From IBS to bowel cancer and chronic skin conditions – Dr Zoe Williams answers your questions

WINTER is coming, and with it warnings of a healthcare crisis are rife.

Covid cases are rising, while experts are warning of a nasty flu season too.

The Sun

Figures from the Office for National Statistics show around 1.3million people in England have Covid, and more than 9,500 in hospital.

That’s why the NHS is urging another six million at-risk people, and those over 75, to get their autumn Covid booster.

Reminders are due to be sent out via email, letters and texts. If you have a suppressed immune system, are pregnant, have a learning disability or another health issue, book your jab.

If you are in an at-risk group you don’t need an invite. Attend a walk-in site or book at . If you need help booking, call 119.

Vaccination is the best way to protect yourself, so make it a priority.

If you have any Covid-related questions, send them over and I will do my best to answer as many as possible.

In the meantime, here are this week’s reader questions . . . 

Q: I HAVE irritable bowel syndrome. Should I review symptoms with my GP?

A: Let me reassure you that having irritable bowel syndrome does not increase your risk of getting colorectal cancer.

Inflammatory bowel diseases, such as ulcerative colitis and Crohn’s disease, sadly do increase a person’s risk of colorectal cancer. That’s to clear up any confusion.

When looking for any signs of bowel cancer, it’s the same in somebody who has IBS as a person who does not.

But because some of the symptoms of these conditions overlap, it does add complexity.

The three main symptoms of bowel cancer are blood in the poo, changes in bowel habit — such as more frequent, looser stools — and abdominal pain.

Others to watch for include ­constipation, weight loss, tiredness, or a feeling of needing to strain in your back passage (as if you need to poo), even after opening your bowels.

The main thing for anyone to be aware of is a change from the norm.

People who have been living with IBS for a long time are likely to understand their triggers, and almost expect their symptoms to come on.

If there are new ones, a worsening or deviation from the usual pattern, tell your GP and some simple stool tests can help to reassure.

Blood tests may or may not be needed, depending on your symptoms.

For those eligible, always complete the NHS bowel cancer home-screening tests.

They are available to everyone aged 60 to 74.

The programme is expanding to those aged 50 to 59.

This is happening gradually over four years and started in April 2021.

Q: I TAKE Tamsulosin on prescription from the doctor for an enlarged prostate.

But I have seen an advert for Prostaphytol, a medication that claims to shrink the prostate altogether. It is tempting to try it but I want advice.

A: I’d never heard of this supplement, so did some research.

But as a bit of background, an enlarged prostate is common in men above 50, and is usually caused by a condition called benign prostatic hypertrophy, or BPH for short.

It is benign but can cause symptoms that have a significant impact on quality of life.

We tend to collectively name the symptoms “lower urinary tract symptoms” or Luts for short.

These are mostly related to voiding of urine, such as a sensation of incomplete bladder emptying, straining to void, urinary hesitancy and a weak ­urinary stream.

Other problems include storage symptoms, such as waking to pee multiple times in the night, frequent urination and urgency.

Of these, the most common is nocturia — waking in the night to wee.

Tamsulosin is in a class of medications called alpha blockers.

It works by relaxing the muscles in the prostate and bladder so urine can flow more easily.

It has been well researched and the clinical trials show it is safe and often effective.

However, it doesn’t suit everyone and the most common side-effects are dizziness and problems when men ejaculate (such as little or no semen).

I’ve looked a little into Prostaphytol. It is a plant-based supplement containing pomegranate seeds, thistle root, saw palmetto, turmeric, nettle, pumpkin seed, flaxseed and zinc.

While this is highly unlikely to do you any harm, and contains some great nutrients for general health, there is zero evidence it will or can shrink the prostate gland.

Look, the bottom line is this, BPH is a benign condition, and there is no harm in trying a supplement like this if you really want to (as long as you have checked with your GP that it will not interact with other medication you take).

If it seems to make a difference — even if that is a placebo effect — there is no harm in continuing if you can afford it.

But if there is no benefit after a couple of months, I would suggest investing the money in a higher-quality diet instead to benefit your overall health, even if you do still need to take the Tamsulosin to manage the symptoms of BPH.

Q: CAN you please tell me about lichen sclerosus?

A: This is a chronic skin condition that can affect any part of you but most often occurs on the vulva and around the anus.

It can start at any age but is most common after menopause, although we don’t really know why. It’s not known what causes lichen sclerosus.

One theory is it is linked to autoimmune conditions, where the immune system attacks normal tissue.

It’s not caused by an infection, is not contagious, doesn’t affect your internal organs and is not related to hormones or allergies.

Symptoms include itching and soreness, especially if the skin breaks, which it can commonly do due to scratching.

The skin can also become thinner, with tissue loss.

This can sometimes result in narrowing of the vaginal opening, which can make sex painful.

Skin can also become prone to tearing and in children, constipation is a symptom.

The affected skin usually has a shiny white appearance and can either look like skin is thickened and raised, or thinned.

It becomes fragile, and scratching can lead to breaking blood vessels and fissures.

In non-genital areas, it appears as white patches that can join up, so skin looks like wrinkled tissue paper.

GPs usually diagnose it visually, so if you think you have it, arrange a face-to- face appointment.

There is no permanent cure but symptoms and signs can be controlled almost totally with strong steroid creams.

Treatment usually takes at least three months.

If you have lichen sclerosus, use an emollient to wash with instead of soap.

Do not use scented products, take care you are completely dry after you have been for a wee, use Vaseline around your genital area (or something similar) as a barrier cream to protect skin from urine, and keep an eye on the affected area.

In less than five per cent of cases, lichen sclerosus can develop into a skin cancer which can affect the vulva — but it is rare.

If it starts to look like ulcers, lumps or a crust, see your GP.

Lifelong self-examination is really important if you have ever had lichen sclerosus, so stay vigilant.