Ask the doctor - ear, nose and throat

I keep hearing pulsing in my ears

I can often hear blood pulsing through my ears. Can anything be done?

Do see your doctor, who can check your blood pressure, examine your ears and test the function of your cranial nerves. They can also listen with a stethoscope to detect whether this sound is obvious only to you. If so, this form of tinnitus can be related to inner ear problems, and you may be referred to an ear, nose and throat specialist.
Dr Sarah Brewer, Prima

 

Help clear my stuffy nose!

I get a bunged-up nose from hay fever, despite using antihistamine tablets and nasal sprays. Any tips?

Bromelain (a pineapple enzyme) has a natural anti-inflammatory action that helps reduce nasal swelling and break down mucus. Pycnogenol, an extract from the bark of the French maritime pine, is also effective due to its antihistamine action. Olbas Oil (£2.24 for 10ml) contains a combination of essential oils that can help relieve the symptoms of hay fever. Put a few drops onto a tissue near your pillow, or use the new Olbas vaporiser (£6.99). Visit www.olbas.co.uk.

Dr Sarah Brewer, Prima 

My son has recurrent nosebleeds

My seven-year-old son is always getting nosebleeds. How should I stop the bleeding?

Nosebleeds are common in childhood, when they are usually insignificant and easily stopped. Most occur when fragile, poorly supported blood vessels running through the nasal lining are damaged. This is often due to over-zealous blowing, inflammation during a cold, or simply picking. To stop a nosebleed, get him to sit forward slightly with his mouth open. Pinch the lower (soft) part of his nose for five to ten minutes, while he breathes through his mouth. Release the nostrils slowly, to check bleeding has stopped. Applying an ice pack can help, or try using nosebleed plugs, which are readily available in pharmacies. These can be trimmed to size for small nostrils, but are not advisable for children under the age of five. If bleeding does not stop after 20 minutes, seek medical advice. A fragile blood vessel can be cauterised (sealed with heat) to prevent recurrent bleeding.
Dr Sarah Brewer, Prima

Is this the real cause of my hoarseness?

My voice has been some what husky for several months now, and my GP's just diagnosed an underactive thyroid gland. I've never heard of thyroid problems affecting your voice - is he right?
Hoarseness (especially a lowering of the pitch of your voice) can indeed be caused by an underactive thyroid gland. Other, more common, symptoms include tiredness, putting on weight, constipation, feeling the cold, dry skin and thinning hair. It's always worth getting hoarseness of the voice checked out by your GP if it lasts for more than a few weeks - or sooner if you've ever been a smoker. Most of the causes of hoarseness are nothing to worry about, but occasionally they can be due to a tumour in the upper airways. Being a smoker increases the risk of this enormously, which is why, if you've ever smoked, you need to seek help sooner.
Dr Sarah Jarvis, Good Housekeeping

 

I want to boost my immune system

I had viral labyrinthitis a year ago and although I never normally get colds, I’ve had seven since then. The virus has obviously damaged my immune system, how can I boost it?I had viral labyrinthitis a year ago and although I never normally get colds, I’ve had seven since then. The virus has obviously damaged my immune system, how can I boost it?

Lots of people believe that having an infection affects your resistance to colds, but this is rarely true. It’s hard to say why you’ve had more colds in the past year – but if you haven’t had any more serious infections (such as pneumonia or bronchitis), it’s unlikely to be anything serious. Eating healthily, getting enough sleep and generally looking after yourself may help you fight off minor illnesses, and cope better when you have them. Echinacea, available from your local health shop or pharmacy, may help to prevent colds, but there’s no evidence that zinc or antihistamines do. Vitamin C might also be useful, but you can get enough of this from fruit and vegetables in your diet.
Dr Sarah Jarvis, Good Housekeeping
 

Cotton buds and ear problems

My ears seem to be very waxy, and I try to keep this under control by using cotton buds to clean them. Now I’ve heard that doing this is bad for your ears. Should I stop?
 
