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Croup

Croup | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotlands Service Directory 0 Home Illnesses and conditions Lungs and airways Croup Croup About croup Symptoms of croup Causes of croup Diagnosing croup Treating croup Complications of croup About croup Croup isa childhood condition that affects the windpipe (trachea), the airways to the lungs (the bronchi) and the voice box (larynx). Childrenwith croup have a distinctive barking cough andwill make a harsh sound, known as stridor, when they breathe in. They may also have ahoarse voice and find it difficult to breathe because their airway is blocked. Take your child to A&E or phone 999 if your child: has severe breathing difficulties has an increased breathing rate (theyre too breathless to feed or talk) or silent chest (youre unable to hear sounds of breathing) has a worsening cough or rasping sound shows distress and agitation has dark, blue-tinged or pale skin the skin around their ribs and chest appears to be pulled in and tight, making the bones of their chest and ribs more visible has abnormal drowsiness and sleepiness has an inability to drink fluids Contact your GP or, if your GPs closed, phone 111 if: is less than 3 months old and has a temperature of 38 C or above is aged 3 months or older and has a temperature of 39 C or above your child has a distinctive barking cough your child makes a harsh sound when they breathe in Croup can usually be diagnosed by a GP and treated at home. Read more about the symptoms of croup and diagnosing croup Why does crouphappen? Commonly, croup is caused by a virus. Several viruses can cause croup but in most cases it is the parainfluenza virus. Read more about the causes of croup Who is affected by croup? Croup usually affects young children aged between six months and three years, with most cases occurring in one-year-olds. However, croup can sometimes develop in babies as young as three months, and older children up to 15 years of age. Adults can also get croup but this is rare. The condition is more common during thelate autumn and early winter months. Ittends to affect more boys than girls. A child may experience croup more than once during childhood. Treating croup Most cases of croup are mild and can be treated at home. Sitting your child upright and comforting them if they are distressed is important, because crying may make symptoms worse. Your child should also drink plenty of fluids to prevent dehydration. Asingle dose of an oral corticosteroid medication called dexamethasone or prednisolone will usually also be prescribed to help reduce the swelling in the throat. If your child has breathing problems they may need hospital treatment, such as adrenaline and oxygen through a mask. Read more about treating croup Complications Mostcasesof croup clear up within 48 hours. However, in some cases symptoms can last for up totwoweeks. It is extremely rare for a child to die from croup. There are a number of conditions thatcan followcroup, such as pneumonia and middle ear infection . Read more about the complications ofcroup . Preventing croup Croup is spread in a similar way to the common cold, so it is difficult to prevent. Good hygiene is the main defence against croup, such as regularly washing hands and cleaning surfaces. A number of your childs routine vaccinations also protect against some of the infections that can cause croup. These include: MMR protection from measles, mumps and rubella DTaP/IPV/Hib protection from diphtheria, tetanus, whooping cough, polio and Haemophilus influenzae type b Symptoms of croup A child can get croup at any time of the year, although its more likely to occur duringlate autumn or early winter. This may be because there are more viruses, such as colds and flu,around at this time of year. Typical symptoms of croup include: a bark-like cough a hoarse or croaky voice difficulty breathing a harsh grating sound when breathing in, called stridor Stridor is often most noticeable when the child cries or coughs. But in more severe cases of croup it can also occur when the child is resting or sleeping. Symptoms tend to be worse at night. Some children have cold-like symptoms for a few days before developing croup symptoms. These cold-like symptoms can include: sore throat runny nose cough high temperature (fever) Although croup symptoms usually only last for a few days, they can occasionally last up to two weeks. When to seek medical advice Croup can usually be diagnosed by a GP and mild cases can be treated at home. Take your child to A&E or phone 999 if your child: has severe breathing difficulties has an increased breathing rate (theyre too breathless to feed or talk) or silent chest (youre unable to hear sounds of breathing) has a worsening cough or rasping sound shows distress and agitation has dark, blue-tinged or pale skin the skin around their ribs and chest appears to be pulled in and tight, making the bones of their chest and ribs more visible has abnormal drowsiness and sleepiness has an inability to drink fluids You should take them to your nearest hospitals accident and emergency department or dial 999 for an ambulance. Some of these symptoms may indicate a potentially life-threatening underlying condition called epiglottitis (inflammation and swelling of the epiglottis). The symptoms could also indicate tracheitis (inflammation of the windpipe), which also requires immediate medical attention. Causes of croup Croup usually develops as the result of a viral infection. The infection causes the larynx (voice box) to become swollen and the trachea (windpipe) to become blocked, and may affect the tubes in the lungs (bronchi). It is sometimes called laryngo-tracheo-bronchitis Parainfluenza virus The parainfluenza virus is the most common cause ofcroup.Four strains of the virus are responsible for most croup cases. These are: parainfluenza I parainfluenza II parainfluenza III parainfluenza IV Parainfluenza I isresponsible for most cases of croup. The virus can be transmitted through close contact with infected people, as well as contaminated objects and surfaces. As with many airborne viruses, the parainfluenza virus is often spread by breathing in droplets from infected coughs or sneezes. Other viruses Anumber of other viruses can also cause croup. These include: influenza A and B (flu viruses) the measles virus, in children who have not been immunised against measles the rhinovirus (common cold virus) enteroviruses the respiratory syncytial virus (RSV), which can cause severe breathing problems and pneumonia in babies Othercauses Less common causes of croupinclude: inhaling a small object such as a peanut or a pen cap (inhaled foreign body) epiglottitis inflammation of the epiglottis, (the flap at the base of the tongue that keeps food from going into the windpipe) an allergic reaction to substances such as pollen or dust mites inhalation ofirritants, such as chemicals acid leaking back out of the stomach and into the throat ( acid reflux ) Diagnosing croup A GP can diagnose croupby studyingyour childs symptoms, particularlythe sound of their cough. Theymay alsocheck your childs temperature for a fever and ask whether they have recently had a cold orviral infection. In some cases, a pulse oximetry test may be carried out. This involves clipping a sensor onto your childs earlobe or finger to find out their oxygen levels. The test does not hurt and should not distress your child, and determines whether your child is absorbing enough oxygen into their blood. Your GP will decide whether your child needs to be admitted to hospital or whethertheir croup is safe to treat at home. You should not try to check your childs throat yourself, because it could trigger a spasm (sudden narrowing) of the airway. This could cause the airway to swell even more, making breathing even more difficult. Ruling out other conditions Croup can usually be diagnosed by studying your childs symptoms, but your GP may want to rule out other conditions that can cause similar symptoms. Other possible causes for your childs symptoms are: an abnormality of the airway, which has been present from birth anabscess in the tissues in the back of the throat inhaled material (something they have breathed in) swelling of the deeper layers of the skin (angio-oedema) epiglottitis congenital lesion an allergic reaction In very rare cases, epiglottitis (inflammation of the epiglottis) or tracheitis (inflammation of the windpipe) can cause similar symptoms to croup. In these cases, however, your child will usually feel very unwell generally, rather than just having the specific symptoms of croup. Differentiating these causes from croup may require further tests. Further investigation If your child is admitted to hospital with severe croup, or if treatmentisunsuccessful, further investigations may be needed to examine their neck and chest area for a possible obstruction. AnX-ray may be recommended if it is thought your child may have inhaled something and it is obstructing their airway. Treating croup Treatment of croup depends on how severe the symptoms are. Most cases are mild and can be managed at home. However, if your child has severe croup, they will need to be admitted to hospital urgently. Treatment croup at home If your GPthinks your child has mildcroup, they will usually recommendmanaging itat home. Thiswill ofteninvolve using childrens paracetamol to ease any pain associated with the condition and may help lower your childs temperature if they have a fever. You should also ensure your child is well hydrated by encouraging them to drink plenty of fluids. Comforting your child is alsoimportant because their symptoms mayget worseif they are agitated or crying. If your child is distressed, sitting them upright on your lap will help to comfort and reassure them. Your GP will usually prescribe a single dose of an oral corticosteroid medication called dexamethasone or prednisolone to help reduce swelling (inflammation) in your childs throat. Side effects of these medications can include restlessness, vomiting, upset stomach and headache. Steam treatment is not advised for the treatment of croup. There is no evidence that allowing your child to breathe in humid air, for example steam from a hot bath or shower in a closed room, will help. You should seek urgent medical advice if you notice your childs symptoms getting worse. Painkillers for children Painkillers, such as paracetamol and ibuprofen , are available in liquid form for children.You can get liquid paracetamol and ibuprofen over the counter from pharmacies and some supermarkets. Children under 16 years of age should not be given aspirin. Speak to your pharmacist or GP if you are unsure about what type of painkiller is suitable for your child. Do not use cough medicines or decongestants as these do not help ease the symptoms of croup.These treatments often have drowsy side effects, which can be dangerous when a childhas breathing difficulties. Hospital treatment In severe cases of croup, treatment in hospital may be required. Breathing problems, such as shortness of breath, are a major symptom of severe croup. You should dial 999 immediately for an ambulance if your child is struggling to breathe. If your child has severe croup, they may be given adrenaline through a nebuliser. This will help improve symptoms within 10 to 30 minutes and the effects should last for up to two hours. A nebuliser allows your child to breathe the medication as a mist. If your child is very distressed and finding itdifficult to breathe, they will be given oxygen through an oxygen mask. As with milder cases of croup, oral dexamethasone or prednisolonewill usuallybe given to help reduce any swelling in your childs airways. In rare cases croup may require hospitalisation, where a child may need intubation. During intubation, a tube is inserted either through a nostril or the mouth and passed down into the windpipe. This will help your child breathe more easily. Intubation is usually performed under general anaesthetic . This means your child will be completely unconscious throughout the procedure so they do not experience pain or distress. Complications of croup Complications that develop as a result of croup are rare. Airway obstruction If an obstructed airway is not treated promptly, it can lead to: severe breathing difficulty (respiratory distress) respiratory arrest(where breathing stops but the heart continues beating) Always phone 999 for an ambulance if your child is struggling to breathe. Your child may find it difficult to drink fluids as a result of an obstruction in their airway. However, it is important they have plenty of fluids to avoid dehydration . If your child refuses fluids, try not to force them. This could distress your child and make the condition worse. Secondary infection A secondary infection can sometimes develop following the initial viral infection that caused croup. A secondary infection can potentially cause: pneumonia , a chest infection which causes swelling of the tissue in one or both lungs bacterial tracheitis, which isa serious and potentially life-threatening infection that can occur after a viral respiratory infection Other complications Although rare, other possible complications of croup can include middle ear infection and lymphadenitis, an infection of the glands of the immune system (lymph nodes). Source: NHS 24 - Opens in new browser window Last updated: 15 June 2023 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Dont include personal information e.g. name, location or any personal health conditions. Email Address e.g. [email protected] Message Maximum of 500 characters Send feedback Add this page to\n Info For Me NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats 2023 NHS 24 v1.1.1.17852

Cystic fibrosis

Cystic fibrosis | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotlands Service Directory 0 Home Illnesses and conditions Lungs and airways Cystic fibrosis Cystic fibrosis About cystic fibrosis Symptoms of cystic fibrosis Causes of cystic fibrosis Diagnosing cystic fibrosis Treating cystic fibrosis About cystic fibrosis Cystic fibrosis is an inherited condition in which the lungs and digestive system can become clogged with thick, sticky mucus. Itcan cause problems with breathing and digestion from a young age. Over many years, the lungs become increasingly damaged and may eventually stop working properly. Most cases of cystic fibrosis in the UK are now identified through screening tests carried out soon after birth. Its estimated that 1 in every 2,500 babies born in the UKhas cystic fibrosis. A number of treatments are available to help reduce the problems caused by the condition,but unfortunately averagelife expectancy is reduced for people who have it. Symptoms of cystic fibrosis Symptoms of cystic fibrosis tend to start in early childhood, although they can sometimes develop verysoon after birth, or may not be obvious until adulthood. Some of the main symptoms of cystic fibrosis can include: recurring chest infections difficulty putting on weight frequent, wet-sounding coughs diarrhoea occasional wheezing and shortness of breath People with the condition can also develop a number of related conditions, including diabetes ,thin, weakened bones ( osteoporosis ) and liver problems. Read more about the symptoms of cystic fibrosis Causes of cystic fibrosis Cystic fibrosis is caused by a faulty gene that a child inherits from both of their parents. The faulty gene means that some cells struggle to move salt and water across the cell wall. This, along with recurrent infections, can result in a build-up of thick, sticky mucus in the bodys tubes and passageways. To be born with cystic fibrosis, a child has to inherit two copies of this faulty gene one from each of their parents. Their parents will not usually have the condition themselves, because they will only carry one faulty gene and one that works normally. If both parents carry the faulty gene, theres a 25% chance that each child they have will be born with cystic fibrosis. Read more about the causes of cystic fibrosis Screening and testing for cystic fibrosis Most cases of cystic fibrosis are now detected soon after birth through the newborn blood spot test . This involves collecting a drop of blood from the babys heel and testing it forabnormalities that could indicate cystic fibrosis. More testswill be needed to confirm the diagnosis, such as: a sweat test to measure the amount of salt in sweat, as the sweat of someone with cystic fibrosis has higher levels of salt than normal a genetic test where a sample of blood or saliva is checked for the faulty gene that causes cystic fibrosis These tests can also be carried out in older children and adults with symptoms of cystic fibrosis who havent been screened previously. If you have a family history of cystic fibrosis, you can be tested to determine if youre at risk of having a child with the condition by checking if youre acarrier of the faulty gene that causes it. Read more about how cystic fibrosis is diagnosed Treatments for cystic fibrosis Theres currently no cure for cystic fibrosis, but a number of treatments are available to help control the symptoms, preventcomplications, and make the condition easier to live with. Possible treatments include: antibiotics to prevent and treat chest infections medicinestomake the mucus in the lungs thinner and easier to cough up medicines to widen the airways and reduce inflammation special techniques and devices to help clear mucus from the lungs medicines that help the person absorb food better following a special diet and taking supplements to prevent malnutrition A lung transplant may eventually be needed if the lungs become greatly damaged. Read more about treating cystic fibrosis Outlook for cystic fibrosis Cystic fibrosis is a progressive condition, which means it tends to get worse over time. Eventually the condition can be fatal if it leads to a serious infection or the lungs stop working properly. The outlook for cystic fibrosis has improved considerably in recent yearsbecause ofadvancements in treatment, although most people with cystic fibrosis will have a shorter-than-average life expectancy. Currently, about half of the people with cystic fibrosis will live past the age of 40. Children born with the condition nowadays are likely to live longer than this. Information about you If you or your child hascystic fibrosis, your clinical team will pass information about you/your childon to the National Congenital Anomaly and Rare Diseases Registration Service (NCARDRS). This helps scientists look for better ways to prevent and treat this condition. You can opt out of the register at any time. Find out more about the register Symptoms of cystic fibrosis Cystic fibrosis can cause a range of problems. The lungs and digestive system are the main areas that are affected. Symptoms tend to start in early childhood,but sometimes they can develop soon after birthand very occasionallythey may not be obvious until adulthood. Nowadays, cystic fibrosis is usuallydiagnosed before symptoms appear, through screening tests carried out soon after birth. Read more about screening forcystic fibrosis . The main problems associated with cystic fibrosis are outlined below. Lung problems Cystic fibrosis can cause sticky mucus to clog the lungs and airways. This can cause: recurring chest infections these occur because mucus in the lungs is an ideal breeding ground for bacteria persistent inflammation of the airways, which can cause them to become abnormally widened ( bronchiectasis ) increased coughing occasional wheezing and shortness of breath Over time, the lungs can become increasingly damaged and may eventually stop working properly. Digestive system problems The mucus can also block parts of the digestive system, whichcan affect how food travels through the gut and how itsbroken down or absorbed. This can cause: a serious bowel obstructionin the first few days of life (meconium ileus)this will often need an operation to remove the blockage jaundice diarrhoea or large, smelly stools problems putting on weight and growing this can occur because the bodystruggles todigest and absorb nutrients ( malnutrition ) diabetes from late childhood or early adulthood this can develop if the pancreas becomes severely damaged Other problems People with cystic fibrosis can alsoexperience a number of other problems, including: sinusitis nasal polyps thin,weakened bones ( osteoporosis )this can occur as a result of repeated infections, poor growth, lack of physical activity and malnutrition swelling and pain in the joints ( arthritis or arthralgia) from late childhood difficulty conceiving children most men with cystic fibrosis are unable to have children naturally (although some fertility treatments may still work) because the tubes that carry sperm dont develop correctly; women can become pregnant, however liver problems caused bythe tiny bile ducts in the liver becoming blocked by mucus leaking of small amounts of urine, particularly during coughing fits ( stress incontinence ) Causes of cystic fibrosis Cystic fibrosis is caused by a faulty gene that a child inherits from both their parents. The faulty gene means that some cells struggle to move salt and water across the cell wall. This, along with recurrent infections, can result in a build-up of thick, sticky mucus in the bodys tubes and passageways particularly the lungs and digestive system. The condition is present from birth and cannot be caught from someone else who has it. How cystic fibrosis is inherited Genes come in pairs. You inherit one set from your mother and one set from your father. To be born with cystic fibrosis, a child has to inherit a copy of the faulty gene from both of their parents. This can happen ifthe parents are carriers of the faulty gene. This means they dont have cystic fibrosis themselves, but they can have a child with the condition if their partner also carries the faulty gene. Its estimated that around 1 in every 25 people in the UK are carriers of the faulty gene that causes cystic fibrosis. If both parents are carriers, theres a: 25% chance that each child they have will not inherit any faulty genes and wont havecystic fibrosisor be able to pass it on 50% chance that each child they have will just inherit one copy of the faulty gene from one parent and be a carrier 25% chance that each child they have will inherit copies of the faulty gene from both parents and will havecystic fibrosis This is known as an autosomal recessive inheritance pattern. Diagnosing cystic fibrosis Tests can be carried out to diagnose cystic fibrosis at any age. Most cases are now detected soon after birth through newborn screening, but older children and adults with symptoms of cystic fibrosis who werent screened can also have tests to check for the condition. Tests to find out if you are a carrier of the faulty gene responsible forcystic fibrosismay also be recommended for some people. Newborn screening A newborn blood spot test is offered to all babies in Scotland to help detect problems early on, including cystic fibrosis. When your baby is five to eight days old, a health professional will prick their heel and collect drops of blood on a special card. The blood is then sent to a laboratory to be checked for abnormalities that could indicate cystic fibrosis. You should receive the results by the time your baby is six to eight weeks old. You will be contacted sooner if a problem is found, and youll be asked to attend a hospital appointment. The screening result isnt 100% accurate, so more tests will be carried out to confirm the diagnosis. You, your partner and any other children you have may also be tested to see if you carry the faulty gene that causes cystic fibrosis. Confirminga diagnosis Tests to confirm a diagnosis will be carried out if screening suggests that your child may have cystic fibrosis, or your doctor thinks you could have the condition and you havent been screened previously. Two main tests can be used to diagnose cystic fibrosis: sweat test a test to measure the amount of salt in sweat, as the sweat of someone with cystic fibrosis has higher levels of salt than normal genetic test where a sample of blood or saliva is checked for the faulty gene that causes cystic fibrosis The sweat test is most commonly used, althoughgenetic testing may be done if the sweat test result is inconclusive or to identify the specific genetic fault thats causing the condition. Carrier testing Testing tofind out if you carry the faulty gene that causes cystic fibrosis may be useful if: youhave a close relative, such as a child, sibling or parent,whos a known carrier youhave a close relativewith cystic fibrosis your partner is known to carry thecystic fibrosis gene This can be done using a blood test, or occasionally a special mouthwash, to collect a sample of cells. The sample is then sent to a laboratory so it can be checked for the faulty gene. Finding out whether youre a carrier of the faulty gene can help determine if youre at risk of having a child with cystic fibrosis.A genetic counsellorwill explain the results of the testto you and discuss the implications and options available forfuture pregnancies. Treating cystic fibrosis Theres currently no cure for cystic fibrosis, but its possible to help control the symptoms, prevent or reduce complications, and make the condition easier to live with. A person with cystic fibrosis will be supported by ateam of healthcare professionals at a specialist cystic fibrosis centre. A care plan will be drawn up thats tailored to their individual needs. A range of treatments may beused and sometimes treatment in hospital will be needed. Regular appointments to monitor the condition will also be recommended. Some of the main treatments for cystic fibrosis include: Medications for lung problems People with cystic fibrosis may need to take a number of different medicines to treat and prevent lung problems. These may be swallowed, inhaled or injected. Some of the main medicines for cystic fibrosis are: antibiotics to prevent and treat chest infections medicines to make the sticky mucus in the lungs thinner, such as dornase alfa, hypertonic saline and mannitol dry powder a medicine called ivacaftor to help reduce the levels of mucus in the body although this is only suitable for fewer than 1 in every 20 people (4%) with cystic fibrosis bronchodilators to widen the airways and help make breathing easier steroid medication to treatnasal polyps(small growths inside the nose) Its alsoimportant that people with cystic fibrosis are up to date with all routine vaccinations and have the flu jab each year once theyre old enough. Airway clearance techniques In addition to medication, special techniques can be used to help keep the lungs and airways clear. A physiotherapistcan give you advice. Some of the main techniques include: active cycle of breathing techniques (ACBT) a technique that involves a sequence of relaxed breathing, followed by deep breathing exercises and then huffing autogenic drainage a series of gentle breathing techniques that clear mucus from the lungs modified postural drainage a technique that involves changing your position to make it easier to remove mucus from your lungs airway clearance devices handheld devices that use vibration and air pressure to help remove mucus from your airways; you may have to pay in the region of 45-60 for one of these devices Your care team can provide more information on the techniques mentioned above. Dietary and nutritional advice For people with cystic fibrosis, getting the right nutrition is vital in helping them develop normally and stopping them becoming frequently ill. However, the majority of people with cystic fibrosis cannot digest food and absorb nutrients from when theyre a baby. Occasionally, the condition can cause the pancreas to become damaged over time, causing the same problem. A dietitian will advise on what you can do to help avoid malnutrition . They may recommend: taking digestive enzyme capsules with all meals and snacks to help with digestion the number of capsules needed depends on the food being eaten and varies from person to person following a special balanced diet thats high in calories (energy), fat and protein takingvitamin and mineral supplements Lung transplants In severe cases of cystic fibrosis, when the lungs stop working properly and all medical treatments have failed to help, a lung transplant may be recommended. A lung transplant is a serious operation that carries risks, but it can greatly improve the length and quality of life for people with severe cystic fibrosis. The outlook for people with cystic fibrosis is often better than for many transplant patients, as theyre often younger and in better general health. Itsestimated that up to 9 out of 10 people will survive for at least a year after a transplant. The Cystic Fibrosis Trust has information on lung transplants in cystic fibrosis . Treatments for associated problems People with cystic fibrosis can have a number of other problems that may benefit from treatment. For example: exercise can help keep bones and joints healthy, and is recommended for everyone withcystic fibrosisany sport or exercise is usually good, but if youre not sure about a particular activity, you should ask your physiotherapist for advice medicines called bisphosphonates can help treat weak and brittle bones that may occur as a result of cystic fibrosis if the person doesnt get enoughvitaminD and calcium(from their diet and/or from supplements) insulin medication and a special diet may help someone with diabetes caused bycystic fibrosis control their blood sugar levels Source: NHS 24 - Opens in new browser window Last updated: 18 October 2023 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Dont include personal information e.g. name, location or any personal health conditions. Email Address e.g. [email protected] Message Maximum of 500 characters Send feedback Add this page to\n Info For Me Other health sites Cystic Fibrosis Trust Genetic Alliance UK NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats 2023 NHS 24 v1.1.1.17852

Cystitis

Cystitis | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotlands Service Directory 0 Home Illnesses and conditions Kidneys, bladder and prostate Cystitis Cystitis About cystitis Symptoms of cystitis Causes of cystitis Treating cystitis About cystitis Cystitis is inflammation of the bladder, usually caused by a bladder infection. Its acommon type of urinary tract infection (UTI) , particularly in women, and is usually more of a nuisance than a cause for serious concern. Mild cases will often get better by themselves within a few days. However, some people experience episodes of cystitis frequently and may need regular or long-term treatment. Theres also a chance that cystitiscould lead to a more serious kidney infection in some cases, so its important to seek professional advice ifyour symptoms dont improve. Signs and symptoms of cystitis The main symptoms of cystitis include: pain, burning or stinging when you pee needing to pee more often and urgently than normal urine thats dark, cloudy or strong smelling pain low down in your tummy feeling generally unwell, achy, sick and tired Possible symptoms in young children include a high temperature (fever) of 38C (100.4F) or above, weakness, irritability, reduced appetite and vomiting. Read more about the symptoms of cystitis When togetprofessional advice Speak to your pharmacist if you think you may have cystitis or symptoms of a urine infection. Women who have had cystitis before dont necessarily need to see their GP if the condition returns, asmild cases often get better without treatment. You can try theself-help measures, or ask your pharmacist for advice. Pharmacy First Scotland: Urinary infection treatment from your pharmacy Women over 16 with symptoms of a mild urinary infection can get advice and treatment directly from their pharmacist through the Pharmacy First Scotland service. Your pharmacist may be able to provide you with treatment to clear the infection, although there may be situations where they will recommend you see your GP. Find your local pharmacy on Scotlands Service directory. Search for a pharmacy near you You should see your GP if: your symptomsdont start to improve within a few days you get cystitis frequently you have severe symptoms, such asblood in your urine youre pregnant and have symptoms of cystitis youre a man and have symptoms of cystitis your child has symptoms of cystitis Your GP should be able to diagnose the problem by asking about your symptoms. They may test a sample of your urine for bacteria to help confirm the diagnosis. What causes cystitis? Most cases are thought tooccur when bacteria that live harmlessly in the bowel or on the skin get into the bladder through the urethra (tube that carries urine out of your body). Its not always clear how this happens, but itcan be caused by: having sex wiping your bottom aftergoing to the toilet particularly if you wipe from back to front inserting a tampon or urinary catheter (a thin tube inserted into the urethra to drain the bladder) using a diaphragm for contraception Women may get cystitis more often than men because their anus (back passage) is closer to their urethra, and their urethra is much shorter, which means bacteriamay be able toget into the bladder more easily. Read more about the causes of cystitis Treatments for cystitis If you see your pharmacist with symptoms of cystitis you can be treated under the Pharmacy First Scotland service. If you are female over 16 with signs of a mild urine infection, the pharmacist may offer you a course of antibiotics to treat the infection where appropriate. These should start to have an effect within a day or two. If youve had cystitis before and dont feel you need to see your pharmacist or GP, you may want to treat your symptoms at home. Until youre feeling better, it may help to: take paracetamol or ibuprofen drink plenty of water hold a hot water bottle on your tummy or between your thighs avoid having sex Some people find it helpful to try over-the-counterproducts that reduce the acidity of their urine (such as sodium bicarbonate or potassium citrate), but theres a lack of evidence to suggest theyre effective. If you keep getting cystitis, your GP may give you an antibiotic prescription to take to a pharmacy whenever you develop symptoms, without needing to see yourdoctor first. Your GP can also prescribe a low dose of antibiotics for you to take continuously over several months if necessary. Read more about treating cystitis Preventing cystitis If you get cystitis frequently, there are some things you can try that may stop it coming back. However, its not clear how effective most of these measures are. These measures include: not using perfumed bubble bath, soap or talcum powder around your genitals use plain, unperfumed varieties having a shower, rather than a bath thisavoids exposing your genitals to the chemicals in your cleaning products for too long going to the toilet as soon as you need to pee andalways emptying your bladder fully staying well hydrated drinking plenty of fluids may help to stop bacteriamultiplying in your bladder always wiping your bottom from front to back when you go to the toilet emptying your bladder as soon as possible after having sex contraception instead wearing underwear made from cotton, rather than synthetic material such as nylon, andnot wearing tight jeans and trousers Drinking cranberry juice has traditionally been recommended as a way ofreducing your chances of getting cystitis. However,large studies have suggested it doesnt make a significant difference. Symptoms of cystitis Cystitis can cause problems with peeing and make you feel unwell. Symptoms of cystitis in adults Cystitis in adults can cause: pain, burning or stingingwhen you pee needing to pee more often and urgently than normal feeling like you need to pee againsoon after going to the toilet urine thats dark, cloudy or strong-smelling pain low down in your tummy feeling generally unwell, achy, sick and tired blood in your urine In adults, cystitis doesnt usually cause a high temperature (fever). If you have a temperatureof 38C (100.4F) or above and pain in your lower back or sides, it may be a sign of a kidney infection . Symptoms of cystitis in children It can be difficult to tell whether a child has cystitis, because the symptoms can be vague and young children cannot easily communicate how they feel. Possible symptoms of cystitis in young children may include: ahigh temperature (fever) of 38C (100.4F) or above weakness and tiredness irritability reduced appetite vomiting Childrenwith cystitis can sometimes also have symptoms usually found in adults, such aspain whenpeeing, peeing more often than normal and pain in their tummy. When to seeyour GP You should see your GP if you or your child have symptoms of cystitis for the first time. Cystitis isnt usually a cause for serious concern, but thesymptoms canbe similar to several other conditions, soits important to get a proper diagnosis. If youre a woman who has had cystitis before, you dont necessarily need to see your GP again. Cystitis is very common in women and mild cases often get better on their own. Speak to a pharmacist if you need any advice about treating cystitis . However, you should see your GP if your symptoms are severe or dont start to get better in a few days, you get cystitis frequently,or youre pregnant. Children and men should always be seen by a GP if theyhave symptoms of cystitis, as the condition is less common and could be more serious in these groups. Causes of cystitis Cystitis is usually caused by a bacterial infection, although it sometimes happens when the bladder is irritated or damaged for another reason. Bacterial infections Mostinfections are thought tooccur when bacteria that live harmlessly in the bowel or on the skin get into the bladder through the urethra (tube that carries urine out of your body) and start to multiply. Cystitis is much more common in women than men, probably because the anus (back passage) is closer to the urethra in women and the urethra is much shorter. Its not always obvious how the bacteria get into the bladder, but it can be caused by: having sex wiping your bottom aftergoing to the toilet particularly if you wipe from back to front inserting a tampon or urinary catheter (a thin tube inserted into the urethra to drain the bladder) using a diaphragm for contraception What can increase yourrisk? There are a number of things that can increase your chances of developing an infection in your bladder. Not being able to empty your bladder If youre unable to empty your bladder fully, any bacteria that get inside may not be flushed out when yougo to the toiletand can multiply more easily. You may not be able to empty your bladder fully if: you have a blockage in your urinary system, such as a bladder stone youre pregnant, as thebaby may be pressing on your bladder (in men) you have an enlarged prostate gland that presses on the urethra Menopause For women whohave been through the menopause , or are going through it, the lining of the urethra can shrink and become thinner because ofa lack of the hormone oestrogen. The natural balance of bacteria in the vaginamay also change, which can allow potentially harmful bacteria to become more common. Thiscan make the urethra more vulnerable to infection, which could spread into the bladder. Diabetes Youre more likely to get cystitis if you have diabetes a condition where the level of sugar in your body becomes too high. High levels of sugar in your urine can provide a good environment for bacteria to multiply, so any bacteria that get into the bladder are more likely to cause cystitis. Other causes of cystitis Cystitis can also be caused by damage or irritation to the urethra and bladder. This can be the result of: friction from sex chemical irritants, such as those in perfumed soap or bubble bath damage caused by acatheter or surgery on your bladder radiotherapy to your pelvis or treatment with certain chemotherapy medicines awomans genitalshaving beendeliberately cut or changed for cultural, religious and social reasons (an illegal practice called female genital mutilation or FGM ) Cystitis has also been linked to recreational use of the drug ketamine. Treating cystitis Mild cystitis will usually clear up on its own within a few days, although sometimes you may need to take antibiotics. See your GP for advice and treatment if: you have symptoms of cystitis for the first time your symptomsdont start to improve within a few days you get cystitis frequently you have severe symptoms, such as blood in your urine youre pregnant and have symptoms of cystitis youre a man and have symptoms of cystitis your child has symptoms of cystitis Women who have had cystitis before dont necessarily need to see their GP if the condition returns, asmild cases oftenget better without antibiotics . You can try the self-help measures or ask your pharmacist for advice. Things you can try yourself If youve had cystitis before and dontfeel you need to see your GP, the following advice may help to relieve your symptoms until the condition clears up: take over-the-counter painkillers, such as paracetamol or ibuprofen always read the medicine information leaflet beforehand to check whether you can take it, and check with your pharmacist if youre not sure drink plenty of water its been suggested this may help flush the infection out of your bladder and some people find it helpful, although its not clear how effective it actually is use a hot water bottle holding a hot water bottle on your tummy or between your thighs may reduce any discomfort dont have sex until youre feeling better, becauseit may make the condition worse Some people find drinking cranberry juice or using products that reduce the acidity of their urine (such as sodium bicarbonate or potassium citrate) reduce their symptoms, but theres a lack of evidence to suggest theyre effective. These products are also not suitable for everyone. Check with your GP or pharmacist before trying themif youre taking any other medication. Antibiotics In some cases, your GP may prescribe acourse of antibiotics. This will usually involve taking a tabletor capsule 2 to4 times a day for 3 days. Antibiotics should start to have an effect quite quickly. Return to your GP if your symptoms havent started to improve within a few days. Most people wont have any side effects from antibiotic treatment, but possible side effects can include feeling or being sick, itching , a rash and diarrhoea . Ifcystitis keeps coming back If you keep getting cystitis (known as recurrentcystitis) your doctor may prescribe stand-by antibiotics or continuous antibiotics. A stand-by antibiotic is a prescription you can take toa pharmacy the next time you have symptoms ofcystitis, without needing to visit your GP first. Continuous antibiotics are taken for several months to prevent further episodes of cystitis. These may be prescribed: if cystitis usually occurs after having sex you may be given a prescription for antibiotics to take within 2 hours of having sex if cystitis is not related to having sex you may be given a low-dose antibiotic to take for a trial period of 6 months Your doctor may also recommend some measures you can take to prevent cystitis, although its not clear how effective these are. Source: NHS 24 - Opens in new browser window Last updated: 01 December 2023 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Dont include personal information e.g. name, location or any personal health conditions. Email Address e.g. [email protected] Message Maximum of 500 characters Send feedback Add this page to\n Info For Me Also on NHS inform Self-help guide: Urinary infection Kidney infection Search for a pharmacy near you Enter a place or postcode NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats 2023 NHS 24 v1.1.1.17852

