A GP for 26 years, Dr Chris Brown specialises in women’s health
Meds and meals
Why is it that some tablets have to be taken with food and some have to be taken on an empty stomach? I get so confused.
Vicki, Bolton
Anti-inflammatory drugs like Ibuprofen can cause inflammation of the stomach lining if they’re taken into an empty stomach, so these should always be taken with or immediately after food. Steroid tablets and some antibiotics such as erythromycin can irritate sensitive stomachs, in which case they should be taken with food. Some antibiotics, such as penicillin and amoxycillin are absorbed better if they go into an empty stomach. Antibiotic tetracycline shouldn’t be in the stomach at the same time as milk, or it doesn’t get absorbed properly. Some medications for IBS should be taken about an hour before meals so that they are effective at meal times. For lots of other drugs, timing in relation to food doesn’t matter. But always check on the drug information leaflet.
Poo problem
I’ve been constipated for three months now. I’ve had laxatives suppositories, enemas and a drug called Picolax. I’ve now been referred to hospital. What happens next?
Annie, Bristol
You really are bunged up if Picolax doesn’t shift it! It’s a ‘bowel cleanser’ rather than a laxative, and should only be used to clean out the bowel before tests or bowel surgery. You certainly shouldn’t use that regularly. Sometimes this level of constipation is due to an underactive thyroid gland. Have a blood test to check, if this hasn’t already been done. Sometimes a sugary, low-fibre diet combined with a poor fluid intake and lack of exercise is the problem. If all these possibilities have been explored, I expect the hospital will want to do some tests, including a camera (colonoscopy) examination, having first cleared the bowel with a heftier bowel cleanser.
Bad back
Is it true that you shouldn’t stay in bed for long with a bad back? Years ago, I had a bad back and was put on two weeks bed rest. It happened again recently, and my GP is trying to get me out of bed after two days. Can this be right?
Marie, Dunstable
Yes, it’s right. The treatment of acute back pain has been turned on its head. A couple of days of bed rest is ok, but then you need to get moving. The idea is to potter about for a while, sit for a while, lie down for a while, but stay mobile. Don’t do anything such as lifting and carrying which could further increase the back pain. Your GP should prescribe some painkillers that are strong enough to allow you to do this. If it’s not settling, some physio might help.
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