Dr Bernadette Carr answers your questions on insect bites and gallstones

Dr Bernadette Carr says the best way to avoid insect bites is a combination of insect repellent and covering your skin. 

Q. I am a woman in my 30s and plan to go on a walking holiday in Spain soon. 

On previous holidays I have got bitten by midges and my skin was very itchy. I want to avoid a repetition, what should I do?

A. The best way to avoid insect bites is a combination of insect repellent and covering your skin. 

When an insect bites, its saliva can cause a local (skin) reaction such as an itchy lump which may last for several days and can develop up to 24 hours after the bite. If the area becomes more painful with localised area of redness, you will need to attend your GP as this may be a sign of an infection.

You may not always know that you have been bitten if it is not painful. If you realise you have been, wash the area with soap and water

Preparation is the key particularly on the days that you are walking. Here are some general suggestions to consider:

* Wear light coloured rather than bright clothing

* Tops should have long sleeves and wear trousers rather than shorts

* Wear shoes that cover your entire foot

* Don’t wear perfume, hair spray or strongly perfumed body lotions

* Cover any exposed areas with an insect repellent and reapply regularly

* Keep doors and windows closed and, if necessary, use a plug-in insect repellent

If you do get bitten and have any lumps are itchiness, a hydrocortisone cream and / or antihistamine tablets may be useful. 

You may also use calamine lotion. Your pharmacist will be able to advise you.

Occasionally the immune system can react to a bite and trigger an allergic reaction usually within minutes of being bitten. 

If you experience any of the following then you need to seek urgent medical assistance: rash; swelling of the face or any part of it; fast heart rate; feeling faint; wheezing or difficulty breathing.

I hope you enjoy the holiday.

Q. My sister developed gallstones in her 40s. Now that I am approaching her age, I wonder if there is anything I can do to avoid them?

A. Gallstones are small stones, usually made from cholesterol, that form in the gallbladder or bile duct. 

It is thought that if the levels of cholesterol in bile are too high that the excess cholesterol turns into stones.

Gallstones are very common and women are affected twice as often as men. 

Other risks of developing gallstones are pregnancy, lack of physical activity, overweight or obesity, aged 40 or over and family history.

I would advise you to make an appointment with your GP to have a fasting cholesterol test. 

Given your sister’s medical history, it is important to mention this during your visit.

Cholesterol is a fatty substance that is made by a number of cells in your body with the liver making about a quarter of the total. It is carried around the body by proteins in your blood.

There are two main types of cholesterol:

Low-density lipoprotein (LDL) carries cholesterol from your liver to other cells and is known as ‘bad cholesterol’. 

It is called the bad cholesterol because it sticks to the walls in your arteries making it narrow.

High-density lipoprotein (HDL) carries cholesterol from the cells back to the liver where it is broken down and is known as ‘good cholesterol’.

There are a number of reasons for high cholesterol and making lifestyle changes can be beneficial.

* Reduce the amount of saturated fat by eating lean meat

* Reduce the amount of processed meat products such as sausages

* Chose low-fat dairy products, low-fat spreads and use healthy ways of cooking, such as grilling

* Reduce your salt intake

* If you are overweight, lose weight

* If you are a smoker, stop

* Reduce alcohol

* Take regular exercise

Your GP will be able to advise you once the results of the fasting test become available.


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