. Since 2017, gonorrhea and chlamydia cases in this group have increased by 20 percent, according to a study by the Association of Local Governments released last week.
The news didn’t surprise me at all – it’s a trend GPs have been noticing for a while now. Many of these people are newly single in midlife after divorce or death of a partner, and have been using dating apps and websites with enthusiasm.
However, at this age, couples often do not consider using condoms, as they think contraception is not necessary.
It’s not uncommon for me to see women who have been suffering from symptoms for some time and attribute them to a myriad of other things, such as menopausal symptoms. I have to tell you: they have contracted an STI. Of course, this is nothing to be ashamed of, but they are often dumbfounded.
I’m interested to know if anyone has experience with this and how you were treated when you sought help or advice. Write me and tell me at the email address DrEllie@mailonsunday.co.uk.
Since 2017, cases of gonorrhea and chlamydia in people over the age of 65 have increased by 20%, according to a study by the Association of Local Governments published last week.