I always struggle with hay fever despite taking antihistamines. What else can I do to reduce the symptoms?

There are a range of simple measures that can help reduce the discomfort of hay fever symptoms. Taking antihistamines, as you have done is just one of them. Speaking to your pharmacist would be useful. They will discuss your particular symptoms and make a recommendation on the 'next steps'.

Sometimes other medications e.g. a nasal spray can be useful. There is useful information to read about hay fever on the NHSinform website and our Self Help Guide at NHS24.scot can also give useful advice on how to start managing symptoms of hay fever.

I have tummy bloating and pain after foods that are high in gluten what could this be?

People with a true gluten intolerance have 'Coeliac' disease. Gluten is a protein in wheat ,barley and rye and therefore foods containing them. The body's immune system reacts to gluten and this specifically affects the lining of the small bowel which is involved in absorbing food.

This leads to a number of symptoms related to the bowel but also to reduced uptake of nutrients which result from its irritation. These include a feeling of bloating of the tummy, crampy abdominal pain, diarrhoea or constipation. There may have unexpected weight loss and lethargy as well. In children Coeliac disease can lead to slowing down of growth or 'failure to thrive'.

The symptoms of Coeliac symptoms can be caused by a wide range of other conditions and if any are persistent then you should speak to your GP.

Coeliac disease is treated by eating a diet that permanently excludes gluten and once it is started patients begin to feel better quite quickly.

What is Hyperacusis?

'Hyperacusis' is an extreme aversion and hypersensitivity to sounds that are generally not an issue to others.

Electrical and machine noises, as well as sudden high-pitched noises, are usually hard to tolerate for people with hyperacusis. However, any sound can potentially trigger a reaction in someone with hyperacusis – even the sound of their own voice.

It's very different from the reduced tolerance for noise that most of us have when we're tired or stressed, or reacting to an obviously unpleasant noise, such as chalk scratching a blackboard.

Symptoms

Hyperacusis can be just a minor nuisance for some, with people feeling uneasy or uncomfortable when they hear the noise. For others, it can have a major impact on life. Low-level noises may be perceived as intrusively loud and may trigger anxiety.

Noise can be painful for people with severe hyperacusis. High-pitched sounds can be felt as 'a nail being driven into the head' and low-pitched thrumming 'like sandpaper moving across the brain'.

Some react by covering their ears or leaving the room. Crying, anger and panic reactions are not uncommon.

As a result, people with hyperacusis may avoid noisy situations and become socially isolated. People with severe hyperacusis may feel suicidal.

Children with hyperacusis may struggle at school, where background noise can make it difficult for them to concentrate, thereby affecting their achievement. Some will need professional help in this critical period of their lives, but they may grow out of the problem over time.

Diagnosis

Hyperacusis is a difficult problem to study and diagnose because it is a subjective experience that is hard to measure.

Anyone who has a severe sound intolerance should see their GP. They may be referred to an ear, nose and throat (ENT) consultant or a hearing disorders specialist (audiologist) to have a hearing test.

This test involves listening through headphones to sounds of increasing intensity, and pressing a button when the sound becomes uncomfortably loud. Self-reporting questionnaires can also be used to measure how much hyperacusis affects the person's life.

Treatment

Doctors will want to rule out any medical condition that may be causing hyperacusis. Treating the former may cure the latter.

If the underlying cause isn't certain or there's no obvious treatment, a referral may be needed for retraining counselling and sound therapy.

This therapy is widely available privately, and may be available on the NHS for people with very severe or persistent hyperacusis. It should only be carried out by someone specially trained in the technique.

It teaches patients how emotions and the nervous system may play a role in hyperacusis, and encourages them to reclassify troublesome noises as neutral signals. Sound therapy helps this process by temporarily desensitising the hearing system so that the individual can go to noisy places without being constantly affected by them. "Desensitising" means listening to and gradually getting used to the sound, which is achieved through the use of noise generators.

These are small devices worn like hearing aids for around six hours each day. Gradually the noise level they produce is increased until the person is able to tolerate normal sound exposure. The noise produced is steady and gentle and does not prevent the person from hearing other sounds normally.

Some people may also be advised to have cognitive behavioural therapy (CBT) especially if they have anxiety or depression as a result of their condition.