There's absolutely nothing wrong with using cotton buds, except in your ears - and the same goes for car keys, pen tops and all those other implements that people use to scratch inside them. Your ears produce wax to help prevent infection, and the wax naturally migrates outwards and comes out of your ear. If you shove cotton buds into your ear canals, you'll be lucky if you get away with only making the wax worse by pushing it further into your outer ear canal and impacting it. You could also scratch the sensitive lining of the outer ear canal, making you more prone to outer ear infection - or even perforate your eardrum. Basically, never put anything in your ear that is smaller than your elbow! This really is a case of leaving well alone - the wax will work its way out naturally. And if it does build up so that you have difficulty hearing, make an appointment to see your GP who can advise you on eardrops or syringing.
Dr Sarah Jarvis, Good Housekeeping
 

Sinusitis treatment

I have problems with my sinuses and get lots of infections, especially in the winter. My GP mentioned surgery, but I’m not keen on the idea. Is there any other treatment?

Sinusitis is a common problem, and it's often worse in winter because it can be brought on by the same viruses that cause coughs and colds. The symptoms of acute sinusitis include cold-like symptoms, pain in your sinuses when bending forward, pain in your teeth, pus-coloured discharge from your nose and sometimes pain over one cheekbone. Unfortunately, decongestants and antihistamines haven't been shown to do much good, although antibiotics can sometimes help. If you get a lot of attacks, a steroid nasal spray may help reduce the frequency. But if it doesn't, surgery would probably be the next step. It's not fun, and you'll probably be off work for several days afterwards, but it does have a high success rate, so it's certainly worth talking through this option with your GP.
Dr Sarah Jarvis, Good Housekeeping
 

Ear infections

I dread the thought of the ear infections I always seem to get when I’m on holiday. They clear up with the drops my GP prescribes back home, but the itching and pain ruin my holiday. How can I avoid these infections?

Outer ear infection, or otitis externa, is common in people who regularly spend time with their ears under water. Swimming is often the culprit, hence your ruined holidays. To reduce the chance of getting an infection this summer, always wear earplugs when you swim and, if you wash your hair in the bath, avoid putting your head under the water.
Dr Sarah Jarvis, Good Housekeeping
 

Surgery for polyps

For months, I’ve had a blocked nose on one side, and my GP says I have a polyp, which I should have removed. I’m not keen on the idea, though. Is there an alternative?

As long as you're not suffering from nosebleeds, ask your doctor if it's worth trying a steroid nasal spray or drops, as these can sometimes shrink the polyp. Otherwise, I'm afraid, the only cure is surgery to remove it - although, fortunately, the operation itself is relatively minor and you shouldn't have to stay in hospital overnight.
Dr Sarah Jarvis, Good Housekeeping
 

Help for tinnitus

I suffer from tinnitus in both ears and was recently referred to an ENT surgeon who assured me there’s nothing seriously wrong. However, the only treatment he could offer was a ‘masking device’, as he said there were no medicines that could help. Is this true?

I'm afraid so. Although tinnitus needs to be checked out medically if you get it, no really effective drug treatment is available yet for this condition. It causes noises that sufferers variously describe as a constant ringing, buzzing, roaring, whistling or hissing. Research into drug treatments is happening, though, and in the meantime, the masking device does help many people. It's totally harmless and just distracts your brain from the signals it gets from the tinnitus.
Dr Sarah Jarvis, Good Housekeeping

 

Antibiotics for sinusitis

I get regular attacks of sinusitis and wonder if antibiotics really help. I don’t want to take them unnecessarily.

In acute sinusitis, you'll usually get a fever, with tenderness and pain over your sinuses, which is often worse when you bend forwards. You'll probably also have a yellow or green discharge from your nose or dripping down the back of your throat. Antibiotics can help in this case, although three out of five people get better just as fast without them. So if you're keen to avoid antibiotics, you could give regular steam inhalations and painkillers a try instead.
Dr Sarah Jarvis, Good Housekeeping

 

Loss of sense of smell and taste

Over the past four months I’ve lost my sense of smell. It’s affected my sense of taste, too, so I can only really appreciate sweet and sour dishes. My doctor says that it will come back by itself, but is there anything positive I can do in the meantime?

