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Medscape
02-07-2025
- Health
- Medscape
Chelation Therapy for Heart Disease? The Hype Doesn't Hold
This transcript has been edited for clarity. If you're like me, you use social media to follow dog accounts because the dogs are all very good boys. If you surf the dark corners of the internet where people with no medical training dole out medical advice without any qualifications, then you may have heard someone talk about heavy metals — and no, I don't mean the music. Heavy metals — things like mercury, lead, arsenic, and iron — supposedly cause everything from heart disease to autism. Now, you might be saying to yourself, 'Wait a second, lead poisoning isn't good for you. I learned that in medical school.' You are right, but the problem here is that people are using this factoid to push chelation therapy on an unsuspecting public. Now, if you don't know, chelation therapy is a medical procedure where you remove heavy metals from the body. This is obviously useful in cases of acute lead poisoning, for example. It isn't going to cure autism, and it's certainly not going to reduce your cardiovascular risk. However, about a decade ago, the TACT trial suggested that it there were problems with this study, such as a high dropout rate, maybe blinding failed, and numerous interim analysis. To make a long story short, even with all these caveats, the benefit was mainly limited to people with diabetes. A confirmatory follow-up study was planned. TACT2 was supposed to settle this issue definitively, and it was negative. If someone tries to sell you chelation therapy, don't buy it. It doesn't prevent heart disease, it doesn't treat autism, and it's potentially dangerous. It took over a decade and how many millions of dollars for us to figure it out, but at least it's done now. For Medscape, I'm Dr Christopher Labos.
Health Line
24-06-2025
- Health
- Health Line
What Are The Causes of a Perineum Lump?
Having a perineal cyst or lump can be caused by anything from an injury to a sexually transmitted illness (STI). It's often not serious, but if you experience pain or swelling, your doctor can rule out more concerning causes. The perineum is a small patch of skin, nerves, and blood vessels between your genitals and anus. It may not seem that important because it's small, typically unseen, and doesn't seem to serve much purpose. But at some point, you may notice a lump on or near your perineum. Sometimes it's expected, such as when you're pregnant, and the perineum becomes swollen or painful near the end of the pregnancy. In other cases, you may feel perineum pain or notice abnormal bleeding or discharge from the perineum. This can disrupt otherwise simple daily tasks like sitting or using the bathroom. There are a few reasons you can get a perineum lump. Some perineum lumps are harmless, but others, like hemorrhoids, may cause discomfort or pain and require treatment. The use of binary terms such as 'male' and 'female' or 'men' and 'women' in this article reflects the language of the sources we've used. Unless otherwise noted, it's unclear whether the research we reference included participants with expansive gender identities. Causes Some causes of perineum lumps are common to all sexes. But others are more common in people with vulvas than in people with penises. We'll start with common causes in all sexes, and then we'll get down to the specific causes of perineum lumps in people with vulvas and people with penises. Common causes in all sexes Here are some of the possible causes of perineum lumps regardless of sex: Injuries Impacts to the groin area during physical activity or from falling on your rear can bruise, tear, or rip your perineum, causing a lump there. A lump can also result from chronic injuries to the nerves, blood vessels, and skin from pressure caused by sitting for long periods of time. Pelvic floor dysfunction Pelvic floor dysfunction happens when the muscles and ligaments around the bottom of your hips are injured, strained, or weakened. This causes the muscles to tighten or contract involuntarily when they're supposed to be relaxed. A perineum lump may appear where muscles are tight. Hemorrhoids Hemorrhoids happen when blood vessels near your anus or rectum get swollen. You may notice them as tender or painful lumps close to your perineum. Sexually transmitted infections (STIs) Many common STIs, like herpes and pubic lice, can cause red bumps around your genital and anal area, including on your perineum. Cysts These are fluid-filled sacs that can develop in the anus. Though they don't typically cause any symptoms, they can fill with fluid