My heart will suddenly beat fast for no particular reason. When this happens I struggle to catch my breath and feel anxious. I wear a smartwatch and it says my pulse rate is normal. What could be the problem?
Dr Ellie replies: Sudden racing or pounding in the chest is usually a palpitation. It gives the sensation of the heart beating faster, harder or irregularly, even if the actual rate is not dramatically raised.
Many patients describe an unsettling thumping or fluttering feeling that can come on without warning. This often goes hand in hand with breathlessness and anxiety, because the body releases the hormone adrenaline, triggering a ‘fight or flight’ response, which can make breathing feel more difficult and amplify the sensation.
In most cases palpitations are harmless, as they are usually triggered by stress, anxiety, caffeine or medications, such as asthma inhalers.
The symptom is not usually life-threatening and can be tackled by treating the underlying issue. For example, talking therapy may help relieve feelings of anxiety.
For some, palpitations can be caused by thyroid problems. The butterfly-shaped organ in the neck produces crucial hormones. However, it can sometimes overproduce these chemicals – known as hyperthyroidism.
A GP can usually diagnose it using a blood test, and there are medicines, such as carbimazole, that can treat it.
That said, it is important to rule out a heart rhythm problem, such as atrial fibrillation – where the heartbeat becomes irregular and can increase the risk of stroke.
Palpitations are not usually life-threatening and can be tackled by treating the underlying issue, says Dr Ellie Cannon
Dr Ellie advises that patients should not rely solely on smartwatches to measure their health
Palpitations should always be checked by a GP, who might recommend a 24-hour electrocardiogram, or ECG, where the heart is monitored using a wearable gadget for a day to spot any signs of the disease.
Finally, patients should not rely solely on smartwatches to measure their health. While these gadgets can be helpful, they are not medical devices and can miss serious signs of disease.
I’m in my early 70s and sometimes my urine has a strange smell. It comes and goes, with no other symptoms. What could be the cause?
Dr Ellie replies: A significant change in urine smell could be due to a bladder infection.
It’s normal for urine odour to vary – this can often be influenced by hydration or diet.
However, it can also be a sign of a mild urinary tract infection (UTI). The condition is most often associated with pain or a burning sensation while peeing.
However, for patients with a low-grade infection, it can also lead to a change in urine smell.
UTIs are usually treated with antibiotics. But when it is not causing any painful symptoms it is generally not considered harmful and should resolve itself without treatment.
However, over time, repeated UTIs can be a problem. For some people, most of whom are women, UTIs can become chronic – meaning they return again and again. In these cases, antibiotics can be ineffective or only offer temporary relief.
So it’s important that UTI sufferers take steps to limit the risk of them returning.
These include drinking plenty of water, avoiding tight-fitting clothes and urinating after sex.
In rare cases, recurrent UTI symptoms – such as a change in smell – in older women can be a sign of ovarian cancer, so a GP may recommend an ultrasound scan of the pelvis to rule this out.
UTIs can become chronic – meaning they return again and again and in these cases, antibiotics can be ineffective or only offer temporary relief
A low-residue diet following bowel surgery means raw fruit and vegetables are avoided as they are harder to digest and can irritate the healing bowel
Following bowel surgery, a low-residue diet has been recommended. When is it safe to return to a normal diet?
Dr Ellie replies: A low-residue diet – also known as a low-fibre diet – is usually only needed temporarily after bowel surgery.
Most patients can begin returning to a normal diet within around six to eight weeks – although this varies depending on the type of surgery they have had and their recovery.
This diet is designed to reduce the amount of undigested food passing through the bowel by limiting the amount of fibre. Foods such as whole grains, seeds, nuts, raw fruit and vegetables are avoided as they are harder to digest and can irritate the healing bowel.
Instead, patients are advised to eat more easily digestible foods, such as white bread, refined cereals and well-cooked vegetables without skins or seeds. This allows the bowel to rest and recover.
During recovery, fibre is usually reintroduced gradually. This is done slowly to avoid triggering symptoms such as pain, bloating or diarrhoea.
The speed of reintroduction of fibre depends on the patient, the nature of the surgery and whether there is any ongoing bowel disease.
Crucially, when a patient undergoes bowel surgery, a note is sent by the surgical team to their GP, explaining any post-operative instructions. This should include how long the patient needs to stick with a low-residue diet.
So this is something that patients should be able to check with their GP.
Which vitamins do you take regularly?
Research has found that people who take a daily multivitamin age slightly slower than those who don’t
It’s one of the most common questions I’m asked in clinics: which vitamin supplements are worth taking?
Earlier this year, a study called COSMOS concluded that people who take a daily multivitamin age slightly slower than those who don’t – but the difference in ageing between the two groups was only three months.
However, it got me thinking about what advice GPs should be giving to their patients.
Personally, I take vitamin D pills all year round because it’s proven to be good for bones. I also take vitamin C and zinc throughout the winter to protect myself from viral infections such as flu and colds.
Which supplements do you take? Do you notice any health improvements once you started on them? Please write in on the email address DrEllie@mailonsunday.co.uk and let me know.
Reason sciatica is on the rise
Have you suffered with sciatica recently? A colleague of mine who specialises in the agonising nerve pain issue says it’s on the rise.
I certainly see a lot of sciatica patients at my surgery.
The condition causes pain, tingling and numbness down the legs, and can be really difficult to treat. It occurs when a nerve that runs down the back and into each leg – called the sciatic nerve – becomes irritated.
The condition is more common in people who are obese, which might explain why it’s on the rise in the UK, with more of us than ever carrying excess weight. Gentle exercise seems to help with the problem, but it can take some time to heal.
I’m interested to hear whether you have developed sciatica – and, if so, what you think set it off.
If you have a question for Dr Ellie Cannon, write to DrEllie@mailonsunday.co.uk