Loss of smell is a remarkably common problem and one which more than half of us will experience at some time in our lives. Fortunately it's fairly short-lived for most people, but obviously you haven't been so lucky. The causes include head trauma; polyps in your nose; rhinitis (inflammation of your nasal lining, usually caused by an allergy); or a previous upper respiratory tract infection - put simply, a nasty cold. Treatment will depend on the cause, although most people who lose their sense of smell after a viral infection will recover it spontaneously within about six months. If your nose feels blocked or itchy, or if you're having problems with snoring, you may well have polyps or rhinitis. Talk to your GP about using a steroid nasal spray or, if the problem is very troublesome, ask about being referred to an ear, nose and throat (ENT) surgeon.
Dr Sarah Jarvis, Good Housekeeping
 

Snoring

For the past few months, I’ve been woken almost every night by my wife’s snoring. She is unbothered by it, and wakes fully refreshed – unlike me! Her GP recommended a nasal spray, which helped a bit, but has no other ideas apart from separate bedrooms, which neither of us wants. What can we do?

The nasal spray was probably a steroid one, which can be useful if you have hay fever or a similar allergy causing blocking of the nostrils. If this hasn't solved the problem, there are lots of simple lifestyle measures that can help. They include losing a few pounds (if she's overweight), regular exercise, avoiding smoking, and cutting down alcohol and sleeping tablets before bed. If your wife tends to snore when on her back, old advice such as strapping a tennis ball to her back at night can stop her from rolling on to it! Ear plugs could make separate rooms unnecessary. If the problem persists, ask for a referral to an ear, nose and throat surgeon.
Dr Sarah Jarvis, Good Housekeeping
 

Spots in nostrils

Every time I get tired and run down, I suffer from painful spots inside my nostrils. They eventually disappear, but Is there anything I can take to stop them from occuring in the first place?

A simple cream may well solve your problem. Many people get spots or sore patches in their nostrils caused by a common germ called staphylococcus aureus. Naseptin cream, used four times a day for 10 days, should completely get rid of this germ from your nose. Have a chat to your doctor about it.
Dr Sarah Jarvis, Good Housekeeping

I have tonsil problems

I have a persistent sore throat and white spots on my tonsils. My doctor says I may need my tonsils removed – is there an alternative?

 Recurrent sore throats can be difficult to treat. Echinacea is effective against bacterial, viral and fungal infections, and combines well with elderberry extracts, which also boost immunity. Sucking lozenges containing zinc, vitamin C and/or propolis can also help. Drink plenty of fluids and eat a healthy wholegrain diet containing at least five servings of fruit and vegetables per day – preferably more. You may also benefit from a vitamin and mineral supplement. Keep seeing your doctor, so he or she can monitor your situation.
Dr Sarah Brewer, Prima
 

MRSA concern
 
When I went into hospital for a routine check up the doctors told me that they had found MRSA in my nasal passage, but no sign of infection. Since then I’ve heard that a deadly form of MRSA can affect healthy adults. Should I be concerned?

MRSA is a strain of the bacterium Staphylococcus aureus, a bug carried harmlessly by about one in three people. Problems with MRSA traditionally occur in hospitals, where people are vulnerable to infection.
Its resistance to most conventional antibiotics also makes it tough to treat.

I think the deadly strain you’re talking about is PVL MRSA. It does seem to be more virulent than previous strains of MRSA and isn’t confined to hospitals. But it is very rare in the UK, with just seven associated deaths in the last two years, so I don’t think you should worry. Simply washing your hands is the most important measure to help prevent contamination – invest in an antibacterial hand gel, such as NO-GERMS Instant Hand Sanitizer (available nationwide).
Dr Louise Selby, SHE
 

My kids are kept awake

There’s a horrible cough going round which stops my kids getting to sleep. Can I give them cough medicine?

A cough is a protective reflex triggered by something irritating the airways, and helps stop infection getting down into the lungs, as well as helping to bring up phlegm. If the cough is ‘productive’, then this should be encouraged, as excess secretions need to be removed. I wouldn’t recommend anything to suppress it (though some cough medicines claim to help loosen mucus, so it’s coughed up more easily). If the cough is dry and tickly however, it’s fine to damp it down at night to help your child sleep. Try Covonia’s Dry & Tickly Cough Linctus (£3.39 from pharmacies and supermarkets), which is designed to reduce the irritation that triggers coughing. If the cough is persistent, occurs immediately on waking, or if your child is short of breath, seek medical advice, as it could signal asthma or a chest infection.
Dr Sarah Brewer, Prima

 

Click here to return to the main Ask the doctor page

The answers to specific problems may not apply to everyone and are not substitutes for professional medical advice. If you're worried, see your GP. For more information, visit www.netdoctor.co.uk