ASK DR ZOE
From bloating after every meal to testicle pain – Dr Zoe Williams answers your health questions
And what could be wrong when your sense of taste and smell has gone
THE NHS has warned blood stocks are critically low – with donors needed now more than ever.
Recent cyber attacks have made the situation worse, with an Amber Alert issued at some NHS hospitals, restricting O negative and O positive blood types.
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If you are an O-type donor, call 0300 123 23 23 to make an appointment or visit orlo.uk/bPTiE.
Don’t be put off if you don’t know your blood type – you are still wanted!
Sign up on the NHSBT website, nhsbt.nhs.uk, to get started.
You can donate during your lunch break and just an hour of your time can save up to three lives.
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There are just under 800,000 regular blood donors, 108,000 of whom are O negative and the NHS is now asking people to donate more regularly.
Hospitals will continue to carry out emergency surgery, cancer surgery, transplant surgery and blood transfusions for those who need blood.
But they will need to prioritise patients and you never know when a loved one will need help.
Here’s a selection of what readers have asked me this week . . .
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Q: I AM 79-year-old male and 52 years ago I had a vasectomy.
In the past six weeks I have had pain in my testicles and lower abdomen and I am urinating ten times a day.
Foods that should come with a cigarette-style health warning
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After seeing my GP, he sent me for a scan, which showed two cysts where the tubes had been tied.
Although he said there was nothing to worry about, the pain is worse.
Could it be more serious?
A: Thanks for writing in with this problem.
I can see why you have connected your symptoms right now with the vasectomy 52 years ago, but if that is really the cause, my question would be “why has this pain started now?”.
And I cannot find a sensible answer to that question.
But, of course, I am not a urologist.
The cysts are likely to have been there since shortly after the procedure and probably started out as sperm granulomas – small masses created by the body’s inflammatory reaction to the sperm that get trapped after a vasectomy.
They occur in up to 40 per cent of cases and do not pose any risk to health.
I think you should go back to your GP to explore some of the other potential reasons for testicular pain with lower abdominal pain and polyuria (peeing more often than normal).
These include urinary tract infections, which a urine dipstick test and laboratory sample can check for, and possibly a blood test for your kidneys and prostate.
Your GP should examine you for hernias, ask about constipation and consider an examination of your prostate if you are experiencing other prostatic symptoms.
These include a weak stream, feeling as though you cannot empty your bladder or dribbling after you’ve finished having a wee.
These symptoms should not be ignored but rather explored and then investigated to find out exactly what’s going on.
GPs will often perform investigations to rule out the most serious diagnosis first – in this case perhaps the ultrasound scan was to rule out testicular cancer or torsion (which are both rare in older men).
If the test is normal, that is reassuring, but go back to your GP for the next line of investigation if your symptoms persist.
Why am I so bloated?
Q: I AM suffering from a bloated feeling after nearly every meal.
I don’t smoke and only have a beer on occasion.
I have had a camera investigate both ends but so far nothing untoward has been found.
I am trying to cut out high FODMAP foods, which can cause digestive issues.
Can you please help?
A: Sometimes people with irritable bowel syndrome (IBS)are temporarily put on low FODMAP diets, under the supervision of a dietician.
The clunky acronym stands for fermentable, oligosaccharides, disaccharides, monosaccharides and polyols.
In plain English, they are a group of carbohydrates that can contribute to IBS symptoms.
This diet requires extensive exclusions of many, sometimes most of the foods that people typically eat, so they are not easy to get on with unless supported by an appropriate healthcare professional.
Just to give an idea, the list of foods to avoid includes cereal grains like wheat, rye and barley, such as bread, pasta, noodles and many breakfast cereals.
Also savoury and sweet biscuits, cakes, pastry, breadcrumbs and batter, with the exception of wheat- free/gluten-free variations.
There’s also a long list of fruits and vegetables to be avoided, and beans, pulses and types of sugar.
It might feel like that exhaustive list doesn’t leave much but rice, oats, potatoes, corn and quinoa are fine, as are porridge oats, oat cereals, rice crackers, oat cakes, plain or salted popcorn, plain crisps, and also some flourless cakes.
And most major protein sources, including meat, poultry, fish eggs, tofu, tempeh and soya products do not contain FODMAPs.
Four to six weeks is usually long enough to see if there’s been a significant improvement.
The crucial thing about a FODMAP diet is the reintroduction phase, which comes next.
Dieticians usually do this in a gradual way to help determine which carbohydrates tend to be problematic.
Whilst ideally the FODMAP diet would be guided by a healthcare professional such as a nutritionist, I know that these are not always available on the NHS.
I would chat with your GP about your intentions and see if they can steer you.
The key thing then will be planning and making sure you reintroduce foods properly.
Team of the week
NEXT time you have a pizza, burger or lasagne for dinner, why not try swapping the sides like garlic bread and chips for a big salad?
Not only is it prime time for salads now with the hot weather, it’s an easy, simple swap to help you increase your daily vegetable intake.
Sense of taste and smell has gone
Q: OVER the last four years, I have gradually lost my sense of taste and smell. I haven’t seen a doctor about it, but I put it down to having type 1 diabetes for 34 years.
On top of that I have a continuous salty tongue due to a dry mouth, which started in January.
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I have tried various products for this but they’re all ineffective.
Day-to-day living is a struggle.
I feel bad because there are worse things people have to live with but not being able to enjoy food is having a massive effect on me.
Do you have any advice?
I am 56 and I take insulin, lisinopril for blood pressure, atorvastatin for cholesterol and HRT to stop symptoms of hot flushes.
A: Smell and taste disorders affect around five in 100 people so they are not particularly common.
First off, you mention you have not seen your doctor about it, so I would advise you to make an appointment.
Your GP will likely ask if you have any nasal symptoms that have affected one nostril only, whether you have had any bleeding or discharge from your nose or any crusting or scabbing in the cavity.
They should ask if you feel like you can constantly smell something that is unpleasant or if there’s any swelling or accompanying visual issues, or if you find you are getting severe headaches at the front of your head too.
All of these are classed as red-flag symptoms that require further questioning or investigations.
Your issues could be related to your type 1 diabetes as this can have an effect on both taste and smell and sometimes the medications used to treat it can too.
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However, your loss of taste and smell could be something entirely unrelated so it’s vital you speak to your doctor.
You should expect a thorough examination and, if necessary, you should be referred on to an ear, nose and throat specialist.
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