I’m 83 and have had gastritis for years, relieved with Gaviscon and esomeprazole. These have also eased the gurgling and bubbling stomach noises I’ve recently had. I’ve had pernicious anaemia for ten years and read that stomach cancer risk is higher with this. Should I have a scan or MRI?

Name and address supplied.

Dr Martin Scurr replies: A gurgling stomach is a common problem, as gases and fluids are moved along the digestive tract. This can happen for a number of reasons, but let’s start with the significant part of your story, pernicious anaemia.

This is where the immune system damages the stomach lining, destroying the cells that produce stomach acid which helps break down food so nutrients can be absorbed, as well as the cells that make intrinsic factor, a protein needed to absorb vitamin B12 further along the gut.

This all leads to a lack of red blood cells, nerve damage and fatigue among other symptoms.

A gurgling stomach can happen for a number of reasons including irritable bowel syndrome, coeliac disease or small intestinal bacterial overgrowth, says Dr Scurr

It’s more common with age (over 60) and in women.

This condition does raise stomach cancer risk slightly. But it carries an increased risk of a less aggressive cancer, a neuroendocrine tumour in the stomach.

This can lead to the bubbling and gurgling sounds you describe, possibly as the smooth muscle in the walls of the gut are overexcited, stimulated by hormones secreted by the tumour.

Yet you say Gaviscon or esomeprazole have helped, so a neuroendocrine tumour seems an unlikely cause, as pernicious anaemia means your stomach produces little or no acid.

So I wonder if the stomach noises are due to something else – for instance, irritable bowel syndrome, coeliac disease or small intestinal bacterial overgrowth (where you have too many bacteria in the small intestine).

Even what you’ve eaten can cause these noises (if, say, more intestinal gas is produced). It’s a similar thing with a ‘rumbling’ hungry tummy, the muscles pushing along gases and liquid with no food to muffle the sound.

As for investigations, it’s better to examine the tissue directly via an endoscopy (where a camera on a thin tube is passed through your mouth to inspect the stomach and intestine) and a biopsy. I recommend that you ask your GP to refer you to a gastroenterologist.

I’m 82 and drink four pints of beer every night. I recently halved my intake as I was getting up five times a night to urinate. But I’m still having to pee and often it’s just a dribble. What can I do?

David Baldwin, Alnwick, Northumberland.

Dr Martin Scurr replies: It sounds as if you have benign prostatic hyperplasia (BPH) – an enlarged prostate – which is common in older men.

Symptoms include weak stream, dribbling and hesitancy – where you need to empty the bladder but it can take several minutes to get going.

An urge to pee immediately and needing the loo more

than once a night are also common signs of it. BPH is due to age-related growth of the prostate, which then presses on the urethra, which carries urine out of the body.

It also distorts the base of the bladder, so most men with the condition may think they’ve emptied their bladder but it may still be relatively full.

This is exacerbated at night because as we age, our bodies produce less of a hormone that helps the kidneys produce less urine as we sleep.

Treatment usually begins with an alpha blocker drug such as tamsulosin to relax the muscle fibres in the prostate and ease pressure on the urethra.

A synthetic form of the hormone can also help but first you should reduce your evening beer intake further – or at least drink it at lunchtime instead.

• Write to Dr Scurr at Good Health, Daily Mail, 9 Derry Street, London, W8 5HY or email: drmartin@dailymail.co.uk – include your contact details. Replies should be taken in a general context. Always consult your own GP with any health worries.