Healthwise
SNORING
Most people deny they snore and if they admit claim it doesn't bother them, but in some cases snoring can cause health problems.
What causes it? The noise of snoring is caused by parts of the nose and throat - in particular, the soft palate - vibrating as you breathe in and out. At night, the muscles that help keep your airways open relax and become floppy. This causes the airways to narrow and vibrate more, making snoring more likely.
There are also a number of factors that can make snoring worse:
Alcohol or sleeping tablets - these relax the muscles even further
Being overweight - this puts pressure on the airways
Colds, allergies, nasal polyps, a damaged or crooked nose - can block the nose, causing you to breathe through your mouth
Smoking - smokers are twice as likely as non-smokers to snore because their airways get inflamed and blocked
Sleeping on your back
What are the effects?
- Prods, kicks, and punches from your partner, the threat of divorce and complaints from the neighbours are all common.
- You may also be suffering with obstructive sleep apnoea. In this condition, the relaxed throat muscles block the airway briefly hundreds of times each night stopping you breathing and depriving your body of oxygen.
- In the short-term this causes tiredness during the day, irritability and restlessness, and puts you at risk of accidents when driving, for example.
- In the long-term it can cause high blood pressure, heart attacks and strokes. Treatment involves wearing a dental splint and using a continuous positive airways pressure (CPAP) machine while you sleep to keep the airways properly ventilated.
Who's affected?
More than 3.5 million people in the UK snore. It's thought to affect four out of ten men and up to three out of ten women. And, of course, millions of partners and neighbours suffer sleep-disturbed nights as a result.
What's the treatment?
The following can help reduce the chances of you snoring:
- Avoid drinking alcohol late at night
- Maintain your ideal weight
- Raise the head of the bed
- Sleep on your side (to stop you rolling on to your back, sew a ball in the back of your pyjama top or wedge a pillow under your back)
- Keep your nasal passages clear by using a humidifier, inhaling steam or rubbing a few drops of eucalyptus or olbas oil on your pillowcase (antihistamine tablets and/or anti-inflammatory nasal sprays may help; always check with the pharmacist that they're suitable for you, especially if you're taking other medicines)
- Other 'cures' you may want to try include nasal strips, devices that reposition the jaw and sprays. Try a few to see what works for you.
- As a last resort, surgery can be used to remove nasal polyps, straighten crooked noses and cut out floppy soft palate tissue to stop it vibrating. Laser surgery stiffens the palate to reduce vibration. Somnoplasty uses radio frequency energy to shrink the floppy soft palate tissue rather than cutting it out.
Advice and support:
British Sleep Society
Email: enquiries@sleeping.org.uk
Website: www.sleeping.org.uk
British Snoring & Sleep Apnoea Association
Sleep Apnoea Trust
Tel: 0845 606 0685
Website: www.sleep-apnoea-trust.org
SKIN CANCER
Skin Cancer is one of the most common cancers in the UK. Each year in the UK there are more than 76,500 cases of non melanoma skin cancer and more than 9,500 new cases of melanoma skin cancer.
WHAT IS SKIN CANCER?
Over the last 25 years, rates of melanoma skin cancer in Britain have risen faster than any other common cancer. There are two main types of skin cancer: melanoma (or malignant melanoma) and non-melanoma. Non melanoma skin cancers include basal cell carcinoma (BCC) and squamous cell carcinoma (SCC).
SYMPTOMS
Non melanoma skin cancers are usually slow growing and occur on sun exposed areas of the skin. These cancers rarely spread. BCC affects all sun exposed areas of the body. The main symptom is a small painless lump, pink/brownish-grey in colour, with a smooth surface with blood vessels and a waxy or pearl-like border. The lump grows, developing a central depression with rolled edges. SCC usually affects the face. The main symptom is an area of thickened, scaly skin and develops into a painless, hard lump, reddish brown in colour with an irregular edge. The lump becomes a recurring ulcer and doesn’t heal. Melanoma skin cancer can occur anywhere on the body and is more dangerous. The main symptom is a quick- growing, irregular, dark-coloured spot on previously normal skin or in an existing mole that changes size, colour, develops irregular edges, bleeds, itches, crusts or reddens. Occasionally, melanoma skin cancer
may present with swollen lymph glands or rarely in unusual places including the sole of the foot, mouth or eye.
