My husband has an enlarged prostate and takes the drug tamsulosin. The problem is that his body now gives off an unpleasant odour which I can smell all over the house. What can he do?
Dr Ellie Cannon replies: Tamsulosin can be a very effective treatment for an enlarged prostate.
It tackles one of the most common and uncomfortable symptoms of the condition – difficulty urinating – by relaxing the bladder congestion.
But it can have some unwanted side effects, including dizziness, dry mouth and heart palpitations. However, some patients may also experience excessive sweating – and this may lead to worsening body odour.
One possible solution would be to switch medication.
The tablet finasteride is one of the most commonly prescribed treatments for enlarged prostate, so it might be worth trying.
But there are other possible causes of body odour.
Some medicines, such as antidepressants, are linked to bad body odour
People with obesity, as well as those with kidney or liver disease, are more likely to suffer with bad odour.
Some medicines, such as antidepressants, are also linked to the problem.
I have a painful verruca, and have tried all the usual remedies at the chemist to no avail. I went to my GP for help, but she said doctors don’t deal with them. What other options do I have?
Dr Ellie replies: A verruca is a type of wart that grows on the sole of the foot.
They’re caused by a virus called human papillomavirus (HPV), that is usually picked up from walking barefoot in contaminated places – such as public showers.
People with breaks in the skin of their feet – also known as fissures – are more at risk.
In the past, GPs offered cryotherapy – a freezing treatment – but this is no longer funded by the NHS. Despite verrucas being highly infectious, and often painful, guidelines now state we are supposed to tell patients to simply leave them alone.
This is not an ideal situation. Verrucas do eventually go away on their own, though this can take years. One over-the-counter treatment is a cream called salicylic acid, which is applied every day for three months. But it is often ineffective, so can mean having to pay a podiatrist for treatment.
On rare occasions, a GP might refer a patient to hospital, but this would only be for those with multiple verrucas or a weakened immune system that makes it difficult for the body to clear the infection.
One at-home remedy is the duct tape method. This involves covering the verruca with duct tape for six days, before soaking in warm water and rubbing it with an emery board or pumice stone. This is repeated for two months. Research suggests that it is as effective at seeing off the verruca as cryotherapy.
For more than three years, I’ve had a pain in my back passage. It feels like it’s constantly under pressure – as though there’s something lodged in there. My consultant prescribed me nortriptyline, but I read online that it can trigger depression and other side effects. What should I do?
Dr Ellie replies: Problems that affect the bottom are distressing – they’re not only uncomfortable but can also affect bowel movements.
Feeling a constant pressure in the rectum is a condition called tenesmus. Patients often feel a constant need to go the toilet, even after they’ve just been.
It can also trigger bowel spasms and cramps, which can be very uncomfortable.
Tenesmus can be a sign of inflammatory bowel disease, such as Crohn’s or ulcerative colitis. However, these are usually accompanied by other distressing symptoms such as diarrhoea and bloody stools.
In rare cases, cancer can also be a cause, which is why a colonoscopy – a tiny camera that checks inside your bowels – would always be advised.
However, many people experience tenesmus which is not linked to an underlying issue – and when the cause cannot be found it’s harder to treat.
There is evidence that tenesmus is linked to stress or anxiety. While they may not be the cause of the pain, they may aggravate it.
Two common treatments for tenesmus are amitriptyline and nortriptyline, which are types of antidepressants that can combat nerve pain and reduce the sensation of needing to go to the toilet.
Like all drugs they can cause side effects, including dizziness, constipation, dry mouth and –
in rare cases – depression. However, for the vast majority of patients they are safe, so it’s worth giving them a go if other treatments have failed.
Moreover, it can sometimes takes several weeks for any effect to be felt, so it’s important that patients stick with the tablets before giving up.
Have dizzy spells left you spinning in limbo?
Thousands of Britons are battling chronic dizziness – which can sometimes last for months
Over Christmas, I suffered a bout of severe dizziness that left me feeling fragile and disorientated.
Thankfully, it passed after ten days. But it left me wondering whether the NHS is well-equipped to handle this extraordinarily common problem.
Thousands of Britons are battling chronic dizziness – which can sometimes last for months – and, often, doctors cannot find the exact cause.
When this happens, there are very few treatments the NHS can offer patients.
However, in many cases, GPs do not treat the problem as a serious issue. And perhaps we don’t spend enough time with patients discussing their possible options.
It’s easy to feel ignored when you have a unseen medical problem which doesn’t have a clear diagnosis.
Have you suffered with dizzy spells and felt fobbed off by your GP? Write and let me know, as my team at The Mail on Sunday plan to investigate.
No way to free up NHS beds
I was horrified to read last week about a vulnerable woman who was forced to leave an NHS hospital after she was threatened with a £600 fine.
According to a report, which first appeared on MailOnline, the woman was still suffering with a chest infection and ‘looked like she weighed five stone’.
However, staff at a South East London hospital told her that she would need to leave in order to free up a hospital bed for a new patient.
I have never heard of this happening before, but I’m not surprised. For years, now the NHS has suffered from a lack of hospital beds due to delays discharging elderly or vulnerable patients.
But this is a problem triggered by our ailing social care system, which means it is difficult to find homes or care workers to look after frail patients once they leave hospital.
Fining people who haven’t found somewhere to go is not only heartless, but it also won’t fix the underlying issue.
Have you ever been fined or threatened with one for staying in hospital too long? Write and let me know.
