You've found blood in your urine. This is what you need to know - and MUST do now: DR ELLIE

Last month I noticed some blood in my urine. I thought it might be due to premenopausal bleeding, but didn't have any spotting.

My GP ordered a urinary tract infection test but that came back normal. What should I do?

Dr Ellie replies: Blood in the urine can be a sign of bladder or kidney cancer but these are not the most common causes. Usually, the likely cause is a bladder infection, also known as a urinary tract infection (UTI).

Another possible cause can be kidney stones, but that would normally be accompanied with severe back or stomach pains.

Anyone over 45 who finds blood in their urine – regardless of how many times it occurs – should absolutely speak to their doctor. This is because patients with this symptom should always be checked for cancer.

In fact, someone who tests negative for an infection who shows this symptom is even more in need of a cancer check, as this rules out one of the more frequent causes.

Normally, this check involves blood and urine tests carried out by the GP. Patients will then undergo a cystoscopy, which involves inserting a tiny camera into the bladder while the patient is under local anaesthetic.

This hospital procedure helps doctors find the cause of any bleeding in the bladder.

Another check is a CT scan, which can look for abnormalities in the kidneys and bladder.

While these checks are crucial, they are designed to eliminate the worst possible outcome.

Sometimes, what appears to be blood in the urine can, in fact, be something else. Some foods, such as beetroot, are know to turn urine a reddish colour.

My aunt was diagnosed with lymphoedema. She was given a steroid cream to help combat the swelling. However, she has since begun experiencing hallucinations. Could the cream be to blame?

Dr Ellie replies: Steroid creams are unlikely to be the cause of hallucinations.

These treatments – which are often called corticosteroids – are also not commonly used in the treatment of lymphoedema, a condition that results in significant swelling in the arms or legs. It occurs when the body's drainage system – called the lymphatic system – becomes blocked and fluid begins to build up in the limbs.

This can happen as a result of breast cancer surgery.

But, for some, it can occur for no clear reason.

Lymphoedema can stretch the skin, which can be painful. It can also increase the risk of infections, as the skin can tear, creating open wounds. To get this under control, specialists often use compression stockings to encourage the fluid to drain, as well as exercises and massage.

Creams are often used to keep the skin soft and flexible. Steroid creams are only occasionally used for this purpose. This is because overuse of steroids can thin the skin which increases the risk of infection.

However, hallucinations are not a known side effect.

Instead, this is more likely to be triggered by a brain issue such as Alzheimer's or Parkinson's disease, both of which are incurable degenerative brain diseases. For this reason, it is important that any patient who experiences hallucinations sees a doctor as soon as possible.

I suffer with burning mouth syndrome, which seems to get worse when I'm stressed. I take a daily amitriptyline tablet but this doesn't seem to help. I've noticed that I also get dry, sore skin around my mouth. Is this a normal symptom of burning mouth syndrome – or might it suggest I have a different, undiagnosed condition?

Dr Ellie replies: DRY and sore skin is not a typical symptom of burning mouth syndrome (BMS).

The condition triggers a burning, scalding or tingling feeling in the mouth.

It is most common among those over the age of 60, particularly women who are post-menopausal. Unfortunately, there is no cure, but many patients find that the nerve pain drug amitriptyline significantly reduces symptoms.

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The exact cause remains a mystery, but there is evidence that stress can increase the chances of a flare-up.

Interestingly, stress is also linked to another facial skin condition called perioral dermatitis. This is an inflammatory skin disease which leads to a rash around the mouth.

It can be triggered by soap, detergent, or steroid cream. But, like BMS, there is often no clear cause. However, it is also more common in post-menopausal women.

So it is possible that someone who suffers from BMS could also develop perioral dermatitis. Treatment usually involves a topical antibiotic cream prescribed by a GP. There is also a similar condition caused angular stomatitis, which causes redness, soreness and cracks at the corners of the mouth.

It is more common in people who use dentures or braces, as well as those with eczema.

Usually, doctors treat this with a combination of steroid creams or an antifungal or antibiotic cream.

When I first qualified as a doctor in the early 2000s, cases of autism were few and far between.

Today, there are thought to be around 700,000 people in the UK with the lifelong developmental disability, and there are competing theories why cases have risen.

One is that children exposed to high levels of pollution may be more at risk. Conspiracy theorists have blamed vaccines, but all evidence shows this is not true.

In the past, doctors didn't know enough about autism to spot it. Now, I believe, we are better at recognising the signs, which is why we diagnose more people.

It stands to reason there are thousands of adults who have never been diagnosed.

In 2017, TV presenter Chris Packham revealed he was diagnosed in his 40s.

Do you believe you might have undiagnosed autism? Please write in on the email address below and let me know why.

I'm concerned that people are living with a life-threatening condition without realising it.

Many who have heard of liver disease wrongly assume it is caused by drinking too much booze.

However, it is more common for it to occur as a result of obesity or type 2 diabetes. This is known as fatty liver disease and can lead to total organ failure and even death.

Research suggests the number of liver disease cases has risen by nearly 40 per cent in the past 20 years, primarily driven by rising levels of obesity. Around one in five adults have the condition, which can be spotted using a blood test. But most patients do not experience symptoms until they have already suffered severe liver damage.

Have you recently been diagnosed with fatty liver disease? Did it come as a shock? Write and let me know.

• Do you have a question for Dr Ellie Cannon? Email [email protected]. Dr Cannon cannot enter into personal correspondence and her replies should be taken in a general context.