From incontinence to spider veins… Dr Zoe Williams answers YOUR questions | The Sun

From incontinence to spider veins… Dr Zoe Williams answers YOUR questions | The Sun

WE all worry about our health sometimes – it’s only natural.

But if your concerns are taking over and it’s all you can think about, it is time to seek help.

You might be putting it off due to embarrassment, or because you don’t want to waste your GP’s time.

But I am here to tell you it is important to take care of yourself and ask for support when you need it.

Here are this week’s reader questions . . . 

Q: WHEN I need to urinate, I have to do so almost immediately. The urgency is upon me and there is no waiting. I have tried pelvic-floor muscle exercises to no avail.

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I have sometimes had a wee then returned to the bathroom within an hour to go again. This is now affecting my day-to-day living and my confidence is waning.

If I go out, I need to know there are public toilets close by. What is happening?

When the symptoms you describe are associated with leakage, this is urge incontinence, and it’s different.

This is when the detrusor muscles of the bladder wall are overactive and essentially contract and try to squeeze the urine out of the bladder before you are ready for them to do so.

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So you have a very sudden, urgent need to go to the loo, sometimes before your bladder is full, and sometimes so urgently that you don’t get there in time.

Sometimes people experience both stress and urge symptoms and we call this mixed incontinence. Pelvic-floor training is a good place to start for all types, but it won’t be the solution for everyone.

There are many possible treatments, ranging from lifestyle changes, devices, cognitive behavioural therapy and medication through to surgery.

A good next step for you would be “bladder training”. This will help you regain control of your overactive bladder by suppressing its contractions.

There is a helpful resource on the NHS website at ruh.nhs.uk. It’s also worth noting that stress and anxiety can make the bladder more overactive. If things don’t improve, you should explore next steps with your GP.

Q: I AM absolutely beside myself and really don’t know which way to turn. I have irritation down below that I have suffered from for years. I am very clean and I do not have an intimate relationship.

I used to think it was connected to when I had a period. I have had this for more than 20 years, but it seems to be getting worse. It doesn’t stop. I drink cranberry juice, I have used live yoghurt, I have had internal tablets and different creams.

I just can’t stand it any longer. I am shouting at people, I get road rage and at 66 I can’t be doing that. The irritation is just outside the vagina entry.

When I spoke to a doctor’s receptionist she said she went to a dermatologist. Please help me – is there anything I can do?

A: I’m so sorry that you are experiencing this infuriating symptom. It sounds like you are at your wits’ end. First and foremost, it is important to determine if there is an underlying disease. Potential causes include infections and skin conditions such as eczema and psoriasis.

A severe vulval itch may also be due to inflammatory conditions such as Lichen simplex, Lichen sclerosus or Lichen planus. With any of these you would expect there to be some additional findings alongside the itch, and I’m guessing you have been assessed by your GP numerous times over the years.

If medical assessment finds no cause or skin condition, then this problem is referred to as “pruritus vulvae”, which quite simply translates as itchy vulva.

The most common cause is actually irritation from something that the vulval skin is coming into contact with. This can be fabrics, dyes, soaps, semen, etc. but it can also be your own natural secretions.
Too much washing can also cause irritation. Lack of oestrogen related to menopause can be a cause too.

If you’ve never seen a dermatologist, I would request a referral as they would be able to consider taking a skin biopsy of the area, which may be necessary to determine exactly what’s going on.

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If you haven’t already, some things that could be tried while waiting for the dermatology appointment are: anti-histamine tablets and hydrocortisone cream, which can be used safely and bought without a prescription.

If hormone depletion due to menopause is a possibility, then topical oestrogel, applied to the affected area, is worth a try.

Your spidery quest is in vein

Q: WHY do I keep getting loads of spider veins on my feet and ankles and why are they painful? What can I do to help stop them developing and is there anything I can put on them?

A:  Spider veins usually appear as  blue, purple or red dilated small veins that are visible on the skin. They are caused by venous insufficiency — the term for when your leg veins don’t allow blood to flow back up to your heart. It also causes varicose veins, which tend to be larger.

Let me explain. The job of most veins is to carry deoxygenated blood from the body, back to the heart. Veins have a one-way valve that closes once the blood goes through it to prevent it flowing backwards.

If this valve stops working properly due to damage, the blood can then flow backwards and it can build up in the veins. This can eventually cause these veins to become visible and appear as either spider or varicose veins.

Both are especially common in the lower legs, like in your case, because legs are the limbs furthest from the heart, and the blood flow also has to work against gravity, flowing upward.

However, it is possible for them to appear on any part of the body. Spider veins are not usually painful, but if you also have varicose veins, in some people they can cause itching and aches or burning pain.

If your spider veins are actually sore to touch, then I would advise getting this checked by your GP to make sure they are actually spider veins.

Whether or not you get spider veins is largely down to genetics, but being active and maintaining as healthy a weight as possible can help to reduce the risk. There isn’t anything you can put on them to get rid of them.

There are some treatments, but these are only available in the private sector, because spider veins are usually only bothersome from a cosmetic appearance point of view. The main treatments are either by laser, or injections into the veins, which is called sclerotherapy.

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