Update on ulcers
Ulcer - it's not a pretty word and usually it's not a pretty sight. A skin ulcer is any breakdown of the skin's covering, and legs are among the most common places to get them. Fortunately, although they become more common with age, they're by no means inevitable - 98% of people don't have them even in their 80s.
Venous leg ulcers are the most common type of leg ulcer. They're down to raised pressure in the veins carrying blood from the legs back to the heart. This leads to fluid leaking out of the veins, producing swelling and pressure on the skin, usually around the ankle. In time, this damages the skin.
You can cut your risk of getting leg ulcers with simple lifestyle measures. But if you do get an ulcer, you'll be treated with regular dressings and compression bandages. These reduce the pressure in your veins and promote healing. Once the ulcer has gone (usually within three months) you should wear compression stockings in the daytime to help stop another one.
Your nurse will know your pressure!
Don't be surprised if your nurse puts a blood pressure cuff round your leg if you have a leg ulcer! It helps her work out if your ulcer relates to problems with your veins or your arteries - the treatments are different. It can be dangerous to apply compression bandages if you have blocked arteries, so she'll need to check this before she considers pressure dressings.
Leg ulcers - how can I help myself?
If you read my pages regularly, you'll know I have a bee in my bonnet about smoking. Guess what? Stopping smoking will cut your risk of leg ulcers too!
Get a leg-up - when lying down, try to keep your legs higher than your hips to help blood flow back to the heart. Rest your legs on pillows in bed and on a stool when sitting
Legs down too! Standing or sitting with your legs down increases fluid in your legs, but walking around pumps blood and fluid out of your legs, reducing the pressure.
Diabetes - foot alert!
If you have diabetes, you're more prone to damage to the nerves supplying your feet and lower legs. This can cause pain but also numbness, making you less aware of damage to the skin. Blood circulation can also be affected, so injuries don't heal well. Without the right precautions, this can lead to serious foot ulcers or worse.
These days doctors are very aware of these risks and should examine your feet at least once a year. You should get advice on protecting your feet from damage and what signs to look out for. You may also be referred to a podiatrist. Keeping your blood sugar well controlled will protect your feet. Get into good habits - your feet will thank you for it!
Mouth ulcers are common, and most people get them at some point. Four out of five are 'minor' ulcers - they're small (2-8 mm across), shallow and go away without leaving a scar in a couple of weeks, although they can be sore. They're not caused by infection but often coincide with periods of stress or anxiety. Smoking increases your risk, but recurring mouth ulcers can be due to gut problems like coeliac disease or being deficient in iron or vitamin B12. Get mouth ulcers checked out if you keep getting them or you have one that lasts for more than three weeks or is getting more painful and inflamed.
Your glorious gut
Stomach and duodenal ulcers are sometimes called 'peptic ulcers'. Like other forms of indigestion, they cause burning pain at the top of your tummy. Rarely they can cause internal bleeding. Tablets to reduce the acid in your stomach often settle symptoms but they may come back. A germ called H pylori, which lives in the stomach, is a common cause of ulcers as well as other forms of indigestion. If tests show you have it, a one-week course of three types of tablet usually cures it and cuts the risk of the problem coming back.
With thanks to 'My Weekly' magazine where this article was originally published.