CAUSES AND RISK FACTORS
Skin cancer is caused by overexposure to the sun’s harmful UV rays. A suntan isn’t healthy; in fact it’s a sign of skin damage. The results of sunbathing are skin that ages more quickly and an increased risk of cancer. Non melanoma skins cancers result from prolonged sunlight exposure over many years. The main cause of melanoma skin cancer is exposure to short periods of intense sunlight: the kind of exposure people get on a two week holiday.
TREATMENT AND RECOVERY
Diagnosis of skin cancer can usually be made by your GP or hospital specialist by simple skin examination. Sometimes, the skin cancer will need to be removed by a small operation or biopsy; both for treatment and lab testing. Other routine tests, including X-rays and scans aren’t usually required. Non-melanoma skin cancers are usually treated by surgical removal or freezing (cryotherapy). Occasionally, special creams (chemotherapy or immunotherapy) can also be advised, particularly if the cancers are multiple or recur. Melanoma skin cancer is treated by surgery. This also involves removing additional healthy skin, the amount dependent on the thickness of the melanoma. In some instances this may also require a small skin graft to cover the area and help healing. Occasionally a small biopsy of a lymph node may also be taken at the same time, defining future risks of recurrence. Most melanoma skin cancers can be cured with surgery if caught early. Some melanoma skin cancers can spread to other parts of the body. Where melanoma has spread beyond the skin or local lymph nodes, the treatment approach is very individualised and aimed at controlling the disease while minimising side effects and improving symptoms. Chemotherapy, radiotherapy, biological therapy and surgery may all be used in various combinations. It’s quite common to be invited to enter a trial comparing one treatment approach with a newer approach to see if this improves results or reduces side effects. All trials are very carefully scrutinised by independent ethics committees to ensure to ensure they meet current best standards of care. Most skin cancers are easily treated and cured when detected early. Melanoma skin cancer remains the most dangerous subtype because of the risk of spread. About 1,800 people die from melanoma skin cancer annually in the UK. Even so, nearly 80 per cent of men and over 90 per cent of women are alive at five years following treatment.
PREVENTION
The best way to prevent skin cancer is to avoid too much time in the sun. You don't have to be sunbathing to get burned. You can get too much sun while walking to the shops, driving a car with the windows down, even under light cloud cover. Time of day and location are important too. The intensity of UV radiation increases during the middle of the day, between April to September, nearer the equator and at higher altitudes.
HOW TO PROTECT YOURSELF AND YOUR CHILDREN:
- Stick to the shade between 11am and 3pm
- Cover up with clothes, a wide brimmed hat and sunglasses
- Apply a high-factor sunscreen (minimum SPF15 and three stars) regularly
- Drink plenty of water to avoid overheating
- Avoid using sun lamps or sunbeds
WATCH THOSE MOLES
Many moles aren't cancerous, but it's vital to keep an eye on any you have. Watch out for moles that change shape or colour, become bigger, itchy or inflamed, or that weep or bleed. If you notice any changes or are worried, get them checked by a doctor.
IRRITABLE BOWEL SYNDROME
Irritable bowel syndrome (IBS) causes a variety of unpleasant abdominal symptoms.
SYMPTOMS OF IBS INCLUDE:
- Abdominal pain, bloating and wind
- Diarrhoea or constipation, or episodes of both
- Passing mucus when you open your bowels
- A feeling of incomplete emptying of the rectum
- Nausea and vomiting
- Depression, anxiety and stress
- Other possible symptoms that aren't related to the gut include backache, tiredness, headaches, and urinary or gynaecological symptoms.
About one third of those with IBS predominantly have problems with diarrhoea while another third are mostly troubled by constipation, and the remainder have both loose and hard motions, and others switch between types. While IBS can cause huge disruption and destroy the quality of life for those severely affected, it's important to know that IBS is not linked to life-threatening diseases and doesn't develop into bowel cancer, for example.
CAUSES AND RISK FACTORS
Although the exact cause is unknown, and it isn't possible to prevent IBS from developing, there are certain things that trigger attacks and so should be avoided, including stress, certain foods (different in every individual), irregular mealtimes and, in some cases, a lack of dietary fibre. What research is starting to show is that people with IBS seem to have a colon (also called the large bowel) that is super-sensitive. This is supported by the fact that some people develop IBS following gut infections and food poisoning, suggesting that these illnesses have somehow changed the gut and made it more sensitive. The whole length of the bowel is controlled by a nervous system, which carries signals back and forward between the gut and the brain, controlling factors such as how fast food is pushed through the intestines. Some experts believe this 'enteric' nervous system is faulty in people with IBS.
