Q: I have had piles for many years, and they don’t bother me much. Lately, though, there has been blood when I wipe myself: that is fairly new. Can I assume that it’s just the piles, or do I really need to have an internal examination.

A: You can’t assume it’s the piles, although, on balance they are by far the most likely cause of the bleeding. You should ask your doctor’s opinion. In any case why not get the haemorrhoids seen to? In the long run you will feel better: they can only get worse if you leave them. If you are losing a significant amount of blood, you could become anaemic and bleeding piles can also become infected.

Q: I’ve smoked for 40 years ago, and I’m trying to stop. Recently my cough has got worse but I’ve also noticed a change in my finger ends. They have become swollen and bulging, and they have a bluish tinge. Is this related to the smoking, or could they be a sign of another problem?

A: You are describing club fingers, which are caused by deteriorating lungs – lack of oxygen to the tissues of the fingers produce these changes. You are now close to complete lung failure, so you absolutely must be a non-smoker from now on.