Has too much summer partying made me ill?

Every week Cork GP Dr Pixie McKenna answers your medical questions

I’VE had a really unhealthy summer, culminating in a two-week, all-inclusive sun holiday. While I was away I ended up going out ten nights on the trot and ate and drank too much. I noticed this morning that my bowel motion was very dark, almost like tar in colour. Is that a bad sign? I feel weak and terrible. This is more than just post-holiday blues!

Sarah, Portlaoise

IN A word, YES! This sounds very much like melena, which is the passage of a black and tarry stool due to the presence of altered blood.

In layman’s terms, this is due to blood coming from the gut and, given your story, this could well be from a bleeding ulcer. This is an emergency and needs checking out as soon as possible if you have not already done so by the time you read this. Call a doctor or get yourself to A&E!

If you had been stressed on the run-up to the holiday and then gone hard at it with alcohol and late nights, it’s a recipe for disaster. People also inadvertently take aspirin or ibuprofen when they have hangovers, which don’t help. Drinking tea, coffee or cola isn’t good either as these beverages increase acid production, which adds more fuel to the ulcer fire.

Excess acid causes irritation of the stomach and duodenum (the small bowel), which we refer to as gastritis or duodenitis, whereas an actual ulcer causes holes in the lining of the stomach or duodenum. I guess you could say excess acid is akin to stripping paint off your walls and an ulcer is l i ke drilling right through the wall, so it’s going to cause some structural damage.

If an ulcer perforates i.e. breaks through the wall (continuing the drill analogy, t hat would be like drilling into your next- door neighbour’s house), then it’s an emergency. It could potentially kill you: most studies put the mortality rate at 10 per cent. The longer you wait for treatment, the worse you fare.

There are several other reasons for passing a dark stool that aren’t an emergency. First, we are a nation of stout drinkers and this is one substance that turns our motions dark. If you take iron supplements you can also pass dark stools, and munching excessively on black liquorice or blueberries could be the cause.

Preparations that contain the compound bismuth also turn motions dark, so do let the doctor know if you have had any of the above lately. We term this false melena, as the actual cause isn’t due to bleeding, and as such it isn’t an emergency because the discoloration stops once you stop ingesting the offending item.

But don’t be reassured by this: I would still advise you to seek medical help straight away as the fact that you are feeling awful could be due to low blood pressure or loss of blood, which go hand in hand with a bleeding ulcer.

See your doctor and if you can’t get an appointment today, this i s one occasion that warrants a trip to A&E as it fits the ‘E’ for emergency criteria. MY NEWBORN baby was born normally but now he has a big lump on his tummy, near his belly button, which the doctor says is a hernia. Do you think he should have surgery?

Peter, Dublin WE CALL this an umbilical hernia: umbilical means belly button and hernia stands for when an internal part of the body pokes outwards through a weakness in a muscle or tissue wall.

During pregnancy, the umbilical cord can pass through an opening in the baby’s abdominal wall, which should close before the baby is born. In some babies it doesn’t, giving rise to an umbilical hernia, like the one your little boy has.

For some reason, boys and babies born prematurely are more likely to have this problem. Children of Afro-Caribbean descent are also more likely to be affected. The hernia tends to become more obvious after the belly button has healed, when your baby is around two weeks old.

It looks like a little lump in the navel, which becomes more pronounced if the baby is pooing, has wind or is laughing.

As many as one in ten children are born with an umbilical hernia. It is very common. The good news is that in the vast majority of cases, it heals before the child is 12 months old and 90 per cent heal by the time the child is four.

THIS means waiting is the best option. Your doctor may refer you to a surgeon if there is concern that the hernia is very large or at risk of strangulation, whereby a bit of the bowel can get stuck in the bulge and become twisted.

You may have heard of friends whose kids have had hernia operations and wonder why it isn’t being suggested for your son. Operations usually take place for other types of hernia, not the umbilical kind.

In the context of a groin hernia, for example, surgery is usually advised as these are at far greater risk of strangulation.

The good news for you is that by the time your little one hits his first birthday, it is highly likely that the umblicalhernia will have disappeared. This is very much a case of watch and wait.

However, if the bulge appears uncomfortable, stuck externally or your child is in pain and vomiting, always seek medical advice.