Inside Health

50,000 people end up in hospital every year in the UK because of bleeding from the top end of the gut - an upper gastrointestinal bleed. Around 1 in 10 of them will die. Gastrointestinal or GI bleeds are often due to ulcers - a side effect of taking aspirin and other non-steroidal anti-inflammatory drugs like ibuprofen and diclofenac. The bleeding can occur in the gullet, stomach or the first part of the intestine, the duodenum. Other causes include cancers and liver disease. The location of the bleed can be pinpointed by using an endoscope - a camera to look inside the gut - and treatments include stopping the bleeding with clips, heat or injections of adrenalin. The National Institute for Health and Clinical Excellence hopes to change that with new guidelines on managing GI bleeds - guidelines which, as of last month, hospitals in England, Wales and Northern Ireland will be expected to follow. Scotland has had similar guidance in place for the last few years. David Patch is a Consultant Hepatologist at the Royal Free Hospital in London and has a special interest in this type of bleeding. He says that patients whose needs cannot be met at smaller hospitals should be transferred to specialist units where they can be treated promptly. Tariq Iqbal who's a consultant gastroenterologist at the University of Birmingham is evaluating a new kind of treatment called Hemospray. This is a powder that can sprayed over the bleeding area to stop or slow any bleeding by accelerating the natural clotting process. New research appears to show that standing at work for long periods in pregnancy can affect the unborn child. Research in the journal Occupational and Environmental Medicine, followed 4,680 mothers throughout their pregnancies. Some of the women had jobs where they were on their feet a lot - such as hairdressing, sales and working with toddlers. Women who stood for a long time had babies with smaller heads. It's thought that standing for long periods of time causes blood to "pool" in the legs, limiting the blood supply to the rest of the body including the uterus and therefore the developing foetus. The study also showed that working up to 36 weeks of pregnancy had no impact on birth weight, size or prematurity. Previous studies have shown that heavy lifting increased the risk of babies being born early - but this study showed no such link. Many people with pain and stiffness in the shoulder are told they have a frozen shoulder. But the label is often incorrect as a truly frozen shoulder means restricted movement in all directions, accompanied by pain. It's not known what causes it but it is commoner in people with diabetes. During the very painful initial phase it's best to rest the shoulder and use analgesia to help relieve the pain, especially at night time when it can be at its worst. TENS and acupuncture can help sometimes. The tissues in the shoulder "capsule" appear to be thickened and rubbery - and some relief can be gained from surgery, to let the shoulder move more freely. If left alone about half of patients still have discomfort after 7 years - so the common belief that it lasts 2 years is a myth. As the pain starts to recede physiotherapy can be helpful and if there is inflammation - eg with calcified tendonitis - then steroid injections can relieve pain. Producer: Paula McGrath.

In Inside Health, Mark Porter clarifies recent headlines claiming that researchers have found a "Blood test that identifies depression". It certainly isn't that simple. GP Margaret McCartney reports from Paisley Abbey in Glasgow on the health benefits of joining a choir.And do special muscle building drinks live up to the marketing hype? Max Pemberton looks at the science behind the recent explosion in sales of high protein sports drinks.Plus a new treatment for helping people with fluid retention due to heart failure, that can transform a puffy face to a chiselled jaw bone overnight.Producer: Erika Wright.

Whooping cough is making a comeback - the latest figures show that there were more confirmed cases in the first 3 months of this year than there were in the whole of 2010. But the condition can only be monitored properly if GPs test for it - and it's estimated that up to 40% of persistent coughs in children could actually be down to whooping cough. Kamran Abassi who's Editor of the Journal of the Royal Society of Medicine, explains how immunity wears off as we get older. The coughing can last for up to 3 months and is most serious in small babies. Up to 10 deaths are reported each year in the UK and antibiotics can be used to treat it. In the UK all deaths in pregnancy and childbirth are recorded. Just 1 in 10,000 British women currently die - on average one woman every week. The information is held by the Maternal and Newborn Clinical Outcomes Review Programme - known as the Confidential Enquiry. Last year this clinical audit was effectively suspended after the process was put out to tender. Susan Bewley who's Professor of Complex Obstetrics at King's College, London explains why it's so important to keep such detailed information. Blushing can become a vicious cycle - with those severely affected finding it impossible to lead a normal life. Some turn to psychological therapies. Dr Jennifer Wild from the Centre for Anxiety Disorders and Trauma in Oxford says she sees a success rate of 90% in patients who opt for cognitive behavioural therapy. An operation called a sympathectomy - where the nerves are cut - can be carried out by surgeons like Alan Cameron, who works in Ipswich. He sees mixed results - with many experiencing side effects like increased sweating and sensitivity to light and sound. Dr Margaret McCartney doesn't like it when doctors use euphemisms for our genitals. Children often use words like "twinkle" or "pee pee" instead of the correct anatomical terms. But whose blushes are they sparing - theirs or their parents? An Inside Health listener emailed the programme to find out about what happens to the food he he eats - specifically how quickly peas pass through his gut into the loo. Neuro-gastroenterologist Anton Emmanuel from University College Hospital, London, demystifies gut transit times.

