Page 44
they should be left alone.
In some cases, however, the stones
can attract bacteria, leading to bad
breath, embarrassment and distress.
Antibiotics do not help — despite
the involvement of bacteria — and
are not recommended.
Some people try to clear them
away with their finger or a cotton
bud, but I would advise against this,
as it can damage the throat.
Instead, I suggest a daily, vigorous
gargle with warm, salty water. If this
is done regularly, the tonsilloliths
will eventually dislodge. Continuing
the gargles, in tandem with frequent
brushing and flossing of the teeth
(not the tonsils, I must stress), will
stop the stones recurring.
Removal of the tonsils is carried
out less commonly these days and
the NHS usually reserves this for
patients with recurrent tonsillitis.
It is not regarded as a treatment
for tonsil stones, since these mostly
can be treated successfully at home.I HAVE age-related macular
degeneration and wonder
if laser treatment would help. A
relative had it, but my consultant
says it’s not an option for me and
recommends a diet of eggs, leafy
green vegetables and oily fish. I am
84 and awaiting cataract surgery.
Mrs J. D., London.
Age-RelAted macular
degeneration (AMd) is a
disease that blurs central vision and
makes everyday activities, such as
reading and watching tV, difficult.
Caused by the death of cells in the
macula, the part of the retina we use
to see straight ahead, AMd is the
main cause of sight loss in the UK,
affecting more than 600,000 people,MY 27-YEAR-OLD granddaughter
is plagued by tonsil stones. Her
consultant said her tonsils could be
taken out, but that she would have to
pay for it privately. What causes tonsil
stones? Is there anything she can do?
Name and address supplied.
OUR tonsils aren’t smooth, but are
covered in nooks and crannies where
food, dead cells and other debris become
trapped, forming hard deposits. Yellow or(^) Daily Mail, Tuesday, August 13, 2019
THE deaths of 12 people in Essex
from a rare, invasive bacterial
infection, caused by the group A
streptococcus bacterium, in June
should concern us all.
Most group A strep infections
cause mild illnesses, such as strep
throat and skin infections — but
these recent cases, which mainly
occurred among elderly patients
in care homes, sadly proved fatal.
We must ask why. I suspect one
factor is the modern failure to test
before prescribing antibiotics.
There was a time when doctors
would take a swab from a patient
with a severe sore throat; people
with urinary symptoms had to
provide a clean catch of urine;
and those with a productive cough
would be asked for a specimen of
sputum. These would then be sent
off to a laboratory for analysis.
This meant a decision to treat
with antibiotics could be based
not only on symptoms, but the
bacteria cultured, and the patient
would be given antibiotics lethal
to that particular infection. Sure,
it would mean a wait to get the
result — but it was only 48 hours.
This system required a follow-up
phone call to the patient to advise
them of the result of the analysis
and, where necessary, to arrange
for a correct prescription.
But now, instead, because of that
‘nuisance’ value and, no doubt, the
cost, diagnosis is based on guess-
work and dreaded NHS algorithms.
If an antibiotic is prescribed, it’s
often the same tired old regimen
of amoxicillin or trimethoprim
banged out on reflex, rather than
utilising the correct drug for the
scientifically identified bacteria.
Is this why sepsis is on the rise in
England? Cases have more than
doubled in three years. Shouldn’t
we be doing the best for our
patients, taking a bit more time
and trouble — and hang the cost?
IN MY VIEW... IT’S CRUCIAL WE
PRESCRIBE THE RIGHT ANTIBIOTICS
A
Q
white in colour, these range in size, from
being so small the person isn’t aware they
are there, to the size of a large grape.
the largest on record, reported in 1936,
measured a whopping 14½ cm.
As many as one in ten of the population
has tonsil stones, or tonsilloliths. they
are more common in teenagers and young
adults and often occur after recurrent
bouts of tonsillitis. they’re not harmful,
despite their unpleasant appearance,
and, if they aren’t causing any symptoms,
WRITE TO DR SCURR
n WRITE to Dr Scurr at Good
Health, Daily Mail, 2 Derry
Street, London W8 5TT or
email [email protected]
— include your contact details.
Dr Scurr cannot enter into
personal correspondence.
Replies should be taken in a
general context and always
consult your own GP with any
health worries.
Q
A
and is most common in those aged
65 and over.
there are two types of AMd — dry
and the more severe wet type, which
is mainly treated with injections into
the eye. these injected drugs, called
vascular endothelial growth factor
inhibitors, prevent the growth of
the abnormal blood vessels that are
behind this form of the condition,
stop the deterioration of sight and,
in some cases, even improve vision.
laser treatment on the blood
vessels can be used, but it has largely
been replaced by the injections.
Your relative probably had wet
AMd, however, from what you say in
your longer letter, I am hopeful you
have the dry type.
While there is no treatment, it
progresses more slowly and causes
less severe vision loss. It is linked
to a build-up of waste products in
the eye.
do heed your consultant’s advice
about diet. Fruit, leafy green veg,
eggs, fish and nuts contain nutrients
that help delay damage to the retina
and so preserve sight for longer.
Cataracts are a separate condition
in which the eye’s clear lens clouds
over. Surgery to replace the lens is
the most common operation in the
UK and the success rate is high.
I hope that, after cataract surgery,
you will experience a considerable
degree of improvement in your
eyesight, despite your AMd.
DR MARTIN
SCURR
ASK THE GP
Picture: GETTY
What tonsil stones are
and ways to treat them
V2