5 medical concerns we don’t talk about
Looks at some of the not-so-nice medical complaints people don’t love to talk about. But should.
As I was driving home last week, and getting my daily fix of Radio New Zealand, I had to smile at an interviewee who was talking about bacterial and virual infections.
Apparently ‘‘infections’’ are not in the least bit sexy – in her words ‘‘nobody holds a fundraiser for diarrhoea!’’
This got me thinking about the myriad of conditions I see coming through my door every week, many of which aren’t ‘‘sexy’’ at all – they can be annoying, disruptive, and occasionally dangerous, but tend to be things we don’t want to admit having, and wouldn’t readily discuss at the dinner table.
So here is my list of the ‘‘top’’ five medical conditions that you might not want to hear about, but will probably be affected by at some point in your life:
1.
Also known as piles, these affect around 50 per cent of adults at some point in their life. Haemorrhoids are congested, enlarged veins, sitting just under the surface tissue of the rectum (lower part of the intestine) or anus. They can be classified as internal or external, depending on where they are situated, and can sometimes be felt as ‘‘grape like’’ swellings.
They can be tender, sometimes excruciatingly painful, and can cause bleeding and itching. You are more likely to get haemorrhoids if you are constipated, overweight or pregnant. The good news is, they can usually be treated quite simply with topical steroids, given in ointment or suppository form.
It is also really important to avoid exacerbating haemorrhoids (and prevent them recurring) by altering your diet and lifestyle – keeping bowel motions soft, and avoiding any need to strain when passing them, is key to successful management. Occasionally, if this treatment doesn’t work, other options need to be considered including ‘‘banding’’, injecting or removing them with surgery.
2.
Fungal infections are known as ‘‘mycoses’’ and are extremely common. They are usually mild, but in sick, frail or immunocompromised people they can be potentially very serious.
Fungi can infect hair, skin, nails, gut and occasionally become systemic (or widespread) throughout the body. The most common types of fungal infection include thrush, athlete’s foot, ringworm and nappy rash. Fungi exist everywhere in our environment, and love to grow in warm moist places – hence they tend to infect armpits, groins, genitalia, feet and nappy areas. You are more likely to get an infection if your natural protective skin barrier has been compromised, for example by a scratch in the skin.
The symptoms of fungal infections vary depending on the location on the body, but they tend to cause itching, and red, scaly or flaky patches on the skin surface. If nails are affected, they can become thickened, discoloured and crumbly.
Luckily, most fungal infections respond quickly to treatment with antifungal creams and gels, applied to the affected part of the body. Sometimes oral treatment will be required for more stubborn infections.
Avoid recurrence by minimising any moist or damp areas on your body – wearing loose clothing, open shoes and drying thoroughly after showers or baths is a good plan.
3.
These annoying warts grow on the soles of feet, or between the toes. The pressure of walking can cause them to grow into the skin, causing pain, as opposed to growing outwards as warts on other parts of the body do.
As with all warts, they are caused by a virus, and are spread easily by contact with an infected surface such as a swimming pool or communal shower. They are more common in children, as most people have developed immunity to them by adulthood.
They are not dangerous in any way, and if left on their own will go away without treatment. If they are causing symptoms, various methods can be trialled to remove them, including painting them with a solution, freezing or burning them off (not recommended at home!), or getting them cut out.
4.
Dry, flaky skin can be due to lots of things, including eczema, psoriasis or a condition known as seborrheic dermatitis. It can cause huge degrees of embarrassment, impacting on selfesteem, especially if the area of the body affected is very visible such as hands, face or scalp.
Scratching affected areas can also lead to infection. Keeping skin really well moisturised, using a proper ‘‘emollient’’ frequently, and avoiding irritants such as soaps, body washes and other chemicals is the first line of treatment.
If the problem is predominately on your scalp (like severe dandruff) an antifungal shampoo can be really effective. The next step if you aren’t making progress is to talk to your doctor – they should be able to tell you what is causing your skin symptoms, and suggest specific treatment.
5.
This incredibly itchy rash is caused by a parasitic mite that burrows into the skin. It is spread by close contact.
It is especially common in children, young people and elderly, and is more prevalent in areas of overcrowding such as prisons or refugee camps.
The rash appears on trunk and limbs, but spares the scalp, and can take several weeks to appear after exposure to the mites. Treatment includes treating the skin with an overnight application of an insecticide, but also thoroughly cleaning all bedding, towels and clothing to avoid re-infection.
Dr Cathy Stephenson is a GP and forensic medical examiner.