Why do I feel things going all the way down after I swallow? Just ask DR ELLIE CANNON

I have developed the uncomfortable sensation of feeling anything I swallow – food, or even tablets – ‘going down’ almost all the way into my stomach. It’s very odd. Any ideas what it could be?

This would fall into the category of a swallowing difficulty, and it absolutely should be checked out by your doctor.   

Pain, regurgitating or feeling food is stuck or irritating the gullet on swallowing can be early signs of cancer of the oesophagus – it’s uncommon, so it’s important not to panic, but needs to be ruled out. 

DR ELLIE CANNON: This would fall into the category of a swallowing difficulty, and it absolutely should be checked out by your doctor. Pain, regurgitating or feeling food is stuck or irritating the gullet on swallowing can be early signs of cancer of the oesophagus – it’s uncommon, so it’s important not to panic, but needs to be ruled out (stock)

Most commonly, changes of this type are caused by excess acid from the stomach escaping into the oesophagus, or gullet. We call this gastric reflux, and it’s most often seen in people who are overweight, pregnant or eat too close to going to bed. 

The reflux not only causes heartburn pain or indigestion, it can irritate the lining of the oesophagus and this could certainly cause changes to the sensation with swallowing and a feeling of food being stuck the whole way down. 

This is called oesophagitis. Another common reason for both swallowing difficulty and acid reflux is a hiatus hernia. This is when part of the stomach bulges through a weakness in the diaphragm, the muscle that separates the abdomen and chest. 

DR ELLIE CANNON: This is something we normally see in pre-school-age children, but trauma can trigger such reactions in older children (stock)

DR ELLIE CANNON: This is something we normally see in pre-school-age children, but trauma can trigger such reactions in older children (stock)

It would be reasonable in someone who has had this symptom for a week or two to try an acid-reflux medicine such as omeprazole or lansoprazole to see if this lessens the sensation. 

If it does persist for more than a month, seek a referral for an endoscopy, a test carried out under sedation during which a camera is inserted through the mouth, and down into the gullet. 

If these sensations are happening alongside unexplained weight loss or ongoing nausea or pain, it’s particularly important to get this test. 

It’s not a pleasant procedure, but the endoscopy would differentiate between this being simply acid reflux, a hiatus hernia or worrying changes that could indicate cancer.

Since lockdown ended, my six-year-old son throws tantrums when my partner or I are out of sight. What can we do?

This is something we normally see in pre-school-age children, but trauma can trigger such reactions in older children. 

I am sure lockdown will have induced this kind of separation anxiety for quite a few. 

The important thing is to be consistent with your approach. Ignore tantrums, as long as they are safe. 

Take the opportunity to ‘leave’ them out of sight when they’re at their best, rather than at bad times such as near bedtime when they will be irritable. 

Lockdown’s inconvenient truth: If you want to kickstart the economy, open the public loos again!

Coronavirus restrictions are still keeping public loos closed. 

The upshot is that millions of Britons who rely on them feel unable to get back to their normal lives – for fear of getting caught short. 

Unsurprisingly, I have received a slew of emails and letter from readers agreeing. 

I had a frustrating conversation with a cafe manager in a public park last week, who told me that his life would be at risk if they decided to open their toilet, although beyond saying ‘because of the virus’ he couldn’t seem to explain how.

So I’ll say it again: local councils, shop owners and anyone else reading this who has their toilet shut at present – if you want to boost the economy, and have older people using the high street again, you need to sort it out. 

Giving money off for a meal out is lovely, but you’d think the basic human need of having an accessible bathroom would be a priority too. 

Offer lots of praise when they do stay calm, and perhaps use a reward chart such as stickers. 

Six-year-olds love stickers! 

Basing your response on praising them, rather than giving too much oxygen to the tantrums, will go a long way.

I suffer from gout in my foot. Painkillers help, but I’m often left with pain in my big toe, which makes walking uncomfortable. How long will this last?

Gout is an incredibly painful type of arthritis. It is caused by very high levels of a substance called urate in the blood. We all have some urate but when the levels are very high in gout, crystals are formed which build up in joints. 

The crystals rub against the joint surfaces, causing the pain and swelling typical of an attack of gout. This can come on very suddenly. 

A big toe is the most common place to be affected – patients say it feels hot and unbearably painful at times. When suffering an attack, anti-inflammatory tablets such as naproxen or ibuprofen are ideal and can be continued while pain lasts. If pain lingers, the tablets can be continued, dropping the dose down to once or twice a day, with meals. 

Another drug called colchicine is also used for acute attacks and is effective at reducing the intense inflammation but can’t be used for lingering pain. 

Oral steroid tablets or an injection may be offered by your GP to curb any residual inflammation. In the longer term, medicines called allopurinol and febuxostat can lower urate levels in the blood and prevent attacks. 

Typically a gout attack would last a week, with the worst pain being in the first 48 hours, but it is really important to have an examination with a doctor if the pain persists for longer than this. 

After an operation, I was given co-codamol, which made me constipated. I’m no long taking it, but now have haemorrhoids. My GP says there’s no need to do anything, but they’re getting worse. Can I get treatment on the NHS?

Anything that causes constipation will put you at high risk of haemorrhoids. Also known as piles, they are swollen, often inflamed, veins in the rectum. 

They can be triggered or exacerbated by the pressure that comes with the straining of constipation. Obesity, pregnancy and a poor, low-fibre diet are also linked. Piles cause pain, bleeding, and itchiness – the bleeding is usually bright red. 

Do YOU have a question for Dr Ellie?

Why not write to Dr Ellie Cannon at – [email protected] 

More often than not we treat them without surgery. First and foremost, an examination is important, to rule out anything more serious. 

Haemorrhoids can be external and seen or felt as lumps around the anus, or internally within the rectum. 

The first priority is avoiding constipation through your diet or by medication. A stool-softening diet would include plenty of fluids, dried fruit and fibre. 

There are many types of laxatives but stool-softening ones are necessary for haemorrhoids, such as docusate, which can be prescribed or bought. 

This allows the veins to reduce and the swelling to go down. Steroid cream or suppositories can help reduce inflammation. 

They are usually used for a week and there are many types a GP can prescribe. In conjunction with stool-softening this is usually the only treatment most people need.

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