over time and become large enough to make it difficult to sit. Abscesses An abscess happens when an opening in your anus gets filled with infected pus. This can result in swelling near your perineum. Hematoma A perineal hematoma happens when blood pools in the blood vessels under the skin of your perineum, pushing up the skin and causing a lump. Cancer A cancerous tumor can grow on the skin of the perineum or in the tissues underneath, resulting in a lump. It may get bigger and more painful or tender over time. Both benign and cancerous tumors are more common in your 30s and 40s. In people with vulvas Here are some possible causes of perineum lumps that are more common in people with vulvas: Urinary tract infections (UTIs). UTIs happen when your urethra, bladder, or kidneys get infected. They're more common in people with vulvas because the urinary tract is much shorter, and infectious bacteria can get in more easily. Swelling from a UTI can make your perineum swollen or tender. Interstitial cystitis. Interstitial cystitis happens when the muscles around your bladder get inflamed, sometimes resulting in swelling near your perineum. This happens to people of all sexes, but it's most common in people with vulvas. Vulvodynia. Vulvodynia refers to pain around your vulva that can last for long periods of time, sometimes resulting in swelling around your perineum. Pyramidal protrusion. This is a skin tag that sticks out from the tissues of the perineum. It doesn't typically cause pain or discomfort and is most commonly diagnosed in young children. Swelling during pregnancy. Swelling around the perineum is common during the third trimester of pregnancy. Complications of an episiotomy. During some births, doctors make an incision from the vagina through the perineum called an episiotomy to make it easier for a child to come out. When the perineum is repaired after birth, you may experience bumps, swelling, and itchiness around the perineum as the tissues heal. In people with penises The leading cause of a perineum lump in people with penises is prostatitis. Prostatitis can happen when the prostate gland becomes swollen, which can push against the perineum and cause a lump to appear. Symptoms Here are some other symptoms you may notice along with a perineum lump: redness or other color changes around the swollen area bruising itching unusual discharge from the lump, your genitals, or your anus bleeding, especially after an injury or from a hemorrhoid an open wound unusual new growths or discoloration around the perineum pain when you pee or poop having trouble peeing See your doctor if you experience any intense pain or discomfort along with these symptoms. Diagnosis Your doctor will likely begin a diagnosis by requesting your medical history. They will then do a physical exam of your entire body, including your perineum. Your doctor may palpate (lightly touch) your perineum and the surrounding tissues to see if you experience more pain and discomfort when pressure is applied. They may also order a urine or blood test to check for any abnormalities that might be related to the perineum lump. This is especially important if they're concerned that you may have an infection or a cancerous tumor. Your doctor may also want to order imaging tests like X-rays or a functional magnetic resonance imaging (fMRI) test to look more closely at any abnormalities in your perineum area. Once your doctor has confirmed their diagnosis, they'll walk you through the next steps for treating the cause of your perineum lump. Treatments Here are some treatments you can try to help reduce the discomfort, pain, or swelling that might accompany a perineum lump: Use a donut or hemorrhoid pillow to reduce the pressure on your perineum from your own weight while you sit, especially if you're sitting for an extended period of time or on a hard surface. Use a cold compress or ice pack to relieve pain and swelling in the perineum area. Wear looser pants or clothing that reduces pressure on your perineum and the surrounding area. Try shorts instead of jeans, a dress instead of pants, or boxers instead of briefs. Massage the perineum area gently with your fingers to relieve pain and swelling. If you'd like, use a natural oil like jojoba or coconut while you massage. Use a sitz bath to relieve pain, itching, or swelling in the area of the perineum. Use a perineal irrigation bottle to help clean or wash away any skin damage or sources of irritation. Take pain medication like ibuprofen (Advil) to reduce swelling and pain. Have a doctor drain fluid or pus from a cyst or an abscess. Ask your doctor about surgery to remove a hemorrhoid, cyst, or tumor.
