Is my stye due to stress?

DEAR DOCTOR - I've recently become prone to recurrent styes. I'm told they usually result from stress and poor diet, and that they can run in families. Is this true? I eat a well-balanced diet and don't feel stressed.

• A stye is a bacterial infection causing a small abscess at the edge of the eyelid. A stye might look large, but usually only a single sebaceous gland draining into one of the eyelash follicles is affected. Gently remove the affected eyelash so that pus can drain away - don't squeeze the area or infection may spread - then bathe the eye regularly with an infusion of camomile, eyebright (euphrasia) or marigold (calendula). A recently used camomile teabag works well as a compress. A stye can be confused with an infected meibomian gland, which develops behind the root of an eyelash on the eyelid. This leaves a lump which can keep flaring up and may need to be removed by an ophthalmic surgeon. Recurrent styes are not usually hereditary but suggest your immunity is low. Taking echinacea and a vitamin and mineral supplement may help.

  DEAR DOCTOR - I have started eating linseed, high-fibre cereal with soy milk and am taking a one-a-day red clover tablet for hot flushes. I'm delighted with the reduction in menopausal symptoms - however, I find that I'm excessively thirsty and drink water all day long, with corresponding bladder activity. Could this be due to the supplements I am using?

• Anyone developing excessive thirst (polydipsia) and increased urine production (polyuria) should always consult their doctor, as these symptoms can occur with medical conditions such as diabetes mellitus, raised calcium levels, reduced potassium levels or, more rarely, a condition known as diabetes insipidus.

  Primary or psychogenic polydipsia, an unexplained compulsion to keep drinking fluids, is also relatively common and, if necessary, is diagnosed by assessing changes in blood and urine concentration during a water deprivation test.

  Assuming you are given the "all clear", it is unlikely that the dietary changes you have made would significantly affect your body's water/salt balance. The increased thirst may be related to summer heat or greater levels of physical activity.

  DEAR DOCTOR - I was recently prescribed 75mg aspirin daily because of leg pains, but I am also on medication for high blood pressure. I read that low doses of aspirin are ineffective among men with high BP, and raise the risk of serious internal bleeding. I take fenoprofen for ankylosing spondylitis and ginkgo biloba leaf.

• A recent randomised controlled trial published in the BMJ found that, in a group of about 5,500 men aged between 45 and 69 with increased risk of coronary heart disease, aspirin reduced the risk of heart attack overall by 20 per cent. This benefit was significantly greater in men with a lower blood pressure (systolic less than 130mmg Hg) whose risk was reduced by 45 per cent. For those with a higher BP (systolic greater than 145mm Hg) the risk reduction was only about six per cent.

  When the relative risks for both coronary heart disease and stroke were combined, significant benefit was shown for those with lower BP (risk reduced by 41 per cent) but no benefit was shown for those with a BP above 145mm systolic. The researchers suggest that, if their results are correct, men with pressures of 145mm Hg or more will derive little if any protection against heart attack or stroke, but will be exposed to the risk of troublesome and occasionally serious bleeding, even with 75mg aspirin which, for example, doubles the risk of peptic ulcer bleeding.

  Fenoprofen itself increases the risk of peptic ulceration and bleeding, while aspirin and ginkgo should not be taken together because of a possible increased blood thinning effect. You therefore need to discuss the rationale for taking aspirin with your doctor.

  DEAR DOCTOR - My sense of smell has entirely disappeared despite surgery to remove nasal polyps. I read that oral steroids could help and my GP reluctantly tried me on a course - the relief was almost instantaneous but the effect disappeared after the course ended. I'm reluctant to take steroids again but wonder how else to bring back my sense of smell.

• Smell receptors are located at the top of the nasal cavity and depend on tiny, hair-like nerve endings detecting aromatic substances dissolved in overlying mucus. Complete lack of smell (anosmia) is commonly related to chronic rhinitis, in which inflammation and increased production of mucus block smell receptors. Two types, perennial allergic rhinitis and vasomotor rhinitis, are both associated with nasal polyps and loss of smell. Short courses of oral steroids (prednisolone) readily improve symptoms and continuous treatment with topical corticosteroids (eg fluticasone spray) is sometimes advised to prevent nasal polyp recurrences.

  It is worth undergoing investigations to pinpoint dietary or environmental allergies. Curcumin (extracted from the spice turmeric) has powerful anti-inflammatory actions equivalent to those of some steroids. High dose vitamin C also helps to reduce inflammation (take in the form of ester-C if you are prone to indigestion). The amino acid N-actylcysteine makes mucus less viscous and may improve symptoms. Acupuncture may also help.

• If you have trouble obtaining nutritional supplements featured in this column, the Nutri Centre in London will be happy to supply them by mail order at a 15 per cent discount. Please call 020 7436 5122.
• Letters should be sent to Dr Sarah Brewer, Features Department, The Daily Telegraph, 1 Canada Square, Canary Wharf, London E14 5DT; fax 020 7513 2508. Letters cannot be answered personally. Before following any advice, please consult your GP. No responsibility can be taken for advice given in this column. Questions can be sent by email to: drsarah@bizonline.co.uk

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