‘This is not a symptom you should ignore’ – Dr Zoe urges reader to seek urgent help for strange bowel sensation
I TURNED 45 last week and it got me reflecting on age and health.
I saw a social media post saying scientists had found that we age dramatically in two bursts, once at 44, then again at 60 – and the first bit certainly rang true for me.
The team behind the Stanford University study found the burst at 44 is associated with changes in how the body processes alcohol, caffeine and fat.
The burst at 60 is linked to immune and kidney function and muscle loss, while both ages saw a shift in heart health. In the past year, I’ve been plagued with back issues and had a heart scare that landed me in hospital.
The study suggests that our 40s and 60s are key times to monitor health and adopt healthier habits.
For me, it’s drinking less, spending more time in nature to de-stress, and trying not to sweat the small stuff.
What are you working on this year?
Here’s a selection of what readers have been asking me this week . . .
LYING DOWN MAKES ME NEED THE LOO
Q: SOMETIMES I get a worrying sensation when I am either sitting on the sofa or lying down, as if I need to go to the toilet to open my bowels.
When I get up, the feeling disappears. Obviously, I go to the toilet at other times, but I can’t understand why I get this strange feeling.
I am 61 years old. A blood test came back OK, but I am always falling asleep.
A: This is a symptom that you should not ignore.
From the information you have provided, I’m not certain if you are describing tenesmus, which is the sensation of needing to pass stool, even after the bowels have been emptied. It can involve straining and discomfort.
Tenesmus is felt in the rectum and anus and can be accompanied by abdominal cramping and rectal pain.
Alternatively, if the sensation of needing to poo is predominantly in the abdomen, then this could be a sign of something putting pressure on the rectum from inside the body.
This could also give some explanation for why the symptom is alleviated by standing up, as standing could remove that pressure.
Either way, it is important to be thoroughly assessed, and particularly important to rule out serious underlying causes, such as inflammatory bowel disease, bowel cancer and ovarian cancer, especially as you mention falling asleep a lot.
Do you feel generally fatigued? Have you lost or gained weight? Any bloating or blood in the stool?
All of these would be symptoms that would add some concern.
Of course, there are many less serious causes, too, which can be treated, such as irritable bowel syndrome, haemorrhoids, infections of the anal skin and rectal chlamydia infection, which is becoming more common in heterosexual females.
I do not wish to frighten you – that is never my column’s aim – but it is important to rule out the most concerning potential causes as a priority.
Q: I HAVE been suffering with itchy, scabby ears for the past couple of months.
Both ears are constantly sore and itchy, just on the inside, and it is driving me to distraction.
I keep feeling the urge to pick the scabs and dry skin out of them.
I did go to the doctor and was prescribed ear drops but they just helped with the intermittent pain I was getting, which I no longer have.
A: While this does sound as if it is sore and decidedly unpleasant, it should be relatively easy to treat once you know the underlying cause.
Possible causes for the skin inflammation that you are describing include atopic eczema or psoriasis, which would be more likely if you were affected by these skin conditions in other areas too.
Seborrhoeic dermatitis is an itchy, flaky skin condition that can affect the ears only, but often also the scalp, eyebrows and sides of the nose.
If it is just the ears then infection (bacterial or fungal) or an allergic reaction to something that has come into contact with the ears (earrings, earplugs, hearing aid, hair products or cosmetics) would be more likely.
In this case, a further course of steroid ear drops may help. If the problem is in the external ear canal – which you seem to be describing, so just at the opening of the ear hole – then we call inflammation of this area “otitis externa”.
The first-line treatment tends to be ear drops that contain both an antibiotic and a steroid – my guess is that the GP gave this to you.
Because your symptoms have persisted, you should return to see the GP.
Next steps could include taking a swab from the ear and sending it to the lab to check for a fungal or bacterial infection.
Finally, while I know that it is easier said than done, do try to avoid picking at the scabs, at least for a few days, to allow the underlying skin to heal.