The Guardian
07-06-2025
- Health
- The Guardian
Scott Morrison sought advice to obstruct Nauru asylum seekers from accessing abortions, documents reveal
Scott Morrison overrode medical advice in the case of an asylum seeker in offshore detention trying to access an abortion, and had previously sought advice that would effectively prevent access to terminations entirely, ministerial advice reveals. Documents released under freedom of information laws show Morrison, in 2014 as immigration minister, had sought advice to deny the transfer of women to a hospital on the Australian mainland to access termination services before 20 weeks' gestation. Abortion is illegal on Nauru, except to save the mother's life, and carries a prison term of up to 14 years. Termination laws differ across Australian states, but if pregnant women in offshore detention were prohibited from accessing abortion services in Australia until after 20 weeks, it would be far more difficult to access those services at all. A handwritten note by Morrison, on a document dated June 2014, stated: 'I would also like advice on denying transfer pre 20 weeks for pregnant women.' In the same document, Morrison specified that women should only be transferred to Brisbane, not South Australia, the Northern Territory or Victoria for abortion services. Morrison did not respond to requests for comment, and Guardian Australia cannot confirm what advice he received. In the case of a woman, who was not identified in the redacted documents, medical advice recommended she be transferred to Victoria for an abortion, over Brisbane where she would have had to have waited a week for a hospital ethics panel to consider her case. That policy was in place in Queensland for women seeking a termination after 20 weeks' gestation. In Victoria, a woman could seek a termination without approval of a hospital ethics board until 24 weeks. Guardian Australia understands the woman was taken to Brisbane, rather than Melbourne, where the panel deliberated on her case. One senior source, who spoke to Guardian Australia on the condition of anonymity, said Morrison did not specifically target abortion access. Sign up for Guardian Australia's breaking news email David Manne, a prominent refugee advocate and lawyer, said in his view the broader immigration policy at the time was part of an 'extreme deterrence agenda'. 'Inherent in the [broader] policy was conscious, calculated cruelty,' he said. 'Clearly, [the policy] was far more than reckless indifference, it was deliberate. '[It was] part of a system that was underpinned by the extreme deterrence agenda … the basic rights and dignity of people subject to the policy were essentially irrelevant.' Jana Favero, the deputy CEO of the Asylum Seeker Resource Centre (ASRC), who was an advocate for the centre at the time, said the documents were 'outrageous' and 'consistent' with the ASRC's experience trying to help asylum seekers get medical transfers. 'It was extremely challenging and difficult for the medical transfer from people offshore, in particular women who were pregnant,' she said. Manne claimed the Abbott government was concerned asylum seekers and refugees were using medical transfers as a back door to get into Australia. Once in Australia, and in the Australian onshore detention system, an asylum seeker could go to the court to seek an injunction to prevent being sent back to offshore detention. '[They] could plead their case under law to resist being sent back to Nauru, to further dangers of the kinds that they'd already faced,' Manne said. This wasn't the only concern held by the government. Manne said the policy was based on deterrence, to stop others seeking asylum arriving by boat. 'If we make some exception, if there's a perceived crack of light in this policy, this could see the resumption of boat arrivals, that was clearly the thinking.' Later, in 2019, Peter Dutton, by then the home affairs minister in the Morrison government, accused women in Nauru refugee centres of using rape and abortion claims as a ploy to get to Australia. Over the 18 months from 1 January 2013 to 20 June 2014, IHMS, the government contracted healthcare provider for Nauru, said there were six pregnant transferees who were taken to the mainland for a termination. In June 2014, there were 289 women in detention on Nauru, according to data collated by the Refugee Council of Australia. Numerous internal and external reviews of offshore detention centres found instances of violence and traumatic living conditions, amid allegations and reports of rape, sexual assaults. An independent investigation, by the former integrity commissioner Philip Moss, commissioned by Morrison in October 2014, found evidence of rapes and sexual violence on Nauru and Manus Island, and said incidents were often under-reported. In 2016, Guardian Australia released the Nauru files, a collection of 2,000 leaked incident reports detailing harrowing instances of abuse on the island between May 2013 and October 2015. More than half of the reports (51.3%) involved children, even though children made up only about 18% of those in detention on Nauru during the time covered by the reports. Favero said the ASRC had performed its own audit on medical transfers at the time, and said it sometimes took up to 18 months for an asylum seeker to get help on the mainland. 'From the point where there was a [doctor's] recommendation for a medical transfer, sometimes it took up to 12 to 18 months for that to happen, and it only happened as a result of a huge amount of pressure including legal action,' Favero said. In February 2019, five years later, after Morrison became prime minister, Labor and the crossbench passed the medevac bill, against the Coalition government, that established a medical panel to oversee medical transfers of people from offshore detention. That law lasted less than 10 months, before it was repealed by the Morrison government in December that year. 'The decision [to transfer a patient] should have been in doctors' hands not in bureaucrats and politicians hands which is what that legislation was,' Favero said.