Deafblindness

Deafblindness | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotlands Service Directory 0 Home Illnesses and conditions Eyes Deafblindness Deafblindness About deafblindness Signs and symptoms of deafblindness Causes of deafblindness Diagnosing deafblindness Managing deafblindness About deafblindness Deafblindness is a combination of sight and hearing loss that affects a persons ability to communicate, access information and get around. Its also sometimes called dual sensory loss or multi-sensory impairment. A deafblind person wont usually be totally deaf and totally blind, but both senses will be reduced enough to cause significant difficulties in everyday life. These problemscan occur evenifhearing loss andvision loss are mild, as the 2 senses work together and 1 would usually help compensate for loss of the other. Signs of deafblindness Deafblindness most commonly affects older adults, although it can affect people of all ages, including babies and young children. In older people, it may develop gradually and the person themselves may not realise their vision and/or hearing is getting worse at first. Signs of a problemcan include: needing to turn up the volume on the television or radio difficulty following a conversation not hearing noisessuch as a knock at the door asking others to speak loudly, slowly and more clearly needing to hold books or newspapers veryclose, or sitting close to the television difficulty moving around unfamiliar places If someone already has either a hearing or vision problem, its important to look out for signs that suggest the other sense may be getting worse too. Read more about the symptoms of deafblindness Seeing your GP Visit your GP if you think your hearing and/or eyesight may be getting worse. If youre worried about a friend or family member, encourage them to speak to their GP. Its best to seek advice as soon as possible, as treatment for some underlying causes of deafblindness can be more effective if started early.Early diagnosis will also ensure the person is able to access local support services sooner. Read more about diagnosing and assessing deafblindness What causes deafblindness? There are many potential causes of deafblindness. Some babies are born deafblind, but in many cases the hearing and/or vision loss occurs later in life. Causes of deafblindness include: age-related hearing loss genetic conditions, such as Usher syndrome an infection picked up during pregnancy, such asrubella (German measles) cerebral palsy a problem with the brain and nervous system that mainly affects movement and co-ordination eye problems associated with increasing age, such ascataracts Read more about the causes of deafblindness Living with deafblindness A range ofcare and support services is available to help deafblindpeople. Each deafblind person will have a different level of hearing and sight loss, which means theyll have their own individual care needs. The general aims of care for a deafblind person are to: preserve and maximise any remaining sight or hearing the person has this could involve treating underlying conditions like cataracts, wearing glasses or using ahearing aid teach alternative methods of communication such as hand on hand signing or braille helpretain ordevelop as much independence as possible for example, by training the person to use a long cane, a guide dog or offering acommunicator guide Yourlocal authority should arrange an assessment to determine exactly what care and support is needed. Read more about managing deafblindness Signs and symptoms of deafblindness A person whos deafblind wont usually be totally deaf and totally blind, but both senses will be reduced enough to cause difficulties with everyday activities. The hearing and/or vision problems may be present from birth,but in many cases one or both problems develop gradually as a person gets older andtheymay not notice it themselves at first. If someone you know has a combination of the signs mentioned below, its possible they have some degree of deafblindness and should seek medical advice. Signs of a hearing problem Hearing losscan occur from birth ormay develop gradually or suddenly later on. Signsthat someone may havea problem with theirhearinginclude: not hearing you if you speak to them from behind needing to turn up the volume on the television or radio difficulty following a conversation particularly if several people are speaking or the person theyre speaking to is unfamiliar not hearing noises around them, such as aknock at the door or the doorbell ringing asking others to speak loudly, slowly andmore clearly leaning in very close to hear whats being said If someone already has a hearing problem for example, they wear a hearing aid or use sign language keep an eye out for signs of vision problems that could develop (see below). Signs of a visionproblem Vision losscan also be present from birth or develop later on. Signsthat someone may havea problem with their visioninclude: problemsseeing in low light or bright light difficulty recognising people they know finding it hard to read facial expressions relying on touch to find and identify items more than usual needing to hold books or newspapers close to their face, or sitting near the television difficulty moving around unfamiliar places they may bump into or trip over things regularly not looking directly at you or making proper eye contact If a person alreadyhasa problemwith their vision for example, they wear glasses, use a caneto get around,or havea condition such as glaucoma orcataracts keep an eye out for signs of hearing problems that could develop (see above). Gettingmedical advice Visit your GP if you noticeany deterioration in your hearing or eyesight. If youre worried about a friend or family members vision and hearing, encourage them to speak to their GP. Its best to seek advice as soon as possible, as treatment for some underlying causes of deafblindness can be more effective if started early. Early diagnosis will also ensure the person is able to access local support services sooner, and enable them to plan for the future (such as learning new communication methods). Read more about diagnosing deafblindness and managing deafblindness Causes of deafblindness There are many possible causes of deafblindness. The condition can either be present at birth or develop later in life. Deafblindnessfrom birth Deafblindness from birth is known as congenital deafblindness. It can be caused by: problems associated withpremature birth (birth before 37 weeks of pregnancy) an infection picked up during pregnancy, such asrubella (German measles),toxoplasmosis orcytomegalovirus (CMV) genetic conditions, such as CHARGE syndrome or Downs syndrome cerebral palsya problem with the brain and nervous system that mainly affects movement and co-ordination foetal alcohol syndrome health problems caused by drinking alcohol in pregnancy Deafblindnesslater in life In most cases, deafblindness develops later in life. This is known as acquired deafblindness. A personwith acquired deafblindnessmay beborn without a hearing or sightproblem and then later loses part or all of both senses. Alternatively, someone may be born with either a hearing or vision problem,and then later loses part or all of the other sense later on. Problems that cancontribute toacquired deafblindness include: age-related hearing loss Usher syndrome a genetic condition that affects hearing, vision and balance eye problems associated withincreasing age, such asage-related macular degeneration (AMD),cataracts andglaucoma diabetic retinopathy a complication of diabetes where the cellslining the back of the eyeare damaged by high blood sugar levels damage to the brain, such as from meningitis , encephalitis, a stroke or severe head injury Sense has further information about the causes of deafblindness . Diagnosing deafblindness Deafblindness may be detected soon after a baby is born, or after tests carried out later in life. Speak to your GP if you have any concerns about your or your childs hearing and/or vision at any point. If youre worried about a family member or friend, try to encourage them to speak to their GP. Newborn screening Ifyour baby is born deafblind, this will usually be picked up during newborn screening . These are a series of checks carried out tosee if your baby has any serious health problems from birth, including any problems with their eyes or hearing. If no problems are picked up at this stage, they may be detected during routine checks as your child gets older. Hearing and vision tests for adults In most cases, deafblindnessdevelops as a person gets older. It can happen gradually, so you may not notice that your vision and/or hearing are getting worse at first. Its therefore important to have routine eye tests to check for any problems. Adults should normally have their eyes tested every two years. You can request a hearing test at your GP surgery at any point if you think you may be losing your hearing. A personmay be diagnosed with deafblindness iftests show they haveboth hearing and vision problems. Theirhearing and vision should continue to be regularly assessedeven after theyve been diagnosed, as the level of care and supportthey need will depend on how severely each sense is affected. Find your local optometry practice Specialist assessment As soon as deafblindness has been identified, a specialist assessment should be arranged bythe local authority. The assessmentshould only be carried out by a specially trained professional whois able to identify the deafblind persons abilities andneeds.The assessment should include assessing theirneeds in relation to: communication one-to-one human contact social interaction emotional wellbeing support with mobility assistive technology rehabilitation The assessment will also takeinto account the persons current needs and those that develop in the future. A deafblind person should have access to services suitable to their level of hearing and sight and their individual needs. Mainstream services aimed mainly at blind or deaf people may not always be appropriate. Read more about the treatments and services available for deafblind people . Managing deafblindness Its not always possible to treat the underlying causes of deafblindness, but a range of care and support services is available to help people with the condition. Most deafblind people will still have some hearing and/or vision. The level of care and support they need will depend onhow severe their hearing and vision problems are. Individual care plan The individual abilities and needs of a deafblind person should be assessed soon after theyre diagnosed. This will allow a tailored care plan to be drawn up. The care plan will aim to: preserve and maximise any remaining sensory functions the person has teach alternative communication methods such as the deafblind manual alphabet (see below) help the person retain as much independence as possible for example, by recommending they receive training to use a long cane or guide dog or through the provision of a communicator guide for young children,ensure their educational needs are met Read further information Sense:Benefits and money Sense:Support for disabled children and young people Communication systems As deafblindness can make communicating by speech and writing difficult, alternative forms of communication may be necessary. The main communication systemsused by deafblind people include: clear speech speaking clearly is one of the most effective and common ways of communicating with deafblind people who have some remaining vision and hearing deafblind manual alphabet a tactile form of communication where words are spelt onto the deafblind persons hand using set positions and movements block alphabet a simple tactile form of communication where a word is spelt out in capital letters that are drawn onto the deafblind persons palm hands-on signing an adapted version of British Sign Language (BSL)wherethe deafblind person feels whats being signed by placing their hands on top of the signers hand visual frame signing an adapted version of BSL wherethe signs are adapted to be signed in a smaller space to match the position and size of a deafblind persons remaining sight braille a system that usesa series of raised dots to represent letters or groups of letters moon similar to Braille, but uses raised, adapted capital letters that are simpler to feel Read further information: Sense:Ways of communicating Vision aids For somedeafblind people, it may be possible to improve vision using low vision aids, such as glasses, magnifying lenses and task lights. Specially designed items, such as telephones and keyboards, may also help someone who is visually impaired. The Royal National Institute of Blind People (RNIB) has more information about everyday living with vision loss ,including advice about the technology availableto help with everyday tasks. Many libraries stock a selection of large-print books and talking books, where the text is read aloud and recorded onto a CD. The RNIB also offer a talking book subscription service , where books can be ordered and delivered directly to your home for a small annual fee. Read further information: RNIB: Assistive aids and technology Hearing aids and implants Some deafblind people may benefit from wearing ahearing aid. There are various hearing aid styles available to suit different types of hearing loss and personal preference. Hearing aids use microphones to collect the sound from the environment, amplify it and deliver it into the ear canal of the wearer so that it can be processed by the auditory system. An audiologist (hearing specialist) will be able to recommend the most suitable type of aid after testing your hearing. For some people, hearing aids that deliver the sound into the ear canal are not appropriate. In these cases, hearing may be improved using a surgically implanted hearing system, such as a cochlea implant or bone conducting hearing implant. While these still use a microphone to collect the sound initially, they then covert that sound into either an electrical signal or vibration, passing it to the inner or middle ear for processing by the auditory system. Want to know more? Sense:Assistive technology for people with hearing loss RNID: Hearing aids One-to-one support Every deafblind person is entitled to help from aspecially trained one-to-one support worker if they need it. Depending on the persons situation, this may be a: communicator guide someone who works with people who have become deafblind later in life, to offer the support the person needs to live independently interpreter someone who acts as a communication link between the deafblind person and other people, using the deafblind persons preferred method of communication intervenor someone whoworks withchildren and adults who were born deafblind, to help them experience and join in the world around them as much as possible Treating underlyingconditions Some conditions that affect hearing and vision can be treated using medication or surgery. For example: cataractscan often be treated by surgically implanting an artificial lens in the eye glaucomacan often be treated using eye dropsor laser surgery read more about treating glaucoma diabetic retinopathy can be treated in the early stages using laser surgery Somecauses of temporary hearing loss are also treatable, such as a build-up of earwax or middle ear infections . Source: NHS 24 - Opens in new browser window Last updated: 15 January 2024 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Dont include personal information e.g. name, location or any personal health conditions. Email Address e.g. [email protected] Message Maximum of 500 characters Send feedback Add this page to\n Info For Me Also on NHS inform Hearing loss Other health sites Action on Hearing Loss British Deaf Association Hearing Link Royal National Institute of Blind People Sense NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats 2023 NHS 24 v1.1.1.17852

Deep vein thrombosis

Deep vein thrombosis (DVT) - Illnesses & conditions | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotlands Service Directory 0 Home Illnesses and conditions Blood and lymph Deep vein thrombosis Deep vein thrombosis About deep vein thrombosis Deep vein thrombosis causes Deep vein thrombosis treatment Complications of deep vein thrombosis Deep vein thrombosis prevention About deep vein thrombosis Deep vein thrombosis (DVT) is a blood clot that develops within a deep vein in the body, usually in the leg. Blood clotsthatdevelop ina vein are also known as venous thrombosis. DVT usually occurs in a deep leg vein,a larger vein that runs through the muscles of the calf and the thigh. It can also occur in the pelvis or abdomen. It can cause pain andswelling in the leg and may lead to complications such as pulmonary embolism. DVT and pulmonary embolism together are known as venous thromboembolism (VTE). DVT symptoms In some cases, there may be nosymptoms of DVT. If symptoms do occur they can include: pain, swelling and tenderness in one ofyour legs (usually your calf or thigh) a heavy ache in the affected area warm skin in the area of the clot red skin, particularly at the back of your leg below the knee DVT usually (although not always)affects oneleg. The pain may be worse when you bend your foot upward towards your knee. If you think you have deep vein thrombosis ask for an urgent GP appointment or call 111 Phone 999 or go to A&E if you have symptoms of DVT like: pain and swelling of the leg, along with either breathlessnessor chest pain Pulmonary embolism This is a serious condition that occurs when a piece of blood clot breaks off into the bloodstream. This then blocks one of the blood vessels in the lungs, preventing blood from reaching them. Ifleft untreated, about 1in 10 people with a DVT will develop a pulmonary embolism. A pulmonary embolism is a very serious condition which causes: breathlessness which may come on gradually or suddenly chest pain which may become worse when you breathe in sudden collapse Both DVT and pulmonary embolismneed urgent investigation and treatment. Seek immediate medical attention if you have pain, swelling and tenderness in your leg and develop breathlessness and chest pain. Read more about the complications of DVT DVT causes Each year,DVT affects around 1person in every 1,000 in the UK. Anyone can developDVT, butit becomes more common over the age of 40. As well as age, there are alsosome other risk factors, including: having a history of DVT or pulmonary embolism having a family history of blood clots being inactive for long periods such as after an operation or during a long journey blood vessel damage a damaged blood vessel wall can result in the formation of a blood clot having certainconditions or treatmentsthat cause your blood to clot more easily than normalsuch as cancer (including chemotherapy and radiotherapy treatment), heart and lung disease, thrombophilia and Hughes syndrome being pregnant your blood also clots more easily during pregnancy being overweight or obese The combined contraceptive pill andhormone replacement therapy (HRT)both contain the female hormone oestrogen, which causes the blood to clot more easily. If youre taking either of these, your risk of developing DVT isslightly increased. Read more about the causes of DVT Diagnosing DVT See your GP as soon as possible ifyou think you may have DVT for example, if you have pain, swelling and a heavy ache in your leg.Theyll ask you about yoursymptoms and medical history. D-dimer test Itcan bedifficult to diagnose DVT from symptoms alone. Your GP may advise that you have a specialised blood test called a D-dimer test. This test detects pieces of blood clot that have been broken down and are loose in your bloodstream. The larger the number of fragments found, the more likely it is that you have a blood clot in your vein. However, the D-dimer test isnt always reliable because blood clot fragments can increase after an operation, injury or during pregnancy. Additional tests, such asan ultrasound scan, will need to be carried out to confirm DVT. Ultrasound scan An ultrasound scan can be used to detect clots in your veins. A special type of ultrasound called a Doppler ultrasound can also be used to find out how fast the blood is flowing through a blood vessel. This helps doctors identify when blood flow is slowed or blocked, which could be caused by a blood clot. Venogram A venogram may be used if the results of a D-dimer test and ultrasound scan cant confirm a diagnosis of DVT. During a venogram, a liquid called a contrast dye is injected into a vein in your foot. The dye travels upthe leg and can be detected by X-ray , which will highlighta gap inthe blood vessel where a clot is stopping the flow of blood. DVT treatment Treatment for DVT usually involves taking anticoagulant medicines. These reduce the bloods ability to clot and stop existing clots getting bigger. Heparin and warfarin are 2 types of anticoagulant often used to treat DVT. Heparin is usually prescribed first because it works immediately to prevent further clotting. After initial treatment, you may also need to take warfarin to prevent another blood clot forming. A number of anticoagulants, known as directly acting oral anticoagulants (DOACs), may also be used to treat conditions such as DVT. These medications include rivaroxaban and apixaban, and theyve been shown to be as effective as heparin and warfarin with less serious side effects. Youll also be prescribed compression stockings to wear every day, which will improve your symptoms and help prevent complications. Read more about treating DVT DVT prevention If you need to go into hospital for surgery, a member of your care team will assess your risk of developing a blood clot while youre there. If youre at risk of developing DVT, there are a number of things you can do to prevent a blood clot occurring, both before you go into hospital. These include temporarily stopping taking the combined contraceptive pill,and while youre in hospital, such as wearing compression stockings. When you leave hospital, your care team may also make some recommendations to help prevent DVT returning or complications developing. These may include: not smoking eating a healthy, balanced diet taking regular exercise maintaining a healthy weight orlosing weight if youre obese Theres no evidence to suggest that taking aspirin reduces your risk of developing DVT. See your GP before embarking on long-distance travel if youre at risk of getting a DVT, or if youve had a DVT in the past. When taking a long-distance journey(6 hours or more) by plane, train or car, you should take steps to avoid getting DVT. Drink plenty ofwater, perform simple leg exercises and take regular, short walking breaks. Read more about preventing DVT Deep vein thrombosis causes Deep vein thrombosis (DVT) sometimes occurs for no apparent reason. However, the risk of developing DVT is increased in certain circumstances. Inactivity When youre inactive your blood tends to collect in the lower parts of your body, often in your lower legs. This is usually nothing to worry about because when you start to move, your blood flow increases and moves evenly around your body. However, if youre unable to move for a long period of time such as after an operation, because ofan illness or injury, or during a long journeyyour blood flow can slow down considerably. A slow blood flow increases the chances of a blood clot forming. In hospital If you have to go into hospital for an operation or procedure, your risk of getting a blood clot increases. This isbecause DVT is more likely to occur when youre unwell or inactive, or less active than usual. As a patient, your risk of developing DVT depends onthe type of treatment youre having. You may be at increased risk of DVT if any of the following apply: youre having an operation that takes longer than 90 minutes, or 60 minutes if the operation is on your leg, hip or abdomen youre having an operation for an inflammatory or abdominal condition, such as appendicitis youre confined to a bed, unable to walk, or spending a large part of the day in a bed or chair for at least three days You may also be at increased risk of DVT if youre much less active than usual because of an operation or serious injury and have other DVT risk factors, such as a family history of the condition. When youre admitted to hospital youll be assessed for your risk of developing a blood clot and, if necessary, given preventative treatment. Blood vessel damage If the wall of a blood vessel is damaged, it may become narrowed or blocked, which can cause a blood clot to form. Blood vessels can be damaged by injuries such as broken bones or severe muscle damage. Sometimes, blood vessel damage that occurs during surgery can cause a blood clot, particularly in operations on the lower half of your body. Conditions such asvasculitis (inflammation of the blood vessels), varicose veins and some forms of medication, such as chemotherapy ,can also damage blood vessels. Medical and genetic conditions Your risk of getting DVT is increased if you have a condition that causes your blood to clot more easily than normal. These conditions include: cancer cancer treatments such aschemotherapy and radiotherapy can increase this risk further heart disease and lung disease infectious conditions, such as hepatitis inflammatory conditions, such as rheumatoid arthritis thrombophilia a genetic condition where your blood has an increased tendencyto clot antiphospholipid syndrome an immune system disorder that causes an increased risk of blood clots Pregnancy During pregnancy, blood clots more easily. Its the bodys way of preventing too much blood being lost during childbirth. Venous thromboembolism (VTE) DVT and pulmonary embolism affects about 1in 100,000 women of childbearing age. DVTs are also rare in pregnancy, althoughpregnant women are up to 10 times more likely to develop thrombosis than non-pregnant women of the same age. A clot can form at any stage of pregnancy and up to 6weeks after the birth. Having thrombophilia (a condition where the blood has an increased tendency to clot), or having a parent, or brother or sister, whos had a thrombosis, increase your risk of developing a DVT during pregnancy. Other risk factors during pregnancy include: being over 35 years old being obese (with a BMI of 30 or more) expecting 2 or more babies having recently had acaesarean section being immobile for long periods of time smoking (find out how to stop smoking ) having severe varicose veins dehydration Low molecular weight heparin (LMWH) is usually used to treat pregnant women with DVT. LMWH is an anticoagulant, which means it prevents the blood clot getting bigger. Its given by injection and doesnt affect your developing baby. Contraceptive pill and HRT The combined contraceptive pill and hormone replacement therapy (HRT) both contain the female hormone oestrogen. Oestrogen causes the blood to clot a bit more easily than normal,so your risk of getting DVT is slightly increased. Theres no increased risk from the progestogen-only contraceptive pill . Other causes Your risk of getting DVT is alsoincreased if you or a close relative have previously had DVT and: youre overweight or obese you smoke youre dehydrated youre over 60 particularly if you have a condition that restricts your mobility Deep vein thrombosis treatment If you have deep vein thrombosis (DVT), youll need to take a medicine called an anticoagulant. Anticoagulation Anticoagulant medicinesprevent blood clots getting bigger.They can also help stop part of the blood clot breaking off and becoming lodged in another part of your bloodstream (an embolism). Although theyre often referred to as blood-thinning medicines, anticoagulants dont actually thin the blood. They alter proteins within it, which prevents clots forming so easily. Heparin and warfarin are 2 types of anticoagulants that are used to treat DVT. Heparin is usually prescribed first because it works immediately to prevent further clotting.After this initial treatment, you may also need to take warfarin to prevent another blood clot forming. Heparin Heparin is available in 2different forms: standard (unfractioned) heparin low molecular weight heparin (LMWH) Standard (unfractioned) heparin can be given as: an intravenous injection an injection straight into one of your veins an intravenous infusion where a continuous drip of heparin (via a pump)is fed through a narrow tube into a vein in your arm (this must be done in hospital) a subcutaneous injection an injection under your skin LMWH is usually given as a subcutaneous injection. The dose of standard (unfractionated) heparin to treat a blood clot varies significantly from person to person, so the dosage must be carefully monitored and adjusted if necessary. You may need to stay in hospital for 5 to 10 days and have frequent blood tests to ensure you receive the right dose. LMWHworks differently from standard heparin. It contains small molecules, which means its effects are more reliable and you wont have to stay in hospital and be monitored. Both standard heparin and LMWH can cause side effects, including: a skin rash and other allergic reactions bleeding weakening of the bones if taken for a long time (although rare with LMWH) In rare cases, heparin can also cause an extreme reaction that makes existing blood clots worse and causes new clots to develop.This reaction, and weakening of your bones, is less likely to occur whentaking LMWH. In most cases, youll be given LMWHbecauseits easier to use and causes fewer side effects. Warfarin Warfarin is taken as a tablet. You may need to take it after initial treatment with heparinto prevent further blood clots occurring. Your doctor may recommend that you take warfarin for 3to 6 months. In some cases, it may need to be taken for longer,even forlife. As with standard heparin, the effects of warfarin vary from person to person. Youll need to be closely monitored by having frequent blood tests to ensure youre taking the right dosage. When you first start taking warfarin, you may need to have 2 to 3blood tests a week until your regular dose is decided. After this, you should only need to have a blood test every 4weeks at an anticoagulant outpatient clinic. Warfarin can be affected by your diet, any other medicines youre taking, and by how well your liver is working. If youre taking warfarin you should: keep your diet consistent limit the amount of alcohol you drink (no more than 14 units of alcohol a week) take your dose of warfarin at the same time every day not start to take any other medicine without checking with your GP, pharmacist or anticoagulant specialist not take herbal medicines Warfarin isnt recommended for pregnant women who are given heparin injections for the full length of treatment. Rivaroxaban Rivaroxaban is a medication recommended by the National Institute for Health and Care Excellence (NICE)as a possible treatment for adults with DVT, or to help prevent recurrent DVT and pulmonary embolism. Rivaroxaban comes in tablet form. Its a type of anticoagulant known as adirectly acting oral anticoagulant (DOAC). It prevents blood clots forming by inhibiting a substance called factor Xa and restricting the formation of thrombin (an enzyme that helps blood clot). Treatment usually lasts 3months and involves taking rivaroxaban twice a day for the first 21 days and then once a dayuntilthe end of the course. Read the NICE guidance about rivaroxaban Apixaban NICE also recommendsapixaban as a possible method of treatment and prevention for DVT and pulmonary embolism. Likerivaroxaban, apixaban is a DOAC thats taken orally as a tablet, and prevents blood clots forming by hindering factor Xa and restricting the formation of thrombin. Treatment usually lasts at least 3 months and involves taking apixaban twice a day. Read the NICE guidance about apixaban Compression stockings Wearing compression stockings helps prevent calf pain and swelling, and lowers the risk of ulcers developing after having DVT. They can also help prevent post-thrombotic syndrome. This is damage to leg tissue caused by the increase in venous pressure that occurs when a vein is blocked by a clot and blood is diverted to the outer veins. After having DVT, stockings should be worn every day for at least 2years. This is because symptoms of post-thrombotic syndrome may develop several months or even years after having a DVT. Compression stockings should be fitted professionally and your prescription should be reviewed every 3 to 6months. The stockings need to be worn all day but can be taken off before going to bed or in the evening while you rest with your leg raised. A spare pair of compression stockings should also be provided. Exercise Your healthcare team will usually advise you to walk regularly once compression stockings have been prescribed. This can help prevent symptoms of DVT returning and may help to improve or prevent complications of DVT, such as post-thrombotic syndrome. Raising your leg As well as wearing compression stockings, you might be advised to raise your leg whenever youre resting. This helps to relieve the pressure in the veins of the calf and stops blood and fluid pooling in the calf itself. When raising your leg, make sure your foot is higher than your hip. This will help the returning blood flow from your calf. Putting a cushion underneath your leg while yourelying downshould help raise your leg above the level of your hip. You can also slightly raise the end of your bed to ensure that your foot and calf are slightly higher than your hip. Read more about preventing DVT Inferior vena cava filters Although anticoagulant medicines and compression stockings are usually the only treatments needed for DVT, inferior vena cava (IVC) filters may be used as an alternative. This isusually because anticoagulant treatment needs to be stopped, isnt suitable, or isnt working. IVC filters are small mesh devices that can be placed in a vein. They trap large fragments of a blood clot and stop it travelling to the heart and lungs. They can be usedto help prevent blood clots developing in the legs of people diagnosed with: DVT pulmonary embolism multiple severe injuries IVCscan be placed in the vein permanently, or newer types of filters can be placed temporarily and removed after the risk of a blood clot has decreased. The procedure to insert an IVC filter is carried out usinga local anaesthetic (where youre awake but the area is numb). A small cut is made in the skin and a catheter (thin, flexibletube) is inserted into a vein in the neck or groin area. Thecatheter is guided using an ultrasound scan . The IVC filter is theninserted through the catheter and into the vein. Complications of deep vein thrombosis The 2 main complications of deep vein thrombosis (DVT) are pulmonary embolism and post-thrombotic syndrome. Pulmonary embolism A pulmonary embolismis the most serious complication of DVT. It happens when a piece ofblood clot (DVT)breaks off and travels through your bloodstream to your lungs, where it blocks one of the blood vessels. In severe cases this can be fatal. If theclot is small, it might not cause any symptoms. If its medium-sized, it can causechest painand breathing difficulties . A large clotcan cause the lungs to collapse, resulting in heart failure , which can be fatal. About onein 10people with an untreated DVT develops a severe pulmonary embolism. Post-thrombotic syndrome Ifyouve had a DVT, you may develop long-term symptoms in your calf known as post-thrombotic syndrome. Thisaffects around 20-40% of people with a history of DVT. If you have DVT, the blood clot in the vein of your calf can divert the flow of blood to other veins, causing an increase in pressure. This can affect the tissues of your calf and lead to symptoms, including: calf pain swelling a rash ulcers on the calf (in severe cases) When a DVT develops in your thigh vein, theres an increased risk of post-thrombotic syndrome occurring. Its also more likely to occur if youre overweight or ifyouve had more than one DVT in the same leg. Deep vein thrombosis prevention If youre admitted to hospital or planning to go into hospital for surgery, your risk of developing a blood clot while youre there will be assessed. Surgery and some medical treatments can increase your risk of developing DVT see causes of DVT for more information. If youre thought to be at risk of developing DVT, your healthcare team can take a number of measures to prevent a blood clot forming. Before going into hospital If youre going intohospital to have an operation, and youre taking the combined contraceptive pill or hormone replacement therapy (HRT) , youll be advisedto temporarily stop taking your medication four weeks before your operation. Similarly, if youre taking medication to prevent blood clots, such as aspirin , you may be advised to stop taking it one week before your operation. Theres less risk of getting DVT when having a local anaesthetic compared with a general anaesthetic .Your doctor will discuss whether its possible for you to have a local anaesthetic. While youre in hospital There are a number of things your healthcare team can do to help reduce your risk of getting DVT while youre in hospital. For example, theyll make sure you have enough to drink so you dont become dehydrated , and theyll also encourage you to move around as soon as youre able to. Depending on your risk factors and individual circumstances, a number of different medications can be used to help prevent DVT. For example: anticoagulant medicines suchasdabigatran etexilate or fondaparinux sodium, which are often usedto help prevent blood clots after certain types of surgery, including orthopaedic surgery low molecular weight heparin (LMWH) often used in many cases to help prevent blood clots, including during and shortly after pregnancy unfractionated heparin (UFH) often used in people with severe kidney impairment or established kidney failure Compression stockings or compression devices are also commonly used to help keep the blood in your legs circulating. Compression stockings are worn around your feet, lower legs and thighs, and fit tightly to encourage your blood to flow more quickly around your body. Compression devices are inflatable and work in the same way as compression stockings, inflating at regular intervals to squeeze your legs and encourage blood flow. Your healthcare teamwill usuallyadvise youto walk regularly after youve been prescribed compression stockings. Keeping mobile can help prevent the symptoms of DVT returning and may help prevent or improve complications of DVT , such as post-thrombotic syndrome. Read more about treating DVT When you leave hospital You may need to continue to take anticoagulant medicine and wear compression stockings when you leave hospital. Before you leave, your healthcare team should advise you about how to use your treatment, how long to continue using it for, and who to contact if you experience any problems. Lifestyle changes You can reduce your risk of getting DVT by making changes to your lifestyle, such as: not smoking eatinga healthy, balanced diet getting regular exercise maintaining a healthy weight or losing weightif youre obese Travelling See your GP before long-distancetravel if youre at risk of getting a DVT, or if youve had a DVT in the past. If youre planning a long-distance plane, train or car journey(journeys of six hours or more), make sure you: drink plenty of water avoid drinking excessive amounts of alcohol because it can cause dehydration avoid taking sleeping pills because they can cause immobility perform simple leg exercises, such as regularly flexing your ankles take occasional short walks when possible for example, during refuelling stopovers wear elastic compression stockings Read more about preventing DVT when you travel Travel insurance If youre travelling abroad, its very important to ensure youre prepared should you or a family member fall ill. Make sure you havefull travel insurance to cover the cost of any healthcare you may need while abroad. This is particularly important if you have a pre-existing medical condition, such as cancer or heart disease , which may increase your risk of developing DVT. DVT can be a very serious condition, and its important you receive medical assistance as soon as possible. Treating DVT promptly will help minimise the risk of complications. Source: NHS 24 - Opens in new browser window Last updated: 09 November 2023 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Dont include personal information e.g. name, location or any personal health conditions. Email Address e.g. [email protected] Message Maximum of 500 characters Send feedback Add this page to\n Info For Me Also on NHS inform Warfarin Other health sites Lab Tests Online UK: D-dimer test NICE: Pulmonary embolism NICE: Reducing the risk of VTE NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats 2023 NHS 24 v1.1.1.17852

Dehydration

Dehydration - Illnesses & conditions | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotlands Service Directory 0 Home Illnesses and conditions Nutritional Dehydration Dehydration About dehydration Symptoms of dehydration Causes of dehydration Treating dehydration Preventing dehydration About dehydration Dehydration occurs when your body loses more fluid than you take in. When the normal water content of your body is reduced, itupsets the balance of minerals (salts and sugar) in your body, which affects the way it functions. Water makes up over two-thirds of the healthy human body. It lubricates the joints and eyes, aids digestion,flushes out waste and toxins, and keeps the skin healthy. Some of the early warning signs ofdehydration include: feelingthirsty and lightheaded adry mouth tiredness having dark coloured, strong-smelling urine passing urine less often than usual A baby may be dehydrated if they: have a sunken soft spot (fontanelle) on their head have few or no tears when they cry have fewer wet nappies are drowsy The bodyis affectedeven when you lose a small amount of fluid. Read more about the symptoms of dehydration What causes dehydration? Dehydration is usually caused by not drinking enough fluid to replace what we lose. The climate, the amount of physical exercise you are doing (particularly inhot weather)and your diet can contribute to dehydration. You can alsobecome dehydrated as a result of an illness, such aspersistent vomiting and diarrhoea, orsweating from a fever. Read more about the causes of dehydration Who is at risk from dehydration? Anyone can become dehydrated, but certain groups are particularly at risk. These include: babies and infants they have a low body weight and are sensitive to even small amounts of fluid loss older people they may be less aware that they are becoming dehydrated and need to keep drinking fluids people with a long-term health condition such as diabetes or alcoholism athletes they can lose a large amount of body fluid through sweat when exercising for long periods What to do If youre dehydrated, drink plenty of fluidssuch as water, diluted squash or fruit juice. These are much more effective than large amounts of tea or coffee. Fizzy drinks may contain more sugar than you need and may be harder to take in large amounts. If youre finding it difficult to keep water down because youre vomiting,try drinking small amounts more frequently. Infants and small children who are dehydrated shouldnt be given large amounts of water alone as the main replacement fluid. This isbecause it can dilute the already low level of minerals in their body too much and lead to other problems. Instead, they should be given diluted squash or a rehydration solution (available from pharmacies). You might find a teaspoon or syringe can be helpful for getting fluid into a young child. If left untreated, severe dehydration can be serious and cause fits (seizures), brain damage and death. Read more about treating dehydration When to see your GP See your GP if your symptoms continue, despite drinking plenty of fluids, or if you think your baby or toddler is dehydrated. If your GP suspects dehydration, you may have a blood test or a urine test to check the balance of salts (sodium and potassium) in your body. Contact your GP, out-of-hours service or NHS 24 111 service straight away if you have any of the following symptoms: extreme thirst feeling unusually tired (lethargic) or confused not passing urine for eight hours rapid heartbeat dizziness when you stand up that doesnt go away after a few seconds You should also contact your GP if your baby has hadsix or more episodes of diarrhoea in the past 24 hours, or if they have vomited three times or more in the past 24 hours. Symptoms of dehydration Dehydration can be mild, moderate or severe, depending on how much of your body weight is lost through fluids. Two early signs of dehydration are thirst and dark-coloured urine. This is the bodys way oftrying to increase water intake and decrease water loss. Other symptoms may include: dizziness or light-headedness headache tiredness dry mouth , lips and eyes passing small amounts of urineinfrequently (less than three or fourtimes a day) Dehydration canalsolead toaloss ofstrength and stamina. Itsa maincause of heat exhaustion. You should be able to reverse dehydration at this stageby drinkingmore fluids. If dehydration is ongoing (chronic), it can affect your kidney function and increase the risk of kidney stones . It can also lead to muscle damage and constipation . When to see your GP See your GP if your symptoms continue despite drinking fluids, or if you suspect that your baby or toddler is dehydrated. You should also contact your GP if your baby hashadsix or more episodes of diarrhoeain the past 24 hours, or if they have vomited three times or more in the past 24 hours. If dehydration is suspected, you may be given a blood test or a urine test to check the balance of salts (sodium and potassium) in your body. Severe dehydration If dehydration is left untreated, it can become severe. Severe dehydration is a medical emergency and requires immediate medical attention. Contact your GP,out-of-hours serviceor NHS 24 111 servicestraight away if you have any of the following symptoms: feeling unusually tired (lethargic) or confused, and you think you may be dehydrated dizziness when you stand up that doesnt go away after a few seconds not passing urine for eight hours a weak pulse a rapid pulse fits (seizures) a low level of conciousness Ifseveredehydration is not treated immediately, it can lead to complications. This level of dehydration needs hospital treatment and you will be put on a drip to restore the substantial loss of fluids. Dehydration in babies A baby may be dehydrated if they have: a sunken soft spot (fontanelle) on their head few or no tears when they cry a dry mouth fewer wet nappies dark yellow urine drowsiness fast breathing cold and blotchy-looking hands and feet Read about how to treat dehydration in babies Causes of dehydration Dehydration is caused by not drinking enough fluid or by losing more fluid than you take in. Fluid is lost through sweat, tears, vomiting, urine or diarrhoea. The severity of dehydrationcandepend on a number of factors,such as climate, level of physical activity and diet. There are several causes of dehydration, which are described below. Illness Dehydration is often the result of an illness, such as gastroenteritis , where fluid is lost through persistent bouts of diarrhoea and vomiting. Sweating You can also become dehydrated if you sweat excessively after a fever, exercise, or carrying out heavy, manual work in hot conditions. In these situations, its important to drink regularly to replace lost fluids. It doesnt necessarily need to be hot for you to lose a significant amount of fluid from sweating. Children and teenagers are particularly at risk because they may ignore the symptoms of dehydration , or not know how to recognise and treat them. Alcohol Dehydration can also occur as a result of drinking too much alcohol .Alcohol is a diuretic, which means it makes you wee more. The headache associated with a hangover indicates that your body is dehydrated. You should try to drink plenty of water when you have been drinking alcohol. Diabetes If you have diabetes, youre at risk of becoming dehydrated because you have high levels of glucose in your bloodstream. Your kidneys will try to get rid of the glucose by creating more urine, so your body becomes dehydrated from going to the toilet more frequently. Read more about the different types of diabetes Whos at risk? The groups of people most at risk of dehydration are: babies and infants their low body weight makes them sensitive to even small amounts of fluid loss older people they may be less aware theyre becoming dehydrated and need to drink fluids people with a long-term health condition such as diabetes oralcoholism athletes they can lose a large amount of body fluid through sweat when exercising for long periods Hyponatremia Its possible to become overhydrated while exercising. This is known as hyponatremia and its caused by low sodium (salt) levels in the blood. It can occur if too much water is drunk over a short period of time. Hyponatremia sometimes affects athletes whose blood sodium level is reduced through sweat and then diluted by drinking large amounts of water. Symptoms of hyponatremia include nausea, vomiting and headache. In serious cases, the brain can swell, causing confusion, seizures, coma and, in rare cases, death. Treating dehydration The best way to treat dehydration is to rehydrate the body by drinking plenty of fluids, such as water, diluted squash or diluted fruit juice. A sweet drink can help to replace lost sugar, and a salty snack can help to replace lost salt. Babies If your baby is dehydrated, takethem to see your GPas soon as possible. Theyll be able to recommend appropriate treatments, such as those outlined below. Giveyour baby plenty of liquids, such as breastmilk or formula. It can often be better to give them smaller amounts of fluid more frequently. Dont dilute your babys formula (if you use it). Babies who are formula-fedand those on solids can begiven extra water. Avoid giving your baby fruit juice, particularlyif they have diarrhoea and vomiting,because it canmake it worse. Giving your baby regular sips(a few times an hour) of oral rehydration solution (ORS)in addition to their usual feed (breastmilk, formula milkand water) will help to replace lost fluids, salts and sugars. Infants and children Infants and children who are dehydrated shouldnt be given solely water, because it can dilute the already low level of minerals in their body and make the problem worse. Instead, they should have diluted squash or a special ORS (see below). If you or your child is finding it difficult to hold down fluids because of vomiting, take smaller amounts more frequently.You may find it easier touse a spoon or a syringe to give your child small amounts of fluid. Read more about vomiting in adults and vomiting in children and babies Oral rehydration solutions Whenyoure dehydrated, you lose sugar and salts, as well as water. Drinking a rehydration solutionwill enable you to re-establish the right balance of body fluids. The solution should contain a mixture of potassium and sodium salts, as well as glucose or starch. There are several different rehydration products available over the counter from pharmacies or on prescription from your GP, including solutions that are suitable for infants and children. Ask your GP or pharmacist for advice about the most suitable rehydration solution for you or your child. Severe dehydration Seekimmediatemedicalhelp if you suspect someone is severely dehydrated (see symptoms of severe dehydration ). They may need to be admitted to hospital for treatment. In particular, babies, infants and elderly people will need urgent treatment if they become dehydrated. Fluid may be given up the nose using a nasogastric tube orusinga saline drip into a vein (intravenously). This will provide essential nutrients faster than using solutions that you drink. If you have had bowel surgery, some rehydration solutions may not contain enough salt. In this instance, you will need a higher-strength solution. Your GP or surgeon can recommend a suitable rehydration solution for you. Preventing dehydration You should drink plenty of fluids to avoid becoming dehydrated. Most of the time, you can prevent dehydration by drinking water regularly throughout the day. Be guided by your thirst, but be aware that in hot weather, when exercising and during illness, you should drink more. Mild dehydration can be relieved by drinking more water and diluted fruit squash. If necessary, you can purchase oral rehydration solutions (ORS) from a pharmacy. As a guide, passing pale or clear-coloured urine (wee) is a good sign that youre well hydrated. Drinkregularly If youre active, or if the weather is particularly hot, theres a greater risk that you will become dehydrated. To prevent becoming dehydrated, you should increase your fluid intake. Asdifferent peoplesweat at different rates, its very difficult to provide specific recommendations about how much fluid you should drink. However, you should drink more than normal while exercising, and its particularly important tokeep well hydrated if youreexercising in warm conditions. This isbecause you will sweat more and fluid will be lost from your body more rapidly. Rarely, drinking more fluid than your body can process can reduce theamount of sodium (salt) in yourblood. This can lead to a serious and potentially fatal conditioncalled hyponatremia. If you start to feel discomfort and bloating from drinking, stop drinkingand allow time to recover. Illness If you, your child or someone you are caring for is ill, particularly witha fever, vomiting or diarrhoea , theres a high riskof becoming dehydrated, so its important to start replacing fluid as soon as possible. Advice for children There are no specific recommendations regarding the amount of water or other fluids that children need. However, its important for children to replace lost fluid, to prevent dehydration. Like adults, children lose more water when they are in hotter climates and when they are physically active. You should give your child healthy drinks as part of an overall healthy, balanced diet . Source: NHS 24 - Opens in new browser window Last updated: 21 November 2023 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Dont include personal information e.g. name, location or any personal health conditions. Email Address e.g. [email protected] Message Maximum of 500 characters Send feedback Add this page to\n Info For Me Other health sites NICE: Diarrhoea and vomiting in children under five (1) NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats 2023 NHS 24 v1.1.1.17852

