What you need to know:
- Puberty can start any time from eight to 14 years
- It usually starts with breast development in girls
- Rarely, puberty may also start early if there is a problem with the ovaries
My daughter is eight years old but her breasts have started growing. Is this a medical condition and what should I do to slow down this process?
Puberty can start any time from eight to 14 years, and it usually starts with breast development in girls, so your daughter is within the normal age of puberty onset. If puberty starts before age eight, it is considered to be early, which many times may not have a specific cause so it cannot be treated, though it may be due to family tendency. Rarely, puberty may also start early if there is a problem with the ovaries, the thyroid gland or the brain, in which case then puberty may be delayed if the underlying problem is addressed.
Sometimes I cough up these stinky, small white balls from my throat. What are they and where do they come from? How can I get rid of them once and for all?
Those stinky white balls from the throat are called tonsil stones or tonsiloliths. They form on the tonsils, which are lymphatic glands at the throat and that have an irregular surface. Bacteria, mucous, dead cells, and food particles can become trapped in the folds on the surface of the tonsils. The trapped substances then join together and form the bad-smelling chunks. If these chunks harden, they are called tonsil stones or tonsiloliths. Tonsil stones are more common in people with chronic tonsillitis, or sinusitis and post-nasal drip.
These stones may cause bad breath, bad taste in the mouth, throat discomfort, difficulty swallowing or ear pain. Other than this discomfort, tonsil stones are usually not dangerous.
To manage them, observe good oral hygiene by brushing your teeth after meals, gargle using salty water or a mouth wash to reduce the bad breath, or you can have the stones removed by the doctor. Before brushing your teeth, remove food particles from your mouth by drinking water and by swishing water in your mouth and spitting out. It would be advisable to visit a dentist and ENT specialist so that any underlying problem can be treated.
I am 29 years old. I have this protrusion on the top part of my left wrist. I also feel pain on the top part of my right wrist joint when I fold it, but there is no protrusion. This protrusion comes and goes or moves to my other wrist.
That swelling is called a ganglion cyst. It occurs when there is a protrusion of the synovial fluid and the membrane around it from a joint or a tendon. The synovial fluid is the fluid around joints and tendons that provides lubrication and cushioning during movement.
Ganglions can occur at any joint but are most common on the back of the wrist. There is no known cause of the protrusion. If it causes pain or limits movement at the joint, then it can be removed surgically. Otherwise, it can be left as it is because it is not dangerous.
I have a persistent heartburn. What could be causing it and how do I stop it?
A heartburn occurs because of irritation or inflammation of the lining of the stomach and the lower part of the oesophagus, caused by excessive stomach acid and digestive enzymes. The inflammation may be worsened by having an infection in the stomach, like H pylori, but not everyone who has heartburn has H pylori infection. If the irritation continues, it can lead to a break in the lining of the stomach, forming a wound or sore, which is called an ulcer. This can also occur in the lower part of the oesophagus or in the first part of the small intestines (duodenum).
This causes abdominal pain, chest pain, loss of appetite, nausea and vomiting, poor digestion, bloating, and when severe, it can lead to weight loss, dark or bloody stools, severe pain and vomiting blood.
Some tests can be done, especially if it keeps recurring. These include stool tests, barium tests and endoscopy. For treatment, you will be given medication to reduce the amount of acid your stomach makes, medicine to neutralise the acid, medicine to protect the lining of the stomach, some drugs to control reflux and pain medication. You may need to be on this medicine for a long time.
In some people, the disease may take long to treat, or it may keep coming back. This may be because your stomach continues to produce a lot of acid, either because of genetics, or because it is triggered by stress or anxiety. It may also be due to having other problems like inflammatory bowel disease, other infections, liver or kidney disease, or even stomach cancer. To reduce or prevent the symptoms, avoid alcohol and smoking; avoid some painkillers like ibuprofen, aspirin, diclofenac and also long-term use of steroids. Do not skip meals, avoid spicy foods, chilli, very fatty foods, sodas, black tea and coffee, or very concentrated tea and coffee, and other foods and drinks that are acidic.
Every person who has the disease has different triggers. You can keep a food diary and see if you can match which foods and drinks trigger the symptoms. In the long run, the purpose of treatment is to relieve the symptoms, so that you can be able to eat what you would like.
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