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CASE NOTES
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PROGRAMME INFO |
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Dr听Mark Porter听gives listeners the low-down on what the medical profession does and doesn't know. Each week an expert in the studio tackles听a particular topic and there are reports from around the UK on the health of the nation - and the NHS.
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PRESENTER |
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"I spend half my week practising medicine and the other half writing and talking about it as a GP in Gloucestershire. Working on Case Notes has been a boon for both me and my patients. One of the principal aims of the programme is to keep our listeners up-to-date with the latest developments in healthcare, and to accomplish that I get to interview a wide range of specialists at the cutting edge of medicine. A rare privilege that ensures our listeners aren't the only ones to learn something new."
Mark Porter
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PROGRAMME DETAILS |
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 Full programme transcript >>
Itching
We鈥檙e used to idea that a rash or a scab can be itchy, but there are other conditions that leave no signs on the skin but make us itch.
Conditions like eczema, chickenpox and prickly heat all have itching in common - and the almost irresistible response to an itch: scratching.听
Some people听who itch, however,听have no rash or other signs on their skin. They may be referred to dermatologists like Tony Bewley - who has clinics at Whipps Cross and Bart's and the London hospitals - for further investigations.
Iron Deficiency
Young women who are menstruating and have young families can be prone to low iron levels because their diet may not be iron-rich enough.
This iron deficiency can cause itching.
They may not look that pale but often have thinning hair because of their low iron stores. Iron deficiency can be confirmed by a blood test.
Some patients prefer to boost their iron through their diet by eating spinach or liver, for example. If these foods are eaten with a mild acid such as a听squirt of lemon or a glass of orange juice, the body's ability to absorb it is boosted.
Alternatively iron tablets can be taken.
Behaviour Management
Although we commonly associate itching with scratching, patients report that only about half of their scratching is associated with itching - the rest is habit.
Psychiatrists like Dr Chris Bridgett can help to break this itch-scratch cycle with habit reversal techniques.
Patients are given a small counter, which they click every time they scratch.听
The patient is taught how to replace the scratching with another behaviour such as clenching the hands by their sides for 30 seconds.
If the itch persists, they can then touch or pinch the skin until the sensation disappears.
Obstetric Cholestasis
Obstetric cholestasis - or OC - is an complication of pregnancy which causes a build up of bile acids in the bloodstream.
The main symptom is persistent itch in the last trimester of pregnancy.
It affects about 1 in 100 pregnancies in the UK but is more common in twin or triplet pregnancies.听
The usual treatment is to take medication to reduce the level of bile acid. Once the condition has been diagnosed - by blood tests for liver function and bile acids - more frequent ante-natal check ups are advised.
The risk of stillbirth with OC increases sharply after about 36-37 weeks, so many specialists advise an early delivery of the baby.
Itching in older skins
Another group of people who often suffer from itching where no rash is present is the elderly.
As we get older our skin becomes less oily.听 If older people wash too often using too much soap the skin can become unbearably itchy.
This can usually be easily remedied by swapping soap or shower gel with a soap-free cream cleanser or bath oil, and using an emollient cream after washing.
In more severe cases, anti-histamine tablets or carefully-monitored sunlight treatment might be prescribed.
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