Dementia

Dementia guide | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotlands Service Directory 0 Home Illnesses and conditions Brain, nerves and spinal cord Dementia Dementia Dementia is a common condition. Your risk of developing dementia increases as you get older, and the condition usually occurs in people over the age of 65. Find out more about the condition. About dementia Information about dementia including causes, possible preventions and treating dementia Living with dementia Living well with dementia Information on living well with dementia, including staying independant and maintaining relationships Dementia care and support Dementia care and support Information about dementia care and support including organising care, care homes and managing legal affairs NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats 2023 NHS 24 v1.1.1.17852

Dementia with Lewy bodies

Dementia with Lewy bodies - Illnesses & conditions | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotlands Service Directory 0 Home Illnesses and conditions Brain, nerves and spinal cord Dementia with Lewy bodies Dementia with Lewy bodies About dementia with Lewy bodies Symptoms of dementia with Lewy bodies Diagnosing dementia with Lewy bodies Treating dementia with Lewy bodies About dementia with Lewy bodies Dementia with Lewy bodies, also known as Lewy body dementia, is a common form of dementia estimated to affect more than 100,000 people in the UK. The term dementia describes a loss of mental ability (cognitive impairment) associated with gradual death of brain cells. Its rare in anyone younger than 65. Symptomsusually develop gradually and become more severe over the course ofseveralyears. Signs and symptoms People with dementia with Lewy bodies not only experience problems with memory and judgement, like those with Alzheimers disease , but are also likely tohave difficulties with concentration and visual perception (recognising objects and making judgements about where they are in space). They may experience: slowed movement, stiff limbs, and tremors recurrent visualhallucinations (seeing things that arent there) sleep disturbances, including sleepiness during the day fainting, unsteadiness, and falls People with the conditiontend to swing from a state of alertness to drowsiness or staring into space. These extreme changes may be unpredictable and happen from hour to hour or day to day. Read more about the symptoms of dementia with Lewy bodies What causes dementia with Lewy bodies? Dementia with Lewy bodies is caused by deposits of anabnormal protein called Lewy bodies inside brain cells. These deposits, which are also found in people with Parkinsons disease , build up in areas of the brain responsible for things such as memory and muscle movement. Its not clear why the deposits develop and how exactly they damage the brain, but its thoughtthey disrupt the brains normal functions by interfering with chemical signals transmitted from one brain cell to another. Dementia with Lewy bodies usually occurs in people with no family history of the condition, althoughthere have been reports of rare cases that seem to run in families. Diagnosing dementia with Lewy bodies If you think you may have early symptoms of dementia, its a good idea to see your GP. If youre worried about someone else, encourage them to make an appointment, and perhaps suggest that you go along with them. Your GP can do some simple checks to see if there is chance you could have dementia, and they can refer you to a memory clinic or another specialist clinic if necessary. At one of these clinics,you will be asked about your symptoms and have a physical check-up and memory test. You may also have blood tests and brain scans. The results of these checks and tests will give your doctor a good idea as to whether your symptoms are caused bydementia with Lewy bodies, another type of dementia, orsomething elseentirely. Read moreabout how dementia with Lewy bodies is diagnosed How dementia with Lewy bodies is managed There is no cure for dementia with Lewy bodies or anymedication that will slow it down. However, a few different medicines can be effective in controlling some of the symptoms. In particular,acetylcholinesterase inhibitors (used to treat Alzheimers disease ) have been shown to improve symptoms such as hallucinations and confusion in some people. Supportivetreatments such asphysiotherapy, occupational therapy , and speech and languagetherapy can help improve any problems with movement, everyday tasks, and communication. Psychological therapies and specific dementia activities , such as memory cafs, can also helpwith memory loss, confusion, and feelings of disorientation. Read more about treating dementia with Lewy bodies Outlook How quick dementia with Lewy bodies progresses varies from person to person. Home-based help will be needed, and some people will eventually need residential care in a nursing home. The average survival after the time of diagnosis is similar to that of Alzheimers disease around five to eight years. However, as with Alzheimers disease, this can be highly variable. If you or a loved one has been diagnosed with dementia, remember that you are not alone. The NHS, social services, and voluntary organisations will be able to provide advice and support to help you and your family. Symptoms of dementia with Lewy bodies The symptoms of dementia with Lewy bodies usually develop gradually and become more severe over the course of a few years. Like other forms of dementia, thecondition causes problems with: thinking speed language understanding judgement memory (although significant memory loss may not occur until later on) People withdementia with Lewy bodies may also have other symptoms that can help distinguish it from other types of dementia, such as: extreme swingsbetween alertnessand confusion or drowsiness, which may happen unexpectedly and change from hour to hour or day to day slow movement, stiff limbs, andtremors (as seen in Parkinsons disease ), which cause shuffling when walking seeing or hearing things that arentreal (hallucinations), which canrange frompleasant to distressing fainting, unsteadiness, and falls sleep disturbances, whichcan cause talking in your sleep or acting out dreams loss of facial expression difficultyswallowing (dysphagia) depression These symptoms can make daily activities very difficult and can lead to further health problems, such as injuries from falls, and chest infections caused by accidentally inhalingfood instead of swallowing it. Seeking medical advice If you think you may have early symptoms of dementia, its a good idea to see your GP. If youre worried about someone else, encourage them to make an appointment and perhaps suggest that you go along with them. Symptoms of dementia can have a number of different causes. Your GP will be able to carry out some simple checks to try to find out what the cause may be, and they can refer you to a specialist for further tests if necessary. Read more about diagnosing dementia with Lewy bodies Diagnosing dementia with Lewy bodies Confirming a diagnosis of dementia can be difficult, particularly when the condition is in its early stages. This is because many of the symptoms of dementia can also be caused by other conditions. For dementia withLewy bodies to be diagnosed correctly, you will have a number of tests and assessments, including: an assessment of your symptoms for example, whether you have typical symptoms of dementia with Lewy bodies a full assessment of your mental abilities a physical examination a review of the medication you are taking a range of tests, including blood tests , to rule out other possible causes of your symptoms, such as a vitamin B12 deficiency brain scans, such as a computerised tomography (CT) scan or a magnetic resonance imaging (MRI) scan , whichcan check for signs of a stroke, brain tumour or brain shrinkage asingle photon emissionCT (SPECT) scan, which looks at the dopamine system in the brain, can also sometimeshelp Some of these tests can be carried out by your GP. Some will be carried out by other specialists, such as a neurologist (an expert in treating conditions that affect the brain and nervous system), an elderly care physician, or a psychiatrist with experience of treating dementia. Assessing your mental abilities The Mini Mental State Examination (MMSE) is widely used to help test mental ability. The MMSE can be used to assess a number of different mental abilities, including: short- and long-term memory attention span concentration language and communication skills ability to plan ability to understand instructions The MMSEinvolves a series of tasks, which togethercarry amaximum score of 30 points. Exampletasks include: memorising a short list of objects and then repeating the list back correctly identifying the day of the week, the date, or the year The MMSE is not a test to diagnose dementia, but its useful for assessing the level of mental impairment a person with dementia may have. Treating dementia with Lewy bodies Theres currently no cure for dementia with Lewy bodies, but treatments can help manage the symptoms. First of all, your future health and social care needs will need to be assessed and a care plan drawn up. Thisis a way of ensuring you receive the right treatment for your needs. It involves identifying areas where you may need some assistance, such as: what support you or your carer need for you to remain as independent as possible whether there are any changes that need to be made to your home to make it easier to live in whether you need any financial assistance Read more about care plans Medication Medication cannot stop the progression of dementia with Lewy bodies, butit can sometimes help reduce the symptoms. Acetylcholinesterase inhibitors Acetylcholinesterase inhibitors, such asdonepezil (Aricept), galantamine (Reminyl) or rivastigmine (Exelon), may help improve hallucinations, confusion, and drowsiness in some people. These medicineswork by increasing levels of the chemical acetylcholine in the brain, which improves the ability ofthe brain cells to send signals to each other. Common side effects ofacetylcholinesterase inhibitors include feeling and being sick, diarrhoea , headaches , fatigue (extreme tiredness), and muscle cramps. Othermedications Other medications that may help control some of the symptoms of dementia with Lewy bodies include: levodopa (a medication used to treat Parkinsons disease ) can help reduce movement problems, although it can also worsen hallucinations and other psychotic symptoms, so it needs to be carefully monitored by your doctor antidepressants may help you cope if you have depression clonazepam can sometimes help improve your sleep if you experience sleep disturbances Antipsychotics, such as haloperidol, should be avoided wherever possible, and should only be usedto treatseverely challenging behaviour that is putting you or others at risk of harm. This is because they can cause a range of serious side effects, including rigidity and immobility. If antipsychotics are needed, they will be prescribed at the lowest possible dose, for the shortest possible time, by a specialist experienced in treating dementia with Lewy bodies. Supportive measures andtreatments In addition to medication, there area number of therapies and practical measures that can help make everyday living easier for someone with dementia. These include: occupational therapy to identify problem areas in everyday life, such as getting dressed, and help work out practical solutions speech and language therapy to help improve any communication or swallowing problems physiotherapy to help with movement difficulties psychological treatments, such as cognitive stimulation , to help improve memory, problem-solving skills and language ability relaxation techniques, such as massage, and music or dance therapy home modifications, such as removing loose carpets and potential trip hazards, ensuring the home is well lit, andadding grab bars and handrails checking for problems with vision and hearing that could be contributing to hallucinations Read more about living well with dementia Legal matters If you have been diagnosed with dementia, you will need to make arrangements for your care that take into account thegradual decline in your mental abilities. Thisshould include ensuring that your wishes are upheld ifyoure not able to make decisions for yourself. You may wish todraw up anadvance decision after first receiving a diagnosis of dementia. This makes your treatment preferences known now, in case you are unable to do this in the future. You may alsowanttoconsidergiving a relativelasting power of attorney . This is the power to make decisions about you if you are unable to. Read more about managing legal affairs for someone with dementia Advice for carers If youcare for someone with dementia, you may find it helpful to read more about: respite care this can allow you to take breaks from caring legal issues for carers such as what to do when someone can no longer make decisions for themselves benefits for carers such as allowances and tax credits that may be available looking after someone with dementia Telecare Self-Check online tool Visit the Telecare Self-Check online tool to find the right support for you in your area. This easy to use online tool allows you to find helpful information on telecare services that could help you live independently at home for longer. Source: NHS 24 - Opens in new browser window Last updated: 06 March 2024 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Dont include personal information e.g. name, location or any personal health conditions. Email Address e.g. [email protected] Message Maximum of 500 characters Send feedback Add this page to\n Info For Me Also on NHS inform Living well with dementia Dementia care and support Other health sites Lewy Body Society Dementia UK Alzheimer Scotland - dementia with lewy bodies NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats 2023 NHS 24 v1.1.1.17852

Dental abscess

Dental abscess | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotlands Service Directory 0 Home Illnesses and conditions Mouth Dental abscess Dental abscess If you have a dental problem you should, in the first instance always phone the dental practice that you normally attend . If you are not registered with any dental practice thenyou should read our advice on dental emergencies . A dental abscess is a collection of pus that can form inside the teeth, in the gums, or in the bone that holds the teeth in place. Its caused by a bacterial infection. An abscess at the end of a tooth is called a periapical abscess. An abscess in the gum is called a periodontal abscess. Dental abscesses are often painful, but arent always. In either case, they should be looked at by a dentist. Its important to get help as soon as possible, because abscesses dont go away on their own. They can sometimes spread to other parts of the body and make you ill. Symptoms of a dental abscess Symptoms of an abscess in your tooth or gum may include: an intense, throbbing pain in the affected tooth or gum that may come on suddenly andgets gradually worse painthat spreads toyour ear, jaw and neck on the same side asthe affected tooth or gum pain thats worse when lying down, which may disturb your sleep redness and swelling inyour face a tender, discoloured and/or loose tooth shiny, red and swollen gums sensitivity to hot or cold food and drink bad breathand/or an unpleasant taste in your mouth If the infection spreads, you may also developa high temperature (fever) and feel generally unwell. In severe cases, you may find it hard to fully open your mouth andhave difficulty swallowing or breathing. What to do if you have a dental abscess You should see a dentist as soon as possible if you think you have a dental abscess. Avoid visiting your GP, as there is little they can do to help. You can get help from: your registered dentist if its out of hours, they should have an answerphone message with details of how to access out-of-hoursdental treatment NHS 24 111 service who can give you details ofdental services in your area your localclinical commissioning group (CCG)who can tell you the phone number ofyour localdental access helpline your local accident and emergency (A&E) departmentif there are no other options or youre having difficulty breathing You may have to pay for emergency NHS dental treatment, depending on your circumstances. Read about NHS dental charges. Relieving your symptoms While youre waiting to see a dentist, painkillers can help control your pain. Ibuprofen is the preferred painkiller for dental abscesses, but if youre unable to take it for medical reasons, you can take paracetamol instead. Aspirinshouldnt be given tochildren under 16. If one painkiller doesnt relieve the pain, taking both paracetamol and ibuprofen at the doses shown in the medicine leaflet may help. This is safe for adults, but not for children under 16. It may also help to: avoid hot or cold food and drink if it makes the pain worse try eating cool, soft foods if possible, using the opposite side of your mouth use a soft toothbrush and temporarily avoid flossing around the affected tooth These measures can help relieve your symptoms temporarily, but you shouldnt use them to delay getting help from a dentist. Treatments for a dental abscess Dental abscesses are treated by removing the source of the infection and draining away the pus. Depending on the location of the abscess and how severe the infection is, possible treatments include: removing the affected tooth (extraction) this may be necessary if root canal treatment isnt possible root canal treatment a procedure to remove the abscess from the root of an affected tooth before filling and sealing it incision and drainage where a small cut (incision) is made in the gum to drain the abscess (this is usually only a temporary solution and further treatment may be needed) Local anaesthetic will usually be used to numb your mouth for these procedures. More extensive operations may be carried out under general anaesthetic (where youre asleep). Antibiotics arent routinely prescribed for dental abscesses, but may be used if the infection spreads or is particularly severe. What causes dental abscesses? Your mouth is full of bacteria, which form a sticky film on your teeth called plaque. If you dont keep your teeth clean, acids produced by the bacteria in plaque can damage your teeth and gums, leading to tooth decay or gum disease . The following can increase your chances of developing a dental abscess: poor oral hygiene plaque can build-up on your teeth if you dont floss and brush your teeth regularly consuming lots of sugary or starchy food and drink these can encourage the growth of bacteria in plaque and may lead to decay that can result in an abscess an injury or previous surgery to your teeth or gums bacteria can get into any damaged parts of the teeth or gums having a weakened immune system this includes people with certain underlying health conditions, such as diabetes ,andthose having treatment, including steroid medication or chemotherapy Preventing dental abscesses You can reduce your risk of developing dental abscesses by keeping your teeth and gums as healthy as possible. To do this, you should: use floss or an interdental brush at least once a day to clean between your teeth and under the gum line brush your teeth with afluoride toothpaste twice a day spending at least two minutes each time avoid rinsing your mouth with water or mouthwash after brushing because this washes the protective toothpaste away just spit out any excess toothpaste cut down on sugary and starchy food and drinks particularly between meals or shortly before going to bed visit your dentist regularly your dentist can suggest how often you should have a check-up, based on your oral health Read more on how to keep your teeth clean and dental check-ups . Source: NHS 24 - Opens in new browser window Last updated: 05 December 2023 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Dont include personal information e.g. name, location or any personal health conditions. Email Address e.g. [email protected] Message Maximum of 500 characters Send feedback Add this page to\n Info For Me NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats 2023 NHS 24 v1.1.1.17852

Depression

"Depression | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotlands Service Directory 0 Home Illnesses and conditions Mental health Depression Depression What is depression? \u200bSymptoms and causes of depression \u200bDiagnosing and treating depression \u200bLiving with depression \u200bPsychotic depression Depression self-help guide What is depression? Everyone has spells of feeling down, but depression is more than just spending a few days feeling sad or unhappy. Depression can make you feel persistently sad and down for weeks or months at a time. While some people believe that depression is trivial or not a genuine health problem, its actually a real condition that affects around one in 10 people over the course of their lives. It impacts people of all genders and ages including children. Studies show that around 4% of children in the UK between the ages of five and 16 are depressed or anxious. With the right support and treatment, most people recover fully from depression. Do I have depression? Depression has a range of different symptoms, and it can affect everybody differently. The symptoms include feeling very tearful, feeling hopelessness and sadness, and losing interest in things you enjoyed before. Its also common for people with depression to have symptoms of anxiety . Physical symptoms happen with depression too these can include feeling tired all the time, getting poor sleep, losing your sex drive, losing your appetite, and feeling aches and pains. If the symptoms are mild, you might simply experience a persistent low mood. Its common to feel stressed, sad or anxious during difficult times in your life, and a low mood can get better after a short time, rather than being a symptom of depression. Learn more about low mood and depression here . Severe symptoms of depression can make people feel suicidal as if life is no longer worth living. Read more about depression symptoms here . Seeing a doctor about depression Big changes in your life, like bereavement, losing a job, or even having a baby, can cause symptoms of depression. Youre also more likely to experience depression if you have a family history of depression. However, its also possible to become depressed without there being an obvious reason. You can learn more about depression causes here . \u200bSymptoms and causes of depression Symptoms of depression can be very different from person to person. However, as a general rule, if you are depressed you feel hopeless, sad and lacking interest in things that used to make you feel happy. Depression symptoms are bad enough to interfere with work, social life and family life, and can persist for weeks or months. Doctors describe depression in one of three ways, depending on how serious it is: mild depression it has some impact on daily life moderate depression it has a significant impact on your daily life severe depression this makes it nearly impossible to get through your life day to day A few people with severe depression may have symptoms of psychotic depression . Below is a list of depression symptoms its unlikely that one person would have all of them. Psychological depression symptoms include: continuous sadness or low mood losing interest in things losing motivation not getting any enjoyment in life feeling tearful feeling guilty feeling anxious feeling irritable finding it hard to make decisions feeling intolerant of other people feeling helpless feeling hopeless low self-esteem feeling worried thinking about suicide thinking about harming yourself Physical symptoms include: speaking or moving slower than usual aches and pains that cant be explained losing, or sometimes gaining, appetite or weight constipation loss of interest in sex disturbed sleep (having trouble falling asleep, for example, or waking up very early) loss of energy changes in your menstrual cycle (the time of the month when you get your period) Social symptoms are common too. These include: avoiding talking to or spending time with your friends taking part in fewer social activities neglecting interests and hobbies doing poorly at work difficulties with your family or home life Its not always possible to tell that youre having symptoms of depression right away it can start and progress gradually. A lot of people dont realise theyre ill and try to carry on and cope with their symptoms. Sometimes it takes a friend or family member to notice that theres a problem. Depression and grief Depression and grief have a lot of the same features, and it can be hard to tell them apart. However, theyre different in many important ways. Depression is an illness grief is a completely natural response to loss. If youre grieving, you may find your feelings of sadness and loss come and go, but its still possible to enjoy things in life and look forward to the future. People with depression feel sad persistently, find it difficult to be positive about the future, and dont get enjoyment from anything. Learn more about the differences between grief and depression here . Different types of depression There are different types of depression, and there are some conditions where depression is a symptom. These conditions include: Bipolar disorder people with bipolar disorder, which is also known as manic depression, experience times of depression, where the symptoms are similar to clinical depression. They also go through phases when they have excessively high moods (known as mania). Bouts of mania can include harmful behaviour like unsafe sex, spending sprees and gambling. Seasonal affective disorder (SAD) is also called winter depression. Its depression that is related to weather, usually winter, so it happens seasonally. Postnatal depression happens to some women after theyve had a baby. Its treated similarly to other types of depression, with antidepressant medication and talking therapy. Learn more about how depression is diagnosed here . Causes of depression Depression doesnt have one single cause it can have a range of triggers, and there are many different reasons a person can develop the condition. Some people are affected after a stressful life event, like a bereavement or divorce. Other people experience depression related to illness, job loss, or money worries. Different reasons can combine and trigger depression. If youre feeling low after a job loss or health issues, and then experience something traumatic, like a bereavement, you can develop depression. Its common to hear about depression being brought on by a downward spiral one thing causing other problems that combine to cause depression. For example, losing your job could make you feel sad, so you spend less time with family and friends and maybe drink more alcohol. These things all make you feel worse, which triggers depression. There are studies that suggest people are more likely to become depressed when they get older. Theres also evidence that depression is more common for people whose economic and social circumstances are difficult. Depression and illness Long-lasting or life-threatening conditions like cancer or coronary heart disease can put you at higher risk of developing depression. Many people dont know that head injuries can cause depression, and a severe head injury can lead to emotional problems and mood swings. Underactive thyroid (hypothyroidism) can happen as a result of immune system problems. Its also possible, although rare, for a minor head injury to damage the pituitary gland. This is a gland the size of a pea which sits at the base of the brain and produces hormones that stimulate the thyroid. Damage to the pituitary gland can cause symptoms, including severe tiredness and a lack of interest in sex, which can then cause people to develop depression. Depression and drugs and alcohol Drowning your sorrows is actually a bad idea when it comes to depression. Alcohol is categorised as a strong depressant which can make depression worse, and drinking or taking drugs to cope can lead to a downward spiral by having a negative affect on other parts of your life. Theres evidence that cannabis can cause depression, particularly in teenagers, even if it helps you relax. Other causes of depression There are a number of things that can lead to developing depression. Stressful events big changes in your life, like bereavement, the end of a relationship or the loss of a job, can be difficult to deal with. When these things happen, its important to keep seeing friends and family instead of trying to deal with problems alone this increases your risk of developing depression. Giving birth pregnancy and birth can make some people vulnerable to depression. Postnatal depression can happen as the result of physical changes, hormonal changes, and the responsibility of taking care of a new baby. Loneliness your risk of depression gets higher if you arent in contact or spending time with family and friends. Personality some personality traits can put you at a higher risk of developing depression. These include low-self esteem or a habit of criticising yourself too much. These personality traits can come from your genes, which you get from your parents, or they can be as a result of experiences in your early life. Family history its more likely for someone to develop depression if a family member, like a sibling or parent, has experienced it before. \u200bDiagnosing and treating depression Theres no physical test for depression. If you experience depression symptoms most of the day, every day, for more than two weeks, you should visit your GP. This is especially important if: you have symptoms of depression that arent getting any better you have thoughts of self-harm or suicide your work, relationships with friends and family, or interests are affected by your mood It can be hard for people with depression to imagine that anything can help them but the sooner you seek help, the sooner the symptoms start to get better. Your GP may examine you and perform blood or urine tests to make sure there isnt another condition causing your depression symptoms, like an underactive thyroid . When you see your GP, theyll try to find out if you have depression by asking you questions. These are likely to be about your health, how youre feeling, and how that is affecting you mentally and physically. Telling your doctor your symptoms and the affect they are having on you will help your GP to tell if you have depression, and how severe the condition is. Its important to be as open as possible. Your conversation with your GP will be confidential. This rule can only be broken if your GP thinks there is a significant risk of harm to you or others, and that telling a family member or carer would make that risk lower. Treating depression The first place to go is your GP they will refer to you local talking treatments for depression that are available on the NHS. You may also have the option to self-refer, depending on where you live, so you can go directly to a professional therapist if youd rather not talk to your GP. Talking treatments for depression There are a number of talking therapies for depression. Cognitive behavioural therapy (CBT) CBT helps you make sense of your thoughts and behaviour and the affect they have on you. Part of its recognising that past events may have played a part in making you who you are, but the main focus is changing how you feel, behave and think now. You can use CBT to learn how to overcome negative thoughts this can help you to tackle feelings of hopelessness, for example. Most people have a course of six to eight CBT sessions that goes over 10 to 12 weeks. Sessions are one-to-one, between you and a CBT-trained counsellor. You might also be offered group CBT. Computerised CBT (CCBT) This type of CBT is done using a computer instead of face-to-face with the counsellor. It should be supported by a healthcare professional your GP may prescribe it, and you might have to use the computer in the GP surgery to access it. CCBT involves a series of weekly sessions. Interpersonal Therapy (IPT) IPT is focused on your relationships with people around you, and problems that you might be having with them. These can include problems communicating, or dealing with a bereavement. Theres evidence that suggests IPT can be as effective for depression as CBT or medication, but more research needs to be done. Psychodynamic psychotherapy This is also known as psychoanalytic psychotherapy. Youll work with a therapist who encourages you to say whatever youre thinking. This helps you to find hidden patterns and meanings in your words and behaviour that could be contributing to your depression. Read more about psychotherapy here . Counselling Counselling is a type of therapy that works really well if you have good mental wellbeing overall but need help coping with a crisis thats currently going on in your life. These can include anger, bereavement, infertility, relationship problems, job loss and serious illness. On the NHS, counselling usually takes place over six to 12 sessions, each an hour long. The sessions are confidential. A counsellor helps you to think about whats going on in your life and find new ways of dealing with the problems. Theyll offer practical advice, support you, and help you find solutions, but they dont tell you what to do. Antidepressants Antidepressants are medicines that treat depression symptoms. There are almost 30 different types of antidepressant that can be prescribed to you. Most people who have moderate or severe depression notice improvement when they take antidepressants, but this isnt the case for everyone. One type of antidepressant might not work for you, but another one could. It can take two or more different treatments to find the right one for you. Side effects vary between different people and different antidepressants, but the different types of antidepressant all work around as well as each other. If youre prescribed antidepressants, you should see your GP or specialist nurse regularly while you first start taking the medication every week or two for at least four weeks. This is so your treatment provider can see how the antidepressants are working. If the medication is working for you, you should continue taking them at the same dose for at least four to six months after the depression symptoms have eased. People who have had depression in the past might have to take antidepressants for up to five years, maybe longer. Antidepressants arent addictive. However, you might have withdrawal symptoms if you stop taking them suddenly or miss a dose. You can read more about withdrawal symptoms below. Selective serotonin reuptake inhibitors (SSRIs) If your GP thinks you would benefit from taking an antidepressant, youll usually be prescribed a modern type called a selective serotonin reuptake inhibitor (SSRI) . Examples of commonly used SSRI antidepressants are Seroxat (paroxetine), Prozac (fluoxetine) and Cipramil (citalopram). They help increase the level of a natural chemical in your brain called serotonin, which is thought to be a good mood chemical. SSRIs work just as well as older antidepressants and have fewer side effects. They can, however, cause nausea and headaches, as well as a dry mouth and problems having sex. However, all these negative effects usually improve over time. Some SSRIs arent suitable for children under the age of 18. Research shows that the risk of self-harm and suicidal behaviour may increase if theyre taken by under-18s. Fluoxetine is the only SSRI that can be prescribed for under-18s, and even then only when a specialist has given the go-ahead. Tricyclic antidepressants (TCAs) This group of antidepressants is used to treat moderate to severe depression. TCAs, which includes Imipramil (imipramine) and amitriptyline, have been around for longer than SSRIs. They work by raising the levels of the chemicals serotonin and noradrenaline in your brain. These both help lift your mood. Theyre generally quite safe, but its a bad idea to smoke cannabis if you are taking TCAs because it can cause your heart to beat rapidly. Side effects of TCAs may include a dry mouth, blurred vision, constipation, problems passing urine, sweating, light-headedness and excessive drowsiness, but vary from person to person. The side effects usually ease after seven to 10 days, as your body gets used to the medication. Other antidepressants New antidepressants, such as Efexor (venlafaxine), Cymbalta or Yentreve (duloxetine) and Zispin Soltab (mirtazapine), work in a slightly different way from SSRIs and TCAs. Venlafaxine and duloxetine are known as SNRIs (serotonin-noradrenaline reuptake inhibitors). Like TCAs, they change the levels of serotonin and noradrenaline in your brain. Studies have shown that an SNRI can be more effective than an SSRI, though theyre not routinely prescribed as they can lead to a rise in blood pressure. Withdrawal symptoms Antidepressants are not addictive in the same way that illegal drugs and cigarettes are, but when you stop taking them you may have some withdrawal symptoms, including: upset stomach flu-like symptoms anxiety dizziness vivid dreams at night sensations in the body that feel like electric shocks In most cases these are quite mild and last no longer than a week or two, but occasionally they can be quite severe. They seem to be most likely to occur with paroxetine (Seroxat) and venlafaxine (Efexor). Withdrawal symptoms occur very soon after stopping the tablets, so can easily be told apart from symptoms of depression relapse, which tend to occur after a few weeks. Other treatments for depression There is a range of other treatments that people are given for depression. St Johns Wort St Johns Wort is a herbal treatment that you can buy from pharmacies and health food shops. Some people take it for depression. Theres some evidence that it can help the symptoms of mild-to-moderate depression, but doctors dont recommend St Johns Wort because the amount of active ingredients change depending on the brand and batch. This means that you can never be sure what kind of effect it will have. If you take St Johns Wort with other medications, like anticonvulsants, anticoagulants, antidepressants and the contraceptive pill, it can cause serious problems. St Johns Wort can interact with the contraceptive pill and reduce its effectiveness at preventing pregnancy. You shouldnt take St Johns Wort while pregnant or breastfeeding, as we cant be certain that its safe. Electroconvulsive therapy (ECT) electric shock treatment If you have severe depression and other treatments, like medication, havent worked, ECT might be recommended for you. When receiving ECT, you will be given an anaesthetic and medication that relaxes your muscles to begin with. Electrodes will be placed on your head that give an electrical shock to your brain. ECT is given over a series of sessions, normally twice a week for three to six weeks. ECT can cause side effects including nausea, headaches, aches in the muscles and memory problems. Most people find that ECT is good for relieving severe depression, but the beneficial effects tend to wear off when several months have passed. Lithium If youve tried several different antidepressants and had no improvement, your doctor may offer you a type of medication called lithium in addition to your current treatment. There are two types of lithium: lithium carbonate and lithium citrate. Both are usually effective, but if youre taking one that works for you, its best not to change. If the level of lithium in your blood becomes too high, it can become toxic. Youll therefore need blood tests every three months to check your lithium levels while youre on the medication. Youll also need to avoid eating a low-salt diet because this can also cause the lithium to become toxic. Ask your GP for advice about your diet. \u200bLiving with depression Theres a lot of advice available for living with depression and feeling better. Talking about depression You can find support and insight by talking about depression with another person or a group. According to research, talking can help you to recover and deal better with stress. If you dont feel comfortable talking about your symptoms and feelings with other people, you can write about how you feel or use poetry or art to express yourself doing this can also help you to feel better. Smoking, drugs, alcohol and depression It might feel like cigarettes and alcohol are helpful, but in the long run they can make you feel worse. If you have depression its especially important to be careful when it comes to cannabis. Research has shown theres a strong connection between mental health problems and cannabis use. According to the evidence, if you smoke cannabis while dealing with depression: your symptoms get worse you feel less interested in things youre more likely to have earlier and more frequent relapses of depression youre less likely to recover fully from depression you feel more tired you wont respond as well to antidepressants youre more likely to stop taking antidepressants You can get advice and support from your GP on cutting down or stopping drinking, smoking, and drug use. Learn more about stopping smoking here Learn more about help to cut down or stop drinking alcohol here Work, money, and depression You might need to take time off work if your depression is caused by working too much, or if the symptoms are making it hard for you to do your job. However, research has shown that taking a long time off work can make depression worse, and that going back to work can help you to get better. When youre dealing with depression its important to avoid as much stress, work-related and otherwise, as you can. If youre working you might be able to change to shorter hours, or work more flexibly. This is especially true if pressure at work causes you to experience depression symptoms. The Equality Act means that employers need to make reasonable adjustments to make it possible to employ people with disabilities this can include people who have been diagnosed with depression and other mental health conditions. You can find more information about dealing with stress at work here . If your depression means you are unable to work, there are benefits you may be eligible to claim. These include: Attendance Allowance Carers Allowance Council Tax Benefit Personal Independence Payment ( PIP ) Housing Benefit Employment and Support Allowance (ESA) Statutory Sick Pay Bereavement and depression Your depression can be triggered by losing someone who is close to you. The emotional blow suffered when a person you care about dies is powerful it might feel like you will never recover from the loss. Along with time, the right help and support can make it possible to start living your life again. Find out more about coping with a bereavement here . Looking after someone who has depression If youre close to someone with depression, their condition can affect you too. Your relationship, and family life in general, can be strained, and you might not know what to do or how to help. Talking about the situation can help. Finding a support group, or talking to other people in a similar situation, can make it easier to cope. If the condition is causing difficulties in your relationship with your partner, you could contact a relationship counsellor who can talk things through with both of you. When suffering from depression, men are less likely to ask for help than women. Theyre also more likely to turn to drugs and alcohol to cope with the symptoms. Depression and suicide The majority of suicide cases are linked with mental disorders, and most of them are triggered by severe depression. Warning signs that someone with depression may be considering suicide are: making final arrangements, like giving away their things, making a will or saying goodbye to friends talking about death or suicide this may be with direct statements, like I wish I was dead, but often depressed people talk about the subject indirectly, saying things like: I think dead people must be happier than us or wouldnt it be nice to go to sleep and never wake up self-harm, like cutting their arms or legs, or burning themselves with cigarettes a sudden lifting of mood, which could mean that a person has decided to commit suicide and feels better because of this decision If youre feeling suicidal or are in a crisis of depression, contact your GP as soon as possible. They will be able to help you. If you cant or dont want to contact your GP, call the Samaritans on 116 123, 24 hours a day, seven days a week. Alternatively, visit the Samaritans website or email [email protected] . Helping a suicidal friend or relative If you see any of the above warning signs: get professional help for the person let them know theyre not alone and that you care about them offer your support in finding other solutions to their problems If you feel there is an immediate danger, stay with the person or have someone else stay with them, and remove all available means of committing suicide, such as medication. Over-the-counter drugs such as painkillers can be just as dangerous as prescription medication. Also, remove sharp objects and poisonous household chemicals such as bleach. \u200bPsychotic depression Some people who have severe depression will also experience symptoms of psychosis these are hallucinations and delusional thinking. Depression with psychosis is known as psychotic depression. Symptoms of severe depression People who have severe clinical depression feel sad and hopeless for most of the day, and feel no interest in anything. They feel this way practically every day, and getting through the day feels nearly impossible for them. Other symptoms include: fatigue (exhaustion) losing pleasure in things inability to concentrate difficulty making decisions sleep disturbance appetite changes feeling guilty feeling that theyre worthless having thoughts about suicide, or death Read more about the different types of depression symptoms here . Symptoms of psychosis Moments of psychosis are known as psychotic episodes. The person experiencing a psychotic episode will have: Delusions beliefs or thoughts that are likely to be false. Hallucinations hearing, seeing or sometimes smelling, feeling or tasting things that arent there. Hearing voices is a common type of hallucination. Hallucinations and delusions almost always reflect the deeply depressed mood of the person experiencing them. They may believe they have committed a crime or that they are to blame for something. People with psychosis also commonly experience something called psychomotor agitation. People experiencing this cannot sit still or relax, and fidget all the time. The opposite symptom can also happen psychomotor retardation can cause a persons thoughts and the movement of their body to slow down. People who have psychotic depression are at a higher risk of thinking about suicide. Causes and treatments of psychotic depression We dont fully understand what causes psychotic depression yet. However, we know that depression doesnt have one single cause, and that the condition has a lot of different triggers. Causes of psychotic depression Big, stressful events like divorce, serious illness, financial worries, or bereavement can trigger depression for some people. Severe depression can run in families, which suggests genes might play a role in depression, but the reason some people develop psychosis as part of severe depression is not known. Many people who have psychotic depression have experienced a difficult time in childhood, like a traumatic event. Learn more about causes of clinical depression Treating psychotic depression Treatment for psychotic depression has three main parts: medication taking a combination of antipsychotics and antidepressants can help to relieve psychosis symptoms psychological therapies cognitive behavioural therapy (CBT) is a talking therapy done one-to-one with a trained counsellor, and it has succeeded in helping some people with psychosis social support support with social needs like employment, education and accommodation People with psychotic depression may have to spend some time in hospital to receive treatment. Electroconvulsive therapy (ECT, or electric shock treatment) is sometimes recommended if other treatments, including antidepressants, havent worked for severe depression. Although treatment for psychotic depression is usually very effective, people with the condition still need follow-up appointments with their treatment team so they can be continuously monitored. Getting help for someone with psychotic depression Often friends, relatives, or carers have to seek help for a person with psychotic depression. This is because people with psychosis often dont know theyre acting and thinking strangely. If youre worried about someone you know and think they may be experiencing psychosis, and theyve been diagnosed with a mental health condition before, contact their community mental health team or social worker. If theyve never shown signs of a mental health condition and you think they may be experiencing psychotic depression, contact their GP or take them to Accident and Emergency (A&E). If you think the persons symptoms are putting them at risk, you can: take them to the nearest A&E, if they agree phone their GP phone the local out-of-hours GP phone 999 and ask for an ambulance Advice and support Visit the SANE website or the Mind website for more information, support and advice about psychotic depression. Learn more about psychosis here Depression self-help guide Part of treating and living with depression is learning healthy thought patterns and coping skills that can help when youre feeling depressed. Our mental health self-help guides are based on Cognitive Behavioural Therapy (CBT) and have proven highly successful in helping people with depression and other mental health issues. Depression self-help guide Work through a self-help guide for depression that uses Cognitive Behavioural Therapy (CBT). Depression self-help guide Source: NHS 24 - Opens in new browser window Last updated: 08 January 2024 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Dont include personal information e.g. name, location or any personal health conditions. Email Address e.g. [email protected] Message Maximum of 500 characters Send feedback Add this page to\n Info For Me Also on NHS inform Low mood and depression What to do if you're worried someone is depressed Exercise for depression Tips for coping with depression Mind to Mind Coping with money worries Other health sites Choice and Medication: Depression SIGN: Treating depression without using prescribed medication NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats 2023 NHS 24 v1.1.1.17852"

