My stomach has felt very uncomfortable for a while. I went for an ultrasound and I was told I have fluid in my endometrial cavity. I was referred to a gynaecologist but I can’t get an appointment for nine months. Can you tell me more about this condition? Should I be worried?
I am 65.
No patient should wait nine months to see a gynaecologist for investigations into an unusual collection of fluid. I understand hospitals are stretched, but this type of problem could be serious, especially in older people.
It is normal for fluid to collect in the womb and surrounding areas before the menopause because of the monthly bleed. But when a woman stops having periods, an excess of fluid could be a sign of something sinister. It may be an overgrowth of the womb lining, or even cancer.
The endometrium is the lining of the womb and it should remain thin after the menopause. It may be thicker in women who take HRT, and the treatment can also cause a build-up of fluid.
Today’s patient is a 65-year-old woman who complains of excessive fluid in the womb and has asked for advice on why she must wait nine months to see a gynaecologist
Usually in post-menopausal woman, fluid in this area would warrant further investigations, including a test called endometrial biopsy. This involves analysing a piece of the womb lining and is performed in the same position as a smear test.
I’d recommend making an appointment with the GP to check why the specialist’s waiting time is so long. Doctors are supposed to make urgent referrals for suspected cancer symptoms, so that the patient is seen within two weeks.
When patients with worrying symptoms have an extended wait, it is often due to the referral being put through incorrectly as ‘non-urgent’. It is worth checking with the GP.
My wife has seven herniated discs in her back and two cracks in her coccyx, the small bones at the base of the spine. She is in constant pain but, weirdly, her specialist seems to think no intervention is needed. Instead, she relies on strong painkillers daily. Can anything be done?
Back pain is one of the most common conditions in the UK. It can cause job losses, relationship difficulties and a great deal of doctors’ appointments. For most people, back pain gets better by itself within six weeks or so, but for some, the pain becomes chronic. At this point, it can be disabling and life-changing, warranting further tests, treatment and pain control.
Patients may be referred for an MRI, but scans don’t give us the full picture – surgeons consider a detailed history and examination to be useful, too.
The scans can spot abnormal structures but not the cause of the pain. And they may not match the symptoms patients experience. A normal-looking MRI does not guarantee no pain.
Spinal surgeons usually adhere to the mantra ‘treat the person, not the scan’. They are especially useful when surgery is considered – this includes spinal fusion and disc replacement.
But only three per cent of people with back pain are suitable for surgery, and experts believe that exercises and painkillers are safer. Spine exercises are less risky than surgery, and recent data shows they are equally as effective. It’s worth having a second discussion with a GP to make sure you have a referral to the right specialist. You can find NHS community musculoskeletal services in many areas these days. These offer options such as physiotherapy with back specialists, GPs with an interest in pain and pain clinics.
I am a long-term sufferer of irritable bowel syndrome (IBS). A recent colonoscopy showed something called diverticulosis. My NHS specialist told me this shouldn’t cause any problems but a private doctor said I have ‘slow movement’ in my colon. He advised eating a low-fibre diet, which is the opposite to what I’ve been told. What should I do?
Often, when people suffer gut problems, there is more than one underlying issue. IBS is a very common condition that causes abdominal pain, bloating, unusual bowel habits, diarrhoea and constipation.
More from Dr Ellie Cannon for The Mail on Sunday…
People with IBS usually find there are certain triggers – such as foods and stress – that make symptoms worse. Most treatments designed to help regulate bowel habits depend on which problems they endure.
Those who suffer constipation would be advised to increase the amount of fibre they eat, particularly soluble fibre which absorbs water, such as oats. But people who are more prone to diarrhoea would be advised to reduce insoluble fibre, which includes wholemeal or high-fibre bread and cereals high in bran.
Diverticulosis is a different condition – when small pouches, or diverticula, develop within the colon, which is the large part of the bowel. It is thought the condition is caused by pressure built up by slow stool movement.
When the pouches cause difficulties, such as pain in the lower tummy, it’s called diverticular disease. If they become inflamed or infected, doctors call this diverticulitis.
Diverticula are thought to develop in people who have a lifelong low-fibre diet. It is also more common in people who smoke and eat a lot of red meat.
A low-fibre diet may be recommended for certain types of IBS, but for diverticulosis, patients are told to eat plenty of whole grains, fruit, vegetables, seeds and nuts.
If you are over-paying for mobility aids, tell me
Have you had to pay through the nose for essential mobility equipment, such as a bath hand rail or a walking frame?
I’ve been shocked by the high prices some of my disabled patients tell me they’re paying for these aids.
One woman paid £100 for a special cup for her disabled child, which seems to be just a bit of plastic with an extra-long spout. I also know of elderly relatives who have been quoted about £10,000 to have a stairlift fitted – which seems bonkers.
The cynic in me wonders whether there’s some price gouging going on here. Are companies taking advantage of disabled people, who have no choice but to buy these items? Getting local councils to fund disability equipment is more difficult than ever – so these businesses seem to be hiking prices way above what they’re actually worth.
I’m interested to hear from you. If you’ve had to pay an arm and a leg for vital equipment. Email me at the address below.
I’ve been shocked by the high prices some of my disabled patients tell me they’re paying for mobility aids. The cynic in me wonders whether there’s some price gouging going on here. Are companies taking advantage of disabled people, who have no choice but to buy these items?
Why (most) stars dodge dementia
I’m sure I’m not the only one who was upset to hear of Bruce Willis’s dementia diagnosis.
Write to Dr Ellie
Do you have a question for Dr Ellie Cannon? Email DrEllie@mailonsunday.co.uk
Dr Cannon cannot enter into personal correspondence and her replies should be taken in a general context
The 67-year-old’s family made the announcement a year after he quit acting due to a condition called aphasia, which causes problems with speech and language.
Given that dementia is so common, affecting a quarter of men and a third of women, it may seem strange that we don’t hear about more celebrities developing it.
I can think of only a handful, including Barbara Windsor.
But a medical paper I read a while back had studied this phenomenon, examining why famous people are more likely to live longer, healthier lives than the rest of us.
The answer? Wealth and access to the best medical care, fitness trainers and chefs – and, of course, less stress from not having to worry about picking up the dry cleaning or paying the mortgage.
It makes sense, I guess.
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