A Question of Health: Do bacteria cause indigestion? And could my son catch Hepatitis C?

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My 16-year-old son told me (after reading the article on hepatitis C in the Independent) that his girlfriend's father is a carrier, and that she herself was only told this two years ago

Will he catch Hepatitis?

"My 16-year-old son told me (after reading the article on hepatitis C in the Independent) that his girlfriend's father is a carrier, and that she herself was only told this two years ago. It worried her at the time because she had in the past used his razor. My son assures me that he and his friend have not had sex, but nonetheless I am worried, and obviously I cannot approach the girlfriend's parents to ask if she has been tested as she spoke to my son in confidence. How much actual risk is there that my son might pick up the disease if his girlfriend unknowingly has it?"

Hepatitis C is an insidious viral infection that can lead to serious liver problems. It is not spread by ordinary contact within a family or household, but it can be spread by contact with blood and possibly by sexual contact. The risk of contracting hepatitis C by sexual contact, however, is very small. When one partner in a long-standing couple is hepatitis C positive and the other is negative, the standard advice is that they do not need to use condoms. They are advised, however, not to have penetrative sex when the women is having a period. People who have multiple sexual partners are advised to use condoms to reduce their risk of contracting both hepatitis C and other sexually transmitted diseases. Hepatitis C can be transmitted from person to person if they share razors, toothbrushes or similar items. I think your son's risk of catching hepatitis C from his girlfriend in the future must be small. If they do start having sex, using condoms will reduce the risk further. One of the best sources of information about hepatitis C is the website of the British Liver Trust: www.britishlivertrust.org.uk.

Stomach trouble

"I have suffered for quite a few years from indigestion. The symptoms are a feeling of discomfort and fullness after a big meal, and occasional regurgitation of partially digested food. I can have many months of feeling completely well, followed by a week or two of persistent problems. There does not seem to be any rhyme or reason behind the pattern of my symptoms. A friend has said I should have a test for a bacterial infection of the stomach. Is there such a test? Could an infection be the cause of such intermittent symptoms?"

Your friend is referring to an infection with a bacterium called Helicobacter pylori (usually known as H pylori). H pylori infection is definitely implicated as the cause of duodenal and stomach ulcers. But there is quite a lot of uncertainty about whether it can also cause indigestion in the absence of an ulcer. There are several tests for the bacteria - a blood test is the simplest, but it is not always accurate, as it can remain positive even after the infection is eradicated. There is also a test called the hydrogen breath test, which detects the presence of the bacteria. Under the microscope, the bacteria can be seen if a biopsy specimen is taken during an endoscopy examination of the stomach. I think it would be worthwhile having either a blood test or a breath test. If either of these is positive, you could start off with a course of antibiotics, which is a relatively simple way to get rid of the bacteria. Only time will tell if this cures your symptoms. If it does, you'll be one satisfied customer.

A natural cure?

"I am seven weeks pregnant and am feeling incredibly sick most of the time. I know that morning sickness eventually goes away - it lasted for about four weeks with my first pregnancy, and then suddenly disappeared. My doctor doesn't want to prescribe any anti-sickness medication, and even if she did I don't think I would risk taking anything at this stage of pregnancy. Are there any natural remedies that really work?"

I am always reluctant to suggest natural remedies unless there is at least some evidence that they really do work. When your question arrived, I looked into the latest research on the subject and was mildly surprised to discover that ginger has been proved to be a safe and effective treatment for nausea and vomiting in pregnancy. Several research studies have now shown that ginger really does help the symptoms. In a recently published study, ginger capsules helped considerably more than other forms of the spice. But it can also be taken as tea, sweets, biscuits and in various other forms. The usual dose is about one gram of ginger per day. It is reassuring to know that women who took it in early pregnancy had babies who were just as big and just as healthy as women who did not. There is no convincing evidence that ginger does any harm to the growth or development of the baby.

Have your say. Readers write

MP wants to know whether flu jabs can cause mini-strokes (also known as TIAs, or transient ischaemic attacks). Do any readers know of people who have had strokes after flu jabs?

My mother-in-law and four friends, all in their late seventies or early eighties, had flu jabs about three months ago. Within a month or so she had a TIA (from which she recovered within 24 hours). Then she found that all her friends had experienced TIAs of differing severity, within weeks of each other. Just a coincidence? Or are there concerns about flu injections?

DH feels that the exercise programme suggested last week would be too challenging for most overweight people.

Dr Kavalier seemed to advise a reader wanting to lose weight to walk 48 miles a week at 4mph, or to run four miles a day, every day, at 8mph. These would be tough targets for someone lean and fit. For someone overweight and unfit, they would be too much. I would advise the reader to work out a running trail of about two miles starting from her (or his) home or office. When convenient, she can put on running gear and jog gently round, afterwards noting her time and weight. Do this twice a week for three weeks, then three times a week. For variety, she can sometimes run the distance on a running track or treadmill. After two months, if her weight is not falling, she can increase the distance slightly, or add a weekly aerobics class, but the main aim is to get fit and enjoy the exercise. Weight loss will follow.

Send questions and suggestions to A Question of Health, 'The Independent', Independent House, 191 Marsh Wall, London E14 9RS; fax 020-7005 2182; or e-mail health@independent.co.uk. Dr Kavalier is unable to respond personally to questions

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