Dermatitis herpetiformis

Dermatitis herpetiformis | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotlands Service Directory 0 Home Illnesses and conditions Skin, hair and nails Dermatitis herpetiformis Dermatitis herpetiformis Dermatitis herpetiformis (DH) is an autoimmune skin condition that can be linked to coeliac disease . How many people have dermatitis herpetiformis? DH affects around 1 in 10,000 people. DH can appear at any age, but is most commonly diagnosed in those between the ages of 15 and 40. Its more common in men than women and is rare in children. Symptoms of dermatitis herpetiformis (DH) People with DH can have: red, raised patches often with blisters that burst with scratching severe itching and often stinging The rash can affect any area of the skin but is most commonly seen on the: elbows knees buttocks The rash usually occurs on both sides of the body, for example on both elbows. Dermatitis herpetiformis often affects the knees. Source: https://dermnetnz.org/ Gut symptoms Most people with DH will have the same kind of gut damage seen with coeliac disease, but may not complain of gut symptoms like: diarrhoea constipation stomach pain bloating Just over half (60%) of people with DH dont have gut symptoms. Causes of d ermatitis herpetiformis (DH) DH is caused by the bodys immune system reacting to a protein called gluten in foods containing wheat, barley and rye. This reaction causes a skin rash to develop. Diagnosing d ermatitis herpetiformis (DH) A diagnosis of DH is confirmed by a skin test called a skin biopsy. A skin biopsy is a procedure where a sample of skin is removed to be tested. As DH is strongly linked to coeliac disease, blood tests may be taken for this condition as well. What happens during a skin biopsy test? During a skin biopsy test, a specialist skin doctor called a dermatologist will take a small sample of skin from an area without the rash. Samples of skin taken from the area with the rash dont always give an accurate result. The skin sample is then tested. If you test positive for DH youll be referred to a specialist gut doctor called a gastroenterologist to be tested for coeliac disease. Diet before and during diagnosis To ensure an accurate skin test is taken first time, its important to keep eating foods with gluten before and during diagnosis. If youve already removed gluten from your diet, you must reintroduce it in more than one meal every day. You should do this for at least 6 weeks before having the tests. Treating d ermatitis herpetiformis (DH) The treatment for DH is a lifelong gluten-free diet. A gluten-free diet is when all gluten-containing foods are removed from your diet Gluten is found in wheat, barley and rye and sometimes people are sensitive to oats too. A gluten free diet should only start once the diagnosis of DH is given and a referral to a dietitian has been made. Find out how to live with a gluten-free diet How long does treatment take to work? The length of time it takes for the skin to heal varies from person to person but it can take up to 2 years or more. Medication during treatment Some patients will be given medication to help them over this period of recovery. Medication will only be given to control the skin itching and blisters and doesnt treat any other symptoms. The drug most likely to be used is called Dapsone. Dapsone Dapsone is taken in tablet form and must be swallowed. It helps ease the itching and controls the development of blisters. It should work within a few days. If you stop taking Dapsone before the gluten-free diet has taken effect, the rash will return. Side effects of Dapsone The most common side effect of Dapsone is anaemia . Less common side effects are headaches and depression , while nerve damage is rare. Youll always be prescribed the lowest effective dose to help prevent these side effects. DH should be monitored once the drug dose has been reduced. Alternatives to Dapsone Some people cant tolerate Dapsone. If youre one of these people, the following drugs can also be taken to clear the rash: Sulphapyridine Sulphamethoxypyridazine Complications ofd ermatitis herpetiformis (DH) DH can cause the same conditions and complications as coeliac disease . Some potential complications of DH include: osteoporosis certain kinds of gut cancer an increased risk of other autoimmune diseases, such as type 1 diabetes and thyroid disease As with coeliac disease, the risk of developing these is reduced by following a gluten-free diet. Source: Scottish Government - Opens in new browser window Last updated: 05 May 2023 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Dont include personal information e.g. name, location or any personal health conditions. Email Address e.g. [email protected] Message Maximum of 500 characters Send feedback Add this page to\n Info For Me Also on NHS inform Coeliac disease Gluten-free diet Other health sites Coeliac UK: Dermatitis herpetiformis NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats 2023 NHS 24 v1.1.1.17852

Diabetes

About Diabetes | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotlands Service Directory 0 Home Illnesses and conditions Diabetes Diabetes Diabetes Diabetes is a lifelong condition that causes a persons blood glucose (sugar) level to become too high. There are two main types of diabetes type 1 diabetes and type 2 diabetes . Type 2 diabetes is far more common than type 1. In the UK, around 90% of all adults with diabetes have type 2. There are 4.7 million people living with diabetes in the UK. Thats more than one in 15 people in the UK who has diabetes (diagnosed or undiagnosed). This figure has nearly trebled since 1996, when there were 1.4 million. By 2025, it is estimated that 5 million people will have diabetes in the UK. Pre-diabetes Many more people have blood glucose levels above the normal range, but not high enough to be diagnosed as having diabetes. This is sometimes known as prediabetes. If your blood glucose level is above the normal range, your risk of developing full-blown diabetes is increased. Its very important for diabetes to be diagnosed as early as possible because it will get progressively worse if left untreated. When to see a doctor You should therefore visit your GP as soon as possible if you have symptoms, such as feeling thirsty, passing urine more often than usual, and feeling tired all the time. Its also advised to see your GP if you have risk factors of diabetes and are worried about developing diabetes in future. Symptoms of diabetes The main symptoms of diabetes are: feeling very thirsty urinating more frequently than usual, particularly at night feeling very tired weight loss and loss of muscle bulk itching around the penis or vagina, or frequent episodes of thrush cuts or wounds that heal slowly blurred vision Type 1 diabetes can develop quickly over a few hours or even days. Many people have type 2 diabetes for years without realising because the early symptoms tend to be general. What causes diabetes? The amount of glucose in the blood is controlled by a hormone called insulin, which is produced by the pancreas (a gland behind the stomach). When food is digested and enters your bloodstream, insulin moves glucose out of the blood and into cells, where its broken down to produce energy. However, if you have diabetes, your body is unable to break down glucose into energy. This is because theres either not enough insulin to move the glucose, or the insulin produced doesnt work properly. Type 1 diabetes In type 1 diabetes, the bodys immune system attacks and destroys the cells that produce insulin. As insulin production decreases until no more is produced, your glucose levels increase, which can seriously damage the bodys organs. Type 1 diabetes usually develops before the age of 40, often during the teenage years. Type 1 diabetes is less common than type 2 diabetes. In the UK, it affects about 10% of all adults with diabetes. If youre diagnosed with type 1 diabetes, youll need insulin injections for the rest of your life. Youll also need to pay close attention to certain aspects of your lifestyle and health to ensure your blood glucose levels stay balanced. For example, youll need to eat healthily , take regular exercise and carry out regular blood tests. Read more about living with type 1 diabetes Type 2 diabetes Type 2 diabetes is where the body doesnt produce enough insulin, or the bodys cells dont react to insulin. This is known as insulin resistance. If youre diagnosed with type 2 diabetes, you may be able to control your symptoms simply by eating a healthy diet, exercising regularly, and monitoring your blood glucose levels. However, as type 2 diabetes is a progressive condition, you may eventually need medication, usually in the form of tablets. Type 2 diabetes is often associated with obesity . Obesity-related diabetes is sometimes referred to as maturity-onset diabetes because its more common in older people. Read more about living with type 2 diabetes Diabetic eye screening Everyone with diabetes aged 12 or over should be invited to have their eyes screened once a year by the national diabetes retinal screening service. If you have diabetes, your eyes are at risk from diabetic retinopathy, a condition that can lead to sight loss if its not treated. Screening, which involves a half-hour check to examine the back of the eyes, is a way of detecting the condition early so it can be treated more effectively. Read more about diabetic eye screening Gestational diabetes (in pregnancy) During pregnancy, all women need to make more insulin. In some women this doesnt happen and blood glucose levels rise typically in the middle of pregnancy onwards. Diabetes diagnosed in pregnancy is known as gestational diabetes. Risk of gestational diabetes is increased with the same risk factors for type 2 diabetes (increased weight, at risk ethnicity and family history of diabetes), but also if you have given birth to a baby in the past who was bigger than expected. For most women with gestational diabetes, blood glucose levels will return to normal after pregnancy. Although you will have an increased risk of developing diabetes in later life. If youre worried about gestational diabetes then discuss this with your midwife. Blood glucosecontrol is also very important for women with diabetes before pregnancy (type 1, type 2 or other kinds). If youre planning a pregnancy or are in the early stages of pregnancy, its important to discuss this with your GP, midwife or hospital clinic. Other types of diabetes In addition to Type 1, Type 2 and gestational diabetes, there are a range of other types of diabetes. These types of diabetes are much rarer, with about 2% of people having them. The rare types of diabetes include: different types of monogenic diabetes cystic fibrosis-related diabetes diabetes caused by rare syndromes diabetes caused by certain medications such as steroids and antipsychotics diabetes caused by surgery or hormonal imbalances Unfortunately, many people with rarer types of diabetes are misdiagnosed leading to delays in getting the right treatment. For more information on the other types of diabetes visit Diabetes UK and Diabetes Genes . Source: NHS Grampian - Opens in new browser window Last updated: 17 November 2023 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Dont include personal information e.g. name, location or any personal health conditions. Email Address e.g. [email protected] Message Maximum of 500 characters Send feedback Add this page to\n Info For Me Also on NHS inform Type 1 diabetes Type 2 diabetes Other health sites My Diabetes, My Way NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats 2023 NHS 24 v1.1.1.17852

Diarrhoea

"Diarrhoea | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotlands Service Directory 0 Home Illnesses and conditions Stomach, liver and gastrointestinal tract Diarrhoea Diarrhoea Return to Symptoms Enter age Last Updated: Next Review Date: Review my answers Find your local services Search for a service near you by entering your postcode below. Please input your postcode in the following format: A12 1BC GP Practices Dental Services Pharmacies Opticians Postcode Search NHS inform has more information on this condition. Read more Previous Start guide Review my answers You told us your credentials were: : You said: Based on the information you gave us, we made the following recommendation: Close Keep a copy View PDF Diarrhoea is passing looser, watery or more frequent poo (stools) than is normal for you. It affects most people from time to time and is usually nothing to worry about. It can be distressing and unpleasant. It normally clears up in a few days to a week. Diarrhoea self-help guide Complete our self-help guide to check your symptoms and find out what to do next. Phone 999 or got to A&E if you or your child: might have swallowed something poisonous have a stiff neck and pain when looking at bright lights have a sudden, severe headache or stomach ache Speak to your GP if: You or your child has diarrhoea and: its particularly frequent or severe it lasts for more than 7 days youre concerned poo with blood on it persistent vomiting and are unable to keep fluid down a severe or continuous stomach ache weight loss have passed a large amount of very watery diarrhoea it occurs at night and is disturbing sleep have recently taken antibiotics or been treated in hospital have signs of dehydration including drowsiness, peeing less than usual, and feeling lightheaded or dizzy have poo thats dark or black this may be a sign of bleeding inside your stomach Your child: has had 6 or more episodes of diarrhoea in the past 24 hours has diarrhoea and vomiting at the same time has stopped drinking fluids while theyre ill is a baby and has vomited 3 times or more in the past 24 hours is under 12 months with diarrhoea and youre worried If your GP is closed, phone 111. What causes diarrhoea? There are many different causes of diarrhoea. A bowel infection ( gastroenteritis ) is a common cause in both adults and children. Gastroenteritis can be caused by: a virus such as norovirus or rotavirus bacteria such as campylobacter and Escherichia (E. coli), which are often picked up from contaminated food a parasite such as the parasite that causes giardiasis, which is spread in contaminated water These infections can sometimes be caught during travelling abroad, particularly to areas with poor standards of public hygiene. This is known as travellers diarrhoea. Diarrhoea can also be the result of anxiety, a food allergy , medication, or a long-term condition, such as irritable bowel syndrome (IBS) . What to do if you have diarrhoea Most cases of diarrhoea clear up after a few days without treatment. You should drink plenty of fluids to avoid dehydration . Drink small sips of water often. Its very important that babies and children do not become dehydrated. Your pharmacist may suggest you use an oral rehydration solution (ORS) if you or you child are particularly at risk of dehydration. You should eat solid foods as soon as you feel able to. If youre breastfeeding or bottle feeding your baby and they have diarrhoea, you should try to feed them as normal. Stay at home until at least 48 hours after the last episode of diarrhoea to prevent spreading any infection to others. Medications to reduce diarrhoea, such as loperamide, are available. However, these are not usually necessary. Most types of medication should not be given to children. Read further information about managing diarrhoea , including what to eat and drink Preventing diarrhoea Diarrhoea is often caused by an infection. You can reduce your risk by making sure you maintain high standards of hygiene. Do wash your hands thoroughly with soap and warm water after going to the toilet and before eating or preparing food clean the toilet, including the handle and the seat, with disinfectant after each episode of diarrhoea avoid sharing towels, flannels, cutlery, or utensils with other household members avoid potentially unsafe tap water and undercooked food when travelling abroad Source: NHS 24 - Opens in new browser window Last updated: 29 May 2023 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Dont include personal information e.g. name, location or any personal health conditions. Email Address e.g. [email protected] Message Maximum of 500 characters Send feedback Add this page to\n Info For Me Also on NHS inform Self-help guide: Abdominal pain Dehydration Gastroenteritis Other health sites IBS Network: what is IBS? Lab Tests Online UK: stool sample fitfortravel: Travellers' diarrhoea Find your nearest pharmacy Enter a place or postcode NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats 2023 NHS 24 v1.1.1.17852"

Discoid eczema

Discoid eczema | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotlands Service Directory 0 Home Illnesses and conditions Skin, hair and nails Discoid eczema Discoid eczema About discoid eczema Symptoms of discoid eczema Causes of discoid eczema Treating discoid eczema About discoid eczema Discoid eczema is a long-term skin condition that causes skin to become itchy, reddened, swollen and cracked in circular or oval patches. Its also known as discoid dermatitis. The patchescan be a few millimetresto a few centimetres in size and can affect any part of the body, although they dont usually affect the face or scalp. The patches are often swollen, blistered (covered with small fluid-filled pockets) and ooze fluid at first, but becomedry, crusty, cracked and flaky over time. The patches may clear up on their own eventually, but this cantake weeks, months or even years if not treated, and they can recur. Read more about the symptoms of discoid eczema . Discoid eczema caused the skin to become dry, red and itchy. The rash is circular or oval shape. Source: https://dermnetnz.org/ Discoid eczema can appear as swollen and blistered patches. Source: https://dermnetnz.org/ Seeking medical advice You should see your pharmacist or GP if you think you may have discoid eczema. Your GP should be able to make a diagnosis just by examining the affected areas of skin. In some cases they may also ask questions or arrange some tests to rule out other conditions. Your GP may refer you to a dermatologist (a doctor who specialises in managing skin conditions) if they are unsure of the diagnosis or if you need patch testing. Your GP or specialist can recommend suitable treatments. What causes discoid eczema? The cause of discoid eczema is unknown, although it is often accompanied by dry skin and is thoughtto be triggered by irritation of the skin. Discoid eczematends to affect adults and is rare in children. It is more common among men aged from 50 to 70 and womenin their teens or twenties. Some people with discoid eczema may also have other types of eczema, such as atopic eczema . Read more about the causes of discoid eczema . How discoid eczema is treated Discoid eczema is usually a long-term problem, but medications are available to help relieve the symptoms and keep the condition under control. Treatments used include: emollients moisturisers applied to the skin to stop it becoming dry topical corticosteroids ointments and creams applied to the skin that can help relieve severe symptoms antihistamines medications that can reduce itching and help you sleep better There are also things you can do yourself to help, such as avoiding all the irritating chemicals in soaps, detergents, bubble baths and shower gels. Additional medication can be prescribed if your eczema is infected or particularly severe. Read more about treating discoid eczema . Symptoms of discoid eczema Discoid eczema causes distinctive circular or oval patches of eczema. The patches can appear anywhere on the body, including the: lower legs forearms trunk (torso) hands feet The face and scalp are notnormally affected. Thefirst sign of discoid eczema isusually a group of small red spots or bumps on the skin. These then quickly join up to form largerpink, red or brown patches that can range from a few millimetres to several centimetres in size. Initially, these patches are often swollen, blistered (covered with small fluid-filled pockets) and ooze fluid. They also tend to be very itchy, particularly at night. Over time, the patches may become dry, crusty, cracked and flaky.The centre of the patch also sometimes clears, leaving a ring ofdiscoloured skin that can be mistaken for ringworm . You may just have one patch of discoid eczema, but most people have several patches. The skin between the patchesis often dry. Patches of discoid eczema can last for weeks, months or even years if not treated, and they can keeping recurring oftenin the same area that was affected previously. Occasionally, areas of skin affected by discoid eczema can be left permanently discoloured after the condition has cleared up. Discoid eczema can occur anywhere on the body, including the ankles. Source: https://dermnetnz.org/ Signs of an infection Patches of discoid eczema can sometimes become infected. Signs of an infection can include: the patches oozing a lot of fluid a yellow crust developing over the patches the skin around the patches becoming red, hot, swollen, and tender or painful feeling sick chills a general sense of feeling unwell When to seek medical advice You should see your GP or pharmacist if you think you may have discoid eczema, as the condition can take a long time to improve without treatment and it may keep recurring. You should also seek medical advice if you think your skin may be infected, as you may need to use antibiotic cream or, in very severe cases, take antibiotics tablets. Read more about diagnosing discoid eczema . Causes of discoid eczema The cause of discoid eczema is unknown, although it may occur as a result of having particularly dry skin. Dry skin means your skin cannot provide an effective barrier against substances that come into contact with it, which could allowa previously harmless substance, such as soap, to irritate (damage) your skin. Its important to look carefully at all the chemicals in cosmetics and toiletries that may have come into contact with your skin. Contact dermatitis, a type of eczema caused by coming into contact with a particular irritant, may therefore have a role in discoid eczema. Some people with discoid eczema also have a history of atopic eczema , which often occurs in people who are prone to asthma and hay fever . However, unlike atopic eczema, discoid eczema does not seem to run in families. Other possible triggers An outbreak of discoid eczema may sometimes be triggered by a minor skin injury, such as an insect bite or a burn . Some medicines may also be associated with discoid eczema, as patches of eczema can appear in people taking: interferon and ribavirin when they are used together to treat hepatitis C tumour necrosis factor-alpha (TNF-alpha) blockers which are used to treat some types of arthritis statins (cholesterol-lowering medication), which can cause dry skin and rashes Dry environments and cold climates can make discoid eczema worse and sunny or humid (damp) environments may make your symptoms better. Treating discoid eczema There is no simple cure for discoid eczema, but there are medications that can help ease the symptoms. These include: emollients to use all the time soap substitutes to replace irritating soaps and cleaning products topical corticosteroids for flare-ups oral corticosteroids for severe flare-ups antibiotics for infected eczema antihistamines for severe itching There are many different preparations for each type of medication and it is worth taking time with your pharmacist to find the best one for you. A range of emollient products, soap substitutes and some topical corticosteroids can be bought from pharmacies without a prescription. Some of them are cheaper to buy this way than with a prescription. Ask your pharmacist for advice on the different products and how to use them. See your GP if your eczema does not improve after using an over-the-counter preparation. Self-help There are also some self-help tipsthat may help to control symptoms of discoid eczema, such as: avoiding soaps and detergents, including liquid soaps, bubble bath, shower gels and wet wipes even if these do not obviously irritate your skin; you should use an emollient soap substitute instead protecting your skin from minor cuts (for example, by wearing gloves) as they may trigger discoid eczema taking daily lukewarm baths or showers using an emollient when washing may reduce your symptoms, and remember to apply your treatments soon afterwards not scratching the patches keeping your hands clean and your fingernails short may help reduce the risk of skin damage or infection from unintentional scratching making sure you use and apply your treatments as instructed by your GP or pharmacist If you suspect your skin is infected, for example because there is excessive weeping or tenderness in the patches of eczema, see your GP. Infection can spread quickly, and the use of topical corticosteroid creams can mask or further spread the infection. Emollients Emollients are moisturising treatments applied directly to the skin to reduce water loss and cover it with a protective film. They are often used to help manage dry or scaly skin conditions such as eczema. Choice of emollient Several different emollients are available. You may need to try a few to find one that works for you. You may also be advised to use a mix of emollients, such as: an ointment for very dry skin a cream or lotion for less dry skin an emollient to use instead of soap an emollient to add to bath water or use in the shower one emollient to use on your face and hands, and a different one to use on your body The difference between lotions, creams and ointments is the amount of oil they contain. Ointments contain the most oil so they can be quite greasy, but are the most effective at keeping moisture in the skin. Lotions contain the least amount of oil so are not greasy, but can be less effective. Creams are somewhere in between. Creams and lotions tend to be more suitable for red, inflamed (swollen) areas of skin. Ointments are more suitable for areas of dry skin that are not inflamed. If you have been using a particular emollient for some time, it may eventually become less effective or may start to irritate your skin. If this is the case, your GP will be able to prescribe another product. How to use emollients Use your emollient all the time, even if you are not experiencing symptoms as they can help limit the return of your condition. Many people find it helpful to keep separate supplies of emollients at work or school. To apply the emollient: use a large amount dont rub it in, smooth it into the skin in the same direction that the hair grows instead for very dry skin, apply the emollient every two to three hours after a bath or shower, gently dry the skin and then immediately apply the emollient while the skin is still moist If you are exposed to irritants at work, make sure you apply emollients regularly during and after work. Dont share emollients with other people. Side effects Occasionally, some emollients can irritate the skin. If you have discoid eczema, your skin will be sensitive and can react to certain ingredients in over-the-counter emollients. If your skin reacts to the emollient, stop using it and speak to your GP, who can recommend an alternative product. Emollients added to bath water can make your bath very slippery, so take care getting in and out of the bath. Topical corticosteroids To treat the patches of discoid eczema, your GP may prescribe a topical corticosteroid (corticosteroid medication that is applied directly to your skin) to reduce the inflammation. You may be concerned about using medication that contains steroids. However, corticosteroids are not the same as anabolic steroids, which are sometimes used by bodybuilders and athletes. When used as instructed by your pharmacist or doctor, corticosteroids are a safe and effective treatment for discoid eczema. Choice of topical corticosteroid There are different strengths of topical corticosteroids that can be prescribed depending on the severity of your eczema. Discoid eczema usually needs a stronger type of corticosteroid than other types of eczema. You might be prescribed a cream to be used on visible areas, such as face and hands, and an ointment to be used at night or for more severe flare-ups. How to use topical corticosteroids When using corticosteroids, apply the treatment accurately to the affected areas. Unless instructed otherwise by your doctor, you should follow directions on the patient information leaflet that comes with the corticosteroid. Do not apply the corticosteroid more than twice a day. Most people will only have to apply it once a day. To apply the topical corticosteroid, take the following steps: apply your emollient first and ideally wait around 30 minutes before applying the topical corticosteroid, until the emollient has soaked into your skin apply agood amount of the topical corticosteroid to the affected area use the topical corticosteroid until the inflammation has cleared up, unless otherwise advised by your GP Speak to your prescriber if you have been using a topical corticosteroid and your symptoms have not improved. Side effects Topical corticosteroids may cause a mild and short-lived burning or stinging sensation as you apply them. In rare cases, they may also cause: thinning of the skin changes in skin colour acne (spots) increased hair growth Most of these side effects will improve once treatment stops. Generally, using a stronger topical corticosteroid, or using a large amount of topical corticosteroid, will increase your risk of getting side effects. For this reason, you should use the weakest and smallest amount possible to control your symptoms. Corticosteroid tablets If you have a severe flare-up, your doctor may prescribe corticosteroid tablets to take for up to a week. If corticosteroid tablets are taken often or for a long time, they can cause a number of side effects, such as: reduced growth rate in children high blood pressure (hypertension) osteoporosis (brittle bones) diabetes For this reason, your doctor is unlikely to prescribe repeat courses of corticosteroid tablets without referring you to a specialist. Antibiotics If your eczema becomes infected, you may also be prescribed an antibiotic. Oral antibiotics If you have an extensive area of infected eczema, you may be prescribed an antibiotic to take by mouth. This is most commonly flucloxacillin, which is usually taken for one week. If you are allergic to penicillin, you might be given an alternative such as clarithromycin. Topical antibiotics If you have a small amount of infected eczema, you will normally be prescribed a topical antibiotic, such as fusidic acid. This meansthe medicine is applied directly to the affected area of skin, in the form of an ointment or cream. Some topical antibiotics are available in creams or ointments that also contain topical corticosteroids. Topical antibiotics should normally be used forup to 2weeks as necessary. Antihistamines Antihistamines are a type of medicine that work by stopping the effects of a substance in the blood called histamine. Your body often releases histamine when it comes into contact with an irritant. Histamine can cause a wide range of symptoms, including sneezing, watery eyes and itching. Antihistamines may be prescribed during flare-ups of discoid eczema to cope with the symptom of itching, particularly if it is interfering with your sleep. However, they will not treat the damaged skin. Many older types of antihistamines can make you drowsy, which can be useful if your symptoms affect the quality of your sleep. Otherwise, ask your pharmacist or GP to recommend one of the more modern non-sedating antihistamines. Further treatments If the treatments prescribed by your GP are not successfully controlling your symptoms, they may refer you for assessment and treatment by a dermatologist (specialist in treating skin conditions). Further treatments that may be available from your dermatologist include: phototherapy where the affected area of skin is exposed to ultraviolet (UV) light to help reduce inflammation bandaging where medicated dressings are applied to your skin immunosuppressant therapy medicines that reduce inflammation by suppressing your immune system Source: NHS 24 - Opens in new browser window Last updated: 09 November 2023 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Dont include personal information e.g. name, location or any personal health conditions. Email Address e.g. [email protected] Message Maximum of 500 characters Send feedback Add this page to\n Info For Me Also on NHS inform Varicose eczema Atopic eczema Other health sites National Eczema Society: discoid eczema BAD: discoid eczema BAD: atopic eczema Allergy UK: atopic eczema NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats 2023 NHS 24 v1.1.1.17852

Diverticular disease and diverticulitis

Diverticular disease | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotlands Service Directory 0 Home Illnesses and conditions Stomach, liver and gastrointestinal tract Diverticular disease and diverticulitis Diverticular disease and diverticulitis About diverticular disease and diverticulitis Symptoms of diverticular disease and diverticulitis Causes of diverticular disease and diverticulitis Diagnosing diverticular disease and diverticulitis Treating diverticular disease and diverticulitis Complications of diverticular disease and diverticulitis Preventing diverticular disease and diverticulitis About diverticular disease and diverticulitis Diverticular disease and diverticulitis are related digestive conditions that affect the large intestine (colon). Indiverticular disease,small bulges or pockets (diverticula) develop in the lining of the intestine. Diverticulitis is when these pocketsbecome inflamed or infected. Symptoms of diverticular disease include: lower abdominal pain feeling bloated The majority of people with diverticula will not have any symptoms; this is known as diverticulosis. Symptoms of diverticulitis tend to be more serious and include: more severe abdominal pain, especially on the left side high temperature (fever) of 38C (100.4F) or above diarrhoea or frequent bowel movements Read more about the symptoms of diverticular disease and diverticulitis . Diverticulosis, diverticular diseaseand diverticulitis Diverticula Diverticula is the medical term used to describe the small bulges that stick out of the side of the large intestine (colon). Diverticula are common and associated with ageing. The large intestine becomes weaker with age, and the pressure of hard stools passing through the large intestineis thought tocause the bulges to form. Read more about the causes of diverticula . Its estimated that5% of people have diverticula by the time they are 40 years old, and at least 50% of people have them by the time they are 80 years old. Diverticular disease 1in 4people who develop diverticula will experience symptoms, such as abdominal pain. Having symptoms associated with diverticula is known as diverticular disease. Diverticulitis Diverticulitis describes infection that occurs when bacteria becomes trapped inside one of the bulges, triggering more severe symptoms. Diverticulitis can lead to complications, such as an abscess next tothe intestine. Read more about the complications of diverticulitis . Treating diverticular disease and diverticulitis A high-fibre diet can often easesymptoms of diverticular disease, and paracetamol can be used to relieve pain other painkillers such as aspirin or ibuprofen are not recommended for regular use, as they can cause stomach upsets. Speak to your GP if paracetamol alone is not working. Mild diverticulitis can usually be treated at home with antibiotics prescribed by your GP. More serious cases may need hospital treatment to prevent and treat complications. Surgery to remove theaffected section of the intestine is sometimes recommended if there have been serious complications, although this is rare. Read more about treating diverticular disease and diverticulitis . Who is affected Diverticular disease is one of the most common digestive conditions. Both sexes are equally affected by diverticular disease and diverticulitis, although the condition is more likely to appear at a younger age (under 50) in men than in women. Overall, symptoms of diverticulitis are most likely to occur in people over 70 years old. Diverticular disease is often described as a Western disease because the rates are high in European and North American countries, and low in African and Asian countries. A combination of genetics and diet is thought to be the reason for this and the fact that people in Western countries tend toeat less fibre. People aged 50 to 70 who eat a high-fibre diet (25g a day) have a 40% lower chance of admission to hospital with complications of diverticular disease compared to others in their age range with the lowest amount of dietary fibre. Symptoms of diverticular disease and diverticulitis Symptoms of diverticular disease and diverticulitis include abdominal pain, bloating and a change in normal bowel habits. Diverticulosis If diverticula have been discovered during a camera test for another reason (colonoscopy) or during a CT scan, you may be worried about what this means. However, if you have never had abdominal pain or bouts of diarrhoea, there is a 70% to 80% chance that you will never have any symptoms from them. Diverticulaareextremely common over the age of 70 and they do not increase your risk of cancer.Its thought that a high-fibre diet is likely to reduce the risk of any symptoms developing. Diverticular disease The most common symptom of diverticular disease is intermittent (stop-start) pain in your lower abdomen (stomach), usually in the lower left-hand side. The pain is often worse when you are eating, or shortly afterwards. Passing stools and breaking wind (flatulence) may helprelieve the pain. Other long-term symptoms of diverticular disease include: a change in your normal bowel habits, such as constipation or diarrhoea , or episodes of constipation that are followed by diarrhoea a classic pattern is multiple trips to the toilet in the morning to pass stools like rabbit pellets bloating Another possible symptom of diverticular disease isbleeding dark purple blood from your rectum (back passage). This usually occurs after diarrhoea-like cramping pain, and often leads to hospital admission, but fortunately this isan uncommon complication. Diverticular disease does not cause weight loss, so if you are losing weight, seeing blood in your stools or experiencing frequent bowel changes, see your GP. Diverticulitis Diverticulitis sharesmost of the symptoms of diverticular disease (see above). However, thepain associated with diverticulitis is constant and severe, rather than intermittent. It is most likely to occur if you have previously had symptoms of diverticular disease, and develops over a day or 2. Other symptoms of diverticulitis can include: a high temperature (fever) of 38C (100.4F) or above a general feeling of being tired and unwell feeling sick (nausea) or being sick (vomiting) The pain usually starts below your belly button, before moving to the lower left-hand side of your abdomen. In Asian people, the pain may move to the lower right-hand side of your abdomen. This is because East Asian people tend to develop diverticula in a different part of their colon for genetic reasons. When to seek medical advice Contact your GP as soon as possible if you think you have symptoms of diverticulitis. If you have symptoms of diverticular disease and the condition has previously been diagnosed, you do not usually need to contact your GP asthe symptoms can be treated at home. Read more about the treatment ofdiverticular disease . If you have not been diagnosed with the condition, contact your GP so they can rule out other conditions with similar symptoms, such as: a stomach ulcer pancreatitis cholecystitis bowel cancer Irritable bowel syndrome (IBS) can also cause similar symptoms to diverticular disease. Causes of diverticular disease and diverticulitis Diverticular disease is caused by small bulges in the large intestine (diverticula) developing and becoming inflamed. If any of the diverticula become infected, this leads to symptoms of diverticulitis. The exact reason why diverticula develop is not known, buttheyare associated with not eating enough fibre. Fibre makes your stools softer and larger, so less pressure is needed by your large intestine to push them out of your body. The pressure of moving hard, small pieces of stools through yourlarge intestine creates weak spots in the outside layer of muscle. This allows the inner layer (mucosa)to squeeze through these weak spots, creating the diverticula. There is currently no clinical evidence to fully prove the link between fibre and diverticula. However, diverticular disease and diverticulitis are both much more common in Western countries, where many people do not eat enough fibre. Diverticular disease It is not known why only 1in 4people with diverticula go on to have symptoms of diverticulitis. Diverticular disease may be chronic low-level diverticulitis. The symptoms are very similar to irritable bowel syndrome (IBS) and may overlap. However,factors that appear to increase your risk of developing diverticular disease include: smoking being overweight or obese having a history of constipation use of non-steroidal anti-inflammatory drugs (NSAIDs) painkillers, such as ibuprofen or naproxen having a close relative with diverticular disease, especially if they developed it under the age of 50 Exactly how these lead to developing diverticular disease is unclear. Diverticulitis Diverticulitis is caused by an infection of one or more of the diverticula. It is thought an infection develops when a hard piece of stool or undigested foodgets trapped in one of the pouches. This gives bacteria in the stool the chance to multiply and spread, triggering an infection. Diagnosing diverticular disease and diverticulitis Diverticular disease can be difficult to diagnose from the symptoms, alone because there are other conditions that cause similar symptoms, such as irritable bowel syndrome (IBS) . As a first step, your GP may recommend blood tests to rule out other conditions such as coeliac disease (a condition caused by an abnormal immune response to gluten) or bowel cancer . In some cases, you may be offered treatment for IBS and diverticular disease at the same time. Colonoscopy To make sure there is not a more serious cause of your symptoms, your GP may refer you for a colonoscopy, where athin tube with a camera at the end (a colonoscope) is inserted into your rectum and guided into your colon. Before the procedure begins, you will be given a laxative to clear out your bowels. A colonoscopy is not usually painful,but itcan feel uncomfortable. You may beoffered painkilling medicationand asedative beforehand to make you feel more relaxed and helpreduce any discomfort. CT pneumocolon or colonography Another technique for confirming the presence of diverticula is a computerised tomography (CT scan) . A CT scan uses X-rays and a computer to create detailed images of the inside of the body. As with a colonoscopy, you will be given a laxative to clear out your bowels before you have the CT scan. Unlike a regular CT scan, the colonography scan involves a tube being inserted into your rectum, which is used topump some airup into your rectum. The CT scan is then taken with you lying on your front, and again lying on your back. You may need to have an injection of contrast dye before the scan, but this is not always necessary. Diverticulitis If you have had a previous history of diverticular disease, your GP will usually be able to diagnose diverticulitis from your symptoms and aphysical examination. A blood test may be taken, because a high number of white blood cells indicates infection. If your symptoms are mild, your GP will treat it at home and you should recover within 4days. Further tests will be needed if you have no previous history of diverticular disease. If you are unwell, your GP may refer you to hospital for blood tests and investigations. This is to look for complications of diverticulitis and to rule out other possible conditions, such as gallstones or a hernia. An ultrasound scan may be used, as well as a CT scan. A CT scan may also be used if your symptoms are particularly severe. This is to check whether a complication, such as a perforation or anabscess, has occurred. Treating diverticular disease and diverticulitis Treatment options for diverticular disease and diverticulitis depend on how severe your symptoms are. Diverticular disease Most cases of diverticular disease can be treated at home. The over-the-counter painkiller paracetamol is recommended to help relieve your symptoms. Painkillers known as non-steroidal anti-inflammatory drugs (NSAIDs), such as aspirin and ibuprofen, are not recommended because they may upset your stomach and increase your risk of internal bleeding. Eating a high-fibre diet may initially help to control your symptoms. Some people will notice an improvement after a few days, although it can take around a monthto feel the benefits fully. Read more advice about using diet to improve the symptoms ofdiverticular disease . If youhave constipation , you may be given a bulk-forming laxative. These can cause flatulence (wind) and bloating. Drink plenty of fluids to prevent any obstruction in your digestive system. Heavy or constant rectal bleeding occurs in about 1 in20 cases of diverticular disease. This can happen if the blood vessels in your large intestine (colon) are weakened by the diverticula, making them vulnerable to damage. The bleeding is usually painless, but losing too much blood can be potentially serious and may need a blood transfusion . Signs that you may be experiencing heavy bleeding (aside from the amount of blood) include: feeling very dizzy mental confusion pale clammy skin shortness of breath If you suspect that you (or someone in your care) is experiencing heavy bleeding, seek immediate medical advice. Contact your GP at once. If this is not possible then phone NHS 24 111 service or your local out-of-hours service . Diverticulitis Treatment at home Mild diverticulitis can often be treated at home. Your GP will prescribe antibiotics for the infection and you should take paracetamol for the pain.Its important that you finish the complete course of antibiotics, even if you are feeling better. Some types of antibiotics used to treat diverticulitis can cause side effects in some people, including vomiting and diarrhoea . Your GP may recommend that you stick to a fluid-only diet for a few days until your symptoms improve. This is because trying to digest solid foods may make your symptoms worse. Youcan gradually introduce solid foods over the next 2or 3days. For the 3to 4days of recovery, a low-fibre diet is suggested, until you return to the preventative high-fibre diet. This is to reduce the amount of faeces (poo) your large bowel has todeal withwhile it is inflamed. If you have not been diagnosed with diverticular disease before, your GP may refer you for a test such as acolonoscopy orCT colonographyafter the symptoms have settled. Treatment at hospital If you have more severe diverticulitis, you may need to go to hospital, particularly if: your pain cannot be controlled using paracetamol you are unable to drink enough fluids to keep yourself hydrated you are unable to take antibiotics by mouth your general state of health is poor you have a weakened immune system your GP suspects complications your symptoms fail to improve after 2 days of treatment at home If you are admitted to hospital for treatment, you are likelyto receive injections of antibiotics and be kept hydrated and nourished using an intravenous drip (a tube directly connected to your vein). Most people start to improve within 2to 3days. Surgery In the past, surgery was recommended as a preventative measure for people who had 2episodes of diverticulitis as a precaution to prevent complications. This is no longer the case, as studies have found that in most cases, risks of serious complications from surgery (estimated to be around 1 in 100) usually outweigh the benefits. However, there are exceptions to this, such as: if you have a history of serious complications arising from diverticulitis if you havesymptoms of diverticular disease froma young age (it is thought the longer you live with diverticular disease, the greater your chances of having a serious complication) if you have a weakened immune system or are more vulnerable toinfections If surgery is being considered, discuss bothbenefits and risks carefully with the doctor in charge of your care. In rare cases, a severe episode of diverticulitis can only be treated with emergency surgery. This is when a hole (perforation) has developed in the bowel. This is uncommon, but causes very severe abdominal pain, which needs an emergency trip to hospital. Colectomy Surgery for diverticulitis involves removing the affected section of yourlarge intestine. This is known as a colectomy. There are 2ways this operation can be performed: an open colectomy where the surgeon makes a large incision (cut) in your abdomen (stomach) and removes a section of yourlarge intestine laparoscopic colectomy a type of keyhole surgery where the surgeon makes a number of small incisions in your abdomen and uses special instrumentsguided by a camera to remove a section oflarge intestine Open colectomies and laparoscopic colectomies are thought equally effective in treating diverticulitis, and have a similar risk of complications. People who have laparoscopic colectomies tend to recover faster and have less pain after the operation. Emergency surgery when the bowel has perforated is more likely to be open and may result in a stoma being formed. Stoma surgery (having a bag) In some cases, the surgeon may decide yourlarge intestine needs to heal before it can be reattached, or that too much of yourlarge intestine has been removed to make reattachment possible. In such cases, stoma surgery provides a way of removing waste materials from your body without using all of yourlarge intestine. It is known as having a bag as a bag is stuck to the skin on your belly and the faeces (poo) are collected in the bag. Stoma surgery involves the surgeon making a small hole in your abdomen known as a stoma. There are 2ways this procedure can be carried out. An ileostomy where a stoma is made in the right-hand side of your abdomen. Your small intestine is separated from yourlarge intestine and connected to the stoma, and the rest of thelarge intestine is sealed. You will need to wear a pouch connected to the stoma to collect waste material (poo). A colostomy where a stoma is made in your lower abdomen and a section of yourlarge intestine is removed and connected to the stoma. As with an ileostomy, you will need to wear a pouch to collect waste material. In most cases, the stoma will be temporary and can be removed once yourlarge intestine has recovered from the surgery. This will depend on the situation when you had the operation. If it was an emergency operation, you may need a few months to recover before having surgery to reverse the stoma. If a large section of yourlarge intestine is affected by diverticulitis and needs to be removed, or if you have multiple other conditions that make major surgery a risk, you may need a permanent ileostomy or colostomy. Results of surgery In general terms, elective (non-emergency) surgery is usually successful, although it does not achieve a complete cure in all cases. Following surgery, an estimated 1 in 12 people will have a recurrence of symptoms of diverticular disease and diverticulitis. In an emergency setting, the success rate depends on how unwell you are when you require the operation. Complications of diverticular disease and diverticulitis Complications of diverticulitis affect 1in 5people with the condition. Those most at risk are aged under 50. Bleeding Around 15% of people with diverticular disease or diverticulitis experience bleeding,which is usually painless, quick and resolves itself in 70% to 80% of cases. However,if the bleeding does not resolve itself,an emergency blood transfusion may be required due to excessive bleeding. If the bleeding is severe, you may need to be admitted to hospitalfor monitoring. Urinary problems Diverticulitis can lead to the inflamed part of the bowelbeing in contact withthe bladder.This maycause urinary problems, such as: pain when urinating (dysuria) needing to urinate more often than usual in rare cases, air in the urine Abscess The most common complication of diverticulitis is an abscess outside the large intestine (colon). An abscess is a pus-filled cavity or lump in the tissue. Abscesses are usually treated with a technique known as percutaneous abscess drainage (PAD). A radiologist (a specialist in the use of imaging equipment, such as computerised tomography (CT) scans) uses an ultrasound or CT scanner to locate the site of the abscess. A fine needle connected to a small tube is passed through the skin of your abdomen (stomach) and into the abscess. The tube is then used to drain the pus from the abscess. A PAD is performed under a local anaesthetic. Depending on the size of the abscess, the procedure may need repeating several times before allthe pus has been drained. If the abscess is very small usually less than 4cm (1.5 inches) it may be possible to treat it using antibiotics . Fistula Afistula is anothercommon complication of diverticulitis. Fistulas are abnormal tunnels that connect 2parts of the body together, such as your intestine and your abdominal wall or bladder. If infected tissues come into contact with each other, they can stick together. After the tissues have healed, a fistula may form. Fistulas can be potentially serious as they can allow bacteria in your large intestine to travel to other parts of your body, triggering infections, such as an infection of the bladder ( cystitis ). Fistulas are usually treated with surgery to remove the section of the colon that contains the fistula. Peritonitis In rare cases, an infected diverticulum (pouch in your colon) can split, spreading the infection into the lining of your abdomen (perforation). An infection of the lining of the abdomen is known as peritonitis. Peritonitis can be life-threatening, and requires immediate treatment with antibiotics. Surgery may also be required todrain any pus that has built up, and it may be necessary to perform a colostomy . Intestinal obstruction If the infection has badly scarred yourlarge intestine, it may become partially or totally blocked. A totally blockedlarge intestine is a medical emergency because the tissue of yourlarge intestine will start to decay and eventually split, leading to peritonitis. A partially blockedlarge intestine is not as urgent, but treatment is still needed. If left untreated, it will affect your ability to digest food and cause you considerable pain. Intestinal blockage from diverticular disease is very rare. Other causes, such as cancer, are more common. This is one of the reasons your GP will investigate your symptoms. In some cases, the blocked partcan be removed duringsurgery. However, if the scarring and blockage is more extensive, a temporary or permanent colostomy may be needed. Preventing diverticular disease and diverticulitis Eating a high-fibre diet may help prevent diverticular disease, and should improve your symptoms. Your diet should be balanced and include at least 5portions of fruit and vegetables a day, plus whole grains. Adults should aim to eat 18g (0.6oz) to 30g (1.05oz) of fibre a day, depending on their height and weight. Your GP can provide a more specific target, based on your individual height and weight. Its recommended that you gradually increase your fibre intake over the course of a few weeks. This will help prevent side effects associated with a high-fibre diet, such as bloating and flatulence (wind). Drinking plenty of fluids will also help prevent side effects. If you have established diverticular disease, it may be suggested that you avoideatingnuts, corn and seedsdue tothe possibility thatthey could block the diverticular openings and cause diverticulitis. People usually find out themselves if these foods cause symptoms. Probiotics have also been recommended, but evidence is lacking. Overall, there is a lack of good quality scientific evidence on how to prevent diverticular disease. Sources of fibre Good sources of fibre include fruit vegetables nuts breakfast cereals but check fibre content as some are very low starchy foods such as brown bread, rice and pasta Once you have reached your fibre target, stick to it for the rest of your life, if possible. Fresh fruit Good sources of fibre in fresh fruit (plus the amount of fibre that is found in typical portions) include: avocado pear a medium-sized avocado pear contains 4.9g of fibre pear (with skin) a medium-sized pear contains 3.7g of fibre orange a medium-sized orange contains 2.7g of fibre apple (with skin) a medium-sized apple contains 2g of fibre raspberries 2handfuls of raspberries (80g) contain 2g of fibre banana a medium-sized banana contains 1.7g of fibre tomato juice 1small glass of tomato juice (200ml) contains 1.2g of fibre Dried fruit Good sources of fibre in dried fruit (plus the amount of fibre found in typical portions) include: apricots 3whole apricots contain 5g of fibre prunes 3whole prunes contain 4.6g of fibre Vegetables Good sources of fibre in vegetables (plus the amount of fibre found in typical portions) include: baked beans (in tomato sauce) a half can of baked beans (200g) contains 7.4g of fibre red kidney beans (boiled) 3tablespoons of red kidney beans contain 5.4g of fibre peas (boiled) 3heaped tablespoons of peas contain 3.6g of fibre French beans (boiled) 4heaped tablespoons of French beans contain 3.3g of fibre Brussel sprouts (boiled) 8Brussel sprouts contain 2.5g of fibre potatoes (old, boiled) 1medium-sized potato contains 2.4g of fibre spring greens (boiled) 4heaped tablespoons of Spring greens contain 2.1g of fibre carrots (boiled, sliced) 3heaped tablespoons of carrots contain 2g of fibre Nuts Good sources of fibre in nuts (plus the amount of fibre found in typical portions) include: almonds 20 almonds contain 2.4g of fibre peanuts (plain) a tablespoon of peanuts contains 1.6g of fibre mixed nuts a tablespoon of mixed nuts contains 1.5g of fibre Brazil nuts 10 Brazil nuts contain 1.4g of fibre Breakfast cereals Good sources of fibre in breakfast cereals (plus the amount of fibre found in typical portions) include: All-Bran a medium-sized bowl of All-Bran contains 9.8g of fibre Shredded Wheat 2pieces of Shredded wheat contain 4.3g of fibre Bran Flakes 1medium-sized bowl of Bran flakes contains 3.9g of fibre Weetabix 2Weetabix contain 3.6g of fibre muesli (no added sugar) 1medium-sized bowl of muesli contains 3.4g of fibre porridge (milk or water) 1medium-sized bowl of porridge contains 2.3g of fibre Note the own-brand equivalents of the cereals mentioned shouldcontain similar levels of fibre. Starchy foods Good sources of fibre in starchy food (plus the amount found in typical portions) include: crispbread 4crispbreads contain 4.2g of fibre pitta bread (wholemeal) 1piece (75g) contains 3.9g of fibre pasta (plain, fresh-cooked) 1medium portion of pasta (200g) contains 3.8g of fibre wholemeal bread 2slices of wholemeal bread contain 3.5g of fibre naan bread 1piece of naan bread contains 3.2g of fibre brown bread 2slices of brown bread contain 2.5g of fibre brown rice (boiled) 1medium portion of brown rice (200g) contains 1.6g of fibre Fibre supplements usually in the form of sachets of powder you mix with water are also available from pharmacists and health food shops. Some contain sweetener. A tablespoon of fibre supplement contains around 2.5g of fibre.If you require long-term fibre supplements, your GP can prescribe them. Source: NHS 24 - Opens in new browser window Last updated: 13 December 2023 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Dont include personal information e.g. name, location or any personal health conditions. Email Address e.g. [email protected] Message Maximum of 500 characters Send feedback Add this page to\n Info For Me Also on NHS inform Health benefits of eating well Self-help guide: Abdominal pain NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats 2023 NHS 24 v1.1.1.17852

