Why can't my stomach handle beer any more?

Drinking problem

After 20 or so years of regular drinking at the pub, I find now that I am intolerant of bitter. Do I need to worry about what beer might have done to my insides over the years, or is this just a sign of ageing?

Intestinal symptoms – wind and diarrhoea – are fairly common complaints after drinking alcohol of all kinds. Some people find they can tolerate white wine but not red, others beer but not lager. You're not alone, and I don't think you've seriously damaged your intestines. It is simply your body telling you that it can no longer cope with the quantity of bitter you are asking it to process. You don't say how old you are, or how many pints you drink. But if you are asking your intestine to handle five pints a night, seven days a week, I'm not surprised it's protesting.

I'm so tired

I have been to two different doctors in the past month complaining of feeling generally run-down. The second doctor listened to my heart and lungs, felt my belly, tested my urine – but couldn't find anything wrong. Now I've begun to sweat heavily in bed. I work long days behind a desk, but in the evening I just want to lie down and sleep. Until a few months ago I was full of energy and up for anything. I am 35 years old, a non-smoker, and consider myself to be perfectly healthy.

GPs sometimes talk about patients who are suffering from Tatt syndrome, which stands for "tired all the time". Fatigue can be a sign of stress at work, depression and a multitude of other conditions, but the sweating at night needs to be taken seriously. Despite your recent examination, you need to have a more thorough consultation and some blood tests. Your symptoms can be the first sign of serious illnesses such as lymphoma, tuberculosis or chronic leukaemia. You may not turn out to have anything bad, but it should be investigated.

Early menopause could also be the cause, but if your periods are still coming regularly this is very unlikely.

Mystery kidney pain

I am 83 years old and in generally good health, but for the last 10 years I have been suffering from severe pain in the left kidney region. Despite numerous hospital investigations I have been told that my kidneys are working properly and that there is no evidence of stones, though during one investigation after a particularly severe episode some blood was found in my urine. My doctor has recently told me that the probable cause is a dilated kidney pelvis that has been there since birth. I have been prescribed ibuprofen which I take to counter the pain, which occurs at any time of the day or night almost daily. Is it wise to continue taking this medication so frequently, or is there anything else I can take?

You should feel reassured that the tests have not revealed any serious cause for your pain. Although no kidney stones have been found, it is still possible that you produce tiny "stones" – even one the size of a large grain of sand can cause quite severe pain as it passes through the urinary system. X-rays and scans do not usually detect such small things. The blood that appeared in your urine makes me think this could be the cause. Ibuprofen is a good painkiller, but it can cause stomach bleeding in the elderly so it's better that you take it intermittently rather than regularly. It would be safer to take paracetamol, and you should also be drinking plenty of fluids.

Please send your 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 regrets that he is unable to respond personally to questions

Readers write

JR suggests another possible reason why a young boy should be short of breath only when he lies down:

This symptom can be caused by a paralysed diaphragm. The tidal volume (the amount of air that you can breathe in and out) is decreased when you lie flat. Perhaps he sustained damage to the phrenic nerve or diaphragm in the accident.