ASK DR ZOE
I’ve been living with a prolapse for two years – is it something I can live with and is it dangerous?
Here’s a selection of what readers have asked me this week
AS January draws to a close, how well have you stuck at your New Year health goals?
Whether it’s improving fitness, eating healthier, quitting smoking or focusing on mental wellbeing, January can be the fresh start you need. But as February rolls around, it’s not uncommon for motivation to wane.
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Let me reassure you, this is totally normal. Show yourself some kindness and re-focus.
Think about consistency rather than perfection
Small changes are more sustainable than drastic overhauls. There is a whole year ahead to make changes that stick for a lifetime, so take it slowly.
Even if you are trying to quit smoking, you do not need to go “cold turkey” on nicotine.
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Use replacements such as gum, patches or vapes and I insist on using the free NHS stop smoking services to get support.
If you have any questions regarding your health, email me at [email protected].
Here’s a selection of what readers have asked me this week.
PROLAPSE PARANOIA?
Q: I’M a 78-year-old woman and have lived with a prolapsed rectum for about two years.
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When I first discovered it, during a toilet visit, I was scared and worried. It is protruding through the front not back.
A clinic doctor put a clip or something there to keep it up. This did not work so it was removed.
Is the prolapse dangerous or can it cause more problems?
I seem to be more aware of it lately but maybe I’m paranoid. Is it something one can just live with, without it causing problems?
A: Pelvic organ prolapse occurs when the pelvic floor muscles weaken to the point that one or more of the organs from the pelvis slip down and bulge into the vagina.
This can be the womb, bowel, bladder or the top of the vagina.
The type of prolapse that you are describing is a rectocele.
This is when the wall of tissue that separates the vagina and rectum becomes weak, allowing the rectum to bulge into the vagina, and in severe cases protrude from the vaginal opening, which I think is what you are describing.
The types of symptoms that someone may get with a rectocele include problems with passing stools, feeling as though your bowels are not fully emptied, discomfort or pain, incontinence, as well as feeling the rectum bulging into the vagina.
Sometimes women will need to insert a finger into the vagina and push the rectum into position in order to pass stools.
Treatments vary from person to person and include lifestyle changes, pelvic floor exercises, hormone treatment, vaginal pessaries (structures that stay in the vagina to help hold the pelvic organs in place) and surgery.
There are different severities of prolapse and some people do require surgery to correct it permanently, but this would be based on your symptoms and preferences.
The rectocele isn’t dangerous in and of itself, and if you were managing with it without debilitating symptoms and without it impacting your quality of life, then you could carry on as you are without surgery.
Your GP will be able to monitor and guide you towards the best course of action and refer you if you are keen to explore surgical options at some stage.
I'm plagued by daily muscle pain
Q: I SUDDENLY developed pain in my hips in August, literally overnight. I put it down to my mattress but it wasn’t that.
Since then, I get aches in my neck, shoulders, arms and hips, which are worse in the morning. I now do gentle exercises.
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Blood tests from my GP came back normal, but an email was sent to the rheumatology department, which came back with suspected PMR diagnosis. I’m 60 and unsure what to do.
I’m taking painkillers, a turmeric supplement and using Arthro gel to rub on areas of pain.
A: PMR or polymyalgia rheumatica is an inflammatory chronic condition that causes pain and stiffness in the shoulders, neck and hips – all of which you say you have.
The pains can be sudden or develop as the day goes on, but they are often worse in the morning on waking and gradually reduce with movement and activity.
There is a blood test that your GP can do to assess for inflammation called CRP.
A raised CRP isn’t diagnostic, as many conditions can cause CRP to increase.
But if CRP is elevated, alongside your symptoms, it makes PMR more likely, as it is generally thought that a normal CRP can rule it out. It’s not known what causes PMR, with studies suggesting that our genetics play a role and that certain infections can trigger it, too.
Have you been offered steroids, as these are the usual course of treatment?
The supplements you are taking and the gel might take the edge off, but steroids are the only known effective treatment.
They work by blocking chemicals in the body that cause the inflammation.
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You will most likely be prescribed a steroid called Prednisolone.
The normal course for treatment can be up to two years, and often the condition can disappear on its own.
Boozing husband's health
Q: MY husband drinks more than I think he should, but he doesn’t think he has a problem.
Because I’ve raised it a couple of times, and because his health has gone downhill in recent years, he has started hiding it.
I will sometimes find empty beer bottles in the bin. He’s 65 and gets sick drunk more than a person of his age should, although still only on occasion. Why does he not realise this is a problem?
Should I be more reasonable because everyone likes to get drunk sometimes? He doesn’t see how this affects me.
A: It sounds possible that your husband has a problematic relationship with alcohol.
Often, people in this situation don’t like the term “alcoholic” as it musters up images of daytime drinking out of brown paper bags.
But the reality is, a lot of people hold down jobs, raise families and function in society with alcohol problems.
Alcohol dependence is characterised by craving, becoming more tolerant (so needing more to get the same effect), a preoccupation with alcohol and continued drinking, despite harmful consequences, (for example, liver disease or depression caused by drinking). Does he have alcohol-free periods or is he drinking daily? Has he ever sought any help?
Alcohol dependence can affect people differently. Drinkaware has a quick, confidential self-assessment quiz called the that might be worth you asking your husband to do, either with you or alone.
Have you had any conversations with him about it that aren’t incendiary? Maybe pick a time when he’s not drinking. If he’s adamant there’s no problem, let him know that you are always there for him if he wants to discuss it.
If you cannot convince him to go to his GP, the charity has plenty of resources for those who are concerned about their loved ones.
The website provides advice on how to have a conversation about it, what you should and shouldn’t say, how you can offer support and how you can start to have a dialogue about his issues without it sounding like an attack.
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