For years I have suffered from a runny nose. At night it falls down my throat like a waterfall. My eyes also water and I cough constantly. I have been given nasal sprays but nothing works. What do I have to do?
Some people may experience an incessant runny nose without a clear cause, called chronic non-allergic rhinitis, writes Dr. Ellie.
Dr. Ellie answers: A runny nose is often caused by rhinitis, which is where the nasal passages become inflamed. It is also caused by colds and other infections, as well as allergies such as hay fever.
However, some people may experience the condition without a clear cause, called chronic non-allergic rhinitis.
This can last for some time and cause unpleasant symptoms such as congestion, sneezing and postnasal drip, which can lead to coughing and sleep disturbances.
Several medications can trigger this problem, including blood pressure pills and anti-inflammatory pain relievers.
There is also a specific problem called rhinitis medicament which, interestingly, is caused by excessive use of nasal sprays and decongestants. Long-term rhinitis can even be triggered by working with industrial chemicals, regularly drinking alcohol, or eating spicy foods.
In some cases the symptoms may be caused by a physical problem in the nose. This could 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 detected by looking with a camera. If it is caused by polyps or a deviated septum, there are surgical options available. This may involve removing the polyps or correcting the shape of the septum.
It is also possible, in rare cases, that chronic rhinitis is caused by nerve damage.
They recommended I wear compression stockings for poor circulation. However, I have a hard time putting them on and they come down when I walk. 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 cause painful swelling in the extremities, but also increase the risk of blood clots.
Compression stockings (tight knee-high socks) put pressure on the blood vessels in your legs, pushing blood upward.
While they are effective, it is common for people to have problems with them. However, it is important to move forward as they can have great benefit and save lives.
Fortunately, stockings come in a variety of sizes and strengths, referring to how much pressure is exerted. A pharmacist is usually the best person to talk to when finding the right stocking, and can measure your legs to make sure the correct size is used.
Also, consider putting on your socks first thing in the morning, as this is when your legs tend to be least swollen.
If a patient really has difficulty putting it on, a GP can prescribe a medical device called ActiGlide. This is a plastic sheet that is placed over the foot and leg to help put on the stockings.
I am 76 years old and I have been suffering from anal fissure for a year. My GP has been very helpful. Is there anything I can do to relieve the pain?
Dr. Ellie answers: A fissure is a tear in the opening of the anus that can cause excruciating pain. As a result, patients often put off going to the bathroom and end up with constipation.
Fissures can be caused by an infection, diarrhea or constipation. However, a new fissure can also be a sign of bowel cancer, so the problem always requires examination. A GP can order a stool test to check for cancer and can refer patients to hospital for further checks if necessary.
For most patients with a fissure, the main thing they need is pain relief.
Over-the-counter pain relievers such as acetaminophen or ibuprofen can help. However, many patients benefit from
a numbing cream that can be applied to the fissure before going to the bathroom. This can be prescribed by a GP.
Some people also find that sitting in a warm, shallow bath relieves pain.
If the pain continues despite these approaches, then 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 relieve pain and some patients report severe headaches while using it. GTN is also not given to patients with certain heart problems or a history of migraines.
In addition to these measures, it is vital that someone who has a cleft eat foods rich in fiber or use a laxative to keep bowel movements soft. This is because straining when going to the bathroom can make cracks worse. It is also important to drink plenty of water, which will help with bowel movements.
- Write to Dr. Ellie. Do you have a question for Dr. Ellie Cannon? Email DrEllie@mailonsunday.co.uk
- Dr. Cannon cannot engage in personal correspondence and her responses should be taken in a general context.
Once rare, now Scabies is everywhere
In recent years there has been a significant increase in patients coming to my office with scabies.
The unpleasant (and agonizing) mite infection was not something I saw regularly when I started as a GP almost two decades ago. I now see patients with the telltale blotchy, distressingly itchy rash every month.
New data was published last month showing that scabies infections have quadrupled in the last 15 years in the UK. It’s not entirely clear why this happened, but some research suggests that these highly contagious insects are becoming resistant to existing treatments.
Whatever the cause, it is worrying because scabies spreads easily and is difficult to get rid of. If you recently suffered from scabies, do you know where you got it? Please write to me and let me know: Email DrEllie@mailonsunday.co.uk