Gallstones, known medically as cholelithiasis, are small stones, usually made of cholesterol, that form in the gallbladder.

When can gallstones be a cause for concern? DR MARTIN SCURR answers your health questions

A recent ultrasound to monitor my fatty liver showed that I also had gallstones. I have no symptoms, but have been unable to get an in person appointment with my GP to discuss what, if anything, needs to be done. I feel like I’m in limbo. I’m 74 and in good shape for my age.

Don Rae, Allan’s Bridge, Stirlingshire.

Gallstones, known medically as cholelithiasis, are small stones, usually made of cholesterol, that form in the gallbladder.

This sac-like organ is hidden under the liver and stores bile, a fluid produced by the liver that helps break down fatty foods.

In most cases, these stones cause no symptoms or require treatment, and often their presence is detected by chance, such as in your case when someone is having a CT scan for another reason.

Gallstones are very common: about 6% of men and 9% of women have them, and the possible causes are multiple, from age to obesity to sudden weight loss.

Gallstones, known medically as cholelithiasis, are small stones, usually made of cholesterol, that form in the gallbladder.

I can understand that not being given advice on what to do next is alarming, but the official guidelines are not to deal with them unless they cause problems.

Surgery to remove them is only really considered if they cause complications, such as acute cholecystitis (a gallbladder infection), pancreatitis (acute inflammation of the pancreas) or biliary colic (when a stone migrates of the gallbladder and causes a blockage in one of the nearby ducts that drain bile into the intestine – this is extremely painful and requires urgent medical attention).

The surgery involves removing the gallbladder along with the stones and is performed under general anesthesia.

Symptoms that suggest complications usually come on suddenly and include severe pain in your upper right abdomen, high temperature and nausea – but since you don’t have any, no intervention or treatment should be needed.

But should you experience any of the complications described above, you should immediately be listed for surgery to remove your gallbladder, which is normally done during a keyhole procedure. Hopefully the opportunity will arise when you can discuss the subject with a doctor in your practice.

For years I suffered from uncomfortable little cuts at the corner of my mouth. I have tried many remedies but without success. Can you suggest something?

Brian Gibson, via email.

It looks like angular stomatitis, also known as angular cheilitis – a condition that is most common in older people, occurring when saliva collects at the corners of the mouth, causing cracks.

The environment there – with a constant supply of humidity – encourages fungi and bacteria to grow, causing inflammation.

Eczema, ill-fitting dentures and drooling during sleep can make the situation worse.

There is some evidence that a lack of certain nutrients may be involved – particularly B vitamins, iron or insufficient protein.

Other risk factors include long-term smoking and the wrinkles we get as we age. I suggest you buy a tube of two percent clotrimazole cream (available at pharmacies under the brand name Canesten) and apply it sparingly with your little fingertip twice a day for at least two weeks.

This medication is both antifungal and antibacterial and should resolve inflamed fissures.

After that, get into the habit of applying a small dab of Vaseline in the same way, twice a day, to prevent the skin from drying out.

This should almost certainly be effective.

Write to Dr. Scurr

Write to Dr Scurr at Good Health, Daily Mail, 2 Derry Street, London W8 5TT or email: drmartin@dailymail.co.uk – include contact details. Dr. Scurr cannot maintain personal correspondence. Answers should be taken in a general context. Consult your own GP for any health concerns.

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