Dear doctor;

I started school last week, but everyday, I get terrible headache and some times diarrhoea for no apparent reason. They subside when I am back home resting. What could be the problem and how would one adjust? Leo, 22.

Dear Leo,

Regarding headache, you have not specified whether it occurs throughout the day or for a short time in the morning only? Is there any problem of recurrent cold particularly when in school? Is the vision clear or there is trouble seeing blackboard from far or vision becomes blurred or cloudy while reading or writing for long? Is there any associated fever?

Rhinitis or common cold, particularly when associated with blocked nose, can at times cause severe headache.

Maybe there is something in the school environment causing allergy, which causes the cold and headache.

Allergy can be due to dust, insect droppings or any particular food or drink. Cold can also cause acute congestion and inflammation of the air sacs in the skull resulting in severe headache, which would be more in morning.

This is diagnosed by a complete blood count and is cured with suitable antibiotics. Maybe when at home the environment is different and hence the headache does not occur.

Any defect in vision can cause headache, which can be severe at times. One’s eyes are working constantly when awake. Activities like reading, writing or using computers, among others, add to the stress causing headache. A simple vision test can help to detect this.

Fever due to infections like malaria can cause severe headache with no other complaint. Because symptoms in malaria are periodic, the headache also may wax and wane.

Some young persons get severe headache just due to stress with no other apparent reason. This kind of tension headache occurs when exposed to stress and may subside when relaxed.

Regarding diarrhoea in a young individual, most common cause is infection of the intestines. Poor hygiene with regards to cooking, serving or eating food can cause recurrent infection. If food hygiene in school is not good, there can be episodic diarrhea. It may not occur while at home due to good food hygiene. Getting a stool sample examined helps to detect the infection and it cures completely with suitable antibiotics.

At times, one can have unexplained diarrhea simply due to stress, what is known as irritable bowel syndrome.

Dr Rachna Pande  is a specialist in internal medicine at Ruhengeri Hospital