I’ve always been slim but for the past five years my tummy has been bloated, more on the right side. I also have backache and if I eat more than a starter I feel bloated and nauseous. Tests have ruled out bowel cancer but I do suffer from diverticulitis and acid reflux. I’m 85, 5ft 5in and weigh 8st.
Wendy Smith, Surrey.
Clearly, it’s time you had a diagnosis. If you were my patient, the first thing I’d want to know is whether you’ve become shorter or lost weight, for reasons I’ll explain.
Most bloating is generalised. It’s unusual for one side only to be affected and this makes me wonder if it is related to organs on that side – the right-hand section of the colon (which could be related to your diverticulitis), or your right kidney.
Diverticulitis is a condition where diverticula, small pouches that form in the intestinal wall as we age (by the age of 80, around 70 per cent of people have them), become inflamed.
I’ve always been slim but for the past five years my tummy has been bloated, more on the right side. I also have backache and if I eat more than a starter I feel bloated and nauseous
While diverticula mainly affect the colon on the left side, it’s possible that scarring and stricture (narrowing) there could cause backup and swelling of the colon on the right-hand side.
However, you don’t mention changes in bowel habits and, if this was the cause, it would have got worse over the five years.
So could the issue be your right kidney is not draining properly into the bladder? Again, you’ve not mentioned pain or urinary symptoms.
Your backache could be a sign your spine has ‘collapsed’ to a degree – common with age and due to the discs between the vertebrae or the vertebrae themselves, or both, degenerating.
This could cause your spine to shift on the right, with bloating caused by the change in shape of your torso – including your organs shifting position.
This might also, in turn, play a role in your acid reflux and nausea after eating. The fact that you’ve not lost weight and your clear bowel cancer check is reassuring, but chronic bloating in women needs checking.
You need a careful examination of your abdomen and an inspection of the alignment of your spine, followed by a CT scan of the abdomen to reach a diagnosis.
Diverticulitis is a condition where diverticula, small pouches that form in the intestinal wall as we age (by the age of 80, around 70 per cent of people have them), become inflamed
Three of my husband’s brothers have Parkinson’s disease and he has early signs such as stiffness, loss of smell and violent dreams. But his GP won’t diagnose him until he develops a tremor.
Grace Jackson, Lancashire.
Parkinson’s occurs when brain cells that make dopamine, a chemical messenger essential for movement, die off, leading to trembling, stiffness and a shuffling gait.
Other warning signs can also occur years earlier. For instance, loss of sense of smell, severe constipation, depression, apathy and restless-leg syndrome.
Acting out dreams is another indicator of future Parkinson’s and, in your longer letter, you say your husband has begun to shout and kick in his sleep.
Some changes to motor skills can occur early on, too, such as swinging the arms less when walking and handwriting that gets smaller with each word.
But while someone with one or more of these symptoms has a higher probability of developing Parkinson’s, they won’t definitely develop it – so they can’t be used to diagnose the disease, as your GP has pointed out.
Currently, there are no drugs to delay or stop patients slipping from this initial stage into Parkinson’s. But I was heartened to hear that your husband has been accepted on to a clinical trial, as even just being on a trial can have a positive effect.
There’s some evidence for lifestyle changes. An exercise programme that focuses on strength, balance and coordination during the earliest stages can be of great value (there are physiotherapists who specialise in this).
And a Mediterranean-style diet can be beneficial. Taking a proactive approach, as you have, will surely stand your husband in good stead.
In my view… Striking now has been a grave error
At the risk of irritating readers, I do feel some sympathy for resident doctors – the strikes aren’t just about money, but also about working conditions and the problem of too few specialist training posts for the number of graduates emerging from medical school.
Things were easier when I was training back in the 1970s.
But ignoring pleas not to strike over this worrying time for the NHS, with flu cases spiking, seems to me to be risking the universal good reputation of doctors generally. Many now regard these striking doctors as rapacious, greedy and non-caring – no longer the heroes in healthcare, a reputation that’s going to be difficult to re-establish.
They’re also increasingly sacrificing any goodwill amongst their senior colleagues, now quietly venting their fury at the burden of the apparently endless strikes. When I mentioned ‘vocation’ at a recent debate it was met with howls of derision from consultant specialists – that’s long gone, I was told.
I don’t think this augurs well for doctors’ autonomy and respect in the decades to come. But they must lie in that bed and suffer the loss.
