Why do I cough all the time as if I have to clear my throat? DR ELLIE CANNON answers your questions 

I constantly feel as if I have phlegm stuck in my throat. I’m always coughing to try to clear it, and I also suffer terrible breath. What is wrong with me, and is there anything I can do?

Feeling as though there’s phlegm always in the throat (something stuck in your throat is a different sensation and could be cancer) is incredibly common. And more often than not, the underlying cause lies with the nose or stomach, rather than the throat.

For instance, an excess of mucus in the nasal passages can cause fluid to run down to the back of the nose and into the throat. Doctors call this post-nasal drip. Patients feel as though they constantly need to clear their throat and swallow to get rid of the mucus.

More often than not, the underlying cause of feeling as though there’s phlegm always in the throat lies with the nose or stomach, writes DR ELLIE CANNON

Your worrying tales of surgery restrictions 

Last weekend I asked you to write and tell me if GP surgeries in your area were still not offering face-to-face appointments, despite NHS guidance that says they must.

Hundreds of you have written in.

I’ve read many worrying letters from patients suffering with chest pain and serious infections who have been offered only phone consultations. 

Some have been prescribed potent painkillers such as morphine over the phone – with no prior or follow-up appointments.

Other GP surgeries, it seems, have simply decided to shut up shop completely.

The Mail on Sunday’s Health team is now investigating further, so please keep writing to us to let us know what’s happening in your area.

Post-nasal drips can also cause bad breath, usually because the constant swallowing makes the mouth extremely dry. 

A number of things can cause post-nasal drip, including allergies, chronic sinusitis and irritation from smoking. It can also be a side effect of some medications.

Over-the-counter treatments such as antihistamines and nasal steroid sprays can control the inflammation and limit production of excess mucus.

Nasal rinsing – using a sinus rinse to flush it out with sterile water, which you can buy at most chemists – may also help.

Another common cause of excess liquid in the throat is acid reflux, which happens when acid and digestive juices from the stomach travel too far up the food pipe, collecting at the back of the throat and causing chronic irritation, a cough and bad breath.

If this is the case, a pharmacist can offer antacid medication, which should help after a week or two. 

If the feeling persists, make an appointment with your GP who may conduct tests to rule out rare but serious conditions.

My itchy scalp is driving me mad. It feels as if my head is crawling with something all the time. Medicated shampoo doesn’t work – what will?

Chronic scalp itchiness can be absolutely maddening, but is a surprisingly common reason for people to seek the help of a GP.

A number of things could cause it, but mostly it’s because the skin has become irritated by a shampoo or other hair product.

If the itchiness comes with bad dandruff then it is likely a skin condition called seborrheic dermatitis. You might also notice flaky, itchy skin on the face, particularly in the eyebrows and around the nose.

If the problem comes and goes and you notice red, scaly patches too, it could be psoriasis – a skin disease that can also affect the arms and legs.

Medicated shampoos are hit and miss, but it’s worth trying them in the first instance. Look for ones that contain coal tar or selenium sulphide.

A number of things could cause scalp itchiness, but mostly it's because the skin has become irritated by a shampoo or other hair product

A number of things could cause scalp itchiness, but mostly it’s because the skin has become irritated by a shampoo or other hair product

No jab effects? It’s still working! 

I can understand why readers might be worried about suffering side effects from the Covid jab. 

But I’ve also had a fair few letters from people worried about the opposite: that they’ve suffered no side effects whatsoever.

In a previous column I said that common vaccine side effects, such as headaches and fevers, are a good sign – they mean the immune system has been kicked into action. 

However, this seems to have sparked unnecessary worries.

To clarify: while side effects are a result of your immune system doing its thing, it doesn’t follow that having no problems means it’s not working.

In fact, most people get no side effects at all.

I’m a case in point. I didn’t get a single side effect from my Covid jab. Not even a sore arm.

I spent all afternoon prodding my arm after having my jabs, looking for some discomfort, but there wasn’t any. I guess I’m just lucky.

Individual immune systems react differently but, no matter how you feel afterwards, everyone will develop a similar degree of protection. 

For seborrheic dermatitis, you would need a shampoo containing an anti-fungal medicine called ketoconazole.

Taking an antihistamine tablet at night may help to calm down the itch and stop you scratching, which often increases soreness further. A pharmacist can advise about non-drowsy types to take during the day. If nothing works, a GP may prescribe medication.

Sometimes, with conditions such as psoriasis, they may prescribe stronger medicines, including steroids, to keep the problem at bay.

Otherwise a potent cream, applied morning and night, can do the trick.

There’s also a chance that the itchiness is caused by head lice – which can be caught by parents from their young children.

I suffer from pain and feeling of tightness in the front of my lower leg during my morning walk. It eases up when I get home and sit down. What is it?

Sharp, intense pain between the knee and ankle is often referred to as shin splints. It is especially likely in those who do a lot of long-distance walking or have started a new running regime.

Sometimes it is because there has been prolonged pressure on the shin bone, or tibia, triggering inflammation of the tissue surrounding it. Other times it’s because of tight muscles around the knee and ankle.

Usually it is nothing serious. Doctors will recommend you stop whatever exercise you’re doing, before gradually building the activity level back up. You may be advised to start walking on grass rather than pavement.

Ice packs or painkillers such as paracetamol or ibuprofen can also help to ease the pain.

Before a long walk, remember to warm up using gentle exercises and stretch afterwards. 

WRITE TO DR ELLIE

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As the exercise regime builds back up, supportive trainers can prevent it happening again. If the pain still doesn’t go away, see a GP or physiotherapist, who may do further investigations.

Although less common, there are a number of serious conditions that cause pain during exercise, depending on where the pain is and whether there’s any swelling or numbness.

If the pain is in the back of the lower leg and stops instantly when you rest, it might be a condition of the blood vessels known as peripheral arterial disease. 

Otherwise, problems with the veins in the lower legs could be at play, as well as back problems affecting the nerves to the legs.

Diabetes, which can also cause nerve damage in the legs, is another possibility. If this is the case, you may find the pain also reduces with exercise.