A Question of Health: A ringing in the ears and trouble with gallstones

Q. My life is increasingly troubled by tinnitus. I have more or less constant noises in both ears - mostly hissing sounds, but sometimes it decides to become a humming noise. Friends have recommended Ginkgo biloba extract which, they claim, can cure tinnitus. Can it?

Q. My life is increasingly troubled by tinnitus. I have more or less constant noises in both ears - mostly hissing sounds, but sometimes it decides to become a humming noise. Friends have recommended Ginkgo biloba extract which, they claim, can cure tinnitus. Can it?

A. You have asked this question at the right time, because the British Medical Journal has just published the results of a major trial comparing Ginkgo biloba extract with placebo (identical pills with no active ingredients) as a treatment for tinnitus. The trial looked at 1,000 people with tinnitus. Half of them were treated for 12 weeks with Ginkgo biloba and the other half were treated with the placebo pills. About 10 per cent of the people who took Ginkgo biloba thought that their tinnitus was helped by it. But 10 per cent of the people who took placebo pills also thought that their tinnitus improved. On the basis of this study, I think it is unlikely that Ginkgo biloba will help your tinnitus. For other ideas about treatment, get in touch with the British Tinnitus Association on 0800 018 0527 or see the website www.tinnitus.org.uk.

Q. I have had an ultrasound scan of my kidneys. The kidneys look normal, but the scan shows that I have more than a dozen stones in my gallbladder. I have never had problems with my gallbladder, so I don't know if it is sensible to have them removed now.

A. It is quite possible to live a long and healthy life without a gallbladder. But it is also possible to live a long and healthy life with a gallbladder full of gallstones. If you had never had a scan of your kidneys, you probably would never have known about your gallstones. Gallstones only cause serious problems if they leave the gallbladder and get stuck in one of the tubes that carries bile from the liver to the intestine. If this happens, you will know it because it will cause pain and you may become jaundiced (your skin will turn yellow, your urine will turn dark and your stools will become pale). My advice is to leave well alone. If you do eventually need to have your gallbladder removed, it will probably be done with keyhole surgery (nearly 90 per cent of these operations are now done this way). You will only be in hospital for a day or two, and you should be back to work within a week or two.

Q. When I went to a sexually transmitted disease clinic recently it was discovered that I was a carrier of hepatitis B, although as far as I am aware, I have never suffered from hepatitis of any kind. What is the chance that other members of my family will have caught the disease from me?

A. If you are a woman, you may have passed the disease on to your children if you were a carrier at the time of their birth. You may also have passed it on to any sexual partners, because hepatitis B can be sexually transmitted. The chance of passing on the disease through ordinary household contact is very small. All the members of your immediate family should now be tested for hepatitis B, to see if they have become carriers themselves. Anyone who is not a carrier should receive a course of immunisations (three injections) against hepatitis B.

Q. Both of my children have been born with hernias. The first had hernias on both sides of the groin that needed to be operated on when he was just three months old. The second has a hernia around the belly button, but we have been told that this will probably cure itself without an operation. Is this likely? If so, how long is it likely to take?

A. Hernias in the groin - inguinal hernias - never cure themselves and the only way to get rid of them is to have an operation. They are surprisingly common in newborn babies. As you probably discovered, babies of this age get over hernia repair operations remarkably quickly. Hernias around the belly button - umbilical hernias - are also often present at birth, and they are especially common in babies of Afro-Caribbean families. These are caused by a gap in the muscles around the belly button. As babies grow and their abdominal muscles become stronger, this gap usually closes and the hernia disappears. The process may take several years, and paediatricians usually recommend waiting at least until the age of four or five before considering surgery on umbilical hernias.

Please send your questions to A Question of Health, 'The Independent', Independent House, 191 Marsh Wall, London E14 9RS; fax 020-7005 2182 or e-mail to health@independent.co.uk

Dr Kavalier regrets that he is unable to respond personally to your questions