In IBS, the bowel responds with powerful contractions or spasms to stimuli that wouldn't bother other people, for example, simply eating food. The fact that many women with IBS find it's particularly bad just before or during their period has led researchers to suggest that female hormones may play a part too.
TREATMENT AND RECOVERY
There isn't a cure for IBS, but the following actions will help:
Watch your diet Make a food diary. Try to work out how your diet relates to your symptoms, by comparing what you have eaten with bad attacks. The gut normally responds to food by contracting, and the strength of the response seems to be linked to the amount of fat in the meal. So try to cut down on the fat in your diet. Avoid fat-rich food, such as dairy food, ensure your milk is skimmed or semi-skimmed, and cook with minimal fat by baking or steaming food rather than frying or roasting. Avoid large meals as they can trigger spasms. Instead, eat small amounts more often. Make sure that you rule out lactose intolerance as a cause of your symptoms – this condition is often mistaken for IBS. As many as one in ten people in the UK - and more among those of African or Asian descent - has lactose intolerance, as they lack the enzyme necessary to digest lactose (the sugar found in milk and used in many manufactured food products). Lactose from foods passes undigested to the large bowel, where it is fermented by the gut bacteria, resulting in cramps and gas production. Lactose intolerance can cause symptoms very similar to IBS. Cut down on dairy products and see if your symptoms improve. You can also try supplements of lactase –the enzyme that digests lactose.
EAT SOLUBLE FIBRE
Fibre can help to reduce IBS symptoms and prevent spasms. But be careful what type of fibre you eat and how much you consume because people can react very differently. In diarrhoea, fibre may firm up and slow down the passage of stools, but some people with IBS also get constipation and then fibre can bulk up and soften stools, making them easier to pass. But fibre can aggravate both constipation and diarrhoea. Current thinking is that soluble fibre is probably most helpful for people with IBS. High levels of soluble fibre are found in vegetables, such as potatoes, and some fruits (apples and citrus), dried beans, oats and barley. Insoluble fibre may also be helpful for constipation. Good sources include wheat bran, whole grains, cereals, seeds and the skins of many fruits and vegetables. Fibre supplements may be worth a try, too. You may find an increase in gas and bloating at first, but this will soon calm down.
TACKLE STRESS
Try to get as much sleep as you need, ensure there's a least one set period each week when you can have some time exclusively for yourself (ideally, you should do this at least once a day) and take up some relaxation therapies.
GET EXPERT HELP
There are drugs that can help reduce spasms in IBS. Talk to your doctor or pharmacist, especially if things get really bad. A couple of words of warning. Occasionally, chronic gastrointestinal infections can lead to IBS symptoms, so it's important you see your doctor to confirm the diagnosis is IBS. Second, if you pass blood when you open your bowels, get checked by your doctor as this isn't normal, even in IBS.
OTHER TREATMENTS
Peppermint oil and antispasmodic medication relieve abdominal pain. Anti-diarrhoea medication will stop diarrhoea. If constipation is a problem then increasing fluid, fibre, activity, as well as taking a gentle laxative may be recommended. More recent research has shown that improving the natural gut flora or friendly bacteria found within the gut can reduce symptoms. You can do this either by taking prebiotics (special “foods” which increase the levels of your own bacteria), probiotics (extra supplements of gut bacteria themselves) or a combination of both. The most natural source of probiotics are foods such as washed but unpeeled root vegetables, but it is difficult to get enough this way. You can use probiotic yoghurts and drinks but the best way to be sure to get good concentrations of the friendly bacteria into the gut may be to take specific probiotic supplements (ask in the pharmacy or at your health store). Studies have shown that these treatments may help reduce symptoms such as bloating and flatulence. Friendly bacteria to look out for include Lactobacillus rhamnosus plantarum, (a mixture of lactobacilli), and bifidobacteria.
Advice and support
The Gut Trust
Helpline: 0114 272 3253
Email: info@theguttrust
Website: www.theguttrust.rg
Core
Tel: 020 7486 0341
Email: info@corecharity.org.uk
Website: www.corecharity.org.uk