DR ELLIE CANNON: Could the pill for my overactive bladder be causing dementia?

I have an overactive bladder and need to urinate frequently during the day and at least four times at night. A specialist at the urology department prescribed daily solifenacin, but a GP at my practice told me this drug has been linked to dementia. I watched my mother die from dementia and I’d do anything to avoid it. I can’t take other medications for my overactive bladder because they interact with my pills for high blood pressure. What should I do?

Taking any medicine involves weighing up risks and benefits.

Risks can include anything from side effects, potential future problems and even the financial costs of prescriptions.

But taking medication for an overactive bladder comes with a host of important benefits, as the condition can be life-destroying, causing isolation, disturbed sleep and a lot of stress. This in itself is a risk for ongoing mental health issues and illness, as not leaving the house is not good for anyone in the long term, so anything that alleviates the root cause is incredibly valuable.

Solifenacin is what’s called an antimuscarinic medicine, which reduces the activity of certain muscles – they are also used to treat the twitches associated with Parkinson’s disease. With an overactive bladder, the drug can stop incontinence and the need to urinate frequently.

Taking medication for an overactive bladder comes with a host of important benefits, as the condition can be life-destroying, causing isolation, disturbed sleep and a lot of stress

Research has, however, shown a link between drugs such as solifenacin and a higher risk of dementia. This association is not well understood, but if someone has a high risk of the illness or is confused, it’s recommended they stay away from them.

Other medications for the condition may be less worrisome, and you can discuss these with a GP or urologist. For instance, darifenacin and trospium are not shown to be associated with a higher dementia risk.

Early last year I was diagnosed with something called idiopathic pulmonary fibrosis. I know little about it and wondered if there was anything you could tell me about a potential cure. It makes daily activities extremely difficult.

Idiopathic pulmonary fibrosis is a lung disease which causes difficulty breathing due to scars that form on the lungs.

Those affected are usually older, around the age of 70.

The condition is very tough to live with because shortness of breath tends to get worse over time, making simple daily activities very challenging.

Other symptoms include coughing, tiredness and even weight loss.

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People with the condition should be treated by a respiratory specialist, but there is currently no cure – only treatments that help to slow the progression of the disease.

These include medications, oxygen and specific exercises to help ease breathing known as pulmonary rehabilitation.

There are two medicines available, which work by helping to slow the scarring of the lungs, but they are usually offered only to patients who have at least half their normal lung capacity.

New treatments are in development, thanks to greater understanding about the genetic underpinnings of the illness. This means there are a number of new drugs currently undergoing trials, which patients may be able to access.

It may be worth visiting the website of the charity Action For Pulmonary Fibrosis, where upcoming research is sometimes announced (actionpf.org).

I have multiple polyps in my large bowel and recently had an operation to remove them. However, the procedure had to be stopped because I was in so much pain. Another appointment has been made but I worry the same thing will happen again. Can you help?

A polyp is a growth that can develop in any part of the body.

They are essentially a collection of extra cells and are most commonly found in the large bowel, also known as the colon.

One in four people aged over 50 will have at least one bowel polyp.

They are usually detected during a colonoscopy – a procedure where a camera is inserted through the back passage to look inside the bowel. While polyps are not always harmful, they can occasionally develop into cancer over several years, which is why doctors usually opt to remove them.

They can sometimes cause symptoms such as bleeding from the back passage or a change in bowel habits like diarrhoea. A patient with polyps will usually have regular colonoscopies to monitor the problem.

Bowel polyps are often removed during a colonoscopy, in a procedure called a polypectomy, where small growths are snipped off and larger ones are removed with cauterisation – burned off. It is not considered to be painful but it can be uncomfortable and distressing. Most of the time, doctors offer sedation and pain relief medication for a polypectomy. If you still feel pain, it is possible to ask for more of this medication – given via a vein in your arm.

If polyps cannot be removed in this way, the next step would be to discuss the risks of cancer and whether it would be safe just to monitor them. However, in cases where there are multiple polyps, this is unlikely to be an option.

The DIY bowel cancer kit that could save your life

Are you worried about bowel cancer? 

As of last week, if you visit the GP with symptoms of the disease – blood in your stools, changes in bowel habits and stomach pain, for example – you’ll be handed a DIY test to carry out at home.

Its not-so-catchy name is an HM-JACKarc or OC-Sensor quantitative faecal immunochemical test, or FIT test for short.

You take a stool sample using the kit provided, package it up and post it off to a lab. Results come back within a week.

If anything is amiss you’ll be referred for further tests. It’s thought the move will save patients from having needless colonoscopies – a procedure involving a camera passed into the back passage – which is good news.

It’s hugely beneficial to do it. If caught early, bowel cancer is very curable, but it’s a real pain to treat if found late.

Sadly, uptake of the test as part of ongoing NHS screening for bowel cancer isn’t great, as about a third of eligible adults don’t use it. I’d like to know if you have taken it, or been sent one and left it sitting in a desk drawer. If so, why? Write to me at the email address below.

Meningitis vaccine is vital for uni

I was worried by the latest figures showing that about one in eight new university students have not been vaccinated against meningitis.

About 30 people die from meningitis every year in England, and more are left with life-threatening injuries as the infection affects the brain and spinal cord. Children are offered the jab – which protects against four deadly strains of the infection – in years nine and ten at school, but it seems that many are missing out.

It’s particularly concerning when they head for university, as this is the age group at highest risk of becoming infected because of the close mixing with lots of new people.

Every young person should make sure they are protected. And if they are not, they should book an urgent GP appointment to get the jab.

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