I’m 77 and I’ve suffered uncontrollable dribbling for the past six months. Neither my GP nor dentist know what the problem is. The only medicine I take is omeprazole for heartburn. What’s wrong with me?
Dr Ellie replies: Over-salivating is a distressing symptom, and can also irritate around the mouth causing chapped lips and skin infections. The good news is that there are ways of treating it.
A dental issue is usually the cause of dribbling – this includes tooth decay or gum disease.
But if a dentist has investigated and found no problem, that effectively rules this out.
A dental issue, such as tooth decay or gum disease, is usually the cause of dribbling
Acid reflux can also lead to over-salivation. The heartburn medication omeprazole should combat this, but it’s possible that it may not be effectively keeping the problem in check, so it might be worth discussing a change of medicine with a GP.
Dribbling can sometimes be triggered by a neurological condition, such as Parkinson’s, motor neurone disease or multiple sclerosis, though this would usually be accompanied with other symptoms, such as shaking, fatigue and loss of balance.
One option for a patient with this problem would be to see a speech and language therapist – who may be able to pinpoint a problem with the swallowing muscles which could be causing the dribbling.
They should also be able to provide exercises which help alleviate symptoms. A GP can refer patients to one of these specialists.
There are also medicines to help combat over-salivating. These are typically used to treat patients who have excess saliva, but there’s no reason someone with a dribbling issue couldn’t try them too.
Again, a GP should be able to prescribe these treatments.
I have a small lump just below my shoulder that becomes painful several times a day. I’ve put off going to the doctor because I don’t want unnecessary tests. What should I do?
Dr Ellie replies: Anything triggering daily bouts of pain should be looked at by a doctor. Even if the underlying cause is not life-threatening, there is no reason why anyone should have to put up with this level of suffering.
Given that lumps can be a sign of cancer, they should always be checked by a GP.
However, cancerous lumps tend to change shape or grow over time. If one has been present for a number of years without changing, it’s unlikely to be cancer.
A more common cause of skin lumps would be a cyst (a sac of fluid) or a lipoma (a build-up of fat) which form under the skin. Ordinarily the NHS would not remove a non-cancerous growth. But if it is causing pain, surgery may be an option.
Investigating a lump can be done with a straightforward and pain-free ultrasound scan.
A GP can usually refer for this and the wait should not be too long. In rare cases, a sample may be taken with a needle.
Meanwhile, it is worth discussing pain relief options with a GP or pharmacist.
I suffer restless leg syndrome. I take ropinirole and pramipexole but these do not seem to help. Can you suggest any other treatments?
Dr Ellie replies: Restless leg syndrome is a difficult condition to treat because doctors do not fully understand it.
Sufferers experience a need to move their legs around, usually in the evenings and at night. They may also get a feeling of tingling or cramping.
There is some evidence it may be linked to an iron deficiency, but this is not true for all sufferers.
We know smoking, alcohol and caffeine all make it worse, so it’s important to limit your intake of these substances.
Likewise, exercise appears to help reduce the symptoms, so I often recommend patients go for walks and do leg stretches once a day.
A growing number of drugs are prescribed to treat restless leg syndrome. These include pramipexole and ropinirole, originally Parkinson’s drugs, which help combat the shaking that patients experience.
Research also suggests the painkillers gabapentin and pregabalin help reduce the severity of symptoms.
Often the hardest part about living with this uncomfortable condition is that it leads to a loss of sleep, which is not only distressing but can also cause further health problems.
GPs can prescribe the painkiller codeine to help relieve sore legs and improve sleep quality. If patients are already taking the maximum dose, then a referral to a sleep specialist might be needed.
Cutting down on mobile phone time can help those suffering from anxiety and depression (picture posed by model)
Have you tried to ditch your phone?
I am on my phone way too much, so while on holiday I decided to lock it away in a drawer. This digital detox, I have to say, was a massive success.
Rather than responding to work emails and scrolling through social media, I focused on enjoying the sea and sunshine.
In no time I felt a noticeable drop in anxiety levels and my sleep quality improved.
Of course, back in the real world we can’t forget about our phones – they are integral to modern life. But I worry that we are all spending too much time glued to screens.
When patients tell me they are suffering with anxiety and depression, one of the first things I suggest is cutting down on mobile phone time.
Do you think you may be addicted to your phone? Have you tried to get rid of it – and how did that work out? Let me know your thoughts using the email address below.
Do you have a question for Dr Ellie Cannon? Email [email protected]
Dr Cannon cannot enter into personal correspondence and her replies should be taken in a general context.
