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Health Q&As with our online GP
Dr Margaret, our GP answers a range of readers' questions about restless legs, anti-malarial drugs, gastric balloons and more
Stomach pain after eating
Q: I have had stomach trouble for a number of years and various tests done but it is getting so bad now that it is ruling my life. I am 67 years old and have fibromyalgia and chronic osteoarthritis. The problem is that I have great difficulty after meals when it feels as if there is a big lump above my waist and is so uncomfortable. My meal seems to take hours to go down. It was suggested that it could be connected to the fibromyalgia because the muscles aren’t working properly. What do you think?
A: You do not mention what tests you have had but I wonder if you have had an endoscopy - a method of looking directly at the stomach and oesophagus via a fibre-optic tube? This is particularly useful if you have reflux, with or without a hiatus hernia, which could be a cause of your symptoms. I don't see, however, that they could be connected with your fibromyalgia. There are also various tablets that can assist the speedy emptying of the stomach. Have you tried these? For example, you could try Motilium, now available over the counter, taking a tablet about an hour before a meal. If this is not effective I can only suggest that you ask for a referral to a hospital specialist in gastric medicine.
Restless sleeper
Q: My husband, 71, has always snored loudly. In recent years, he has also started shaking violently for a few minutes at a time whilst asleep, throughout the night, and often his whole body jerks suddenly. He has restless legs in the evenings, too. He says he is unaware of this night-time problem, but it is difficult to sleep and he often wakes me. He can't be getting good rest, either. He has no energy at all during the day, and is very apathetic.
A: It sounds as though your husband has two separate problems. The jerking you describe could be myoclonus, a condition that is annoying but usually benign and nothing to worry about. As for the restless legs, if simple measures fail, like exercising the legs before bedtime or massaging them, it would be worth consulting your doctor since there is now medication available for difficult cases especially as your husband is suffering from fatigue. Another option would be to ask for a referral to a sleep clinic where the patient stays overnight and problems like excessive snoring can be investigated and treated.
Polyp fear
Q: Polyps seem to run in the family; my sister had them in her ovaries, my grandfather in his nose. I think I have something similar in my vagina: a small wart which I had for years has suddenly become larger. Should I see a doctor? Very embarrassing.
A: You can be reassured that there is not connection between polyps in the nose and those in the ovaries and in the vagina. The lump you have noticed may be a polyp but it could also be a common benign lump called a Nabothian follicle or even a wart. Don't be shy of consulting your GP about it for reassurance. You may find that your practice has a woman doctor you might prefer to see, or even an experienced practice nurse who is used to doing cervical smears.
Anti-malarial drugs for a vegetarian
Q: I am a vegetarian and all the anti-malarial drugs that I have tried to buy over the counter are not suitable for vegetarians. Do you know any which are suitable for vegetarians? Or indeed any brands which I could get a prescription for?
A: I am surprised that you have found it difficult to find malaria pills suitable for vegetarians as the only type of medication that can commonly present a problem are capsules, which can contain gelatine. The only common anti-malarial to be in capsule form is doxycycline, but even this can be obtained in a dispersible tablet form. Of course the most important thing is to get the right antimalarial for the area you intend to visit since there is a lot of resistance to older products in some areas. Do consult your GP or pharmacy about this.
Blood pressure and pulse rate
Q: Please explain the connection between my blood pressure readings and my pulse rate.
A: Blood pressure is a measure of the pressure exerted by the heart in circulating the blood and the pulse indicates the number of times the heart beats per minute. So when the body requires a high level of oxygen, for example when running fast, both the blood pressure and the pulse rate will increase to respond to the demand. But if the blood pressure drops suddenly the pulse rate will increase to make up the deficit. This is why you get a fast pulse when you are ill with a fever. However, if you suffer from high blood pressure you may be given a beta blocker, a medication which reduces both the blood pressure and the pulse rate, though other drugs may both lower the BP and increase the pulse rate.
Gastric balloons
Q: My husband has been told he would benefit from a bypass operation which would make his life much easier. However he was also told he must lose weight and he has lost some. I found an advert in an American magazine for a plant based gastro-ball (no surgery involved) in which you can lose app.3lbs per 24 hours. Is this a dangerous method or is it normal in the US?
A: There have been various trials in recent years of introducing balloons into the stomach so that the patient feels full and, hopefully, eats less. However, they have not been very successful and I should be especially suspicious of a 'plant based gastroball' which makes such unlikely claims. If your husband has already seen a surgeon about a bypass operation I suspect he is very overweight and needs quite a drastic approach - although it is encouraging that he has managed to lose some weight already. But if he and you have doubts about it perhaps you should discuss other approaches with his surgeon - he will certainly be able to give you an opinion on gastric balloons. If he does not have another appointment before the operation, you could ask your GP to arrange another one.
More from Dr Margaret
- Thigh tremors; stiff shoulder; bunions; platelets; mixing medicines with supplements.
- Aspirin for arthritis; erratic thyroid; seeing spots; sex and arteritis; abdominal pain.
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Information on this site is for interest only and is not a substitute for professional medical advice. You should consult your own doctor about any specific health concerns.