The Sun
02-06-2025
- General
- The Sun
What your ‘embarrassing' symptoms ‘down there' are REALLY trying to tell you – and when it could be deadly
WHEN you notice something out of the ordinary down below, it's only natural to worry. While some changes are normal, others can be a sign of something more serious - and even warrant pretty swift medical attention. But how can you tell one from the other? We've asked the experts, so you don't have to. The overwhelming message is that keeping any unusual signs in and around your nether regions to yourself is the worst thing you can do. More often that not, your GP will tell you not to worry, but it's better to get checked than leave it too late. Here… a team of leading medics share what could be causing those lumps, bumps, unusual smells and strange itches… and reveal when you must seek help. Spotting between periods NOTICING blood when it's not your Time Of The Month can be worrying. After all, 'spotting' is a key symptom of cervical cancer. But Dr Hannah Burrage, lead GP at Livi says that up to 35 per cent of women will experience a 'blip in their usual bleeding patterns'. She tells Sun Health: 'It may be as simple as the type of contraception you are on, for example, the progesterone-only pill. 'Other causes that need further investigation include polyps or fibroids which are growths on the different layers of our womb.' If your spotting is consistent, check in with your GP. Spotting could be caused by a sexually transmitted infection (STI) such as chlamydia. To get tested, visit for free STI testing. Symptoms, treatment and latest research on anal cancer 'Make sure you are up to date with your cervical smear test,' says Dr Burrage. 'The NHS offers screening every three years from age 25 to 49 and every five years from age 50 to 64.' Superdrug Online Doctor, Dr Babak Ashrafi adds: 'If the bleeding becomes heavier or is accompanied by symptoms like dizziness, fatigue, or pelvic pain, consult a doctor urgently.' Peeing without realising THERE are different types of incontinence - that is when you pee without realising or wanting to. 'Stress incontinence may make us think twice before bouncing on a trampoline,' says Dr Burrage. Urge incontinence is when you leak urine as you feel a sudden intense urge to go. 'Urge incontinence is the classic 'key in lock' scenario, where a leakage of urine happens with a sudden need to pass urine which is often hard to control,' says Dr Burrage. She adds that menopause, constipation, a chronic cough, hysterectomy, pelvic floor damage, often after a vaginal birth, and urinary tract infections (UTIs) can make incontinence more likely. To help ease symptoms, Dr Burrage suggests cutting down on caffeine and reducing your fluid intake in the hours before bed. 'There are useful Apps to help with pelvic floor exercises such as Squeezy (£2.99, IOS and Android).' Medications may help overcome incontinence; book an appointment with your GP who will assess if these are right for you. There is also overflow incontinence, which is when you are unable to fully empty your bladder, causing leaking, or total incontinence. If it continues for a long period of time, your GP can refer you to see a urologist. Foamy urine FOAM in your pee can be alarming, but it isn't always a cause for concern, Superdrug's Dr Ashrafi tells Sun Health. 'Typically, foamy urine occurs due to a faster urine stream, which temporarily traps air bubbles or mild dehydration, which makes your urine more concentrated.' Persistently foamy urine could signal a condition called proteinuria, where protein leaks into the urine. Dr Ashrafi says: 'This often points to issues with kidney function. 'Your kidneys help filter out waste while retaining essential proteins in the blood. 'Conditions like diabetes, high blood pressure and even some medications may trigger it.' Both of these health conditions would require a trip to the GP - plus, high blood pressure doesn't typically cause any symptoms. Signs of type 2 diabetes are peeing more than usual, feeling more thirsty, tired and losing weight without trying to. A UTI could also lead to foamy urine. Dr Ashrafi says some people advise drinking cranberry juice can reduce the risk of UTIs. 'Immediate medical attention is necessary if you also experience swelling in your legs or around your eyes,' adds Dr Ashrafi. 