Dizziness (Lightheadedness)

Dizziness (lightheadedness) - Illnesses & conditions Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotlands Service Directory 0 Home Illnesses and conditions Brain, nerves and spinal cord Dizziness (lightheadedness) Dizziness (lightheadedness) Dizziness (lightheadedness) is a common symptom thats not usually a sign of anything serious, but should beinvestigated by a doctor. The term dizziness means different things to different people some use it to describe feeling lightheaded or off balance, while others use it to describe a feelingthat their surroundings are spinning. Because thesymptom is quite vague and can be caused bya wide range of things, it may not always be easy to identify the underlying cause. Thispage explains what you should do if you feeldizzy for no apparent reason, and outlines the most common causes. When to seek help with dizziness Speak to your GP if you: are feeling lightheaded or off balance have fainting episodes experienceheadaches Your GP will want to establish exactly what you mean by dizziness, and check that youre not actually describing vertigo a severe type of dizziness,where you feel your surroundings are spinning or moving. Theyll also want to know: whether the dizziness started for no apparent reason, or if it followed an illness whether you have repeated episodes of dizziness and, if so, when you tend to experience these how long the dizziness lasts Dizziness can sometimes be caused by an ear condition. A simple way of distinguishing between ear-related dizziness and dizziness due to other causes is todetermine whether it occurs only when youre upright or also when youre lying down. If feeling dizzyoccurswhen youre upright its probably not related to the ear. If it happens when youre lying down, its usually caused by a viral ear infection, which cant be treated with antibiotics . Its a good idea to keep a diary recording when and where you feel dizzy and take it with you to your GP appointment. Its helpful to note: what you were doing at the time you felt dizzy how long it lasted and how bad it was whether you had any other symptoms such as fainting,vomiting, nausea, blurred vision, headache, hearing loss or tinnitus If youre taking prescription medicine, your GP will probably review this to check whether dizziness is a possible side effect. If necessary, they can prescribe a different medication for you to try. You may be referred to a specialist for further tests and investigations. Common causes of dizziness The most common causes are: labyrinthitis an inner ear infection that affects your hearing and balance, and can lead to a severe form of dizziness called vertigo migraine dizziness may come on before or after the headache, or even without the headache stress or anxiety particularly if you tend to hyperventilate (breathe abnormally quickly when resting) low blood sugar level (hypoglycaemia) which is usually seen in people with diabetes postural hypotension a sudden fall in blood pressure when you suddenly sit or stand up, which goes away after lying down. This is more common in older people dehydration orheat exhaustion dehydration could bedue to not drinking enoughduring exercise, or illness that causesvomiting, diarrhoea or fever vertebrobasilar insufficiency decreased blood flow in the back of the brain, which may be caused by the blood vessels that lead to the brain from the heart being blocked (known as atherosclerosis) Less common causes of dizziness Less common causes include: having a severe illness or condition that affects the whole body using recreationaldrugsor consuming excessive amounts of alcohol (either binge drinking or long-term alcohol misuse ) certain types of prescription medicine such as antidepressants or blood pressure medication having aheart rhythm problem such as atrial fibrillation (a fast, irregular heartbeat) carbon monoxide poisoning Source: NHS 24 - Opens in new browser window Last updated: 07 March 2024 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Dont include personal information e.g. name, location or any personal health conditions. Email Address e.g. [email protected] Message Maximum of 500 characters Send feedback Add this page to\n Info For Me Also on NHS inform Labyrinthitis Headaches Self-help guide: Headache Other health sites Brain and Spine Foundation: Dizziness and balance problems NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats 2023 NHS 24 v1.1.1.17852

Downs syndrome

"Down's syndrome - Illnesses & conditions | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotlands Service Directory 0 Home Illnesses and conditions Downs syndrome Downs syndrome A babywith Downs syndrome is born with more of chromosome 21 in some or all of the cells that make up their DNA. Its also known as Trisomy 21. People with Downs syndrome may lead active, healthy and independent lives into their 60s, 70s and beyond. Most will have mild to moderate learning disabilities and some may have more complex needs. It cannot be known before birth if a person will need any additional help and support. Living with Downs syndrome There are increasing opportunities and support in education, work and housing for people with Downs syndrome. People with Downs syndrome canlive healthy and fulfilling lives as part of their families and communities. Some may: live independently have jobs be in relationships socialise with minimal support. Evidence suggests most families of people with the condition feel satisfied with their lives. Many children with Downs syndrome attend mainstream school and receive additional support if they need it. Congenital and rare condition register Babies with Downs syndrome are included in the secure congenital and rare condition (CARDRISS) register. The register is maintained by Public Health Scotland. The register records how many babies have this condition, and some relevant personal information. Its also used to support the planning and improvement of health, care, and other public services. Read more about CARDRISS Downs syndrome and health Many children with Downs syndrome have similar health conditions to all children. Some health conditions can be more common in people with Downs syndrome, but some are less common. Around half of all children with Downs syndrome will have heart issues, although fewer than 1 in 5 of those may need surgery. Theyre more likely to have muscle tone and digestion issues and may have reduced hearing or vision. However, theyre less likely to develop some cancers and types of heart disease. Regular health checks can make sure any health conditions are picked up early and managed. Downs syndrome is not a life-limiting condition. People with the condition can lead active, healthy and fairly independent lives into their 60s, 70s and beyond. Screening for Downs syndrome During your pregnancy youll be offered a screening test to detect if your baby might have Downs syndrome. All pregnant women, no matter what age, can be tested. A blood test and nuchal translucency (NT) scan can be used to screen for this condition. Further information You can get more information about Downs syndromeand find out about life with a child with the condition at Downs Syndrome Scotland . Source:\r\n Down's Syndrome Scotland - Opens in new browser window Last updated: 21 February 2024 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Dont include personal information e.g. name, location or any personal health conditions. Email Address e.g. [email protected] Message Maximum of 500 characters Send feedback Add this page to\n Info For Me NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats 2023 NHS 24 v1.1.1.17852"

Dry mouth

Dry mouth | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotlands Service Directory 0 Home Illnesses and conditions Mouth Dry mouth Dry mouth Its normal to occasionally have a dry mouth if youre dehydrated or feeling nervous. A persistently dry mouth can be a sign of an underlying problem though. Contact your dentist or GP if: You have a dry mouth and: your mouth is still dry after trying home or pharmacy treatments for a few weeks you have difficulty chewing, swallowing or talking youre struggling to eat regularly youre having problems with your sense of taste that are not going away your mouth is painful, red, swollen or bleeding you have sore white patches in your mouth you think a prescribed medicine might be causing your dry mouth you have other symptoms, like needing to pee a lot or dry eyes The GP can check what the cause might be and recommend treatment for it. What can cause a dry mouth? A dry mouth can happen when the salivary glands in your mouth do not produce enough saliva. This is often the result of dehydration . This means you do not have enough fluid in your body to produce the saliva you need. Its also common for your mouth to become dry if youre feeling anxious or nervous. A dry mouth can sometimes be caused by an underlying problem or medical condition, such as: medication many different medications can cause a dry mouth including antidepressants , antihistamines and diuretics a blocked nose breathing through your mouth while you sleep can cause it to dry out diabetes a lifelong condition that causes a persons blood sugar level to become too high radiotherapy to the head and neck this can cause the salivary glands to become inflamed (mucositis) Sjgrens syndrome a condition where the immune system attacks and damages the salivary glands If you contact your dentist or GP, tell them about any other symptoms youre experiencing. Also tell them about any treatments youre having. This will help them work out why your mouth is dry. What problems can a dry mouth cause? Saliva plays an important role in keeping your mouth healthy. If you have a dry mouth, you may experience some other problems, such as: a burning sensation or soreness in your mouth dry lips bad breath (halitosis) a reduced or altered sense of taste mouth infections that keep coming back, such as oral thrush tooth decay and gum disease difficulty speaking, eating or swallowing Its important to maintain good oral hygiene if you have a dry mouth. This can reduce the risk of dental problems. You should also see a dentist regularly, so they can identify and treat any problems early on. Treating a dry mouth If your doctor or dentist is able to find out whats causing your dry mouth, treating this may help your symptoms. If medication is suspected as a cause, for example, your doctor may lower your dose or suggest trying a different treatment. Some of the conditions mentioned have specific treatments, like: nasal decongestants for a blocked nose insulin for diabetes Things to try yourself There are things you can do to help relieve your symptoms. Do drink plenty of cold water take regular sips during the day and keep some water by your bed at night suck on ice cubes or ice lollies sip on cold unsweetened drinks chew sugar-free gum or suck on sugar-free sweets use lip balm if your lips are also dry brush your teeth twice a day and use alcohol-free mouthwash youre more likely to get tooth decay if you have a dry mouth Dont do not drink lots of alcohol, caffeine (such as tea and coffee) or fizzy drinks do not eat foods that are acidic (like lemons), spicy, salty or sugary do not smoke do not sleep with dentures in do not use acidic artificial saliva products if you have your own teeth do not stop taking a prescribed medicine without getting medical advice first even if you think it might be causing your symptoms Saliva substitutes and stimulants If the measures above dont help, your dentist, GP or specialist may suggest using an artificial saliva substitute. An artificial saliva substitute will help keep your mouth moist. This may come in the form of a spray, gel or lozenge. Use it as often as you need to, including before and during meals. If your dry mouth is caused by radiotherapy or Sjgrens syndrome, a medication called pilocarpine may be prescribed. This is taken as a tablet several times a day. It helps to stimulate your salivary glands to produce more saliva. Source: NHS 24 - Opens in new browser window Last updated: 05 December 2023 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Dont include personal information e.g. name, location or any personal health conditions. Email Address e.g. [email protected] Message Maximum of 500 characters Send feedback Add this page to\n Info For Me NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats 2023 NHS 24 v1.1.1.17852

Dysphagia (swallowing problems)

Dysphagia (swallowing problems) | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotlands Service Directory 0 Home Illnesses and conditions Stomach, liver and gastrointestinal tract Dysphagia (swallowing problems) Dysphagia (swallowing problems) About dysphagia Causes of dysphagia Diagnosing dysphagia Treating dysphagia Complications of dysphagia About dysphagia Dysphagia is the medical term for swallowing difficulties. Some people with dysphagia have problems swallowing certain foods or liquids, while others cant swallow at all. Other signs of dysphagia include: coughing or choking when eating or drinking bringing food back up, sometimes through the nose a sensation that food is stuck in your throat or chest persistent drooling of saliva Over time, dysphagia can also cause symptoms such as weight loss and repeated chest infections. You should see your GP if you have swallowing difficulties. What causes dysphagia? Dysphagia is usually caused by another health condition, such as: a condition that affects the nervous system, such as a stroke , head injury ,or dementia cancer such as mouth cancer or oesophageal cancer gastro-oesophageal reflux disease(GORD) where stomach acid leaks back up into theoesophagus Dysphagia can also occur in childrenasthe result of a developmental or learning disability. Dysphagia can be caused by problems with the: mouth or throat, known as oropharyngeal or high dysphagia oesophagus (the tube that carries food from your mouth to your stomach), known as oesophageal or low dysphagia Read more about the causes of dysphagia . Treating dysphagia Treatment usually depends on the cause and type of dysphagia. The type of dysphagia you have can usually be diagnosed after testing your swallowing ability and examining your oesophagus. Many cases of dysphagia can be improved with treatment, but a cure isnt always possible. Treatments for dysphagia include: speech and language therapy to learn new swallowing techniques changing the consistency of food and liquids to make them safer to swallow alternative forms of feeding, such as tube feeding through the nose or stomach surgery to widen the narrowing of the oesophagus by stretching it or inserting a plastic or metal tube (known as a stent) Read more about diagnosing dysphagia and treating dysphagia . Complications of dysphagia Dysphagia can sometimes lead to further problems. One of the most common problems is coughing or choking when foodgoes down the wrong way and blocks your airway. If this occurs frequently, you may avoid eating and drinkingbecause you fearchoking, whichcan lead to malnutrition and dehydration . Some people with dysphagia have a tendency to develop chest infections, such as aspiration pneumonia , which require medical treatment. Dysphagia can also affect your quality of lifeas it may preventyou enjoying meals and social occasions. Read more about the complications of dysphagia . Causes of dysphagia As swallowing is a complex process, there are many reasons why dysphagia can develop. Neurological causes The nervous system is made up of the brain, nerves and spinal cord. Damage to the nervous system can interfere with the nerves responsible for starting and controlling swallowing. This can lead to dysphagia. Some neurological causes of dysphagia include: a stroke neurological conditions that cause damage to the brain and nervous system over time,including Parkinsons disease , multiple sclerosis , dementia ,and motor neurone disease brain tumours myasthenia gravis a rare condition that causes your muscles to become weak Congenital and developmental conditions The term congenital refers to something youre born with. Developmental conditions affect the way you develop. Congenital or developmental conditions that may cause dysphagia include: learning disabilities where learning, understanding, and communicating are difficult cerebral palsy a group of neurological conditions that affect movement and co-ordination a cleft lipandpalate a common birth defect that results in a gap or split in the upper lip or roof of the mouth Obstruction Conditions that cause an obstruction in the throat or a narrowing of the oesophagus(the tube that carries food from your mouth to the stomach)can make swallowing difficult. Some causes of obstruction and narrowing include: mouth cancer or throat cancer, such as laryngeal cancer or oesophageal cancer once these cancers are treated, the obstruction may no longer be an issue pharyngeal (throat) pouches, also known as Zenker diverticulum where a large sac develops in the upper part of the oesophagus, which reduces the ability to swallow both liquids and solids;its a rare condition that mainly affects older people eosinophilic oesophagitis where a type of white blood cell known as an eosinophilbuilds up in the lining of the oesophagus as the result of a reaction to foods, allergens, or acid reflux; the build-up damages the lining of the oesophagus and causes swallowing difficulties radiotherapy treatment thiscan cause scar tissue, which narrows the passageway in your throat and oesophagus gastro-oesophageal reflux disease(GORD) stomach acid can cause scar tissue to develop, narrowing your oesophagus infections, such as tuberculosis or thrush thesecan lead to inflammation of the oesophagus (oesophagitis) Muscular conditions Any condition that affects the muscles used to push food down the oesophagus and into the stomach can cause dysphagia,althoughsuch conditions are rare. 2muscular conditions associated with dysphagia are: scleroderma where the immune system (the bodys natural defence system) attacks healthy tissue, leading to a stiffening of the throat and oesophagus muscles achalasia where muscles in the oesophagus lose their ability to relax and open to allow food or liquid to enter the stomach Other causes As you get older, themusclesused for swallowing can become weaker. This may explain why dysphagia is relatively commonin elderly people. Treatment is available to help people with age-related dysphagia. Chronic obstructive pulmonary disease(COPD) is a collection of lung conditions that make it difficult to breathe in and out properly. Breathing difficulties can sometimes affect your ability to swallow. Dysphagia can also sometimes develop as a complication of head or necksurgery. Diagnosing dysphagia See your GP if youre having any difficulty swallowing. Theyll carry out an initial assessment and may refer you for further tests and treatment. Tests will help determine whether your dysphagia isthe result ofa problem with your mouth or throat (oropharyngeal, or high dysphagia), or your oesophagus, the tube that carries food from the mouth to the stomach (oesophageal, or low dysphagia). Diagnosing the specific type of dysphagia can make treatment more effective and reduce your chances of developing complications of dysphagia , such as choking or pneumonia . Your GP will want to know: how long youve had dysphagia whether your symptoms come and go, or are getting worse whether dysphagia has affected your ability to swallow solids, liquids, or both whether youve lost weight Specialist referral Depending on the suspected cause,you may be referred for further tests with: an ear, nose and throat (ENT) specialist a speech and language therapist (SLT) a neurologist a specialist in conditions that affect the brain, nerves, and spinal cord a gastroenterologist a specialist in treating conditions of the gullet, stomach, and intestines a geriatrician a specialist in the care of elderly people Water swallow test A water swallow testis usually carried out by a speech and language therapist, andcangive a good initial assessment of your swallowing abilities. Youll be given 150ml of water and asked to swallow it as quickly as possible. The timeit takes you to drink all of the water and the number of swallows required will be recorded. You may also be asked to swallow a soft piece of pudding or fruit. Videofluoroscopy A videofluoroscopy, or modified barium swallow, is one of the most effective ways of assessing your swallowing ability and finding exactly where the problem is. An X-ray machine records a continuous moving X-ray on to video, allowing your swallowing problems to be studied in detail. Youll be asked to swallow different types of food and drink of different consistencies, mixed with a non-toxic liquid called barium that shows up on X-rays. A videofluoroscopy usually takes about 30 minutes. You may feel sick after the test, and the barium may cause constipation . Your stools may also be white for a few days as the barium passes through your system. Nasoendoscopy A nasendoscopy, sometimes also known as fibreoptic endoscopic evaluation of swallowing (FEES),is a procedure that allows the nose and upper airways to be closely examined usinga very small flexible tube known as an endoscope. The endoscope is inserted into your nose so the specialist can look down on to your throat and upper airways. It has a light and camera at the end so images of the throat can be viewed on a television screen. This allows any blockages or problem areas to be identified. FEES can also be used to test for oropharyngeal dysphagia after youre asked to swallow a small amount of test liquid (usually coloured water or milk). Before the procedure, you may have local anaesthetic spray into your nose, but because the camera doesnt go as far as your throat, it doesnt cause retching. The procedure is safe and usually only takes a few minutes. Manometry and 24-hour pH study Manometry is a procedure to assess the function of your oesophagus. It involves passing a smalltube (catheter) with pressure sensors through your nose and into your oesophagus to monitor its function. The test measures the pressureswithin youroesophagus when you swallow, which determines how well its working. The 24-hour pH study involves inserting a tube into your oesophagus through your nose to measure the amount of acid that flows back from your stomach. Thiscan help determine the cause of any swallowing difficulties. Diagnostic gastroscopy Diagnostic gastroscopy, also known as diagnostic endoscopy of the stomach,or oesophagogastroduodenoscopy (OGD), is an internal examination using an endoscope. The endoscopeis passed down your throat and into your oesophagus, and images of the inside of your body are transmitted to a television screen. It can often detect cancerous growths or scar tissue. Read more about treating dysphagia . Nutritional assessment If dysphagia has affected your ability to eat, you may need a nutritional assessment to check that youre notlacking nutrients (malnourished) . This could involve: measuring your weight calculating your body mass index (BMI) to check whether youre a healthy weight for your height carrying out blood tests Treating dysphagia Most swallowing problems can be treated, although the treatment you receive will depend on the type of dysphagia you have. Treatment will depend on whether your swallowing problemis in the mouth or throat (oropharyngeal, or high dysphagia), or in the oesophagus (oesophageal, or low dysphagia). The cause of dysphagia is also considered when deciding on treatment. In some cases, treating the underlying cause, such as mouth cancer or oesophageal cancer ,can help relieve swallowing problems. Treatment for dysphagia may be managed by agroup of specialists known as a multidisciplinary team (MDT). Your MDT may includea speech and language therapist (SLT), a surgeon, and a dietitian. High (oropharyngeal) dysphagia High dysphagia is swallowing difficulties caused by problems with the mouth or throat. It can be difficult to treat if its caused by a condition thataffects the nervous system.This is because these problems cant usually be corrected using medication or surgery. There are 3main treatmentsfor high dysphagia: swallowing therapy dietary changes feeding tubes Swallowing therapy You may be referred to a speech and language therapist (SLT) for swallowing therapy if you have high dysphagia. An SLT is a healthcare professional trained to work with people with feeding or swallowing difficulties. SLTs use a range of techniques that can be tailoredfor your specific problem, such asteaching you swallowing exercises. Dietary changes You may be referred to a dietitian (specialist in nutrition)for advice about changes to your diet to make sureyou receive a healthy, balanced diet. An SLTcan give you advice aboutsofter foods and thickened fluids that you may find easier to swallow. They may also try to ensure youre getting the support you need at meal times. Feeding tubes Feeding tubes can be used to provide nutrition while youre recovering your ability to swallow. They may also be required in severe cases of dysphagia that put you at risk of malnutrition and dehydration . A feeding tubecan also make it easier for you to take the medication you may need for other conditions. There are 2types of feeding tubes: a nasogastric tube a tube that is passed down your nose and into your stomach a percutaneous endoscopic gastrostomy (PEG) tube a tube that is implanted directly into your stomach Nasogastric tubes are designed for short-term use. The tube will need to be replaced and swapped to the other nostril after about a month. PEG tubes are designed for long-term use and last several months before they need to be replaced. Most people with dysphagia prefer to use a PEG tube because it can be hidden under clothing. However, they carry a greater risk of complications comparedwith nasogastric tubes. Minor complications of PEG tubes include tube displacement, skin infection, and a blocked or leaking tube. 2major complications of PEG tubes are infection and internal bleeding. Resuming normal feeding may be more difficult with a PEG tube compared with using a nasogastric tube. The convenience of PEG tubes can make people less willing to carry out swallowing exercises and dietary changes than those whouse nasogastric tubes. You should discuss the pros and cons of both types of feeding tubes with your treatment team. Low (oesophageal) dysphagia Low dysphagia is swallowing difficultiescaused byproblems with the oesophagus. Medication Depending on the cause of low dysphagia, it may be possible to treat it with medication. For example, proton pump inhibitors (PPIs) used to treat indigestion may improve symptoms caused by narrowing or scarring of the oesophagus. Botulinum toxin Botulinum toxincan sometimes be used to treat achalasia. This is a condition where the muscles in the oesophagus become too stiff to allow food and liquid to enter the stomach. It can be used to paralyse the tightened muscles that prevent food from reaching the stomach. However, the effects only last for around 6months. Surgery Other cases of low dysphagia can usually be treated with surgery. Endoscopic dilatation Endoscopic dilation is widely used to treat dysphagia caused by obstruction. Itcan also be used to stretch youroesophagus if its scarred. Endoscopic dilatation will be carried out during aninternal examination of your oesophagus (gastroscopy)using an endoscopy. An endoscope is passed down your throat and into youroesophagus, andimages of the inside of your body are transmitted to a television screen. Using the image as guidance, a small balloon or a bougie (a thin, flexible medical instrument) is passed through the narrowed part of your oesophagus to widen it. If a balloon is used, it will be gradually inflated to widen your oesophagus before being deflated and removed. You may be given a mild sedative before the procedure to relax you. Theres a small risk that the procedurecould cause a tear or perforate youroesophagus. Inserting a stent If you have oesophageal cancer that cant be removed, its usually recommended that you have astent inserted instead of endoscopic dilatation. This is because, if you have cancer,theres a higher risk of perforating your oesophagus if its stretched. A stent (usually a metal mesh tube)is insertedinto youroesophagus during an endoscopy or under X-ray guidance. The stent then gradually expands to create a passage wide enough to allow food to pass through. Youll need to follow a particular diet to keep the stent open without havingblockages. Congenital dysphagia If your baby is born with difficulty swallowing (congenital dysphagia), their treatment will depend on the cause. Cerebral palsy Dysphagia caused by cerebral palsycan be treated with speech and language therapy. Your child will be taught how to swallow, how to adjust the type of food they eat, and how to use feeding tubes. Cleft lip and palate Cleft lip and palateis a facial birth defect that can cause dysphagia. Its usually treated with surgery. Narrowing of the oesophagus Narrowing of the oesophagus may be treated with a type of surgery called dilatation to widen the oesophagus. Gastro-oesophageal reflux disease (GORD) Dysphagia caused by gastro-oesophageal reflux disease (GORD) can be treated using special thickened feeds instead of your usual breast or formula milk. Sometimes medication may also be used. Breastfeeding or bottle feeding If youre having difficulty bottle feeding or breastfeeding your baby, see your midwife, health visitor or GP. Complications of dysphagia The main complication of dysphagia is coughing and choking, which can lead to pneumonia. Coughing and choking If you have dysphagia, theres a risk of food, drink or saliva going down the wrong way. It can block your airway, making it difficult to breathe and causing you to cough or choke. Read more information and advice about what to do if someone is choking . If you have dysphagia, you may alsodevelop a fear of choking. However, its very importantyou dont avoideating and drinking, as it could cause dehydration and malnutrition . If you often choke on your foodbecause ofdysphagia, you may also be at an increased risk of developing acondition called aspiration pneumonia . Aspiration pneumonia Aspiration pneumonia is a chest infection that can develop after accidentally inhaling something, such as a small piece of food. It causes irritation in the lungs, or damages them. Older people are particularly at risk of developing aspiration pneumonia. The symptoms of aspiration pneumonia include: a cough this may be a drycough, or you may produce phlegm thats yellow, green, brown, or bloodstained a high temperature of 38C (100.4F) or over chest pain difficulty breathing your breathing may be rapid and shallow and you may feel breathless, even at rest Contact your treatment teamimmediately if youre being treated for dysphagia and you develop these symptoms. If this isnt possible, contact your local out-of-hours service or phone NHS 24 111 service . Symptoms of aspiration pneumonia can range from mild to severe, and it is usually treated with antibiotics . Severe cases will require hospital admission and treatment with intravenous antibiotics (through a drip). Read more about treating pneumonia . In particularly old orfrail people, theres a chance the infection could lead to their lungs becoming filled with fluid, preventing them working properly. This is known asacute respiratory distress syndrome (ARDS). Your chances of developing pneumonia as a result ofdysphagia are higher if you havea weakened immune system, chronic obstructive pulmonary disease (COPD) , or if your oral and dental hygiene is poor. Dysphagia in children If children with long-term dysphagiaarent eating enough, they may not get the essential nutrients they need for physical and mental development. Children who have difficulty eating may also find meal times stressful, which may lead to behavioural problems. Source: NHS 24 - Opens in new browser window Last updated: 13 December 2023 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Dont include personal information e.g. name, location or any personal health conditions. Email Address e.g. [email protected] Message Maximum of 500 characters Send feedback Add this page to\n Info For Me Also on NHS inform Gastro-oesophageal reflux disease (GORD) Other health sites The Stroke Association: Life after stroke NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats 2023 NHS 24 v1.1.1.17852

Dystonia

"Dystonia | NHS inform | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotlands Service Directory 0 Home Illnesses and conditions Brain, nerves and spinal cord Dystonia Dystonia Dystonia is a neurological movement disorder. People with dystonia experience involuntary muscle spasms and contractions. Movements are often repetitive and cause unusual, awkward and sometimes painful postures. Tremor (shaking) is often associated with some types of dystonia. Dystonia can be a condition on its own (primary dystonia). Some people experience dystonia as a symptom of another condition (secondary dystonia). Symptoms of dystonia Symptoms of dystonia can include: uncontrolled muscle spasms parts of your body twisting into unusual positions like your neck being pulled to the side or your feet turning inwards shaking (tremors) excessive blinking The symptoms may be continuous or come and go. They may be triggered by voluntary movements. Types of dystonia There are different types of dystonia. Generalised dystonia Generalised dystonia affects all parts of the body. Focal dystonia If you have focal dystonia, only one muscle group is affected. The most common type of focal dystonia is neck dystonia, also known as cervical dystonia. This usually causes the head to be pulled in one direction. This can then affect movement and cause pain. Other types of focal dystonia can impact: your voice (laryngeal dystonia) the muscles around your eyes (blepharospasm) limbs (like writers cramp) Causes of dystonia Dystonia is thought to be caused by a problem with the part of the brain that controls movement. Primary and secondary dystonia may have different underlying causes. Causes of primary dystonia Primary dystonia often begins in childhood. This type of dystonia is more likely to have a recognised genetic cause. Causes of secondary dystonia You might experience dystonia as a symptom of another condition. Secondary dystonia might be caused by: Parkinsons disease cerebral palsy certain medications (like some antipsychotics and some anti sickness medications) injury to the brain stroke Diagnosing dystonia If your GP thinks you have dystonia, they may refer you to a specialist neurologist. You may need to have tests to confirm whether you have primary or secondary dystonia. Depending on your symptoms, you might have a blood test or scan. Treating dystonia There are treatments that can control the involuntary movements and spasms of dystonia. You might need to try several treatment options to find out which one works best. Botulinum toxin If you have focal dystonia, you might be offered botulinum toxin. Botulinum toxin is injected into the affected muscles. It blocks the neurotransmitters within the nerve, reducing muscle spasms. The effects of the injection can last from around 3 months to 6 months. Medication Oral medications, like tablets, can be effective for some people with generalised dystonia. The following are medications which might be used to treat dystonia: anticholinergics baclofen muscle relaxants Physiotherapy Depending on the type of dystonia you have, physiotherapy might help you improve your range of movement. Surgery You might have surgery if your dystonia symptoms dont improve with other treatments. Deep brain stimulation (DBS) Deep brain stimulation (DBS) is a type of brain surgery. Its offered to some people with dystonia where other treatments havent been successful. The surgeon will place a small device, like a pacemaker, under the skin of your chest or tummy. The device sends electrical signals along wires placed in the part of the brain that controls movement. Itll be several weeks or months before you begin to feel the benefit of DBS. Read more about deep brain stimulation Source:\r\n Scottish Government - Opens in new browser window Last updated: 07 March 2024 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Dont include personal information e.g. name, location or any personal health conditions. Email Address e.g. [email protected] Message Maximum of 500 characters Send feedback Add this page to\n Info For Me Also on NHS inform Parkinson's disease Other health sites Dystonia UK NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats 2023 NHS 24 v1.1.1.17852"

