Dr Ellie Cannon explains why harmless heart palpitations can feel terrifying.

Dr Ellie Cannon addresses a reader concerned about sudden heart palpitations that occur without an obvious cause. The individual describes experiencing a rapid, pounding heart rate accompanied by breathlessness and anxiety, despite their smartwatch displaying a normal reading. Dr Cannon explains that this sensation is typically a palpitation, which creates the feeling of an irregular or forceful heartbeat even when the actual rate remains stable.

Many patients report an unsettling thumping or fluttering sensation that appears unexpectedly. This feeling often coincides with difficulty breathing and heightened anxiety because the body releases adrenaline to trigger a fight-or-flight response. That hormonal surge can make breathing feel more labored and intensify the perception of the heart beating erratically.

In most instances, these episodes are harmless and stem from stress, anxiety, caffeine consumption, or specific medications like asthma inhalers. The condition is generally not life-threatening and can be managed by addressing the root cause, such as utilizing talking therapy to alleviate underlying anxiety.

However, some cases may originate from thyroid problems where the butterfly-shaped gland in the neck overproduces hormones known as hyperthyroidism. A general practitioner can diagnose this issue using a blood test, and conditions like carbimazole are available to treat the hormonal imbalance.

It remains crucial to rule out serious heart rhythm disorders such as atrial fibrillation, which causes an irregular heartbeat and elevates stroke risk. Dr Cannon advises that patients should never rely exclusively on smartwatches to assess their health status. While these gadgets offer helpful insights, they lack the precision of medical devices and may overlook significant signs of disease.

A doctor should always evaluate palpitations, potentially recommending a 24-hour electrocardiogram to monitor the heart with a wearable gadget for a full day. This monitoring helps identify any hidden patterns or signs of underlying disease that a standard watch might miss.

Dr Cannon also responds to another reader in their early 70s who notices a strange, intermittent smell in their urine without other symptoms. A significant change in urine odor can indicate a bladder infection or urinary tract infection, though variations are also normal due to hydration levels or diet.

While mild infections often present with pain or a burning sensation during urination, low-grade infections can sometimes manifest solely as a change in smell. These conditions are usually treated with antibiotics, yet asymptomatic cases are often considered harmless and may resolve on their own without medical intervention.

Repeated occurrences of urinary tract infections can become problematic over time, particularly for women who may experience chronic infections that return frequently. Managing these recurrences is essential to prevent long-term complications associated with persistent urinary issues.

Antibiotics often fail to cure urinary tract infections (UTIs) or provide only fleeting relief, making prevention essential for those suffering from these conditions. Patients should adopt specific habits to lower the risk of recurrence, such as consuming ample fluids, wearing loose-fitting clothing, and voiding immediately after sexual intercourse. In rare instances, recurrent symptoms in older women—specifically a change in bodily odor—may indicate ovarian cancer; consequently, a general practitioner might order a pelvic ultrasound to exclude this serious condition.

UTIs can evolve into chronic states characterized by persistent recurrence, rendering standard antibiotic therapy ineffective or merely temporary. Following bowel surgery, patients are frequently prescribed a low-residue, or low-fibre, diet. This regimen avoids raw fruits and vegetables because their tough textures are difficult to digest and can irritate a healing bowel.

Dr. Ellie explains that this dietary restriction is typically temporary. Most individuals can resume a normal diet within six to eight weeks, though the timeline varies based on the specific surgical procedure and the patient's recovery progress. The goal of the low-residue diet is to minimize undigested food passing through the intestines by limiting fibre intake. Instead of whole grains, seeds, nuts, and raw produce, patients are advised to consume easily digestible options like white bread, refined cereals, and well-cooked vegetables without skins or seeds. This approach allows the bowel to rest and heal. During the recovery phase, fibre is reintroduced gradually to prevent symptoms such as pain, bloating, or diarrhoea. The pace of this reintroduction depends on the individual patient, the nature of the surgery, and the presence of any ongoing bowel disease. Crucially, the surgical team sends a note to the patient's GP detailing post-operative instructions, including the duration of the low-residue diet, which patients should verify with their doctor.

Regarding vitamin supplementation, research indicates that daily multivitamin users age slightly slower than non-users, though the difference amounts to only three months according to a study called COSMOS. Despite this modest finding, the question of which supplements are beneficial remains common in clinical settings. Dr. Ellie personally takes vitamin D year-round for bone health and uses vitamin C and zinc during winter months to guard against viral infections like the flu and colds. She invites readers to share their own supplement routines and observed health improvements via email.

The incidence of sciatica is increasing, a trend Dr. Ellie attributes partly to rising obesity rates in the UK. This agonising nerve pain, which causes pain, tingling, and numbness down the legs, occurs when the sciatic nerve running from the back into each leg becomes irritated. The condition is particularly prevalent among obese individuals, suggesting that the growing number of people carrying excess weight explains the surge in cases.

While gentle exercise appears to aid recovery, the healing process can be a slow one.

I am keen to learn if you have developed sciatica and would like to know what you believe triggered the condition.

For those seeking medical advice, questions for Dr Ellie Cannon can be sent to [email protected].