'This can indicate a problem with the kidneys, such as proteinuria, where excess protein leaks into the urine.' Going to the loo: What's normal and what is NOT PEEING What's normal There are lot's of fluctuations between people. But peeing between six and seven times in a 24-hour period is normal for most. Four to 10 times a day can be normal for someone, too, according to Bladder and Bowel community. It's normal to wake up in the night to pee. And urine should be a champagne sort of colour. Pee should come out in a steady stream and you shouldn't need to force it. What's NOT normal You might consider that your peeing habits have become abnormal if you: are going more often than you used to keep going in the night experience pain it doesn't feel like you fully 'empty' the stream is not steady or is weak leak urine see blood in urine There are lots of things that can influence how much we pee. Urge incontinence, overflow incontinence, and total incontinence all refer to disruptions in the way your bladder stores and gets rid of urine. You can read about them on the NHS website. The causes range from an enlarged prostate, constipation, not drinking enough water, caffeine and medications. Serious conditions such as prostate cancer can influence your peeing habits. So get any changes cheked out! POOING What's normal People tend to go for a poo once a day or three to four times a week. As long as the stool is easy to pass and is smooth and sausage or snake shaped (yes, medically, that is how scientists describe a healthy poo on the Bristol Stool Chart!). What's NOT normal Any changes to pooing habits should be seen to by a doctor because they could signal bowel cancer. The symptoms can include: Persistent constipation or diarrhoea Very dark stools, blood in stool or blood on the tissue paper Pencil-thin poos Pancreatic cancer can also cause stools that are described as being pale, oily, difficult to flush and bad-smelling. It's important not to brush off these symptoms - seeing a GP could be the difference between life and death. Other health conditions that may change your bowel habits include IBS. Stools that are hard, difficult to pass or pellet-like can signal constipation. Read how to 'go' easier here. READ MORE A GP reveals how normal is your poo Can you tell the healthy poos from the unhealthy ones? The 5 things your pee is telling you How getting up to pee in the night could be a sign of silent killer – when to see your doctor Anal mucus IT feels icky to talk about but it is a normal part of the body's functioning. Anal mucus, also known as rectal discharge, is produced to help lubricate the movement of your stools. 'Mucus is produced within your intestines to protect the lining and enable food to pass through smoothly,' Dr Todd Green, lead GP, also at Livi, tells Sun Health. It's not usually anything to worry about. 'However, large amounts of mucus or repeated episodes, particularly accompanied by blood in the poo, may indicate inflammation in the intestines,' he warns.. According to Dr Green, this can result from infections such as gastroenteritis or food poisoning, or less commonly, it may indicate an inflammatory bowel disease (IBD) such as ulcerative colitis. 'If you think you have gastroenteritis and notice mucus or any blood in the poo, consult your GP urgently to check for a more serious bowel infection that may need treatment,' warns Dr Green. Sharp pain when going for a poo HAVING a poo should be painless, but episodes of constipation or diarrhoea can occasionally cause discomfort. 'Otherwise, the most common causes of pain when having a poo are haemorrhoids (piles) and anal fissures,' says Dr Green. 'Haemorrhoids occur when the soft 'cushions' lining the inside of the anus become inflamed and irritated, usually resulting from excessive pressure from straining on the toilet, chronic coughs or heavy lifting.' Anal fissures, on the other hand, are common tiny tears within the anus that can occur at any age and may similarly result from constipation. 'A healthy diet with plenty of fibre and fluids can help prevent and treat both haemorrhoids and anal fissures,' says Dr Ashrafi. 'Pharmacists can help with treatments for haemorrhoids to reduce itch and discomfort, while GPs can provide prescription treatments for anal fissures.' More seriously, pain when having a poo can indicate inflammatory bowel disease or bowel cancer. 'If you experience repeated pain on the toilet, with or without bleeding, then consult your GP,' says Dr Green. What are the red flag warning signs of bowel cancer? IT'S the fourth most common cancer in the UK, the second deadliest - yet bowel cancer can be cured, if you catch it early enough. While screening is one way of ensuring early diagnosis, there are things everyone can do to reduce their risk of the deadly disease. Being aware of the signs and symptoms of bowel cancer, spotting any changes and checking with your GP can prove a life-saver. If you notice any of the signs, don't be embarrassed and don't ignore them. Doctors are used to seeing lots of patients with bowel problems. The five red-flag symptoms of bowel cancer include: Bleeding from the back passage, or blood in your poo A change in your normal toilet habits - going more frequently for example Pain or a lump in your tummy Extreme tiredness Losing weight Tumours in the bowel typically bleed, which can cause a shortage of red blood cells, known as anaemia. It can cause tiredness and sometimes breathlessness. In some cases bowel cancer can block the bowel, this is known as a bowel obstruction. Other signs include: Gripping pains in the abdomen Feeling bloated Constipation and being unable to pass wind Being sick Feeling like you need to strain - like doing a number two - but after you've been to the loo While these are all signs to watch out for, experts warn the most serious is noticing blood in your stools. But, they warn it can prove tricky for doctors to diagnose the disease, because in most cases these symptoms will be a sign of a less serious disease. Small lumps around the anus SMALL lumps around your bottom? You may feel something unusual around the anus when using the toilet, or experience associated symptoms. 