Dr Mark Porter goes on a weekly quest to demystify the health issues that perplex us.Professor Jeremy Pearson, Associate Medical Director of the British Heart Foundation, discusses with Mark new research that suggests that giving heart attack victims drugs to ease their chest pain could hamper the heart's ability to heal itself. The standard approach to appendicitis is to remove the inflamed organ. But a new review argues that antibiotics could be an alternative to surgery in some cases. Dileep Lobo, Professor of Gastrointestinal Surgery at the University of Nottingham, explains his team's findings. GP Margaret McCartney is on her soapbox about sick notes, following regulatory pressure from Europe that could allow people who fall ill on holiday getting compensatory time off work.Dr Kamran Abbasi, Editor of the Journal of the Royal Society of Medicine, looks into the evidence that the change from sick notes to fit notes two years ago has had an impact on people returning to work. Mark visits the pathology laboratories at St Thomas' Hospital in London to find out from Senior Biomedical Scientist Diane Murley how blood is analysed. And Dr Andrew Moore from the Pain Research Unit at the Churchill Hospital in Oxford talks about which over the counter painkillers are likely to work best for acute pain. Producer: Deborah Cohen.

Should prescriptions be free for everyone? They already are in Wales, Northern Ireland and Scotland - so why aren't they in England? The BMA says the current list of exemptions is unfair and outdated - but there are no government plans to scrap the charges for the 10% of people who have to pay for them. And as the vaccination campaign for young girls against the virus which causes cervical cancer and genital warts gains momentum - are boys losing out? Uptake of the vaccine among teenage girls in the UK is high - but there are no plans to extend the programme to boys - despite plans to do so in Australia and the United States. There are confusing statistics surrounding the debate over the use of bicycle helmets for both adults and children. Some research points to helmets encouraging car drivers to give cyclists less space in traffic. Up to a third of children in another study said wearing a helmet would put them off cycling in the first place - bad news for parents concerned about childhood obesity. GP Margaret McCartney uses her own risk analysis to work out how to keep herself safe and fit. Producer: Paula McGrath.

Aspirin is over 100 years old, but doctors still can't agree whether the benefits of taking it to prevent heart conditions or cancer outweigh the risks.Dr Mark Porter investigates. And - you've worked flat out to get on holiday, then come down with a stinking cold - is there any science behind why so many of us get sick on vacation. Plus ADHD - not in children, but ADULTS - why is it so hard for grown-ups to get a diagnosis. Producer: Erika Wright.

Dr Mark Porter demystifies discusses polycystic ovary syndrome, the health benefits of garlic, the PSA test for prostate cancer, and concerns over patients' dignity.

A new study shows that a diet rich in red meat increases the risk of developing bowel cancer - so how much is too much? Professor Tom Sanders from Kings College, London, explains how a rise in obesity and an inactive lifestyle could be as much to blame as your favourite steak.This week 17 people - including 2 ambulance crew - were treated for suspected carbon monoxide poisoning at a food plant in Cornwall. The medical adviser to the charity CO Awareness explains how to protect everyone in your home from the accidental poisoning which can have catastrophic effects.NHS screening programmes are based on evidence - so that they target the right groups of people who are most at risk of developing a condition. But more and more private companies are offering tests like CT and ultrasound scans. Abdominal aortic aneurysm is a potentially lethal condition - where the main artery in the abdomen balloons and could burst. Many private companies offer screening for it - but vascular surgeon Hany Hafez from St Richard's hospital in Chichester believes that it's a waste of time and money for women and for men who are under 65 years of age.And Dr Mark Porter gets on a treadmill to answer a listener's question about whether running is truly good for his health - or will end up ruining his knees. Dr Kamran Abassi - the editor of the Journal of the Royal Society of Medicine - casts his expert eye over the evidence behind supplements which are supposed to help keep our joints healthy.

In Inside Health tonight, Dr Mark Porter tackles the confusion and prejudice that surrounds the skin condition Vitiligo - famously said to have been the reason why Michael Jackson skin looked so light. Max Pemberton discovers why surgeons may be wearing masks for their benefit rather than their patients.And Margaret McCartney reminds doctors who tweet to proceed with caution - posting photographs of the first patient you've anaesthetised is likely to get you into trouble!

10 million prescriptions for sleeping pills are written every year in England. So how alarmed should we be over new American research suggesting that people who take them are more likely to die than those who don't? Dr Mark Porter speaks to a leading British sleep expert about the findings and asks what the alternatives are.An Inside Health listener asked us to investigate how safe "electronic" cigarettes are. So Dr Max Pemberton, who uses them himself, talked to Professor John Britton from the UK Centre for Tobacco Control Studies at the University of Nottingham about these currently unregulated products. Rumours abound that a tobacco manufacturer is about to launch the world's first so-called "safe" cigarette. But smokers' reactions are mixed and some prefer other products like nicotine gum.GP Margaret McCartney's column is about whether your doctor's dietary preferences and habits influence your well being.Half of all pregnancies in the UK are unplanned, so women and their babies lose out on important supplements like folic acid to help prevent spina bifida. But for women with an underactive thyroid gland it's even more important that they do their best for their baby by increasing their thyroxine dose as soon as they know they're pregnant. But research from Leicester shows that women often fall through the gaps when seeking care - as GPs, midwives and consultants often think someone else is helping these women.Producer: Paula McGrath.