DR. ELLIE CANNON: If lotions and pills don’t relieve my very itchy skin, what will?

I am 85 and have had severe itching all over my body for three weeks. A slight rash appears in some places, but the itching is just as bad when there is no rash. The doctor prescribed prednisolone and some lotion, neither of which helped. The GP then added fexofenadine, again with no effect. Should I ask for a blood test?

It is not uncommon for people to go to the doctor with complaints of itchy skin, often without a rash. It can be caused by many different skin problems such as eczema and psoriasis, allergic conditions such as urticaria, or infections such as scabies.

But many people with itching have no visible problems with their skin. Non-skin conditions account for about a quarter of itchy patients and are more common in older patients.

It can be the result of kidney or liver disease, both of which can be detected by a blood test. Thyroid problems and blood disorders can also cause itching. Although unlikely, it could be a symptom of some type of blood cancer, such as multiple myeloma or Hodgkin’s lymphoma. For this reason, it is important to have blood tests as your first port of call.

Itching can also be a side effect of a number of medications, including blood pressure medications, diuretics, heart medications such as digoxin, statins, and opioid pain relievers.

Hydroxyzine, a prescription antihistamine, can help stop itching, and water-based creams containing menthol can soothe the skin. Steroids such as prednisolone are unlikely to help unless there is an allergic or inflammatory problem.

Wash in cold water without bubble baths or perfumed products. When the heater is on, the air in the house can be very dry, so placing a wet towel on top of a heater can help moisturize and hydrate the skin.

After ten years of stomach problems I had a scan which showed my bowel was narrowed in one place. A follow-up scan showed that one of my valves had not closed completely. The family doctor prescribed omeprazole, but it didn’t help. I tried over the counter medicine and herbal supplements and avoided certain foods, but nothing worked. Please help me – I can’t sleep due to constant gurgling and stomach pain. I also suffer from irritable bowel syndrome.

Acid reflux is common. This happens when acid and food particles from the stomach back up into the esophagus, causing a burning sensation in the chest and indigestion. It happens when a valve in the upper part of the digestive system that connects the esophagus and stomach does not close properly. Omeprazole is used to reduce stomach acid and thereby reduce irritation of the stomach contents. So if the problem is a faulty valve, the pills won’t fix it.

The worst thing you can do is lie down in bed because the food will move the wrong way in a horizontal position. Try sleeping more upright or on your side instead of lying all the way down. You can also ask your doctor if they recommend over-the-counter medications like Gaviscon.

Irritable bowel syndrome (IBS) is a different condition than reflux. It affects the lower part of the digestive system and is usually accompanied by pain, constipation or loose bowel movements.

There is no cure, but there are specific treatments such as peppermint oil capsules for bloating or antispasmodic medication for pain.

Guidelines recommend trying a probiotic daily for a month to see if it relieves symptoms.

I have type 2 diabetes which is treated with gliclazide. The morning dose keeps my blood sugar at an acceptable level throughout the day, but my readings are always high before breakfast. Is it the wrong drug?

Treatment for type 2 diabetes focuses on preventing long-term complications, such as heart disease and kidney damage. Instead of using daily blood sugar goals, people with type 2 diabetes are advised to have a blood test every three to six months to measure something called Hba1C.

This tells us more about long-term blood sugar control than about any given day.

Regular blood sugar testing is not recommended for type 2 diabetics unless they take insulin regularly or have low blood sugar levels (hypoglycemia).

Gliclazide is a diabetic adjuvant known as a sulfonylurea. It helps the pancreas to produce more insulin to lower blood sugar levels. It also helps the body’s cells to use insulin more effectively.

Usually, sulfonylureas are given as a second medication in addition to metformin or as a first starting medication. If there are problems with the gliclazide, e.g. B. if it does not keep blood sugar stable or if it causes side effects, there are other possibilities.

Metformin is the medicine most often offered – usually given first, depending on other health conditions. There are also other sulfonylurea tablets.

Diabetes care also includes regular eye, kidney, and foot exams, which are taken into account when determining which drug is most effective.

Direct GP referrals save lives

From this month, GPs will be able to refer patients directly for cancer screenings and scans, bypassing specialists and speeding up diagnoses.

This is a brilliant idea and should have been implemented a long time ago.

I have long believed that the time has come to redefine the role of general practitioners, given the increasing demand in almost every area of ​​healthcare.

Many GP appointments with patients are relatively pointless – a waste of our time and theirs. Often we are just an intermediary and put you in touch with specialists who can offer tests. Or we see patients with a cough, runny nose, pain that we can do little about – the specialist they need is usually a pharmacist or physiotherapist.

Anything we can do to speed up patient diagnosis and treatment – and save valuable GP time – is a win.

Sexual infections do not only catch young people…

Would you be shocked if I told you STDs are on the rise among the over 65s? Well they are. Since 2017, the number of cases of gonorrhea and chlamydia in this group has increased by 20 percent, according to a study by the Local Government Association published last week.

I was not at all surprised by the news, it’s a trend that GPs have been noticing for some time. Many of these people are not single until middle age after divorce or the death of a partner and are avid users of dating apps and websites.

However, partners of this age often do not think about using condoms because they think that contraception is not necessary.

It is not unusual for me to see women who have had symptoms for a while and blame them on a host of other things, such as menopausal symptoms. I have to tell you, you contracted an STI. Nothing to be ashamed of of course, but they are often amazed.

I wonder if anyone has experience with this – and how you were treated when you sought help or advice. Write and email me DrEllie@mailonsunday.co.uk.

Since 2017, gonorrhea and chlamydia cases have increased by 20 percent in people over 65, according to a study released last week by the Local Government Association