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When can gallstones be a concern? DR MARTIN SCURR answers your health questions

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A recent ultrasound to check my fatty liver showed that I also have gallstones. I don’t have any symptoms, but I haven’t been able to make a personal appointment with my GP to discuss what might need to be done. I feel like I’m in the dark. I am 74 and fit for my age.

Don Rae, Bridge of Allan, Stirlingshire.

Gallstones, known medically as cholelithiasis, are small stones, usually made up of cholesterol, that form in the gallbladder.

Tucked under the liver, this pouch-like organ stores bile, a fluid produced by the liver that helps break down fatty foods.

In most cases, these stones cause no symptoms and require no treatment, and often their presence is picked up by chance, such as in your case when someone is undergoing a scan for some other reason.

Gallstones are very common: About six percent of men and nine percent of women have them, and the possible causes are many — from age to obesity to sudden weight loss.

Gallstones, medically known as cholelithiasis, are small stones, usually composed of cholesterol, that form in the gallbladder

I can understand it’s upsetting not to get advice on what to do, but the official advice is don’t deal with them unless they cause problems.

Surgery to remove them is only really considered if they cause complications, such as acute cholecystitis (an infection in the gallbladder), pancreatitis (acute inflammation of the pancreas), or biliary colic (when a stone migrates from the gallbladder and causes a blockage in one from the nearby ducts that carry bile to the intestine – this is extremely painful and requires urgent medical attention).

The surgery involves removing both the gallbladder and stones and is performed under general anaesthetic.

The symptoms that indicate complications usually come on suddenly and include intense pain in your upper right abdomen, a high temperature and nausea – but since you don’t have these, no intervention or treatment should be necessary.

But if you should develop any of the complications described above, you should be listed immediately for surgery to have your gallbladder removed, which is normally done during keyhole surgery. Hopefully, an opportunity will arise when you can discuss the topic with a doctor in your practice.

For years I suffered from uncomfortable little cuts in the corner of my mouth. I have tried many remedies but no luck. Can you suggest something?

Brian Gibson, by email.

This sounds like angular stomatitis, also known as angular cheilitis – a condition most common in older people, which occurs when saliva collects at the corners of the mouth, leading to cracking.

The environment there – with a constant supply of moisture – encourages fungi and bacteria to thrive and cause inflammation.

Eczema, ill-fitting dentures, and drooling during sleep can all make it worse.

There is some evidence that a lack of certain nutrients may play a role, especially insufficient B vitamins, iron or protein.

Other risk factors include long-term smoking and the wrinkles we get with age. I suggest you buy a tube of two percent clotrimazole cream (available at pharmacies under the brand name Canesten) and apply it twice a day with your little finger, sparingly, for at least two weeks.

This drug is both antifungal and antibacterial and should resolve the inflamed cracks.

After that, get into the habit of applying a little bit of petroleum jelly in the same way twice a day to prevent the skin from drying out.

This should almost certainly be effective.

Write to Dr. scurr

Write to Dr. Scurr on Good Health, Daily Mail, 2 Derry Street, London W8 5TT or email: drmartin@dailymail.co.uk — please provide contact details. dr. Scurr cannot enter into personal correspondence. Answers should be taken in a general context. Consult your own doctor in case of health problems.

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