'If they are painful lumps, especially when accompanied by constipation and/or bleeding, then they're more likely to be haemorrhoids,' says Dr Green. Less commonly, lumps around the anus can indicate a more serious problem, such as an abscess. An abscess would likely make you feel unwell, too, as it is an infection of an anal gland or other tissue in the area. A lump is also a symptom of cancer. The main symptoms of anal cancer are small lumps around and inside the bottom, itching, pain, or bleeding from the bottom, and discharge. Bowel cancer may cause a lump in the tummy. But look out for changes to your poo and bowel frequency such as blood in stool, abnormal diarrhoea or constipation and feeling like you need to go for a poo even if you've just been. If you notice a new lump around the anus, whether or not there are any other symptoms, book an appointment with your GP. You may also mistake anal warts for these small lumps. Anal warts may appear on their own or in clusters. These warts are a symptom of human papillomavirus (HPV), which is extremely common and passed during sexual/skin-to-skin contact. You should visit a sexual health clinic if these warts become painful, itch or bleed. Odours down there FOR women, vaginal discharge is normal. It fluctuates in consistency depending on the time of your cycle. But it's important to look out for any changes in vaginal discharge that don't feel right to you. Dr Burrage says: 'Thrush can often cause an itch and a thick cottage cheese-like discharge whilst bacterial vaginosis (BV) is often a thinner grey discharge that has a fishy smell.' Medication can be used to treat both of these conditions - you can go to a pharmacy to ask for treatment initially. But if you have repeated episodes, you need to visit your GP or sexual health clinic for advice. 'Consider washing with just water and avoiding scented products,' says Dr Barrage. This will be best for your vaginal health and warding off infections. Men can get thrust too, although it's less common. Dr Ashrafi says: 'It typically appears as redness, itching and a white, sometimes thickened discharge on the head of the penis. 'It can be triggered by factors such as antibiotic use, a weakened immune system or unprotected sex with a partner who has thrush.' For both men and women, Dr Ashrafi says: 'If you're sexually active and notice any abnormal discharge, take an STI test.' For example, large amounts of discharge, discharge that is green, yellow, red or blood-stained. Dr Ashrafi adds: 'Men can also experience unpleasant odours from the genitals, which may indicate poor hygiene, a bacterial or fungal infection, or a sexually transmitted infection (STI). 'If the smell is persistent or accompanied by other symptoms like itching, redness or discharge, it's important to see a healthcare professional for assessment.' Itchy genitals and itchy anus WHETHER both areas are itchy, or just one, this can be incredibly uncomfortable. Both men and women can experience thrush, the key symptom of which is itching. 'These occur more often in warm, moist conditions,' Dr Green says. 'Avoid tight-fitting underwear especially for prolonged periods and keep skin in these areas clean and dry. 'Avoid the use of soaps, fragranced wash products or wet wipes.' But Dr Ashrafi says that skin conditions like eczema, STIs, irritants such as strong soaps and anal warts can also be the cause. 'If the itching is severe or persists despite treatment, seek guidance from your GP.' Dr Green says less commonly, an itchy rash on the genitals - usually in middle-aged women but sometimes also in men - can be caused by a condition called lichen sclerosus. 'The itch tends to be worse at night and can also affect the skin around the anus, which gradually turns white over time,' says Dr Green. Symptoms can be controlled with prescription creams, however, lichen sclerosus carries a 'small increased risk of cancer of the anogenital skin'.
Daily Mail
26-05-2025
- Health
- Daily Mail
How concerned should I be about my crusty brown skin patches? Dr Ellie reveals whether you should be worried about cancer
I am 77 and have crusty patches on my breasts, back and stomach. Could they be cancerous? Dr Ellie Cannon replies: It is unlikely. These sound like seborrhoeic keratoses – harmless skin growths that affect around three-quarters of people over 70 and often appear as rough, crusty patches in shades of tan, brown or black that can grow several centimetres wide.