Earache

Earache | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotlands Service Directory 0 Home Illnesses and conditions Ears, nose and throat Earache Earache Return to Symptoms Enter age Last Updated: Next Review Date: Review my answers Find your local services Search for a service near you by entering your postcode below. Please input your postcode in the following format: A12 1BC GP Practices Dental Services Pharmacies Opticians Postcode Search NHS inform has more information on this condition. Read more Previous Start guide Review my answers You told us your credentials were: : You said: Based on the information you gave us, we made the following recommendation: Close Keep a copy View PDF Earache is a common problem, particularly in children. It can be worrying, but its usually only caused by a minor infection and will often get better in a few days without treatment. Earache can be a sharp, dull or burning ear pain that comes and goes or is constant. One or both ears may be affected. Earache self-help guide Complete our self-help guide to check your symptoms and find out what to do next. When to get medical advice You do not always need to see a GP as earache will usually get better on its own within a few days. Speak to your pharmacist for advice and treatment if you have earache. Your pharmacist may recommend that you speak to your GP practice if required. Find your nearest pharmacy Speak to your GP practice if: You or your child have earache and: a high temperature (fever) vomiting a severe sore throat hearing loss swelling around the ear discharge from the ear there is something stuck in your or your childs ear the earache doesnt improve within a few days your child is under 2 and has earache in both ears If your GP practice is closed, phone 111. Speak to your GP practice if: You or your child: have earache for more than 3 days keep getting earache Treatment for earache Do ask your pharmacist about using over-the-counter painkillers such as paracetamol or ibuprofen , or eardrops to treat the pain place a warm flannel against the affected ear Dont do not use eardrops or olive oil drops if the eardrum has burst If you or your child has an ear infection, you should avoid putting objects in the ear, such as cotton buds, or getting the affected ear wet. Common causes of earache Ear infections If the cause of earache is an ear infection, there may be a watery or pus-like fluid coming out of the ear. Outer ear infections (infections of the tube connecting the outer ear and eardrum) and middle ear infections (infections of the parts of the ear behind the eardrum) are very common causes of earache. Many ear infections clear up on their own without treatment in a few days or weeks, but in some cases your GP may prescribe eardrops or antibiotics . Glue ear Glue ear (also known as otitis media with effusion, or OME) is a build-up of fluid deep inside the ear, which commonly causes some temporary hearing loss . The condition tends to be painless, but sometimes the pressure of this fluid can cause earache. Glue ear will often clear up on its own, although this can take a few months. If the problem is persistent, a minor procedure to place small tubes called grommets in the ear may be recommended to help drain the fluid. Read more about glue ear Damage to the ear Earache can sometimes result from injury to the inside of the ear. For example, by scraping earwax from the ear canal using a cotton bud, or poking a cotton bud too far into your ear, which can puncture the eardrum. The ear canal is very sensitive and can easily become damaged. The ear should heal on its own without treatment, but it can take up to 2 months for a perforated eardrum to heal. If you have a perforated eardrum, eardrops shouldnt be used. Earwax or an object in the ear A build-up of earwax or an object stuck inside the ear can sometimes cause earache. If there is something in your or your childs ear that seems be causing pain, dont attempt to remove it yourself. You may push it further inside and you may damage the eardrum. If you have a build-up of earwax in your ear, your pharmacist will be able to recommend eardrops to soften it so it falls out naturally. In some cases, your GP will organise for removal of the wax (once softened with eardrops) by flushing the ear with water. This is known as ear irrigation. If there is an object in the ear, your GP may need to refer you or your child to a specialist to have it removed. Throat infections If you find it painful to swallow and you have a sore throat, your earache could be a symptom of a throat infection such as tonsillitis or quinsy. Quinsy is an abscess on the back of your throat, which can sometimes make it very difficult to swallow. Some types of tonsillitis will clear up after a few days without the need for antibiotics . But if you have quinsy, you will need to see your GP as soon as possible for treatment. You may have quinsy if your sore throat gets worse very quickly. A problem with your jaw Earache is occasionally caused by a problem with the joint of your jaw bone (where the jaw meets the skull). This is known as temporomandibular joint pain and can be caused by problems such as arthritis or teeth grinding. Jaw pain can often be treated with painkillers, warm or cold compresses, and trying not to clench your jaw and grind your teeth. A dental abscess A dental abscess is a collection of pus that can form in your teeth or gums as a result of a bacterial infection. The main symptom is pain in your affected tooth, which can be intense and throbbing, although the pain can sometimes spread to your ear. If you think you may have a dental abscess, make a dentist appointment as soon as possible. They may need to remove the abscess and drain the pus. Read more about treating dental abscesses Source: NHS 24 - Opens in new browser window Last updated: 30 March 2023 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Dont include personal information e.g. name, location or any personal health conditions. Email Address e.g. [email protected] Message Maximum of 500 characters Send feedback Add this page to\n Info For Me Also on NHS inform Self-help guide: Earache Tonsillitis Otitis externa Middle ear infection (otitis media) NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats 2023 NHS 24 v1.1.1.17852

Earwax build-up

Earwax build-up | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotlands Service Directory 0 Home Illnesses and conditions Ears, nose and throat Earwax build-up Earwax build-up Earwax is made inside your ears to keep them clean. It usually falls out on its own. Sometimes too much can build up and block the ears. A build-up of earwax is a common problem. It can often be treated using eardrops bought from a pharmacy. Symptoms of an earwax build-up A build-up of earwax in your ear can cause: earache hearing loss tinnitus (hearing sounds from inside your body) itchiness in or around the ear ear infections These problems will usually get better once the build up of earwax has been removed. What to do if you think your ear is blocked Do not try to remove a build-up of earwax yourself with your fingers, a cotton bud or any other object. This can damage your ear and push the wax further down. Try eardrops If the earwax is only causing minor problems, you can try buying some eardrops from a pharmacy. Using drops may make your hearing or symptoms a little worse at first before getting better. These can help soften the earwax so that it falls out naturally. There are several different types of eardrops you can use, including drops containing: sodium bicarbonate olive oil almond oil Eardrops arent suitable for everyone and some can irritate the skin. You shouldnt use eardrops if you have a hole or tear in your eardrum. Speak to your pharmacist about the right product for you and make sure you read the leaflet that comes with it. Find your nearest pharmacy When to get medical advice Speak to your GP practice if: youre worried about your symptoms eardrops havent helped after 1 week Diagnosing earwax build up Your GP or practice nurse will look inside your ears to check if theyre blocked. They might carry out some simple hearing tests. Treatments to remove earwax If pharmacy treatment doesnt work, speak to your GP practice. Treatments may include: ear irrigation a quick and painless procedure where an electric pump is used to push water into your ear and wash the earwax out microsuction a quick and painless procedure where a small device is used to suck the earwax out of your ear (you may need to be referred for this) These treatments are not suitable for everyone. Your doctor can discuss this with you. If these treatments dont help, your GP may refer you to an ear, nose and throat (ENT) specialist. What causes a build up of earwax? Some people regularly get blocked ears because they naturally produce a lot of earwax. Other causes include: producing naturally hard or dry earwax having narrow or hairy ear canals (the tube between the opening of the ear and the eardrum) being elderly, as earwax becomes drier with age bony growths in the outer part of the ear canal Earwax can also block your ear if you often insert objects into your ear, such as cotton buds, ear plugs or hearing aids. Source: ENT Scotland - Opens in new browser window Last updated: 28 March 2024 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Dont include personal information e.g. name, location or any personal health conditions. Email Address e.g. [email protected] Message Maximum of 500 characters Send feedback Add this page to\n Info For Me Also on NHS inform Self-help guide: Earache Earache Tinnitus Other health sites British Tinnitus Association: Tinnitus and earwax Action on Hearing Loss: Protect your hearing Hearing Link: Your hearing Find your nearest pharmacy Enter a place or postcode NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats 2023 NHS 24 v1.1.1.17852

Ebola virus disease

Ebola virus disease | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotlands Service Directory 0 Home Illnesses and conditions Infections and poisoning Ebola virus disease Ebola virus disease Ebola virus disease is a serious illness that originated in Africa, where a large outbreak occurred in 2014to 2015.In June 2016, the outbreak was officially declared over. The 2014to 2015 outbreak of Ebola mainly affected 3 countries in west Africa: Guinea, Liberia and Sierra Leone. Some cases also occurred in parts of central Africa. Around 28,000 cases and more than 11,000 deaths were reported by the World Health Organization . This was the largest known outbreak of Ebola. Is Ebola still a risk? Theres still a small chance occasional cases of Ebola may occur in Africa as the virus is present in several countries there, but the risk for people travelling to Africa is minimal. People who remain most at risk are those who care for infected people or handle their blood or fluid, such as hospital workers, laboratory workers and family members. To find out what the health risks are for an area youre planning to visit, check the NHS Fit for Travel destination guide , Travel Health Pro country information or GOV.UK foreign travel advice . The risk of an Ebola outbreak occurring in the UK remains negligible. Symptomsof Ebola A person infected with Ebola virus will typically develop: a high temperature (fever) a headache joint and muscle pain a sore throat severe muscle weakness These symptoms start suddenly between2 and 21 days after becoming infected. Diarrhoea , vomiting , a rash, stomach pain and reduced kidney and liver function can follow. The person may then bleed internally, and may also bleed from the ears, eyes, nose or mouth. What to do if you become ill Get medical advice as soon as possible if you become ill while travelling abroad. Phone 111 or contact your GP if you become ill after returning to the UK. Its extremely unlikely you have Ebola, but it could be another serious condition such ascholera or malaria , so its a good idea to get help in case you need tests or treatment. Always remember to mention your recent travel history, as this will help identify what the problem could be. Sometimes your doctor may want to take a sample of your blood, urine or stools so it can be checked for any infections. How Ebola virus is spread The Ebola virus is spread in the blood, body fluids or organs of a person or animal with the infection. For example, it can be spread by: directly touching the body of someone with the infection who has symptoms orrecently died the virus can survive for several days outside the body cleaning up body fluids (blood, stools, urine or vomit) or touching the soiled clothing of an infected person handling unsterilised needles or medical equipment used in the care of the infected person having sex with an infected person without using a condom studies show traces of Ebola may remain in a mans semen many months after he has recovered handling or eating raw or undercooked bushmeat Ebola cant be caught through routine social contact, such as shaking hands, with people who dont have symptoms. Treatment for Ebola Theres currently no licensed treatment or vaccine for Ebola. Potential new vaccines and drug therapies are being developed and tested. Any area affected by an outbreak should be immediately quarantined, and people confirmed to have the infection should be treated in isolation in intensive care. Dehydration is common, so fluids may be given directly into a vein. Blood oxygen levels and blood pressure also need to be maintained at the right level, and body organs supported while the persons body fights the infection. Healthcare workers need to avoid contact with the bodily fluids of their infected patients by taking strict precautions, such as wearing protective equipment. Ebola virus disease is sometimesfatal. The sooner a person is given care, the better the chance theyll survive. Preventing Ebola Follow these simple precautions to minimise your risk of picking up potentially serious infections. Do wash your hands frequently using soap and water use alcohol hand rubs when soap isnt available make sure fruit and vegetables are properly washed and peeled before you eat them avoid physical contact with anyone who has possible symptoms of an infection Dont do not handle dead animals or their raw meat do not eat bushmeat You can check the advice for an area youre planning to visit using the NHS Fit for Travel destination guide , Travel Health Pro country information or GOV.UK foreign travel advice . Source: NHS 24 - Opens in new browser window Last updated: 29 May 2023 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Dont include personal information e.g. name, location or any personal health conditions. Email Address e.g. [email protected] Message Maximum of 500 characters Send feedback Add this page to\n Info For Me Other health sites Fit For Travel: Viral Haemorrhagic Fever NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats 2023 NHS 24 v1.1.1.17852

Ectopic pregnancy

Ectopic pregnancy | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotlands Service Directory 0 Home Illnesses and conditions Pregnancy and childbirth Ectopic pregnancy Ectopic pregnancy An ectopic pregnancy is when a fertilised egg develops outside the womb. This usually happens in one of the fallopian tubes which lead from your ovaries to your womb. If an egg implants there, it cant develop into a baby. Ectopic pregnancy puts your health at risk too, and can be very serious if it isnt treated. About 1 in 100 pregnancies are an ectopic pregnancy. Symptoms of an ectopic pregnancy Symptoms usually start when youre about 6 weeks pregnant and can include: pain low down and on one side of your abdomen bleeding from your vagina pain in the tip of your shoulder discomfort when going to the toilet a brown watery discharge from your vagina You might also have: other more general symptoms such as pale skin and sweating missed a period some of the early signs of being pregnant, such as feeling tired or having sore breasts Its important to get medical help quickly if you have any of these symptoms. If you have an ectopic pregnancy Unfortunately, its not possible to save an ectopic pregnancy. It will need to be removed: during an operation by taking a medicine prescribed by your doctor Further information in other languages and formats Public Health Scotland have created leaflets on pregnancy. If you need this leaflet in a different format or language, please contact [email protected]. Ready Steady Baby guide in Arabic, Polish, Simplified Chinese (Mandarin) and Ukrainian Source: Public Health Scotland - Opens in new browser window Last updated: 14 December 2023 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Dont include personal information e.g. name, location or any personal health conditions. Email Address e.g. [email protected] Message Maximum of 500 characters Send feedback Add this page to\n Info For Me NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats 2023 NHS 24 v1.1.1.17852

Edwards syndrome

"Edwards' syndrome | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotlands Service Directory 0 Home Illnesses and conditions Chromosomal conditions Edwards syndrome Edwards syndrome Edwards syndrome (also known as trisomy 18) is a genetic condition that begins to affect babies when theyre in the womb, and continues to impact their health throughout their life. Its a rare but serious condition. In the UK, around 3 in every 10,000 births are affected by Edwards syndrome. What is Edwards syndrome? When a baby is conceived (made), they inherit genetic material from both their parents. This genetic material is called a chromosome. Humans normally have 23 pairs of chromosomes. In each pair, 1 of the chromosomes is inherited from the mother and 1 is inherited from the father. If a baby has Edwards syndrome, they have inherited an extra copy of chromosome 18. This extra copy can be present in some or all of the babys cells and can lead to health problems for the baby. There are 3 different forms of Edwards syndrome: Full form In full form Edwards syndrome, the baby has inherited a complete extra copy of chromosome 18. This extra copy is present in all of the babys cells. Around 94% of babies born with Edwards syndrome have the full form of the syndrome. Mosaic form In mosaic form Edwards syndrome, the baby has inherited a complete extra copy of chromosome 18, but the copy is only present in some of the babys cells. Partial form In partial form Edwards syndrome, the baby has only inherited part of an extra copy of chromosome 18. This is a very rare form of Edwards syndrome. Why does Edwards syndrome happen? Most cases result from a random change in the egg or sperm in healthy parents. This change is not caused by anything the parents did before or during pregnancy. Effects of Edwards syndrome on pregnancy Screening for Edwards syndrome Youll be offered screening for Edwards syndrome when youre between 11 and 14 weeks pregnant. The screening test will show if your baby has a high or low chance of having Edwards syndrome. If screening shows that theres a high chance your baby has Edwards syndrome,you can choose to have a further diagnostic test if you wish. No test can tell if your baby has full, mosaic or partial Edwards syndrome or how theyll be affected. Risk of miscarriage and stillbirth Around 7 in 10 (70%) of pregnancies diagnosed with Edwards syndrome from screening tests will end in miscarriage or stillbirth . The risk of miscarriage decreases as the pregnancy progresses, but theres still a risk of stillbirth. Effects of Edwards syndrome on babies If your baby is affected by Edwards syndrome, it is likely they will have associated health conditions (other conditions often found in babies with Edwards syndrome). Some of these may be serious. Exactly how your baby is affected will depend on the form of Edwards syndrome they have. Babies with full form Edwards syndrome Full form Edwards syndrome is considered to be a life-limiting condition. This means it can affect how long a baby can live. Around 5 in 10 (52.5%) will live longer than 1 week. Around 1 in 10 (12.3%) will live longer than 5 years. Babies born with full form Edwards syndrome will have a learning disability which may be severe. Theyre also likely to have a wide range of health conditions, some of which can be serious. Statistically: around 9 in 10 (90%) will have heart issues around 5 in 10 (50%) will have seizures around 5 in 10 (50%) will have hearing loss around 5 in 10 (50%) will have joint contractures (shortening of muscle tissue that can cause a deformity) around 1 in 10 (10%) will have a cleft lip and/or palate Babies with mosaic form and partial form Edwards syndrome Currently we cant predict how babies with mosaic or partial forms of Edwards syndrome will be affected. This is because it depends on: how many cells contain the extra chromosome (mosaic) how much of the extra chromosome they have (partial) Some babies may have severe health problems like those seen in full form Edwards syndrome. Other babies may have much less serious health issues. There are even cases where the baby seems to have no health issues at all. Many babies with the mosaic form of Edwards syndrome will have some form of learning disability and developmental delay (when a child takes longer to start doing certain activities, like walking and talking, than other children their age). The life expectancy for babies with mosaic or partial forms of Edwards syndrome is also very variable. Some will live long lives, while others will have a much shorter life expectancy. Living with Edwards syndrome Each child is unique, and Edwards syndrome will affect each child differently. Like all children theyll have their own personalities, likes and dislikes, and things that make them who they are. Babies with full form Edwards syndrome usually have a low birthweight and are considered medically fragile. This means they are at high risk of infections and complications that require treatment in hospital. They may also: have difficulty feeding and may need fed by a tube have difficulty breathing and have apnoea (pauses in their breathing) Despite their complex needs, children with Edwards syndrome can make progress with their development, although slowly. Many children are reported to be able to communicate their needs, show awareness of surroundings, and some can sit and stand supported. There are also cases of older children attending school. Feedback from many parents suggests that children with Edwards syndrome have a good quality of life and are valued members of the family. Congenital and rare condition register Babies with Edwards syndrome are included in the secure congenital and rare condition (CARDRISS) register. The register is maintained by Public Health Scotland. The register records how many babies have this condition, and some relevant personal information. Its also used to support the planning and improvement of health, care, and other public services. Read more about CARDRISS Further information and support You can find out more information about Edwards syndrome, including stories from parents of a child with the syndrome, at SOFT UK (Support Organisation for Trisomy 13/ 18) Source:\r\n SOFT UK - Opens in new browser window Last updated: 21 February 2024 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Dont include personal information e.g. name, location or any personal health conditions. Email Address e.g. [email protected] Message Maximum of 500 characters Send feedback Add this page to\n Info For Me Also on NHS inform Screening for Downs syndrome, Edwards syndrome and Pataus syndrome Other health sites SOFT UK NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats 2023 NHS 24 v1.1.1.17852"

Endometriosis

"Endometriosis | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotlands Service Directory 0 Home Healthy living Women's health Girls and young women (puberty to around 25) Periods and menstrual health Endometriosis Endometriosis | | Polski | | | British Sign Language (BSL) | Easy Read Endometriosis is a long-term (chronic) condition where tissue similar to the lining of the womb is found elsewhere in the body. Its very common, affecting around 1 in 10 of those who menstruate. For some people, it can have a significant impact on their physical health, emotional wellbeing , and daily routine. What are the symptoms? Symptoms can be different from person to person and month to month. Some people have no symptoms at all. Speak to your doctor if: Youre experiencing: pain in the lower abdomen (tummy), pelvis, lower back or legs painful periods which affect your day to day life for example, you cant go to school or work or take part in day to day activities that you enjoy pain during ovulation heavy or prolonged (long lasting) periods spotting or bleeding between periods pain during and after sex pain or bleeding when going to the toilet (pain before or after peeing or pooing) bleeding from your back passage (rectum) blood in your poo (usually at the same time as your period) persistent exhaustion and tiredness (fatigue) difficulty getting pregnant These symptoms may be endometriosis, but could also be a number of other health conditions. Endometriosis: a hidden condition Causes The exact cause of endometriosis is not known but it is sometimes believed to be genetic. That means, if someone in your family has the condition, its more likely you may have it too. Diagnosis It can be difficult to diagnose endometriosis because symptoms can vary a lot and many other conditions can cause similar symptoms. If you think you have symptoms of endometriosis, its important that you speak to your doctor. Share as much information as possible during your first appointment. Thisll hopefully help speed up your diagnosis. It can be helpful to keep a note of your period dates and symptoms using a calendar, a diary or an app. You can then discuss this with your doctor to give then a better understanding of what you are experiencing. If youre seeing your doctor, there are some useful pieces of information to think about beforehand: the first day of your last period (when it started) how many days your period usually lasts what was the shortest time between your periods (from the first day of one period to the first day of the next) what was the longest time between your periods (from the first day of one period to the first day of the next) how often you need to change your period products on a heavy day if you are over 25, when you had your last smear test When you see your doctor about your symptoms, theyll carry out what is called a pelvic examination. They will look at your vulva, vagina and cervix (the opening between the vagina and the womb). Sometimes other tests might be needed. Your doctor will discuss this with you and you can ask any questions that you might have. As this is an intimate examination, the doctor who performs it will have another person (chaperone) present. You can ask for a female doctor to carry it out. If there isnt a female doctor available, you can ask if theres a female health professional who could carry out the examination. If symptoms continue, your doctor may refer you to a gynaecologist. Laparoscopy The only way to confirm endometriosis is by a laparoscopy. This is an operation in which a camera (a laparoscope) is inserted into the pelvis via a small cut near the belly button. Sometimes its possible to remove some endometrial tissue at the same time. After the laparoscopy, the doctor will be able to tell you if you have endometriosis. This is known as a confirmed diagnosis. Its also possible that no endometriosis is seen at laparoscopy. Your doctor will discuss the findings and any further treatment after laparoscopy. Not everyone with endometriosis will need a laparoscopy if the symptoms can be managed. Your doctor will discuss your treatment options with you so you can decide whats best for you. If you have a type of endometriosis that needs additional treatment, you might be referred to a specialist centre. These are located in Edinburgh, Glasgow and Aberdeen. Your doctor will discuss the best option for you. Whether youre having, or have had a laparoscopy, you can access the Recovering well patient information leaflet for more information. Managing endometriosis There is no cure for endometriosis but there are treatments that can help to control or improve your symptoms. Heat and comfort A hot water bottle or hot bath may help to provide comfort and help you to feel a bit better. Pain relief Paracetamol and non-steroidal anti-inflammatories (NSAIDs), such as ibuprofen and naproxen, can help reduce your pain. Hormone treatment Hormone treatment can be used to help thin the womb lining, causing periods to become shorter and lighter easing the symptoms of endometriosis such as heavy menstrual bleeding Hormone treatments include: contraceptive pill (the pill) contraceptive patch contraceptive injection intrauterine system (IUS) Surgery Some people will have surgery to help treat or remove areas of endometriosis. Not everyone who has endometriosis will need surgery. It depends on where in the body the endometriosis is and how much. Even after surgery, the endometriosis may grow back so some people may need further surgery. Your doctor will discuss this with you and you can ask any questions that you might have. Laparoscopy The only definitive way to confirm or exclude endometriosis is by a laparoscopy. This is called a confirmed diagnosis. A laparoscopy is a procedure where a camera (a laparoscope) is inserted into the pelvis via a small cut near the belly button. The doctor will discuss with you any findings and any course of treatment. Sometimes it is also possible to remove some endometrial tissue during the laparoscopy. If you have a more complex type of endometriosis that needs additional treatment, you might be referred to a specialist centre. These are located in Edinburgh, Glasgow and Aberdeen and your doctor will discuss the best option for you. However, not everyone with endometriosis will need a laparoscopy. Your doctor will discuss your treatment options so you can decide whats best for you. Laparotomy During a laparotomy, the surgeon makes a cut in the tummy so that endometriosis can be removed. Further information about endometriosis treatment Adhesions and ovarian cysts Endometriosis can also cause: adhesions scar tissue that can fuse organs together ovarian cysts fluid-filled cysts in the ovaries that can sometimes become very large and painful Both of these complications can be treated with surgery but may come back if the endometriosis returns. Read information about treating ovarian cysts Endometriosis and fertility Many people with endometriosis are able to get pregnant naturally. However, more severe cases of endometriosis can cause scar tissue (adhesions) making it more difficult to get pregnant. If youre having difficulty getting pregnant, your doctor or specialist may suggest extra support or treatments that can help. Your doctor will discuss these with you and you can ask any questions that you might have. Additional help and support Sometimes it can feel hard to talk about endometriosis and the symptoms youre experiencing. Hearing from other women in Scotland, discussing their experiences with endometriosis within online support networks or in real life can really help. There might be peer support groups near you or other local groups where you can hear other womens stories, and share your own. Living with endometriosis Source: Scottish Government - Opens in new browser window Last updated: 07 March 2023 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Dont include personal information e.g. name, location or any personal health conditions. Email Address e.g. [email protected] Message Maximum of 500 characters Send feedback Other languages and formats | | Polski | | | British Sign Language (BSL) | Easy Read | | Polski | | | British Sign Language (BSL) | Easy Read Add this page to\n Info For Me Also on NHS inform Self-help tool: Periods and mental wellbeing Other health sites Royal College of Obstetricians and Gynaecologists: Laparoscopy - recovering leaflet Endometriosis UK: Endometriosis treatment Endometriosis UK: Endometriosis pain and symptom diary Endometriosis UK: Get support Samaritans British Society for Gynaecological Endoscopy Royal College of Obstetricians and Gynaecologists: Endometriosis patient information leaflet The University of Edinburgh: Endometriosis NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats 2023 NHS 24 v1.1.1.17852"

Epilepsy

Epilepsy | NHS inform | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotlands Service Directory 0 Home Illnesses and conditions Brain, nerves and spinal cord Epilepsy Epilepsy Epilepsy is a condition that affects the brain and is defined by repeated seizures. Epilepsy affects more than 600,000 people in the UK. Almost one in every 100 people has the condition. Symptoms of epilepsy The main symptoms of epilepsy are repeated seizures. There are different types of seizure, depending on which part of the brain it affects. The cells in the brain, known as neurons, conduct electrical signals. They communicate with each other in the brain using chemical messengers. During a seizure, there are abnormal bursts of neurons firing off electrical impulses. This can cause the brain and body to behave strangely. The severity of seizures can differ from person to person. Some people experience an odd feeling with no loss of awareness, or may have a trance-like state for a few seconds or minutes. Others lose consciousness and have convulsions (uncontrollable shaking of the body). Some people might only have a single seizure. If they do not have a high risk of having further seizures, they would not be regarded as having epilepsy. Types of seizures People with epilepsy can experience any type of seizure, although most people have a consistent pattern of symptoms. Seizures can occur when youre awake or asleep. The type of seizure depends on how much of the brain it affects. There are: focal (or partial) seizures where only a small part of the brain is affected generalised seizures where most or all of the brain is affected Some seizures do not fit into these categories and are known as unclassified seizures. Focal seizures There are two main types of focal seizure. Focal aware seizures Focal aware seizures are where you remain fully conscious throughout. Symptoms of a focal aware seizure can include: a general strange feeling that is hard to describe a rising feeling in your tummy sometimes likened to the sensation in your stomach when on a fairground ride an intense feeling that events have happened before (dj vu) experiencing an unusual smell or taste a tingling sensation, or pins and needles, in your arms and legs a sudden intense feeling of fear or joy stiffness or twitching in part of the body, such as an arm or hand These seizures are sometimes known as warnings or auras, because they can be a sign that another type of seizure is on its way. This can give you time to warn people around you and make sure youre in a safe place. Focal impaired awareness seizures Focal impaired awareness seizures are when you lose your sense of awareness. You wont remember what happened after this type of seizure. The symptoms of a focal impaired awareness seizure can involve random bodily behaviour, like: smacking your lips rubbing your hands making random noises moving your arms around picking at clothes fiddling with objects adopting an unusual posture chewing or swallowing During a focal impaired awareness seizure, youll not be able to respond to anyone else. Youll usually have no memory of it. Generalised seizures There are 6 main types of generalised seizure. Absences Absence seizuresmainlyaffect children, but they also occur in adults. They cause the person to lose awareness of their surroundings, usually for up to 15 seconds. The person will seem to starevacantlyinto space. Some people will flutter their eyes or smack their lips. The person will have no memory of the seizure. Absences can occur several times a day. They may affect a childs performance at school. They can be dangerous if they occur at a critical time, like crossing a busy road. Myoclonic seizures These types of seizures cause your arms, legs or upper body to jerk or twitch, as if you have received an electric shock. They often only last for a fraction of a second, and youll normally remain conscious during this time. Myoclonic jerks often happen in the first few hours after waking up. They can occur in combination with other types of generalised seizures. Clonic seizures These cause the same sort of twitching as myoclonic jerks, except the symptoms will last longer, normally up to 2 minutes. You might lose consciousness during a clonic seizure. Atonic seizures Atonic seizures cause all your muscles to relax suddenly. Theres a chance you may fall to the ground and you could injure yourself. Tonic seizures Tonic seizures cause all your muscles to suddenly become stiff. You might lose balance and fall over. Like atonic seizures, theres a risk of injury. Tonic-clonic seizures Tonic-clonic seizures or convulsions have 2 stages. Your body will initially become stiff and then your arms and legs will begin twitching. Youll lose consciousness and some people will wet themselves. The seizure normally lasts a minute, but can last longer. This type of seizure is what most people think of as an epileptic fit. Myoclonic-tonic-clonic seizures and Myoclonic-atonic are seizures involving a combination of the generalised seizures above. What to do if someone has a seizure If you see someone having a seizure, there are some things you can do to help. It will not usually be necessary to call an ambulance after a seizure. Phone 999 if: the seizure has not stopped after 5 minutes the person has more than one seizure without recovering in between you know its the persons first seizure the person is injured, has breathing problems, or needs emergency medical attention for any other reason the persons behaviour after a seizure is unsafe If youre with someone who has a seizure: protect them from injury by removing any dangerous or potentially harmful objects nearby cushion their head with your hands or soft material do not restrain them or attempt to move them (unless they are in immediate danger) dont put anything in their mouth stay calm, and stay with them until they regain consciousness When the convulsions have stopped, put them into the recovery position until theyve recovered. Status epilepticus Status epilepticus is the name for any seizure that lasts longer than 5 minutes, or a series of seizures where the person does not regain consciousness in between. This is a medical emergency and requires treatment as soon as possible. You can be trained to treat status epilepticus if you care for someone with epilepsy. Its important to phone 999 for an ambulance immediately if you suspect status epilepticus. If youve been trained to treat the condition, youll usually have been advised to use either: a medication called buccal midazolam that comes in liquid form and is given by trickling the liquid onto the inside of the persons cheek or up their nose (this is the most common immediate treatment) a medication called diazepam thats placed in the persons rectum (less commonly used) If youve tried one of these treatments and the seizures are continuing, phone 999 for an ambulance. Causes of epilepsy In some cases of epilepsy a cause cannot be found. If theres an identifiable cause, it usually involves the brain being affected by a condition. The brain is a delicate mix of nerve cells, electrical impulses and chemicals, known as neurotransmitters. Any damage has the potential to disrupt the workings of the brain and cause seizures. The categories of epilepsy can be separated by their causes which might be: Structural Causes of structural epilepsy can include: cerebrovascular disease (problems with the blood vessels that supply the brain) such as a stroke or subarachnoid haemorrhage brain tumours severe head injuries Genetic A genetic abnormality can cause epilepsy. Research has found more genetic causes of epilepsy. Sometimes epilepsy is hereditary (passed on from one or both parents) or it can be a new gene abnormality. Infectious Infections like meningitis can cause damage to the brain which can result in epilepsy. Viral infections like HIV can also cause epilepsy. Metabolic Sometimes epilepsy is caused by an imbalance of the bodies chemicals. This is very rare. Immune Autoimmune conditions that cause encephalitis (inflammation of the brain) can cause someone to develop epilepsy. Unknown In many cases, no cause of epilepsy is found. This may be because medical investigations are not advanced enough to identify the cause. Seizure triggers For many people with epilepsy, seizures can occur without any obvious trigger. However, certain circumstances or the use of certain substances can sometimes come before a seizure. These include: stress lack of sleep withdrawal from alcohol following heavy drinking some medications illegal drugs your menstrual cycle or period flashing lights (this is an uncommon trigger that affects less than 5% of people with epilepsy, and is known as photosensitive epilepsy) Keeping a seizure diary is a good way to help find out what might trigger your seizures. Every time you have a seizure, record it and make a note of what you were doing. Over time, you might notice some avoidable things that seem to trigger your symptoms. Diagnosing epilepsy Epilepsy is usually difficult to diagnose quickly. In most cases, it cannot be confirmed until you have had more than one seizure. It can be difficult to diagnose because many other conditions, like fainting, migraines and panic attacks , can cause similar symptoms. If youve had a seizure, youll be referred to a specialist in epilepsy. This will normally be a neurologist (a doctor who specialises in conditions affecting the brain and nervous system). Describing your seizures Some of the most important pieces of information needed to diagnose epilepsy are the details about your seizures. The doctor will ask you what you can remember and any symptoms you may have had before it happened things like feeling strange before the seizure or experiencing any warning signs. It is extremely useful to talk to anyone who seen your seizure and ask them exactly what they saw, especially if you cannot remember. The doctor will also ask about your medical and personal history. Theyll ask whether you use any medicines, drugs or alcohol. The doctor may be able to make a diagnosis of epilepsy from the information you give. They might run further tests like an electroencephalogram (EEG) or magnetic resonance imaging (MRI) scan . Even if these tests dont show anything, its still possible that you have epilepsy based on your symptoms and description of your seizures. Magnetic resonance imaging (MRI) scan An MRI scan is a type of scan which uses strong magnetic fields to produce detailed images of the inside of your body. It can be useful in cases of suspected epilepsy. It can often detect possible causes of the condition, such as defects in the structure of your brain. Electroencephalogram (EEG) An EEG test can detect unusual brain activity associated with epilepsy. It measures the electrical activity of your brain through electrodes placed on your scalp. During the test, you may be asked to breathe deeply or close your eyes and you may be asked to look at a flashing light. The test will be stopped immediately if it looks like the flashing light could trigger a seizure. In some cases, an EEG may be carried out while youre asleep (sleep EEG). Or you may be given a small, portable EEG recording device to monitor your brain activity over 24 hours (ambulatory EEG). You might be asked to come into the hospital for a few days to have a video telemetry and EEG. During this, an EEG and video will be used to monitor you. Treating epilepsy Most people with epilepsy can be successfully treated with anti-seizure medication (ASMs). ASMs do not cure epilepsy, but can prevent seizures from occurring. There are many different ASMs. They work by changing the levels of the chemicals in your brain that conduct electrical impulses. This reduces the chance of a seizure. The type of ASM recommended for you will depend on a number of factors like: the type of seizures you have your age whether there are any concerns about a certain ASM interacting with other medicines (like the contraceptive pill ) whether youre thinking of having a baby Examples of commonly used ASMs include sodium valproate, carbamazepine, lamotrigine and levetiracetam. Taking ASMs ASMs are available in different forms, including tablets, capsules, liquids and syrups. Its important you follow any advice about when to take ASMs and how much to take. Never suddenly stop taking an ASM because it could cause a seizure. You shouldnt take any other medicines whilst taking ASMs without speaking to your GP or epilepsy specialist. This includes over-the-counter medicines or complementary medicines such as St Johns Wort. Other medicines could have a dangerous interaction with your ASM and cause a seizure. Sodium valproate is not usually prescribed for women of childbearing age. This is because it could causea baby to have physical defects or developmental problems. It can be used if there is no alternative, or if your specialist has assessed you and its unlikely youll respond to or tolerate other treatments. Your specialist or GP will also need to check youre using a reliable form of contraception. Learn more about the risks of valproate medicines during pregnancy . Side effects are common when starting treatment with ASMs. Theyre usually short-lived and pass in a few days. Speak to your healthcare team for more information on the side effects. Brain surgery If your epilepsy is still poorly controlled after trying treatment with ASMs, you may be referred to a specialist epilepsy centre. Theyll assess if youre suitable for surgery. This involves having various types of brain scans to find out where the epilepsy is focused. Memory and psychological tests will assess how the surgery might affect you. Surgery is only recommended when: a single area of the brain is causing seizures (focal seizures) removing that part of the brain would not cause any significant loss of brain function Most people recover from the effects of surgery after a few days. But it could be several months before youre feeling fit and able to return to work. Alternative procedures Your doctor might suggest an alternative procedure if: your epilepsy is still poorly controlled after trying treatment with ASMs brain surgery is not suitable for you This might be vagus nerve stimulation (VNS). Vagus nerve stimulation (VNS) VNS involves surgically implanting a small electrical device under your skin, near your collarbone. The device is like a pacemaker . The device has a wire thats wrapped around one of the nerves in the left side of your neck, known as the vagus nerve. The device passes a regular dose of electricity to the nerve to stimulate it. This can help reduce the frequency and severity of seizures. If you feel the warning sign of a seizure coming on, you can activate an extra burst of stimulation. This might prevent the seizure from occurring. The stimulation normally occurs every five minutes and lasts for 30 seconds. How and why VNS works is not fully understood. Its thought that stimulating the vagus nerve alters the chemical transmissions in the brain. Most people who undergo VNS still need to take ASMs. The battery for the VNS device typically lasts up to 10 years. After 10 years youll need another procedure to replace it. Ketogenic diet A ketogenic diet is a diet high in fats and low in carbohydrates and protein. Its thought that it may make seizures less likely by altering the chemical composition of the brain. A ketogenic diet is sometimes advised for children with seizures that are difficult to control and have not responded to ASMs. This is because its reduces the number of seizures in some children. It should only be used under the supervision of an epilepsy specialist with the help of a dietitian. It can also be effective in adults with certain types of epilepsy. Living with epilepsy Regular exercise and a healthy diet are recommended for everyone. They can help prevent many conditions, including heart disease and many forms of cancer . Try to eat a balanced diet, containing all the food groups, to give your body the nutrition it needs. Exercising regularly can increase the strength of your bones, relieve stress and reduce fatigue. Drinking Alcohol can also interact with anti-seizure medication (ASMs). ASMs can heighten the effects of alcohol. Alcohol also can make the side effects of ASMs worse and make the medication less effective. Heavy drinking can disrupt your sleep patterns. This increases your chances of having a seizure. Drinking no more than the recommended daily limits may help reduce this risk. Read more about drinking and alcohol Contraception Some anti-seizure medication (ASMs) can reduce the effectiveness of some types of contraception. This includes: contraceptive injections contraceptive patches the combined oral contraceptive pill often known as the pill the progesterone-only pill (POP) or mini pill contraceptive implants If youre sexually active and do not want to become pregnant, ask your GP or epilepsy specialist if your ASMs could affect your contraception. You may need to ensure you or your partner use another form of contraception like a condom or intrauterine device (IUD) . The effectiveness of the ASM lamotrigine may be reduced if youre taking the combined oral contraceptive pill. Some ASMs can make the emergency contraceptive pill less effective. If you need emergency contraception, you may need an IUD. Your GP, family planning clinic or pharmacist should be able to help you. Pregnancy Theres no reason why women with epilepsy cannot have a healthy pregnancy. Its better if the pregnancy is planned because theres a slightly higher risk of complications. With forward planning, you can minimise these risks. The main risk is that some ASMs increase the chances of a serious birth defect, like spina bifida, cleft lip or congenital heart disease . The risks depend on the type of ASM and the dose youre taking. The UK Epilepsy and Pregnancy Register can provide more information and advice about the use of ASMs during pregnancy. If youre planning a pregnancy, talk to your epilepsy specialist. It may be possible to change the ASM youre taking to minimise risks. Taking 400micrograms (mcg)of a folic acid supplement each day can also help reduce risks of birth defects. You might be recommended to take more than this by your healthcare team. If you discover youre pregnant, do not stop taking your medicine. The risks to your baby from uncontrolled seizures are far higher than any risks associated with your medicines. If youre breastfeeding or planned to breastfeed, discuss the medication youre taking with your healthcare team or midwife. Children and epilepsy Many children with well-controlled epilepsy can learn and take part in their schools activities unaffected by their condition. Others may need extra support to get the most out of their time at school. Make sure your childs teachers know about their condition and the medication they need to control it. Epilepsy is more common among children with learning disabilities and special educational needs. These children are entitled to extra help to overcome their difficulties. Driving You must tell the Driving and Vehicle Licence Authority (DVLA) if youve had any epileptic seizures or blackouts. You must stop driving right away. If you ignore these regulations, you might be prosecuted. The DVLA may wish to contact your GP or epilepsy specialist. The DVLA may issue a licence if your seizures have never caused you to lose awareness or affected your ability to safely control a vehicle. Your GP has a legal responsibility to inform the DVLA if they feel that your driving is putting both you and others at risk. Read about epilepsy and driving on the DVLA website Sudden unexpected death in epilepsy (SUDEP) When somebody with epilepsy dies and theres no clear cause, its known as sudden unexpected death in epilepsy (SUDEP). The risk of SUDEP for someone with epilepsy is low. The exact causes of SUDEP are unknown. Its not possible to predict who it will affect. One theory is that seizures could affect the persons breathing and heartbeat. Things that may lead to SUDEP include: having seizures which cause loss of consciousness and the body to go stiff and jerk (tonic-clonic seizures) poorly controlled epilepsy, such as not using ASMs prescribed to control seizures having sudden and frequent changes to ASMs being a young adult (in particular male) having sleep seizures having seizures when alone drinking large amounts of alcohol If youre worried that your epilepsy is poorly controlled, contact your epilepsy specialist. It may be possible to refer you to a specialist epilepsy centre for further treatment. A charity called SUDEP Action can offer advice and support on SUDEP. They have a helpline for people who have lost a loved one as a result of epilepsy. Last updated: 07 March 2024 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Dont include personal information e.g. name, location or any personal health conditions. Email Address e.g. [email protected] Message Maximum of 500 characters Send feedback Add this page to\n Info For Me Also on NHS inform Febrile seizures Other health sites Epilepsy Society Epilepsy Research UK Epilepsy Action SUDEP Action UK Epilepsy and Pregnancy Register Brain and Spine Foundation: Epilepsy Epilepsy Scotland Choice and Medication: Epilepsy NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats 2023 NHS 24 v1.1.1.17852

