Why is my boy grinding his teeth?

A – Teeth grinding, or bruxism as it is known medically, is very common in children and up to 30 per cent will do it, especially at night during the deep phases of sleep. The exact cause isn’t always clear but it may happen in some children because their top and bottom teeth are not aligned correctly.

In others it may be a response to pain, from either an ear or a growing tooth. In some, stress does seem to be to blame and the causes of this could vary from problems at school to rows with siblings.

In most children bruxism disappears of its own accord and does not cause any harm, although it can occasionally cause muscle tension which leads to headaches. If you are concerned about your son’s teeth get him a dental check-up.

If you suspect stress may be to blame coax him to talk about any problems that may be bothering him.

Q – I frequently knock the backs of my hands and wrists, resulting in red marks which are unsightly and take ages to fade. The practice nurse at my GP surgery says it is because my skin is very thin. What is the best way to deal with this?

– Occationally skin thinning can be due to steroid medication (from creams and tablets, not from asthma inhalers) but the most common cause is simply age. How well your skin ages can be affected by a number of factors, including smoking and sun exposure which accelerate the ageing process.

Your genes are important too. Some people are just born luckier than others when it comes to their complexion. However, even with the best care, the loss of elastic tissue and collagen in the deeper layers and the flattening of the surface layer means skin becomes more transparent, slack and fragile.

The walls of the blood vessels in the skin also become thinner and more fragile and this means that large bruises may appear from just a small knock. So protecting your skin is very important.

Always wear at least SPF 30 sunscreen if you are going outside during the summer months and reapply every few hours and also after you wash your hands.

Keep your skin well moisturised which means applying cream at least three times a day and if you are doing gardening or any chores that might increase the risk of damage to your hands, always wear gloves, even for deadheading a few roses.

Wearing long-sleeved clothing to protect your lower arms is sensible too.

Q – I had my gall bladder removed two years ago. Since then certain foods give me a burning sensation a few hours after eating. Could my small intestine have been damaged due to the operation or is something else causing this?

A – The gall bladder, which lies on the right side of the upper abdomen under the liver, is the storage reservoir for bile which is constantly produced by the liver. After eating a meal the gall bladder contracts, pushing the bile into the small intestine, Why is my boy Daily Express Tuesday July 17 2018 31 your health where the enzymes it contains play an important role in digesting fatty foods.

The most common reason for removing the gall bladder is gallstones which contain fatty material that has solidified and hardened.

Although many people have gallstones and are unaware of them, in about 20 per cent of cases they can cause inflammation inside the gall bladder and small stones may block the tiny passageway from the gall bladder to the intestine, leading to severe pain and jaundice.

About 60 per cent of people who have their gall bladder removed have no problems afterwards but others, like you, are not so lucky. After the gall bladder has been removed there is nothing to store the bile so it just drips steadily into the intestine.

This means there is not a surge of bile after eating fatty foods which in some can lead to nausea or diarrhoea, as the body cannot digest fats as efficiently.

The constant flow of bile can also cause inflammation of the lining of the small intestine where the bile enters and this can lead to nagging abdominal pain and bloating. Eating a low-fat diet, rich in fibre, alongside plenty of fresh fruit and vegetables can usually help a lot.

Try to eat several small meals a day rather than three large ones as this can help “mop up” the constant flow of bile.