HUBBY’S HEART RATE IS JUST 32BPM
Q: MY husband keeps getting low heart readings on his iPhone – 32 to 36bpm at rest.
This has been the case for more than three weeks now. He is aged 80, is quite active and doesn’t have any serious health issues.
He takes daily medication for high blood pressure.
A: I’m assuming he is using an Apple watch, paired with an iPhone?
Smartwatches and other wearable devices can give inaccurate readings, especially in people with dark skin or if the device does not fit well.
I would advise using a more reliable method and comparing to the reading from the watch, as a calibration.
Blood pressure machines also assess heart rate, so getting your own check, either at the pharmacy or GP surgery, would give you the answer regarding accuracy of the watch.
You could also simply assess by feeling the pulse at the wrist or on one side of the neck.
It might take a little practice to identify the pulse correctly, but once you do, you simply count how many beats in a minute.
If the heart rate is genuinely this low then it would be a good idea to inform his GP.
A heart rate below 60 is deemed to be low, even though it can be normal in very fit people.
But even in elite athletes, 32-36bpm is very low, and if persistent, it could cause fatigue, shortness of breath, dizziness, fainting or feeling cold.
You’ve mentioned that your husband takes blood pressure medication. If he takes a beta blocker, then this medicine could be partly to blame, as it works by lowering the heart rate as a way of lowering the effort of the heart and blood pressure.
Beta blockers tend to have “olol” at the end of their name (eg, Bisoprolol, Atenolol and Metoprolol).
Tip of the week
IF you’re waking up with stiff joints that take longer than 30 minutes to loosen up, it could be a sign of rheumatoid arthritis.
Getting an early diagnosis and treatment could prevent long-term joint damage. Other signs include tiredness, a poor appetite and swelling in affected joints.
HIDDEN BANANA POWER
WHEN it comes to reducing blood pressure, eating bananas could be more effective than reducing salt intake, a study has found.
Traditional advice has long emphasised eating less sodium, a major component of table salt.
But new research from the University of Waterloo in Canada suggests balancing the ratio of sodium to potassium, found in bananas, may be just as important.
Around one in three adults in the UK have high blood pressure. Over the long-term it is the leading cause of coronary heart disease and stroke and can lead to other conditions, such as chronic kidney disease.
Patients are advised to eat less salt because salt makes the body retain water, increasing the volume of the blood and upping pressure inside the arteries.
Meanwhile, potassium has the opposite effect and can bring blood pressure down naturally.
Study co-author Professor Anita Layton said: “Our research suggests that adding more potassium-rich foods to your diet might have a greater positive impact than just cutting sodium.”
Researchers found that men develop high blood pressure more easily than pre-menopausal women, but men are also more likely to respond positively to an increased ratio of potassium to sodium.
Other potassium-rich foods include potatoes (especially with their skin still on), broccoli, spinach and butter beans.
REDUCING STROKE RISK
THOUSANDS of heart attacks and strokes could be prevented with a combination of two drugs, according to new research.
In a study of 36,000 patients who had suffered a heart attack, those who were given statins as well as ezetimibe within 12 weeks of their attack had a better prognosis
They were able to lower cholesterol faster and therefore reduce their risk of a new cardiovascular event or death.
Ezetimibe is a cholesterol-lowering drug already used by the NHS. It has a similar effect to statins, which lower cholesterol, too, but works differently.
Professor Kausik Ray, of Imperial College London, which was involved in the research, said: “At the moment patients across the world aren’t receiving these drugs together. That is causing unnecessary and avoidable heart attacks and deaths, and also placing unnecessary costs on healthcare systems.”
The study included data from 36,000 patients in Sweden who had a heart attack between 2015 and 2022.
Patients are most at risk of a second heart attack a year after the first but statins help by reducing “bad” cholesterol.
Cholesterol can contribute to heart attacks and strokes because it creates clumps in blood vessels, restricting or blocking blood flow. The team estimates that 5,000 heart attacks could be prevented in the UK over ten years should ezetimibe be prescribed early.