Erectile dysfunction (impotence)

Erectile dysfunction - Illnesses & conditions | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotlands Service Directory 0 Home Illnesses and conditions Sexual and reproductive Erectile dysfunction (impotence) Erectile dysfunction (impotence) About erectile dysfunction Symptoms of erectile dysfunction Causes of erectile dysfunction Diagnosing erectile dysfunction Treating erectile dysfunction About erectile dysfunction Erectile dysfunction (ED), also known as impotence, is the inability to get and maintain an erection. Erectile dysfunctionis a very common condition, particularly in older men. It is estimated that half of all men between the ages of 40and 70 will have it to some degree. When to see your GP See your GP if you have erectile dysfunction for more than a few weeks. They will assess your general state of health because the condition can be the first sign of more serious health conditions, such as heart disease (when the hearts blood supply is blocked or interrupted). Find your local GP practice Why does erectile dysfunction happen? Erectile dysfunctioncan have a range of causes, both physical and psychological. Physical causes include: narrowing of the blood vessels going to the penis commonly associated with high blood pressure (hypertension), high cholesterol or diabetes hormonal problems surgery or injury Psychological causes of ED include: anxiety depression relationship problems Sometimes erectile dysfunction only occurs in certain situations. For example, you may be able to get an erection during masturbation, or you may find that you sometimes wake up with an erection but you are unable to get an erection with your sexual partner. If this is the case, it is likely the underlying cause of erectile dysfunction is psychological (stress related). If you are unable to get an erection under any circumstances, it is likely that the underlying cause is physical. Erectile dysfunction can also be a side-effect of using certain medicines. Read more about the causes of erectile dysfunction Diagnosis Although you may be embarrassed, its important to get a diagnosisso that the cause can be identified. Your GP can usually diagnose erectile dysfunction. This will involve answering questions about your symptoms, as well as a physical examination and some simple tests. Read more about diagnosing erectile dysfunction How is erectile dysfunction treated? Erectile dysfunction is primarily treated by tackling the cause of the problem, whether this is physical or psychological. The narrowing of the arteries (called atherosclerosis) is one of the most common causes of ED. In these casesyour GP may suggest lifestyle changes, such as losing weight, to try to reduce your risk of cardiovascular disease . This mayhelp to relieve your symptoms as well as improving your general health. You may also be given medication to treat atherosclerosis, such as cholesterol-lowering statins and drugs to reduce your blood pressure. A number of treatmentshavebeen successful in the treatment of erectile dysfunction. Medication, suchas sildenafil (sold as Viagra),can be used to manage it in at least two-thirds of cases. Vacuum pumps that encourage blood to flow to the penis and cause an erection are also successful in 90% of cases. Psychological treatmentsincludecognitive behavioural therapy (CBT) and sex therapy. Overall, treatments forerectile dysfunctionhave improved significantly in recent years. Most men are eventually able to have sex again. Read more about treating erectile dysfunction Symptoms of erectile dysfunction The main symptom of erectile dysfunction (ED) is the inability to get and maintain an erection for satisfactory intercourse. ED should not be confused withejaculation problems such as premature ejaculation, which is a condition where the process of arousal, orgasm and ejaculation occurs very rapidly. Inability to get an erection Sometimes ED only occurs in certain situations. For example, you may be able to get an erection during masturbation, or you may find that you sometimes wake up with an erection but you are unable to get an erection with your sexual partner. In these circumstances, it is likely that the underlying cause of ED is primarily psychological (stress related). However, if you are unable to get an erection under any circumstances, it is likely that the underlying cause is primarily physical. Seek medical advice See your GP if ED persists for more than a few weeks. They will assess your general state of health because the condition can be the first sign of more serious health conditions, such as heart disease (when the hearts blood supply is blocked or interrupted). Many websites offer treatments for ED but their use is not recommended. The medications that are offered by these sites could be fake and may be dangerous. Even if the medications are genuine, they may not be suitable for you. It is important that you only take medication for ED that your GP has prescribed for you. Read more about treating erectile dysfunction Causes of erectile dysfunction Erectile dysfunction (ED) can have many causes, such as certain medical conditions, medications and stress. Its important to identifythe cause of erectile dysfunction and treat any underlying conditions. Erections Whena manbecomes sexually excited (aroused), his brain sends signals to the nerves in his penis. The nerves increase the blood flow to the penis, causing the tissue to expand and harden. Anything that interferes with the nervous system or the blood circulation could lead toerectile dysfunction. Anything that affects the level of sexual desire (libido)can also causeerectile dysfunction because a reduced libido makes it more difficult for the brain to trigger an erection. Psychological conditions, such as depression , can reduce libido, as can changes in hormone levels (chemicals produced by the body). Physical causes There are four main types of health conditions that can cause physical problems resulting inerectile dysfunction. These are: conditions affecting the flow of blood to your penis vasculogenic conditions affecting your nervous system, which is made up of your brain, nerves and spinal cord neurogenic conditions affecting your hormone levels hormonal conditions affecting the physical structure of your penis anatomical Injuries and surgery Penis injuries or surgical treatment of the penis, pelvis or surrounding areas can sometimes lead to erectile dysfunction. Erectile dysfunction is also thought to occur in up to 15-25% of people whoexperience a severe head injury . Vasculogenic conditions Examples of vasculogenic conditions that cause erectile dysfunction include: cardiovascular disease a disease of the heart or blood vessels, such as atherosclerosis (hardening of the arteries) high blood pressure (hypertension) diabetes a condition caused by high blood sugar levels. This can affect both the blood supply and the nerve endings in your penis, so it is also a neurogenic condition Erectile dysfunctionis strongly associated with cardiovascular disease. For this reason, it may be one of the first causes your GP considers whenmaking a diagnosisand planning your treatment. Neurogenic conditions Examples of neurogenic conditions that causeerectile dysfunction include: multiple sclerosis a condition that affects the bodys actions, such as movement and balance Parkinsons disease a condition that affects the way that the brain coordinates body movements, including walking, talking and writing a spinal injury or disorder a stroke a serious condition that occurs when the blood supply to the brain is interrupted Hormonal conditions Examples of hormonal conditions that causeerectile dysfunction include: hypogonadism a condition that affects the production of the male sex hormone, testosterone, causing abnormally low levels an overactive thyroid gland (hyperthyroidism) where too much thyroid hormone is produced an underactive thyroid gland (hypothyroidism) where not enough thyroid hormone is produced Cushings syndrome a condition that affects the production of a hormone called cortisol Anatomical conditions Peyronies disease, which affects the tissue of the penis, is an example of an anatomical condition that can causeerectile dysfunction. Medicine In some men,certain medicines can causeerectile dysfunction, including: diuretics these increase the production of urine and are often used to treat high blood pressure (hypertension), heart failure and kidney disease antihypertensives such as beta-blockers , that are used to treat high blood pressure fibrates medicines used to lower cholesterol levels antipsychotics used to treat some mental health conditions, such as schizophrenia antidepressants used to treat depression and some types of pain corticosteroids medication that contains steroids, which are a type of hormone H2-antagonists medicines used to treat stomach ulcers anticonvulsants used to treat epilepsy antihistamines used to treat allergic health conditions, such as hay fever anti-androgens medication that suppresses androgens (male sex hormones) cytotoxics medication used in chemotherapy to prevent cancer cells from dividing and growing Speak to your GP if you are concerned that a prescribed medicine is causing erectile dysfunction. Alternative medication may be available. However,it is important never tostop taking a prescribed medicine unless you are advised to do so by a qualified healthcare professional who is responsible for your care. Psychological causes Possible psychological causes oferectile dysfunction include: depression feelings of extreme sadness that last for a long time anxiety a feeling of unease, such as worry or fear Erectile dysfunction can often have both physical and psychological causes. For example, if you have diabetes, it may be difficult for you to get an erection, which may cause you to become anxious about the situation. The combination of diabetes and anxiety may lead to an episode of erectile dysfunction. There aremany emotional issues that may also affect your physical ability to get or maintain an erection. These include: relationship problems lack of sexual knowledge past sexual problems past sexual abuse being in a new relationship Other causes Other possible causes oferectile dysfunctioninclude: excessive alcohol intake tiredness using illegal drugs, such as cannabis, heroin or cocaine Cycling Men who cycle for more than three hours per week may be recommended to try a period without cycling to see if this helps improve erectile dysfunction. Riding in the correct position with a properly fitted seat may also help to prevent regular cycling from leading to erectile dysfunction. Diagnosing erectile dysfunction Erectile dysfunction (ED) can often be diagnosed by your GP. They will talk to you about your situation and may carry out a physical examination. Your GP may ask you about: your symptoms your overall physical and mental health your alcohol consumption whether you take drugs whether you are currently taking any medication If you do not want to talk to your GP about erectile dysfunction, you can visit a genitourinary medicine (GUM) clinic. You can find your nearest GUM clinic on the British Association for Sexual Health and HIV(BASHH) website. Sexual history Youll also be askedabout your sexual history. Try not to be embarrassed becauseerectile dysfunction is a common problem.You can request a male GP at your surgery if you prefer. You may be asked about: your previous and current sexual relationships what your sexual orientation is how long you have been experiencing erectile dysfunction whether you can get any degree of erection with your partner, on your own or when you wake up in the morning whether you have been able to ejaculate or orgasm your libido (your level of sexual desire) Erectile dysfunctionthathappens all the time may suggest an underlying physical cause. Erectile dysfunction thatonly occurs when you are attempting to have sex may suggest an underlying psychological (mental) cause. Assessing your cardiovascular health Your GP may assess your cardiovascular health. Narrowed blood vessels are a common cause of erectile dysfunction and linked with cardiovascular disease (conditions that affect the heart and blood flow). Your GP may: measure your blood pressure to see if you have high blood pressure (hypertension) listen to your heart rate to check for any abnormalities measure your height, weight and waist circumference to see if you are a healthy weight for your height ask you about your diet and lifestyle, for example, how much exercise you do test a sample of your blood for glucose (sugar) and lipids (fatty substances), as high levels can indicate conditions affecting your heart or blood vessels Physical examinations and tests Aphysical examination of your penis may be carried outto rule out anatomical causes (conditions that affect the physical structure of your penis). If you have symptoms of an enlarged prostate , such as weak or irregular urination, a digital rectal examination (DRE) may be suggested. Blood tests can alsocheck for underlying health conditions. For example, measuring the levels of hormones such as testosterone can rule out hormonal conditions, such as hypogonadism (an abnormally low level of testosterone). Further testing In some cases you may be referred to a specialist for further testing. This might be the case if youare unusually young to be experiencingerectile dysfunction as its rare in men under 40 years of age. Intracavernous injection test An intracavernous injection test involves injecting a man-made (synthetic) hormone into your penis to increase the blood flow. This helpsassess anyabnormalities in your penis and plan surgery. If the injection doesnt result in anerection it may indicate a problem with the blood supply to your penis. In some cases, you may also need an ultrasound scan . Arteriography and dynamic infusion cavernosometry or cavernosography These specialised tests involve injecting dye into the blood vessels of your penis and studying the dye on a scanner. These are likely to be used if you are being considered for surgery or if a problem has been detected with your blood vessels. Psychological assessment If the cause of your erectile dysfunction is thought to be psychological, you may be refferedfor a psychological assessment. Treating erectile dysfunction If you have erectile dysfunction (ED), treatment will depend on whats causing it. The various treatments for erectile dysfunction are outlined below. Treating underlying conditions If yourerectile dysfunction is caused by an underlying health condition, such as heart disease or diabetes , that condition may need to be treated first. In some cases, treating the underlying cause may also resolve the problem. If you are taking medication that can cause erectile dysfunction, there may be an alternative. It is important never to stop taking a prescribed medication unless you are advised to do so by your GP or another qualified healthcare professional responsible for your care. Lifestyle changes Erectile dysfunction can often be improved by making changes to your lifestyle, such as: losing weight if you are overweight giving up smoking cutting backyour alcohol consumption not taking illegal drugs exercising regularly reducing stress As well as helping to improve yourerectile dysfunction, these changes can also improve your general health and may help to reduce your risk of cardiovascular disease (conditions that affect your heart and blood vessels). Read more about preventing cardiovascular disease Phosphodiesterase-5 (PDE-5) inhibitors Phosphodiesterase-5 (PDE-5) inhibitors are one of the most widely used and effective types of medication for treating erectile dysfunction. They work by temporarily increasing the blood flow to your penis. In England,four PDE-5 inhibitors are available for treating erectile dysfunction. They are: sildenafil sold under the brand name Viagra tadalafil sold under the brand name Cialis vardenafil sold under the brand name Levitra avanafil sold under the brand name Spedra Sildenafil, vardenafil and avanafil work for about eight hours and they are designed to work on demand. Tadalafil lasts for up to 36 hours and is more suitable if you require treatment for a longer period of time, for example, over a weekend. Depending on the type of PDE-5 inhibitor you are taking and the dose, it should take about 30-60 minutes before it starts to work. With sildenafil, vardenafil and avanafil, you should be able to have sex from one to 10 hours after taking the medicine. After taking tadalafil, the effects will last for up to 36 hours. It may take longer to notice the effects if the tablet is taken with food, so its best to take it on an empty stomach. You can then eat after an hour without affecting the medicine. Only take one tablet within a 24-hour period. Your GP should explain the benefits of each medication and how it works. The choice may depend on: how often you are sexually active whether you have tried any of the medications before There have been many studies to test the effectiveness of these medications. In general,at leasttwo-thirds of men report having improved erections after taking one of these medicines. If you do not find that PDE-5 inhibitors are effective it may be because: you have not waited long enough after taking the dose you have waited too long after taking the dose the dose is not high enough you have not had enough sexual stimulation These medications are triggered by sexual stimulation, so you also need to be aroused for it to work. Warnings PDE-5 inhibitors should be usedwith caution in men who have cardiovascular disease , such as coronary heart disease. However, sexual activity is also likely to be beneficial for your cardiovascular health. You should discuss the risks and benefits with your GP. PDE-5 inhibitors should also be used with caution in men who have anatomical problems with their penis, such as Peyronies disease (a condition that affects the tissue of the penis). PDE-5 inhibitors should also be used with caution in men who: are at risk of priapism a painful erection that lasts for several hours are also taking long lasting alpha-blockers a medication used to treat a number of conditions, such as high blood pressure (hypertension) Do not take PDE-5 inhibitors if you are also taking medicines or recreational drugs that contain nitrates. The combination of the two substances can have a dangerous effect on your heart. Organic nitrates are often used to treat angina, and butyl nitrate is a recreational drug that is more commonly known as poppers. Youarealsowarnednot to take PDE-5 inhibitors if you: have been advised not to take part in sexual activity or in activities that widen your blood vessels have low blood pressure (hypotension) have recently had a stroke a medical emergency that occurs when the blood supply to the brain is interrupted have unstable angina an underlying heart condition that causes symptoms such as chest pain have had a heart attack a medical emergency where the blood supply to the heart is suddenly blocked have a history of non-arteritic anterior ischaemic optic neuropathy an eye condition that causes a sudden loss of vision Side effects PDE-5 inhibitors can cause some side effects, including: headaches and migraines flushing (redness) indigestion nausea (feeling sick) vomiting (being sick) a blocked or runny nose back pain vision disturbances muscle pain Vacuum pumps A vacuum pump consists of a clear plastic tube that is connected to a pump, which is either hand or battery operated. You place your penis in the tube and pump out all of the air. This creates a vacuum that causes the blood to fill your penis, making it erect. You then place a rubber ring around the base of your penis to keep the blood in place, allowing you to maintain an erection for around 30 minutes. It may take several attempts to learn how to use the pump correctly, but they are usually effective. After using a vacuum pump,nine out of 10 men are able to have sex, regardless of the cause of their ED. Considerations You should not use a vacuum pump if you have a bleeding disorder or if you are taking anticoagulant medicines , which reduce the ability of your blood to clot. Side effects of vacuum pumps include pain or bruising, although these occur in less than a third of men. Men who qualify for NHS prescriptions for erectile dysfunction treatments may be able to get a vacuum pump on the NHS (see above for more details). However,some men will need to buy one. The Sexual Advice Association produces a number of factsheets, including one on vacuum pumpsthat provides details of companies that supply them. Alprostadil If yourerectile dysfunction doesntrespond to treatment, or you are unable or unwilling to use PDE-5 inhibitors or a vacuum pump, you may be given a medicine called alprostadil. This is a synthetic (man-made) hormone that helps to stimulate blood flow to the penis. Alprostadil is available as: an injection directly into your penis this is called an intracavernosal injection a small pellet placed inside your urethra (the tube that carries urine from your bladder to the tip of your penis) this is called urethral application You may be trained to correctly inject or insert alprostadil. If your partner is pregnant,use a condom during sex if you are inserting alprostadil into your urethra. Alprostadil will usually produce an erection after five to 15 minutes. How long the erection lasts will depend on the dose. In men who did not respond to PDE-5 inhibitors, alprostadil injections were successful in 85 out of 100 men. Alprostadil inserted into the urethra is successful for up to two-thirds of men. Warnings Alprostadil should not be used: inmen at risk of priapism (a painful erection that lasts for several hours) for example, those with sickle cell anaemia alongside othererectile dysfunction medications if you have a penile implant or if you have been advised to avoid sexual activity Urethral application may also not be used in: somemen who have anatomical problems with their penis (conditions that affect the physical structure of the penis) men who have infections of their penis, such asbalantis(inflammation of the head of the penis) Side effects Alprostadil can cause some side effects including: changes in your blood pressure dizziness headache pain in your penis urethral burning or bleeding reactions at the site of the injection, such as swelling NHS prescriptions As with PDE-5 inhibitors, NHS prescriptions for alprostadil may only be available formen with particular health conditions or those receiving some types of medical treatments. If you need to pay the full prescription cost, a single injection of alprostadil costs around 8 to 22, depending on the dose. A single dose of alprostadil for urethral application is around 10. Hormone therapy If a hormonal condition is causingerectile dysfunction, you may be referred to an endocrinologist (who specialises in the treatment of hormonal conditions). Hormones are chemicals produced by the body. Many hormonal conditions can be treated using injections of synthetic (man-made) hormones to restore normal hormone levels. Surgery Surgery forerectile dysfunction is usually only recommended if all other treatment methods have failed. It may also be considered in: younger men who have experienced serious injury to their pelvic area for example, in a car accident men with a significant anatomical problem with their penis In the past, surgery was used if there was clear evidence of a blockage to the blood supply of the penis. The surgeon could unblock the blood vessels to restore a normal supply of blood. However, research now suggests that the long-term results of this type of surgery are poor, so its unlikely to be used. Penile implants Penile implants are a type of surgery that may be considered. These can be: semi-rigid implants which may be suitable for older men who do not have sex regularly inflatable implants which consist of two or three parts that can be inflated to give a more natural erection Penile implants are not usually available on the NHS and inflatable implants may be very expensive. However, around three-quarters of men report being satisfied with the results of this type of surgery. Complications As with all types of surgery, having penile implants insertedcarries a risk of infection. If you take preventative antibiotics, the rate of infection is aroundtwoor threein 100. Mechanical problems with the implants may occur within five years infiveper cent ofcases. Psychological treatments If yourerectile dysfunction has an underlying psychological cause then you may benefit from a type of treatment called sensate focus. If conditions such as anxiety or depression are causing yourerectile dysfunction, you may benefit fromcounselling(a talking therapy). Sensate focus Sensate focus is a type of sex therapy that you and your partner complete together. It starts with youboth agreeing not to have sex for a number of weeks or months. During this time, you can still touch each other, but not in the genital area (or a womans breasts). The idea is to explore your bodies knowing that you will not have sex. After the agreed period of time has passed, you can gradually begin touching each others genital areas. You can also begin to use your mouth to touch your partner, for example, licking or kissing, them. This can build up to include penetrative sex. You can find out more about sensate focus from the CollegeofSexual and Relationship Therapists (COSRT) . Psychosexual counselling Psychosexual counselling is a form of relationship therapy where you and your partner can discuss any sexual or emotional issues that may be contributing to yourerectile dysfunction. By talking about the issues, you may be able to reduce any anxiety that you have and overcome yourerectile dysfunction. The counsellor can also provide you with some practical advice about sex, such as how to make effective use of other treatments forerectile dysfunction to improve your sex life. Psychosexual counselling may take time to work and the results achieved have been mixed. Cognitive behavioural therapy (CBT) Cognitive behavioural therapy (CBT) is another form of counselling that may be useful if you haveerectile dysfunction. CBT is based on the principle that the way you feel is partly dependent on the way you think about things. CBT helps you realise that your problems are often created by your mindset. It is not the situation itself that is making you unhappy, but how you think about it and react to it. Your CBT therapist can help you to identify any unhelpful or unrealistic thoughts that may be contributing to your erectile dysfunction for example, to do with: your self-esteem (the way you feel about yourself) your sexuality your personal relationships Your CBT therapist will be able to help you to adopt more realistic and helpful thoughts about these issues. Pelvic floor muscle exercises Some studies have suggested that, in a few cases, it may be beneficial to exercise your pelvic floor muscles. These are a group of muscles around the underside of the bladder and rectum, as well as at the base of the penis. Pelvic floor muscle exercise involves strengthening and training the muscles used to control the anus (back passage) and urinate. If your GP feels this type of exercise could be beneficial, then you may want to discuss it with a physiotherapist to learn it correctly. By strengthening and trainingthese muscles, you may be able to reduce the symptoms oferectile dysfunction. Complementary therapies Some complementary therapies, such as acupuncture, have claimed to treat erectile dysfunction. However, there is little evidence they are useful. In some cases, they may even include ingredients that could interact with other medications and cause side effects. Always speak to your GP before using any complementary therapies. Source: NHS 24 - Opens in new browser window Last updated: 12 December 2023 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Dont include personal information e.g. name, location or any personal health conditions. Email Address e.g. [email protected] Message Maximum of 500 characters Send feedback Add this page to\n Info For Me Other health sites Prostate Cancer UK Institute of Psychosexual Medicine COSRT: therapy Fertility Network UK Lab Tests Online UK: testosterone British Cardiovascular Society Sexual Advice Association NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats 2023 NHS 24 v1.1.1.17852

Escherichia coli (E. coli) O157

Escherichia coli (E. coli) O157 | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotlands Service Directory 0 Home Illnesses and conditions Infections and poisoning Escherichia coli (E. coli) O157 Escherichia coli (E. coli) O157 Escherichia coli O157, sometimes called VTEC, is a bacterial infection. It can cause severe stomach pain, bloody diarrhoea and kidney failure. E. coli O157 is found in the gut and faeces of many animals, particularly cattle. Its an uncommon cause of gastroenteritis but can be caught by: eating contaminated food, such as raw leafy vegetables or undercooked meat a lways wash all vegetables, including salad leaves, that will be eaten raw,unless they have been pre-prepared and are labelled ready to eat(washing may reduce the risk of infection, but will not eliminate any risk of infection completely) touching infected animals or accidentally coming into contact with their faeces contact with people who have the illness, particularly if you do not wash your hands thoroughly after using the toilet or before handling food drinking water from inadequately treated water supplies swimming or playing in contaminated water, such as ponds or streams Symptoms of E. coli O157 infection Symptoms include diarrhoea, stomach cramps and occasionally fever. About half of people with the infection will have bloody diarrhoea. People usually notice symptoms3 to 4 days after they have been infected. But symptoms can start any time between 1 and 14 days afterwards. These symptoms can last up to 2 weeks. A small number of people with E. coli O157 infection go on to develop a serious condition called haemolytic uraemic syndrome (HUS). This can sometimes lead to kidney failure and death, although this is rare. The risk of HUS is highest in children aged under5 years. Some people become infected but dont develop symptoms. Further information about gastroenteritis Treatment and care at home There is no specific treatment for E. coli O157 infection. People who are infected can usually be cared for at home and most will get better without medical treatment. Its important to drink plenty of fluids, as diarrhoea can lead to dehydration. Contact your GP practice if: you or your child has bloody diarrhoea Antibiotics are not recommended, and may increase the risk of complications. Anti-diarrhoea drugs such as loperamide (Imodium) are also not recommended as they may prolong your exposure to the toxin. Find out more about caring for a child with gastroenteritis and caring for an adult with gastroenteritis . How to prevent E. coli O157 from spreading at home Strict hygiene measures are essential to stop others getting infected. Do wash your hands thoroughly with soap in running water and dry them completely use liquid soap and warm water if you can everyone must wash their hands after contact with an infected person, particularly after handling their clothes or bedding always wash your hands after going to the toilet or changing babies nappies, and before preparing or serving food or eating meals if youve been infected, avoid cooking or preparing food until 48 hours after your symptoms have cleared up wash soiled clothing and bed linen separately from other clothes in a washing machine at the highest temperature possible (for example 60C) wipe down the outside of the washing machine with hot water and detergent after any heavily soiled load clean toilet seats, toilet flush handles, basin taps, surfaces and toilet door handles at least daily, preferably more often, using hot water and detergent disinfection sprays and wipes or alcohol-based wipes may be used on toilet seats and other surfaces, but only after any visible soiling has been removed thick household bleach is highly effective dilute one part bleach to every 10 parts water for soiled surfaces and one part bleach to every 100 parts water for other hard surfaces ideally, use heavy-duty domestic rubber gloves and disposable cloths for cleaning dispose of cloths by placing them in a plastic bag, sealing the neck and placing in household waste thoroughly wash rubber gloves in hot water and detergent after use, then rinse and allow to dry deal with any spillage of faeces immediately clean the soiled area with hot water and detergent using heavy-duty domestic rubber gloves then clean gloves and wash hands thoroughly Dont do not share towels or nappy changing mats do not clean soiled items in the kitchen Returning to work or school Anyone who has had an E. coli O157 infection should stay away from work or school until they have been completely free of symptoms for 48 hours. Most people are no longer infectious after about a week, although some people, particularly children, may carry E. coli O157 for several months after they have got better. Some people need to take special care before returning to work or school. If you work in health or social care, or your work involves handling food, you should ask your local authority environmental health officers about when it is safe to return to work. This advice applies to both people who have been infected and those who live in the same household as someone who has. If you have a child under 5 years of age who has had E. coli, or lives with someone who has, you should talk to your GP about when it is safe for your child to return to school or nursery. Children under 5 years of age who have had an E. coli O157 infection should not swim in public swimming pools, or share paddling pools with others, until they have had test results showing that they are no longer an infection risk to others. Source: NHS 24 - Opens in new browser window Last updated: 29 May 2023 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Dont include personal information e.g. name, location or any personal health conditions. Email Address e.g. [email protected] Message Maximum of 500 characters Send feedback Add this page to\n Info For Me NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats 2023 NHS 24 v1.1.1.17852

Ewing sarcoma

Ewing sarcoma - Illnesses & conditions | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotlands Service Directory 0 Home Illnesses and conditions Cancer Cancer types in adults Ewing sarcoma Ewing sarcoma Ewing sarcoma is a rare type of bone cancer. The 3 main types of primary bone cancer are chondrosarcoma, osteosarcoma and Ewing sarcoma. Ewing sarcoma most commonly affects people who are 10 to 20 years old. Sarcomas A sarcoma is a type ofcancerthat develops in the bodys supporting tissues. Bone sarcomas and soft tissue sarcomas are the 2 main types. Ewing sarcoma usually occurs in bone. It most commonly develops in the: pelvis bone(hips) thigh bone(femur) shin bone (tibia) However,the conditioncan also develop in the soft tissues surrounding the bone or joint. This type of Ewing sarcoma is known as extraosseous, which means outside the bone. Symptoms of Ewing sarcoma The symptoms of Ewing sarcoma will depend on the size of the cancer and where it is in the body. The main symptoms are pain in the affected area that gets progressively worse, and swelling and tenderness. Other possible, but less common, symptoms may include a high temperature (fever), severe tiredness and weight loss. In some cases of Ewing sarcoma, there may not be any symptoms at all. However, as the tumour grows it could weaken the affected bone, increasing the risk of fracture. What causes Ewing sarcoma? Likeother types of bone cancer, the exact cause of Ewing sarcoma isunknown. As thecondition tends to predominantly affect older children and teenagers, one theory isthat it may be related to fast-growing bones. The rapid growth spurt thathappens during pubertymay in some way make bone tissue more vulnerable to cancer. Research has also found babies born with anumbilical hernia are 3 times more likely to develop Ewing sarcoma. However, the increased risk is still small as only 1 in 110,000 children with an umbilical hernia will go on to develop the condition. The Cancer Research UK website has more information about the risks and causes of bone cancer . Diagnosing Ewing sarcoma Whenyou visit your GP because of bone pain, theyll ask you about your symptoms and examine the affected area. Your GP may refer you foran X-ray to check for anything abnormal. Ifabnormalities are found, youll be referred to an orthopaedic surgeon (a bone specialist). They may recommend that youhave a magnetic resonance imaging (MRI) scan to examine the area in closer detail. A bone biopsy may be carried out to confirm whether cancer is present. A fine needleis used to remove a sample of bone marrow from the affected area so it can be examined under a microscope. It can either be carried out using a general anaesthetic or a local anaesthetic . The Cancer Research UK website has more information about tests for bone cancer and the stages of bone cancer . Treating Ewing sarcoma Like all types of cancer, the earlier Ewing sarcoma is diagnosed, the easier it is to treat. Ewing sarcoma is usually treated with a combination of chemotherapy ,surgery and radiotherapy. Chemotherapy may be used before surgery to shrink the tumour and make it easier to remove. Ewing sarcoma also responds well to radiotherapy . It can be used to shrink the tumour after chemotherapy, and before or after surgery to lower the risk of the cancer returning. In some cases, surgically removing Ewings sarcoma can be difficult for example, if it develops in the pelvis. In this case, radiotherapy may be used as the main treatment. Surgery If surgery is recommended, the type youll have will depend on: the size of the tumour where it is in your body whether it hasgrown into the tissues surrounding the bone You may have surgery to remove part or all of the bone affected by cancer. This type of surgery is known as resection. Limb-sparing surgeryinvolves removing the area of bone on an arm or legwhere the cancer is growing. A piece of metal (prosthesis) or a bone graft will be used to replace the piece of bone that is removed. In some cases, your whole arm or leg may need to be removed ( amputation ).This may be the only optionto prevent the cancer returning if its spread into the tissues surrounding the bone. For more information about the types of treatment for bone cancer , visit the Cancer Research UK website. Living with bone cancer If youre diagnosed with bone cancer, it can be upsetting andfrightening.Knowing as much about the type of cancer you have and the best treatment options will help youmake decisions. The majority of people who have surgery for bone cancer have a limb-sparing procedure. However, for some people, having their limb amputated may be the best option. This can be a very difficult situation to cope with and you may experience emotions such as grief and bereavement . Its important to seek help and talk about how youre feeling. You could talk toyour partner, family, friends or the healthcare professionals in charge of your care. Talking to others will help you come to terms with your condition and treatment. There arealso a number of practical issues youll need to deal with, such as financial mattersand coping with day-to-day activitiessuch as school, college or work. The Cancer Research UK website has more informationon coping with bone cancer . Information about you If you or your child hasEwing sarcoma, your clinical team will pass information about you/your child on to the National Congenital Anomaly and Rare Diseases Registration Service (NCARDRS). This helps scientists look for better ways to prevent and treat this condition. You can opt out of the register at any time. Find out more about the register Source: NHS 24 - Opens in new browser window Last updated: 13 November 2023 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Dont include personal information e.g. name, location or any personal health conditions. Email Address e.g. [email protected] Message Maximum of 500 characters Send feedback Add this page to\n Info For Me Also on NHS inform Ewing sarcoma: Children Other health sites Cancer Research UK: Bone cancer types Macmillan Cancer Support: Ewing sarcoma Bone Cancer Research Trust: Ewing sarcoma Search for cancer support services near you Enter a place or postcode NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats 2023 NHS 24 v1.1.1.17852

