How to treat earwax and other common health concerns: experts advise against cotton buds and outline treatments

Excess earwax that interferes with hearing is common and treatable, but GPs and ear specialists warn that cotton buds can make the problem worse and may damage the ear. Patients with persistent blockage are advised to try over-the-counter remedies or seek professional removal rather than attempting deeper cleaning at home.

Earwax, or cerumen, serves protective roles in the ear by trapping dirt, limiting bacterial entry and keeping the skin of the ear canal lubricated. In most people the wax migrates out of the ear naturally and does not require intervention. When wax becomes impacted, it can cause hearing loss, a blocked sensation and, in severe cases, tinnitus or vertigo.

Doctors warn that inserting cotton buds or similar objects into the ear canal is risky because the action often pushes wax deeper, worsening impaction. Puncturing or scratching the eardrum or ear canal with a foreign object can also lead to infection. For many patients, simple measures are recommended first. Softening the wax with olive oil ear drops, applied several times a day for a week, can loosen hardened material. If that does not work, pharmacists can supply stronger ear drops formulated to dissolve earwax.

When over-the-counter treatments fail, a clinical procedure called microsuction is available. Microsuction involves a small suction tube, guided with magnification or a microscope, to remove excess wax safely. Most GP surgeries do not provide microsuction, but many community pharmacies and private clinics offer the service for a fee, commonly around £60 in the U.K.

Patients should inform clinicians about chronic ear symptoms and any prior ear surgery or perforation before undergoing microsuction or other interventions. Persistent hearing changes or recurrent infections merit evaluation by a doctor or an ear, nose and throat specialist.

In related practical advice, clinicians note that the blood-pressure drug ramipril can influence decisions around anaesthesia. Ramipril lowers blood pressure and is generally safe to continue for routine procedures performed under local anaesthetic, such as most tooth extractions. The combination of ramipril and general anaesthesia, however, can increase the risk of severe hypotension because both agents can lower blood pressure. For that reason, patients are sometimes advised to stop ramipril in the 24 hours before procedures requiring general anaesthesia. Ultimately, the operating clinician makes the final decision and patients should disclose all medications before any surgery.

Complaints of ongoing bloating and fatigue are frequent in primary care and can stem from a range of gastrointestinal conditions. Irritable bowel syndrome, which affects about one in 10 people in the U.K., commonly causes bloating as well as diarrhoea, constipation and abdominal cramps. There is no single diagnostic test for IBS; clinicians typically exclude other causes before making the diagnosis. Management strategies include dietary modification, prebiotic supplements and exercise to help reduce symptoms.

Coeliac disease is another potential cause of bloating and fatigue and is triggered by an immune response to gluten found in wheat, barley and rye. Doctors can screen for coeliac disease with blood tests that detect relevant antibodies, and some clinicians may advise a trial of a gluten-free diet if tests are inconclusive. Medical guidance stresses that patients should not begin a gluten-free diet before testing, as this can affect results.

Clinicians caution that not all bloating is benign. When bloating is persistent and does not fluctuate with eating or bowel movements, it may signal more serious conditions, including ovarian or bowel cancer. Patients with ongoing, unexplained abdominal distension or other red-flag symptoms should seek prompt medical assessment.

Chronic itching is another frequently underreported problem that can severely affect quality of life and sleep. Many patients try emollients and topical treatments without relief, and in some cases a clear cause is not identified. Treatment options can include oral antihistamines, low‑dose topical steroids and, where appropriate, medications from other classes such as certain antidepressants that modulate itch pathways. Clinicians say patients with persistent or worsening itch should be evaluated to identify treatable causes and to reduce the burden on mental health and daily functioning.

On the research front, scientists at the University of Cambridge have reported early results for an injectable gel designed to calm inflammatory flares in osteoarthritic knees. Osteoarthritis affects more than 10 million people in the U.K. and is the principal reason for the more than 100,000 NHS knee replacements performed annually. The gel is still in the experimental stage and requires further trials to establish its safety and effectiveness, but researchers say it may one day offer an alternative to surgery for some patients.

Meanwhile, established measures to slow progression of knee osteoarthritis include weight loss for overweight patients and simple leg-strengthening exercises to improve joint support. Clinicians encourage patients with joint pain to discuss conservative management options before considering surgical intervention.

Across these common complaints, medical professionals emphasize that patients should report persistent or worsening symptoms to a healthcare provider. Self-care measures and pharmacy treatments can help in many cases, but clinical assessment is important to rule out underlying conditions and to choose the safest, most effective treatment path.