How to deal with troublesome earwax and other common concerns about medication, bloating, itching and arthritis

Cotton buds should not be used to remove earwax, and people with persistent buildup that affects hearing have several safer options, a health columnist said. Over-the-counter olive oil drops can soften hardened wax, pharmacists can supply stronger ear-dissolving solutions, and severe cases may be treated with microsuction at many pharmacies for about £60.

Earwax is produced to trap dirt, protect against bacteria and lubricate the ear canal, and in most people it falls out naturally. When wax accumulates it can reduce hearing or create a blocked sensation and, in extreme cases, trigger tinnitus or vertigo. Using cotton buds risks pushing wax deeper into the ear canal, worsening blockage, and can scratch the ear canal or damage the eardrum, increasing the chance of infection.

People who try olive oil drops are generally advised to apply them several times a day for about a week to soften wax. If that does not help, pharmacists can recommend or supply stronger cerumenolytic ear drops designed to dissolve wax. For stubborn or severe impaction, microsuction — a procedure that uses a small suction tube to remove excess wax — is widely available in pharmacies and some specialist clinics; most general practitioner surgeries do not offer it.

Patients should not attempt to remove deeply lodged wax themselves and are advised to consult a pharmacist or clinician if symptoms persist, worsen, or are accompanied by pain or discharge.

In related consumer medical questions, the columnist addressed whether the blood pressure drug ramipril should be stopped before a tooth extraction. Ramipril lowers blood pressure and, in combination with general anesthetic, can raise the risk of dangerously low blood pressure. For that reason, clinicians often advise temporarily stopping ramipril in the 24 hours before operations under general anesthesia. However, most tooth extractions are performed under local anesthesia, and the drug is usually considered safe to continue in those cases. Patients are advised to tell treating clinicians about all medications so the surgical team can make an informed decision.

Chronic bloating and fatigue can stem from several bowel conditions, including irritable bowel syndrome, which affects an estimated one in 10 people and may cause diarrhea, constipation, cramps and bloating. There is no definitive test for IBS; clinicians commonly rule out other conditions before diagnosing it. Coeliac disease is another cause of bloating and fatigue and is identified by blood tests for specific antibodies or by observing symptom improvement on a gluten-free diet. The columnist noted that intermittent bloating related to eating and relieved by bowel movements is often not a sign of a serious condition, but persistent bloating that does not vary with diet or toilet habits can, in some cases, indicate ovarian or bowel cancer and should prompt immediate medical evaluation.

Patients with persistent, unexplained itching were urged to seek care rather than assume it must be endured. Chronic itching can affect sleep and mental health and may lack an obvious cause. Initial management commonly includes emollients, antifungal or topical steroid preparations if a specific dermatological condition is suspected, and oral antihistamines. For refractory cases, clinicians may consider low-dose antidepressants or referral to dermatology or specialist clinics to identify less obvious systemic or neurological causes and to trial targeted treatments.

On osteoarthritis, researchers at the University of Cambridge reported early-stage work on an injectable gel intended to reduce painful flare-ups in knee joints, a development that, if validated, could reduce the need for knee replacement surgery. The research is at an experimental stage and will require further trials to establish effectiveness and safety. Meanwhile, established measures to slow progression of knee osteoarthritis include weight loss and muscle-strengthening exercises for the legs.

Across all these issues, the columnist emphasized consulting pharmacists or healthcare professionals for assessment and treatment options. Self-treatment that involves inserting objects into the ear or stopping prescribed medications without professional guidance can cause harm, and persistent or worsening symptoms should prompt timely medical review.