For years I’ve suffered with a runny nose. At night it falls down my throat like a waterfall. It also makes my eyes water and I’m constantly coughing. I’ve been given nasal sprays but nothing works. What should I do?
Some people can experience incessant runny nose with no clear cause – which is called chronic non-allergic rhinitis, Dr Ellie writes
Dr Ellie replies: Runny noses are often triggered by rhinitis – which is where the nasal passages become inflamed. Colds and other infections, as well as allergies such as hay fever, also cause it.
However, some people can experience the condition with no clear cause – which is called chronic non-allergic rhinitis.
This can last for some time and lead to unpleasant symptoms such as congestion, sneezing and post-nasal drip, which can cause coughing and sleep disturbance.
A number of medicines can trigger this problem, including blood pressure pills and anti-inflammatory painkillers.
There is also a specific problem called rhinitis medicamentosa which, strangely, is caused by the overuse of nasal sprays and decongestants. Long-running rhinitis can even be triggered by working with industrial chemicals, regularly drinking alcohol or eating spicy food.
In some cases the symptoms can be caused by a physical problem in the nose. This might be due to tissue growths called polyps, or a deviated septum – where the wall between the two nostrils is not straight.
Any structural issue is usually found by having a look with a camera. If it is caused by polyps or a deviated septum, there are surgical options available. This might involve removing the polyps or fixing the shape of the septum.
It is also possible, in rare cases, that chronic rhinitis may be caused by nerve damage.
I’ve been advised to wear compression stockings for poor circulation. However, I struggle to get them on, and they roll down when I walk about. Can you recommend alternatives?
Dr Ellie replies: Compression stockings are used to treat blood circulation problems in the legs. In older people the body sometimes struggles to pump blood from the feet and legs. It can lead to painful swelling in the limbs, but also raise the risk of blood clots forming.
Compression stockings – tight, knee-high socks – put pressure on the blood vessels in the legs, forcing blood upwards.
While effective, it is common for people to struggle with them. However, it is important to stick with it as they can have a big benefit – and save lives.
Thankfully, the stockings come in a variety of sizes and strengths – referring to how much pressure is provided. A pharmacist is usually the best person to speak to about finding the right stocking, and they can measure the legs to ensure the correct size is used.
Also, consider putting the stockings on first thing in the morning, as this is when the legs tend to be the least swollen.
If a patient is really struggling with getting them on, a GP can prescribe a medical device called ActiGlide. This a plastic sheet that is fitted over the foot and leg to help get stockings on.
I’m 76 and have been suffering with an anal fissure for the past year. My GP has been very unhelpful. Is there anything I can do to relieve the pain?
Dr Ellie replies: A fissure is a tear in the opening of the back passage that can cause excruciating pain. Patients often put off going to the toilet as a result, and end up with constipation.
Fissures can be triggered by an infection, diarrhoea or constipation. However, a new fissure can also be a sign of bowel cancer – for this reason the problem always warrants an examination. A GP can order a stool test to look for cancer, and can refer patients on to hospital for further checks if necessary.
For most patients with a fissure, the main thing they require is pain relief.
Over-the-counter painkillers such as paracetamol or ibuprofen may help. However, many sufferers benefit from
an anaesthetic cream which 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 the pain.
If the pain continues despite these approaches, then there is a cream called glyceryl trinitrate (GTN) which can 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 bad headaches while using it. GTN is also not given to patients with certain heart problems or a history of migraines.
Alongside these measures it is vital that someone who has a fissure eats high-fibre foods or uses a laxative to keep the bowel movements soft. This is because straining while going to the toilet can make fissures 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 [email protected]
- Dr Cannon cannot enter into personal correspondence and her replies should be taken in a general context.
Have you been hit by the new super-norovirus?
Hospital bosses last week warned of a ‘super-norovirus’ sweeping the country. A new and aggressive variant is a frightening prospect – particularly for older adults and care home residents who are often the most severely affected.
Symptoms are the same as regular norovirus, and include chills, fever and headaches, as well as explosive vomiting and diarrhoea.
While the stomach bug usually goes away on its own within two to three days, some people may need to be hospitalised.
There isn’t a specific treatment for the virus other than rest and lots of fluids, and while most people recover it can kill.
Figures released by the UK Health Security Agency on Thursday revealed that cases had jumped 41 per cent in a fortnight.
I’m keen to know if anyone has been caught up in the outbreak. Have you or a family member experienced this new winter bug? Please write in and let me know if so.
Once rare, now SCABIES is everywhere
Over the past few years there has been a significant surge in patients coming to my surgery with scabies.
The nasty – and agonising – mite infection was not something I saw regularly when I started out as a GP nearly two decades ago. Now I see patients with the tell-tale spotty rash and distressing itch every month.
New data was published last month that shows that scabies infections have risen four-fold over the past 15 years in the UK. It’s not entirely clear why this has occurred, but some research suggests the highly contagious bugs are becoming resistant to existing treatments.
Whatever the cause, it’s worrying because scabies are easily spread and hard to get rid of. If you recently suffered with scabies, do you know where you picked them up? Please write and let me know: Email [email protected]