Dr. Chris Steele answers a concerned medical questions

Q and A session with Dr. Chris Steele

Q. A close friend has told me that I smell; it's not just a smell of sweat but a `fishy' smell that is quite offensive. Can you help me?

A. We all sweat, and there is a natural tendency for the sweat produced under moments of stress and excitement to be far stronger smelling than the sweat produced after severe physical exertion.
We all probably know of someone who has an extreme problem with B.O. and it's never an easy task to tell them of this problem.
The obvious way to prevent your body smelling is to shower or bathe every day, dry yourself thoroughly afterwards especially under the arms, in the groin and between your toes, change your underwear and socks daily, and to use deodorants, talcs and perfumes sensibly.
However you, friend, seem to have a particular problem and that may be `Fish Odour Syndrome'. The smell is an extremely unpleasant fishy smell that is caused by the person being unable to convert a substance in their body, called Trimethylamine (TMA) into it's odourless breakdown product. This is a genetic problem and it may be inherited. `TMA' is present in sea fish, eggs, liver, soya beans, mayonnaise and citrus fruits all these products should be avoided by sufferers of this problem. Fish odour syndrome affects both sexes, but some female sufferers notice that the smell is accentuated during menstruation and after intercourse. The best treatment is to avoid the foods listed above. Drugs, which are available only on prescription, that reduce bacteria inside the intestines, such as metronidazole and neomycin may be helpful.
Unfortunately, several popular substances are known to increase sweating, such as tea, coffee, alcohol, tobacco, and aspirin!

Q. I am horrified by the fact that whenever I sneeze, cough or laugh I leak urine and wet myself! I am so embarrassed by this problem, I'm ashamed to even tell my husband, never mind my doctor. Can anything be done to help?

A. The condition you have is called `stress incontinence' and you are not alone! At least three and a half million people in Britain are prepared to admit that they suffer from incontinence!
I call this condition the `Silent Epidemic' after mentioning this topic on `This Morning' programme I received 1,200 letters in the first two weeks.
Your incontinence is caused by the increased strain or stress put upon the muscles in the pelvis when you sneeze, cough or even run or jump.
To help this condition you need to strengthen the muscles of your pelvic floor. This can be done in the following way
1. When you are on the toilet passing water, try stopping the flow of water, and then starting again. This `stopping and starting', will improve the power and tone of your pelvic muscles.
2. Whenever you're sitting down reading or watching television, keep tightening your `bottom' muscles and pulling them upwards, to increase their strength and tone. Whenever laughing, sneezing or coughing try tightening your `bottom' muscles.
This condition can also be helped with the use of vaginal weights, which are cone shaped plastic weights that are held inside the vagina for about 15 minutes, twice a day. As the tone and strength of the pelvic muscles increases the woman moves up to the heavier cone. There are three cones in each pack, and research has shown that 70% of women who have completed a one months course felt that they were cured or improved. These cones are called `Femina 3' cones, they cost 25 pounds and are available from Colgate Medical, 1 Fairacres Estate, Dedworth Road, Windsor, Berkshire, SL4 4LE. This company also provide a free leaflet `Laughter Without Tears' and a free, confidential helpline on 0800 526557.

Q. I was horrified to find that my 4yr old son seems to have `worms', they look like white threads in his stools. I feel ashamed to go to surgery, can I get treatment from the local chemist?

A. Your son appears to have `threadworms'. These cause an itchy bottom, especially at night, along with disturbed sleep. The child is often irritable and restless, and in girls the vagina may be itchy, with a slight discharge.
All members of the family should be treated at the same time, with the same treatment, even if they do not show any signs of threadworm infestation. A treatment you can buy from your local pharmacist is `Pripsen', which is a powder that is taken as a drink, and must then be repeated after 14 days for all members of the family! Two treatments that are available on NHS prescription are `Vermox' and `Combantrin'.
The affected child should have a bath every morning , washing the bottom in particular, keep to his own towel, and regularly change his underclothes, clothes and bedding. Keep the child's fingernails short, scrub his hands and fingernails with a nailbrush after using the toilet, and disinfect the toilet handle, door handle and toilet seat often!
However, do not show your child the worms, nor should you tell him he has worms this could cause great anxiety to a child `worms' are earthworms, and the thought of those creatures crawling around inside your tummy is quite terrifying!


IMPORTANT NOTICE : This content is from the Dr Chris Steele personal archive and is provided for convenience only. Information contained here may no longer agree with the most up to date medical advice. Please check with a medical professional before taking any action.

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