Ewing sarcoma: Children

"Ewing sarcoma: Children | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotlands Service Directory 0 Home Illnesses and conditions Cancer Cancer types in children Ewing sarcoma: Children Ewing sarcoma: Children Ewing sarcoma is a type of bone cancer in children and young people. This information describes Ewing sarcoma, its symptoms, diagnosis and possible treatments. More children than ever are surviving childhood cancer. There are now new and better drugs and treatments, and we can now also work to reduce the after-effects of having had cancer in the past. Its devastating to hear that your child has cancer. At times it can feel overwhelming but there are many healthcare professionals and support organisations to help you through this difficult time. Understanding more about the cancer your child has, and the treatments that may be used, can often help parents to cope. Your childs specialist will give you more detailed information and if you have any questions its important to ask the specialist doctor or nurse who knows your childs individual situation. Sarcomas Sarcomas are rare types of cancer that develop in the supporting tissues of the body. There are 2 main types: bone sarcomas and soft tissue sarcomas. Bone sarcomas can develop in any of the bones of the skeleton, but may also develop in the soft tissue near bones. Soft tissue sarcomas can develop in muscle, fat, blood vessels or any of the other tissues that support, surround and protect the organs of the body. Ewing sarcoma Ewing sarcoma is the second most common primary sarcoma in children and young people. This type of cancer is a bone cancer and most commonly occurs in the long bones, ribs, pelvis and spine (vertebral column). It usually occurs in the teenage years, and is more common in boys. Although Ewing sarcoma is a type of bone cancer, it can also occur very rarely in the soft tissues. This is called extraosseous Ewing sarcoma. Another type of Ewing sarcoma is a primitive neuroectodermal tumour (PNET). These can be found in either the bone or soft tissue. Causes The exact causes of primary bone cancer are unknown. The development of Ewing sarcoma may be related in some way to times of rapid bone growth, which may explain why more cases are seen in teenagers. Like other cancers, its not infectious and cannot be passed on to other people. Signs and symptoms Pain is the most common symptom of bone cancer. It is frequently worse at night. However, symptoms may vary depending on the position and size of the cancer. There may be some swelling in the affected area if the tumour is close to the surface of the body and it may become tender to touch. This may cause a limp if in the leg or pelvis. Bone cancer is sometimes discovered when a bone that has been weakened by cancer breaks after the child has a minor fall or accident. Occasionally, there may be fever or weight loss. How Ewing sarcoma is diagnosed Usually you begin by seeing your GP, who will examine your child and may arrange tests or X-rays. If a sarcoma is suspected, your GP should refer your child directly to a specialist hospital or bone tumour centre. A variety of tests and investigations are needed to diagnose Ewing sarcoma, including an X-ray of the painful part of the bone, a chest X-ray and a blood test. A specialist doctor will remove a small piece of the tumour to look at under a microscope ( biopsy ). Other tests may be done, such as a bone scan, PET scan, a bone marrow biopsy. An MRI or CT scan may also be done. Any tests and investigations that your child needs will be explained to you. Treatment A combination of various treatments is used to treat Ewing sarcoma. These include chemotherapy, surgery and radiotherapy. Treatment will depend on a number of factors, including the size and position of the tumour. Chemotherapy Chemotherapy is the use of anti-cancer (cytotoxic) drugs to destroy cancer cells. This is a very important component of treatment for the majority of children with Ewing sarcoma and can help make surgery more straightforward. A combination of different chemotherapy drugs are given before surgery and continued afterwards in order to destroy any remaining cancer cells and prevent the sarcoma from spreading. Chemotherapy given in this way is called adjuvant chemotherapy. Surgery If surgery is needed, it should be carried out at a specialist orthopaedic bone tumour centre. The aim of surgery is to remove the tumour without causing too much damage. If the tumour is in one of the main bones of the arm or leg, it may be necessary to remove the whole limb (amputation) or part of the affected bone. If only part of the affected bone is removed, this is known as limb-sparing surgery. Amputation Sometimes amputation of the limb is unavoidable if the cancer has affected the surrounding blood vessels and nerves. After amputation, a false limb will be fitted, and this will be regularly adjusted as your child grows. False limbs work very well. It should be possible for your child to join in with normal activities and even sport. Limb-sparing surgery There are several ways in which limb-sparing surgery may be done. It may involve: replacing the bone with a prosthesis (a specially designed artificial part) replacing the bone with bone taken from another part of the body (a bone graft) After limb-sparing surgery, the child is often able to use the limb almost normally. However, it is best not to take part in any contact sports, because any damage to the bone graft or prosthesis may require another major operation to repair or replace it. If the child is growing, the limb prosthesis will need to be lengthened from time to time as the bone grows. This may mean further short stays in hospital, although some prostheses can be lengthened during an outpatient procedure. Radiotherapy Radiotherapy treats cancer by using high energy rays that destroy cancer cells while doing as little harm as possible to normal cells. Ewing sarcoma responds very well to radiotherapy. Its often used after chemotherapy and before or after surgery. If the tumour is impossible to remove surgically, its a good option. Side effects of treatment for Ewing sarcoma Treatment often causes side effects . Your childs doctor will discuss this with you before the treatment starts. Any possible side effects will depend on the actual treatment being used and the part of the body thats being treated. Side effects can include: feeling sick (nausea) and being sick (vomiting) hair loss increased risk of infection bruising and bleeding tiredness diarrhoea Radiotherapy can cause irritation or soreness of the skin in the area being treated and general tiredness. If your child is having surgery, the surgeon will explain the possible complications of the surgery that your child is having. Late side effects A small number of children may develop other side effects, sometimes many years later. These include a reduction in normal bone growth, reduced fertility, a change in heart function, and a small increase in the risk of developing a second cancer later in life. Your childs doctor or nurse will explain all of this to you and will monitor your child carefully for any potential late side effects. Clinical trials Many children have their treatment as part of a clinical research trial. Trials aim to improve our understanding of the best way to treat an illness, usually by comparing the standard treatment with a new or modified version. Specialist doctors carry out trials for childrens cancers. If appropriate, your childs medical team will talk to you about taking part in a clinical trial, and will answer any questions you have. Written information will be provided to help explain things. Treatment guidelines Sometimes, clinical trials are not available for your childs tumour. This may be because a recent trial has just finished, or because the tumour is very rare. In these cases, you can expect your doctors and nurses to offer treatment which is agreed to be the most appropriate, using guidelines which have been prepared by experts across the country. The Childrens Cancer and Leukaemia Group (CCLG) is an important organisation which helps to produce these guidelines. Follow-up care Your child will have regular follow-up appointments, with x-rays or scans as necessary. Many children with Ewing sarcoma can be cured. Even if the tumour comes back, further treatment may be given successfully. Your child will be checked up on every few months for the first 3 years after treatment and then every 6 months for another 2 years. If you have specific concerns about your childs condition and treatment, its best to discuss them with your childs doctor who knows the situation in detail. Your feelings As a parent, the fact that your child has cancer is one of the worst situations you can be faced with. You may have many emotions, such as fear, guilt, sadness, anger and uncertainty. These are all normal reactions and are part of the process that many parents go through at such a difficult time. Its not possible to address here all of the feelings you may have. However, the CCLG booklet Children & Young Peoples Cancer; A Parents Guide talks about the emotional impact of caring for a child with cancer and suggests sources of help and support. Your child may have a variety of powerful emotions throughout their experience with cancer. The Parents Guide discusses these further and talks about how you can support your child. Source: Children's Cancer and Leukemia Group - Opens in new browser window Last updated: 14 November 2023 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Dont include personal information e.g. name, location or any personal health conditions. Email Address e.g. [email protected] Message Maximum of 500 characters Send feedback Add this page to\n Info For Me Search for cancer support services near you Enter a place or postcode NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats 2023 NHS 24 v1.1.1.17852"

Eye cancer

Eye cancer | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotlands Service Directory 0 Home Illnesses and conditions Cancer Cancer types in adults Eye cancer Eye cancer There are a number of different types of cancer that affect the eyes, including: eye melanoma squamous cell carcinoma lymphoma retinoblastoma a childhood cancer Cancer can also sometimes develop in the tissues surrounding your eyeball or spread to the eye from otherparts of the body, such as the lungs or breasts. This topic focuses on melanoma of the eye, one of the most common types of eye cancer. Symptoms of eye cancer Eye cancer doesnt always cause obvious symptoms and may only be picked up during a routine eye test. Symptoms of eye cancer can include: shadows, flashes of light, or wiggly lines in your vision blurred vision a dark patch in youreye thats getting bigger partial or total loss of vision bulging of one eye a lump on your eyelid or inyour eye thats increasing in size pain in or around your eye, although this is rare These symptoms can also be caused by more minor eye conditions, so theyre not necessarily a sign of cancer. However, its important to get the symptomschecked by a doctor as soon as possible. Melanoma of the eye Melanoma is cancer that develops from pigment-producing cells called melanocytes. Mostmelanomas develop in the skin, but its also possible for them to occur in other parts of the body, including the eye. Eye melanoma most commonly affects the eyeball. Doctors sometimes call ituveal or choroidal melanoma, depending on exactly which part of your eye is affected. Itcan also affect the conjunctiva, the thinlayer that covers the front of the eye, or the eyelid. What causes eye melanoma? Eye melanoma occurs whenthe pigment-producing cells in the eyes divide and multiply too rapidly. This produces a lump of tissue known as a tumour. Its not clear exactly why this occurs, but the following factors may increase the risk of it happening: lighter eye colour if you have blue, grey or green eyes, you have a higher risk of developing eye melanoma comparedwith people who have brown eyes white or pale skin eye melanoma mostly affects white people and is more common inthose with fair skin unusual moles if you haveirregularly shaped or unusually coloured moles, youre more at risk of developing skin cancer and eye melanoma use of sunbeds theres some evidence to suggest that exposing yourself to ultraviolet (UV) radiation from sunbeds, for example, can increase your risk of eye melanoma overexposure to sunlight this increases your risk of skin cancer, and may also be a risk factor for eye melanoma The risk of developing eye melanoma also increases with age, with most cases being diagnosed in people in their fifties. Diagnosing melanoma of the eye If your GP or optician (optometrist) suspectsyou have a serious problem with your eyes, they will refer you to a specialist eye doctor called an ophthalmologistfor an assessment. If they suspect you have melanoma of the eye, theyll refer you to a specialist centre for eye cancer. There are 4 centres in the UK, located in London, Sheffield, Liverpool, and Glasgow. Its likely youll have a number of different tests at the centre, including: an eye examination to look at the structures of your eyes in more detail and check for abnormalities an ultrasound scan of your eye a small probe placed over your closed eye uses high-frequency sound waves to create an image of the inside of your eye; this allowsyour doctor tofindout more about the position of the tumour and its size afluorescein angiogram where photographs of the suspected cancer are taken using a special camera after dye has been injected into your bloodstream to highlight the tumour Occasionally,a thin needlemay beused to remove a small sampleof cells fromthetumour (biopsy) .The genetic information in these cells is analysed togive an indication of the chances of the cancer spreading or coming back. Treatments foreye melanoma Treatment for melanoma of the eye depends on the size and location of the tumour. Your care team will explain each treatment option in detail, including the benefits and any potential complications. Treatment will aim to conserve the affected eye whenever possible. The main treatments for eye melanoma are: brachytherapy tiny plates lined with radioactive material called plaques are inserted nearthe tumour and left in place for up to a week to kill the cancerous cells external radiotherapy a machine is used to carefully aim beams of radiation at the tumour to kill the cancerous cells surgery to remove the tumour or part of the eye this may be possible ifthe tumour is small and you still have some vision in your eye removal of the eye (enucleation) this may be necessary if the tumour is large or youve lost your vision;the eye will eventually be replaced with an artificial eye that matchesyour other eye Chemotherapy is rarely used for eye melanoma, but may be suitable for other types of eye cancer. TheCancer Research UK website has more information about the treatment options for eye cancer and thetypes of eye cancer surgery. Source: NHS 24 - Opens in new browser window Last updated: 13 November 2023 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Dont include personal information e.g. name, location or any personal health conditions. Email Address e.g. [email protected] Message Maximum of 500 characters Send feedback Add this page to\n Info For Me Also on NHS inform Radiotherapy Other health sites Cancer Research UK: Eye cancer Macmillan Cancer Support: Eye cancer Search for cancer support services near you Enter a place or postcode NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats 2023 NHS 24 v1.1.1.17852

Febrile seizures

Febrile seizures | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotlands Service Directory 0 Home Illnesses and conditions Brain, nerves and spinal cord Febrile seizures Febrile seizures About febrile seizures Symptoms of febrile seizures Causes of febrile seizures Diagnosing febrile seizures Treating febrile seizures About febrile seizures A febrile seizure is a fit that can happen when a child has a fever. Febrile seizures are also sometimes called febrile convulsions. They are relatively common and, in most cases, arent serious. Around one in 20 children will have at least one febrile seizure at some point. They most often occurbetween the ages of six months and three years. During a febrile seizure, the childs body usually becomes stiff, they lose consciousness and their arms and legs twitch. Some children may wet themselves. This is known as a tonic clonic seizure. Read more about the symptoms of febrile seizures What to do during a seizure If your child is having a febrile seizure, place them in the recovery position . Lay them on their side, on a soft surface, with their face turned to one side. This will stop them swallowing any vomit, keep their airway open and help prevent injury. Stay withyour childand try to make a note of how long the seizure lasts. If its your childs first seizure, or it lasts longer than five minutes,take them to the nearest hospital as soon as possible, or dial 999 for an ambulance. While its unlikely that theres anything seriously wrong,its best to be sure. Ifyour child has hadfebrile seizuresbefore and the seizure lasts for less than five minutes, phone your GP or the NHS 24 111 service for advice. Dont put anything, including medication,in your childs mouth during a seizure because theres a slight chance thatthey might bite their tongue. Almost all children make a complete recovery after having a febrile seizure. Read more about diagnosing febrile seizures and treating febrile seizures Types of febrile seizure There are two main types of febrile seizure. Simple febrile seizure A simple febrile seizure is the most common type of febrile seizure, accounting for about eight out of 10 cases. Its a fit that: is a tonic clonic seizure (see above) lasts less than 15 minutes doesnt reoccur within 24 hours or the period in which your child has an illness Complex febrile seizure Complex febrile seizures are less common, accounting for two out of 10 cases. A complex febrile seizure is any seizure that has one or more of the following features: the seizure lasts longer than 15 minutes your child only has symptoms in one part of their body (this is known as a partial or focal seizure) your child has another seizure within 24 hours of the first seizure, or during the same periodof illness your child doesnt fully recover from the seizure within one hour Why febrile seizures occur The cause of febrile seizures is unknown, although theyre linked to the start of a fever (a high temperature of 38C (100.4F) or above). In most cases, a high temperature is caused by an infection such as: chickenpox flu (influenza) middle ear infections (otitis media) tonsillitis There may also be a genetic link to febrile seizures because the chances of having a seizure are increased if a close family member has a history of them. Around one in four children affected by febrile seizures has a family history of the condition. Read more about the causes of febrile seizures Complications Febrile seizures have been linked to an increased risk of epilepsy , as well as other problems. Recent research findings may indicate a link between febrile seizures and sudden unexplained death in childhood (SUDC), possibly due to the connection between febrile seizures and epilepsy. However, this link hasnt been proven and SUDC is incredibly rare, affecting around one in 100,000 children which is equivalent to a 0.001% chance. In addition, one of the biggest studies of its kind looked at more than 1.5 million children with a history of febrile seizures and found no evidence of an increased risk of death in later childhood or adulthood. Febrile seizures and epilepsy Many parents worry that if their child has one or more febrile seizures, theyll develop epilepsy when they get older. Epilepsy is a condition where a person has repeated seizures without fever. While its true that children who have a history of febrile seizures have an increased risk of developing epilepsy, it should be stressed that the risk is still small. Its estimated that children with a history of simple febrile seizures have a one in 50 chance of developing epilepsy in later life. Children with a history of complex febrile seizures have a one in 20 chance of developing epilepsy in later life. This is compared to around a one in 100 chance for people who havent had febrile seizures. Symptoms of febrile seizures The main symptom of a febrile seizure is a fit that occurs while a child has a fever. Febrile seizures often occur during the first day of a fever, which is defined as a high temperature of 38C (100.4F) or above. However, there appears to be no connection between the extent of your childs fever and the start of a seizure. Seizures can occur even if your child has a mild fever. Simple febrile seizures canhappen when theres a rapid rise in temperatureand you may only realise your child is ill when they have a fit.Alternatively,they can occur as your childs temperature drops from a high level. During simple febrile seizures: your childs body will become stiff and their arms and legs will begin to twitch theyll lose consciousness and they may wet or soil themselves theymay also vomit and foam at the mouth and their eyes may roll back the seizure usually lasts for less than five minutes following the seizure, your child may be sleepy for up to an hour afterwards Complex febrile seizures tend to last longer than 15 minutes, and the symptoms may only affect one area of your childs body. The seizure sometimes recurs within 24 hours or during the period in which your child is ill. Seeking medical advice You should take your child to hospital or dial 999 for an ambulance if: your child is having a fit for the first time the seizure lasts longer than five minutes andshows no signs of stopping you suspect the seizure is being caused by another serious illness, for example meningitis your child is having breathing difficulties If your child has previously had febrile seizures, its recommended that you telephone your GP or call the NHS 24 111 service for advice. You should also contact your GP or the NHS 24 111 service if your child shows signs and symptoms ofdehydration (a lack of fluid in the body). This includes: a dry mouth sunken eyes a lack of tears when crying a sunken fontanelle the soft spot usually found at the top of a young childs head Causes of febrile seizures Febrile seizures are linked to fevers, but the exact cause is unknown. Some researchers think that the biological processes associated with a high temperature may be responsible. A high temperature is thought to be caused by a bacterial or viral infection that stimulates the release of cytokines. Cytokines are proteins that affect the parts of the brain and nervous system responsible for regulating the bodys temperature. Their release causes a rise in the bodys temperature. One theory is that in certain people, high levels of cytokines may temporarily scramble the workings of the brain and nervous system, triggering a seizure. Family history Althoughfebrile seizures are poorly understood, a family history of the conditions is thought to increase the risk. If a child has a first-degree relative (mother, father, sister or brother) with a history of febrile seizures, their risk of having seizures increases. The more relatives affected, the higher the risk. This is probably the result of one or more genetic mutations that a child inherits from their parents, which makes them more susceptible to seizures. A genetic mutation means the instructions carried in certain genesbecome scrambled, resulting in some of the bodys processes not working in the normal way. Associated infections Most febrile seizures occur whena child has a high temperature caused by an infection. The three most common infections associated with febrile convulsions are: viral infections, such as chickenpox and flu middle ear infections (otitis media) tonsillitis Other infections associated with febrile seizures are: urinary tract infections(UTIs) upperrespiratory tract infection an infection of the mouth, nose and throat, and associated tissues and structures gastroenteritis an infection of the digestive system lower respiratory tract infections, such as pneumonia (a lung infection) and bronchitis (an infection of the airways that supply the lungs) Vaccinations In rare cases, febrile seizures can occur after a child has a vaccination. Research has shown that your child has a one in 3,000 to 4,000 chance of having a febrile seizure after having the MMR vaccine . The risks are even lower with the DTaP/IPV/Hib vaccine a one in 11,000 to 16,000. Diagnosing febrile seizures Febrile seizures can often be diagnosed from a description of what happened. Further tests may be needed if the cause of the associated infection isnt clear. Its unlikely that your doctorwill see the seizure, so an account of what happenedis useful. Its useful to know: how long the seizure lasted what happened body stiffening, twitching of the face, arms and legs, staring and loss of consciousness whether your child recovered within one hour whether theyve had a seizure before Tests to identify the source of the infection will only usually be necessary to rule out rarer conditions which can cause similar symptoms, such as meningitis . A blood or urine sample may be needed to test for signs of infection. It can sometimes be difficult to obtain a urine sample from young children, so it may have to be done in hospital. Read more about blood tests Further tests Further tests may be carried out in hospital if your childs symptoms are unusual for example, if they dont have a high temperature or their seizures dont follow the normal pattern. Further testing and observation in hospital is also usually recommended if your child is having complex febrile seizures . Your child may have other tests including an electroencephalogram and lumbar puncture, particularly if theyre less than 12 months old. These two testsare explained below. Electroencephalogram Anelectroencephalogram (EEG) measures your childs electrical brain activity through electrodes that are placed on their scalp. Unusual patterns of brain activity can sometimes indicate epilepsy . However, some studies have suggested that an EEG may not be useful in many cases of febrile seizures. Lumbar puncture During a lumbar puncture , a small sample of cerebrospinal fluid (CSF) is removed for testing. CSF is a clear fluid that surrounds and protects the brain and spinal cord. A hollow needle is inserted into the base of the spine to obtain the CSF sample. During the procedure, local anaesthetic will be used to numb your childs back so that they dont feel any pain. A lumbar puncture can be used to determine whether your child has an infection of the brain or nervous system. Treating febrile seizures In many cases, febrile seizures do not need to be treated, although care should be taken to deal with a seizure as it happens. What to do during a seizure If your child is having a febrile seizure, place them in the recovery position . Lay them on their side, on a soft surface, with their face turned to one side. This will stop them swallowing any vomit, and will keep their airway open and help prevent injury. Stay with your child while theyre having a seizure, and make a note of when the seizure started to keep track of how long it lasts. If the seizure lasts for less than five minutes, phone your GP or call the NHS 24 111 service. If its your childs first seizure, or if it lasts longer than five minutes,take your child to the nearest hospital as soon as possible. While theres probably nothing seriously wrong with your child, its best to be sure. Dont put anything, including medication,in your childs mouth while theyre having a seizure. Theres a slight chance that they might bite their tongue, although any damage isnt usually serious and will heal within a few days. Trying to stop someone biting their tongue by placing your hand or an object in their mouth could be dangerous both for you and forthem. High temperature (fever) Reducing a high temperature can help make your child feel more comfortable. Paracetamol and ibuprofen have been shown to be effective in reducing a high temperature. However, they wont reduce thechances of your child actually having a seizure. Removing any unnecessary clothes and bedding will also help to lower your childs temperature. Aspirin should never be given to childrenunder 16 years of age because theres a small risk that the medication could trigger a condition called Reyes syndrome, which can cause brain and liver damage. The use of cold sponges or fans isnt recommended for treating a high temperature. Theres little evidence that theyre effective, and they may cause your child discomfort. Your GP will be able to give you additional advice about treating the underlying cause of your childs high temperature. Its also important to prevent dehydration during a fever by making sure your child drinks plenty of fluids. Recurring febrile seizures About one third of children will have a febrile seizure again during a subsequent infection. This often occurs within a year of the first febrile seizure. Recurrence is more likely if: the first febrile seizure occurred before your child was 18 months old theres a history of seizures or epilepsy in your family before having the first seizure your child had a fever that lasted less than onehour or their temperature was less than 40C (104F) your child has multiple seizures during the same febrile episode ( complex febrile seizure ) your child attends a day care nursery (this increases their chances of developing common childhood infections, such as the flu or chickenpox ) Itsnot recommended that your child is given a prescription of regular medicines to prevent further febrile seizures. This is because the adverse side effects associated with many medicines outweigh any risksof the seizures themselves. Research has shown that the use of medication to control feverisnt likely to prevent recurrence of further febrile seizures. However, there may be exceptional circumstances where medication to prevent recurrent febrile seizures is recommended. For example, children may need medication if they have a low threshold for having seizures during illness, particularly if the seizures are prolonged. In this case, your child may be prescribed medications such as diazepam or lorazepam to take at the start of a fever. Children whove had a febrile seizure following a routine vaccination (which is very rare), are no more at risk of having another seizure compared to children whove had a seizure due to another cause for fever. Source: NHS 24 - Opens in new browser window Last updated: 07 March 2024 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Dont include personal information e.g. name, location or any personal health conditions. Email Address e.g. [email protected] Message Maximum of 500 characters Send feedback Add this page to\n Info For Me NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats 2023 NHS 24 v1.1.1.17852

Feeling of something in your throat (Globus)

Feeling of something in your throat (Globus) Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotlands Service Directory 0 Home Illnesses and conditions Ears, nose and throat Feeling of something in your throat (Globus) Feeling of something in your throat (Globus) Globus is a symptom that can make you feel like you have a lump in your throat. Its also called globus sensation. Globus is usually not a sign of anything serious. It can be caused by many things, such as an increased tension of muscles or irritation in the throat. Your throat can be irritated by, for example, reflux. There are things you can do to help your globus symptoms at home, without the need to attend your GP. Symptoms of globus Different people describe globus differently. It may be felt as: tightness or a pressure in your throat mucus that you cannot clear ( catarrh ) an area of discomfort in your throat a feeling of something stuck or a lump in your throat If you feel something sticking in your throat, but can eat and drink normally and without pain, you do not need to worry. Your symptoms may: be most noticeable youre swallowing your saliva get worse with stress and worry vary from day to day When to get medical advice Speak to your GP practice if: you develop any difficulty or pain when swallowing you feel a lump in the neck you experience unintentional weight loss your symptoms do not improve If your symptoms do not improve, your GP will provide further support and advice on whether you need to see an ear nose and throat (ENT) specialist. Treatment for globus at home There are a number of things you can do to try to relieve globus symptoms. In most people, symptoms will get better following these self-help tips. However, for some people symptoms can recur off and on for several months. Eating and drinking Do drink at least 1.5 litres (3 pints) of water every day drink in small sips as swallowing helps to relax the throat avoid too much alcohol, tea, coffee and fizzy drinks reduce the amount of fatty and spicy food in your diet leave at least 3 hours between your last meal and going to bed try anti-reflux medication (ask a pharmacist for advice) Stop smoking Smoking causes irritation to your throat. By stopping smoking, you can help to improve your globus symptoms. Further information on stopping smoking Avoid clearing your throat Try not to clear your throat as this can make your globus sensation worse. Try sipping water instead. Maintain a healthy weight Losing any excess weight may reduce your symptoms. Reduce stress Stress can increase your globus sensation. If you think you might be stressed, try to relax in a way that is doable for you and your situation. Breathing and relaxation exercises can sometimes help. If you feel you need further help with managing stress, your GP can discuss this with you. Further information about relieving stress Source: ENT Scotland - Opens in new browser window Last updated: 28 March 2024 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Dont include personal information e.g. name, location or any personal health conditions. Email Address e.g. [email protected] Message Maximum of 500 characters Send feedback Add this page to\n Info For Me NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats 2023 NHS 24 v1.1.1.17852

Fever in adults

Fever in adults | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotlands Service Directory 0 Home Illnesses and conditions Infections and poisoning Fever in adults Fever in adults Return to Symptoms Enter age Last Updated: Next Review Date: Review my answers Find your local services Search for a service near you by entering your postcode below. Please input your postcode in the following format: A12 1BC GP Practices Dental Services Pharmacies Opticians Postcode Search NHS inform has more information on this condition. Read more Previous Start guide Review my answers You told us your credentials were: : You said: Based on the information you gave us, we made the following recommendation: Close Keep a copy View PDF Your normal body temperature is approximately 37C.A fever is usually when your body temperature is 37.8C or higher. You may feel warm, cold or shivery. You can find out if you have a fever by using a thermometer to take your temperature. Fever in adults self-help guide Complete our self-help guide to check your symptoms and find out what to do next. What causes a fever? A fever is your bodys natural response to many common illnesses such as: flu tonsillitis kidney or urinary tract infections (UTIs) Fever helps your body fight infections by stimulating your immune system (your bodys natural defence). By increasing your bodys temperature, a fever makes it harder for the bacteria and viruses that cause infections to survive. When to get help Contact your GP practice immediately if: You have a fever and you: are on treatment for immune deficiency are on immune-suppressant drugs, such as regular steroids, methotrexate, azathioprine or cyclophosphamide are taking medication where you have been warned about a risk of a reduced immune system are on, or recently completed, treatment for cancer, leukaemia or lymphoma are a transplant recipient are HIV positive have chronic lung disease have asthma which has been treated with medication in the last 3 years have heart disease (excluding blood pressure which is currently well controlled) have diabetes or another metabolic disease have chronic gastrointestinal or liver disease have chronic renal (kidney) disease have cystic fibrosis have neurological conditions such as cerebral palsy, stroke, multiple sclerosis or muscular dystrophy have sickle cell disease Contact your GP practice if: you have severe thirst or are peeing less you are passing urine that is darker than normal you are light-headed or weak you have new, severe muscle cramps your symptoms have worsened or you notice new symptoms youve had a fever after recent foreign travel If your GP practiceis closed, phone 111. Treating a fever Most fevers will improveon their own in a few days. However, there are a number of things you can do to help the uncomfortable feelings associated with a fever. Do wear loose comfortable clothing make sure the room you are in isnt too warm drink more fluids (for example water) so you dont get dehydrated you should be peeing approximately every 6 hours (a pale yellow urine means youre unlikely to be dehydrated) avoid alcohol as this can make dehydration worse take a medicine that reduces fever such as paracetamol (unless youre allergic or have been told by a healthcare professional that you cant take it) Dont do not over dress do not attempt to make yourself feel cold Fever in children Fever affects people of all ages, however it often affects babies and younger children in response to minor illnesses such as: coughs colds Find out more about fever in children . Source: NHS 24 - Opens in new browser window Last updated: 05 December 2022 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Dont include personal information e.g. name, location or any personal health conditions. Email Address e.g. [email protected] Message Maximum of 500 characters Send feedback Add this page to\n Info For Me Also on NHS inform Self-help guide: Fever in babies Coronavirus (COVID-19) NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats 2023 NHS 24 v1.1.1.17852

Fever in children

Fever in children | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotlands Service Directory 0 Home Illnesses and conditions Infections and poisoning Fever in children Fever in children Return to Symptoms Enter age Last Updated: Next Review Date: Review my answers Find your local services Search for a service near you by entering your postcode below. Please input your postcode in the following format: A12 1BC GP Practices Dental Services Pharmacies Opticians Postcode Search NHS inform has more information on this condition. Read more Previous Start guide Review my answers You told us your credentials were: : You said: Based on the information you gave us, we made the following recommendation: Close Keep a copy View PDF It can be extremely worrying if your child has a high temperature. But its very common and often clears up by itself without treatment. A quick and easy way to find out whether your child has a fever is to take their temperature using a thermometer. What causes a high temperature? Most fevers are caused by infections or other illnesses.The high body temperaturemakes it more difficult for thebacteria and viruses that cause infections to survive. Common conditions that can cause fevers include: upper respiratory tract infections (RTIs) flu ear infections roseola a virus that causes a temperature and arash tonsillitis kidney or urinary tract infections (UTIs) common childhood illnesses, such as chickenpox and whooping cough Your childs temperature can also be raised after vaccinations, or if they overheat because of too much bedding or clothing. When to seek medical help Phone 999 if your child: has a stiff neck has a rash that does not fade when you press a glass against it ( use the glass test from Meningitis Now ) is bothered by light has a fit ( febrile seizure ) for the first time (they cannot stop shaking) has unusually cold hands and feet has blue, pale or blotchy skin, lips or tongue has a weak, high-pitched cry thats not like their normal cry is drowsy and hard to wake is extremely agitated (does not stop crying) or is confused finds it hard to breathe and sucks their stomach in under their ribs is not responding like they normally do, or is not interested in feeding or normal activities Contact your GP if: Your child: is under 3 months and has a temperature of 38C (101F) or above is over 3 months and has a temperature of 39C (102F) or above has other signs of illness, such as a rash , as well as a high temperature has a high temperature thats lasted for 5 days or more has persistent vomiting does not want to eat, or is not their usual self and youre worried has a high temperature that does not come down with paracetamol is dehydrated such as nappies that are not very wet, sunken eyes, and no tears when theyre crying If your GP is closed, phone 111. If your child seems to be otherwise well for example, if theyre playing and attentive its less likely theyre seriously ill. Fever in babies and children under 2 years of age self-help guide Complete our self-help guide to check your childs symptoms and find out what to do next. Treating a fever If your child has a fever, itsimportant to keep them hydrated by giving them plenty of cool water to drink. Babies should be given plenty of liquids, such as breast milk or formula.Even if your child isnt thirsty, try to get them to drink little and often to keep their fluid levels up. If its warm, you could help your child to stay at a comfortable temperature by covering them with a lightweight sheet or opening a window. However, they should still be appropriately dressed for their surroundings and sponging your child with coolwaterisnt recommendedto reduce a fever. Medicine to reduce fever (antipyretics) Childrens paracetamol or ibuprofen work as antipyretics, which help to reduce fever, as well as being painkillers. You cant give them both at the same time, but if one doesnt work, you may want to try the other later. Antipyretics arent always needed. If your child isnt distressed by the fever or underlying illness, theres no need to use antipyretics to reduce a fever. Always read the patient information leaflet that comes with the medication. This will tell you the correct dose and frequency for your childs age. More serious illnesses Sometimes a hightemperature in children is associated with more serious signs and symptoms, such as: breathlessness vomiting rash fits or seizures Possible serious bacterial illnesses include: meningitis infection of the meninges, the protective membranes that surround the brain and spinal cord septicaemia infection of the blood pneumonia inflammation of the lung tissue, usually caused by an infection Potentially serious causes of fever are relatively rare. Source: NHS 24 - Opens in new browser window Last updated: 29 May 2023 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Dont include personal information e.g. name, location or any personal health conditions. Email Address e.g. [email protected] Message Maximum of 500 characters Send feedback Add this page to\n Info For Me Also on NHS inform Coronavirus (COVID-19) If your child has cold or flu symptoms NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats 2023 NHS 24 v1.1.1.17852

Fibroids

"Fibroids | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotlands Service Directory 0 Home Healthy living Women's health Girls and young women (puberty to around 25) Periods and menstrual health Fibroids Fibroids | | Polski | | | British Sign Language (BSL) | Easy Read Fibroids are non-cancerous growths that develop in the muscular wall of the womb (uterus). These growths are made up of muscle and tissue and can be different sizes. Some can be the size of a pea, others can be the size of a melon. Theyre sometimes known as uterine myomas or leiomyomas. Fibroids are common. Around 1 in 3 people who menstruate develop them at some point in their life. Theyre more common as you get older. Symptoms Many people dont know that they have fibroids because they dont have any symptoms. This is nothing to worry about. Speak to your doctor if: Youre worried about your symptoms or you regularly have: heavy periods painful periods tummy (abdominal) pain lower back pain a frequent need to urinate constipation pain or discomfort during sex symptoms which are affecting your day to day life If your doctor thinks you might have fibroids, theyll usually refer you for an ultrasound scan to confirm the diagnosis. Why fibroids develop The exact cause of fibroids is unknown. Theyre linked to the hormones produced by the ovaries, oestrogen and progesterone. Fibroids usually develop and grow as long as the ovaries are producing these hormones. Fibroids may continue to grow during pregnancy. They tend to shrink when these hormone levels fall, such as after the menopause . Types of fibroids There are different types of fibroid. The main types of fibroids are: intramural the most common type of fibroid, these develop in the muscular wall of the womb subserosal fibroids that develop on the outside part of the wall of the womb and can become very large submucosal fibroids that develop in the muscular layer of the womb beneath the wombs inner lining (endometrium) and grow into the inside of the womb pedunculated subserosal or submucosal fibroids that are attached to the womb with a narrow stalk of tissue Treatment Fibroids will often shrink after the menopause,as hormone levels in your body change. If you have fibroids, but youre not affected by any symptoms then you dont need treatment. However, if you do have symptoms, your doctor can recommend the right treatment for you. Treatment options include: over-the-counter pain relief like ibuprofen the contraceptive pill which can reduce heavy menstrual bleeding medication taken only during your period that can reduce heavy menstrual bleeding medicines that can shrink fibroids by lowering your oestrogen and progesterone levels in rare cases, surgery Your doctor will discuss these treatments with you and you can ask any questions that you might have. Fibroids andgetting pregnant If youre having difficulty getting pregnant, your doctor or specialist may suggest extra support or treatments that can help. Your doctor will discuss these with you and you can ask any questions that you might have. Source: Scottish Government - Opens in new browser window Last updated: 28 February 2023 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Dont include personal information e.g. name, location or any personal health conditions. Email Address e.g. [email protected] Message Maximum of 500 characters Send feedback Other languages and formats | | Polski | | | British Sign Language (BSL) | Easy Read | | Polski | | | British Sign Language (BSL) | Easy Read Add this page to\n Info For Me Also on NHS inform Periods (menstruation) Self-help tool: Periods and mental wellbeing Other health sites NICE: heavy menstrual bleeding NICE: hysteroscopic morcellation of fibroids NICE: MRI-guided percutaneous laser ablation of fibroids NICE: MRI-guided transcutaneous ultrasound for fibroids NICE: uterine artery embolisation for fibroids Pelvic Pain Support Network British Fibroid Trust Fertility Network UK NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats 2023 NHS 24 v1.1.1.17852"

Fibromyalgia

"Fibromyalgia | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotlands Service Directory 0 Home Illnesses and conditions Brain, nerves and spinal cord Chronic pain Fibromyalgia Fibromyalgia Fibromyalgia is a long-term condition that causes pain all over the body. Symptoms of fibromyalgia The main symptom of fibromyalgia is widespread pain that might feel like: an ache a burning sensation a sharp stabbing pain a mixture of these 3 feelings The pain is likely to be continuous, but it might be better or more severe at different times. As well as widespread pain, people with fibromyalgia might also have: increased sensitivity to sensations like touch, light, temperature, noise fatigue (extreme tiredness) muscle stiffness difficulty sleeping problems with mental processes (known as fibro-fog) like problems with memory and concentration headaches irritable bowel syndrome (IBS) a digestive condition that causes stomach pain and bloating dizziness and clumsiness feeling too hot or too cold restless legs syndrome tingling, numbness, prickling or burning sensations in your hands and feet (pins and needles, also known as paraesthesia) unusually painful periods (if you get periods) anxiety depression Speak to your GP or healthcare professional if: you think you might have fibromyalgia Causes of fibromyalgia Its not clear why some people develop fibromyalgia. The exact cause is unknown, but its likely that many factors are involved. Altered pain messages Your brain, nerves and spinal cord make up your central nervous system. Changes in the way your central nervous system sends and receives information to your body might cause fibromyalgia. Fibromyalgia is a type of chronic pain. Read more about chronic pain Genetics Some people are more likely than others to develop fibromyalgia because of the genes inherited (passed on) from their parents. Triggers Fibromyalgia is often triggered by a stressful event. This might be a physically stressful event or an emotionally (psychologically) stressful event. Possible triggers of fibromyalgia might be: an injury a viral infection giving birth an operation the breakdown of a relationship being in an abusive relationship the death of a loved one Sometimes there isnt an obvious trigger. Diagnosing fibromyalgia Diagnosing fibromyalgia can be difficult. Theres no specific test to diagnose the condition. The symptoms of fibromyalgia can vary. The symptoms can be similar to those of several other conditions. Your GP will have to rule out other conditions with similar symptoms. Youll be asked about how your symptoms are affecting your daily life. Youll be examined to check for signs of other conditions. Theyll check for swollen joints which might suggest arthritis, rather than fibromyalgia. Tests to check for some of these conditions include urine and blood tests . You may also have X-rays and other scans. If youre found to have another condition, you could still have fibromyalgia as well. Criteria for diagnosing fibromyalgia For fibromyalgia to be diagnosed, certain criteria usually have to be met. The most widely used criteria for diagnosis are: you have pain in multiple areas of your body your symptoms have stayed at a similar level for at least 3months your symptoms cant be explained by any other reason you feel unrefreshed after sleep you have problems thinking or remembering (cognitive difficulties) you experience fatigue Diagnosing other conditions Its also possible to have other conditions alongside fibromyalgia, like: depression anxiety irritable bowel syndrome (IBS) osteoarthritis hypermobility spectrum disorder Identifying all possible conditions will help to guide your treatment. Treating fibromyalgia Fibromyalgia is a long term (chronic) condition. Theres no cure for fibromyalgia. But there are treatments to help relieve some of the symptoms. This can make the condition easier to live with. Traditional treatments like pain medication arent always helpful for people with fibromyalgia. Learning about your condition and finding the best self management approaches for you is the best way to manage it. A healthcare professional can help you explore your options. Exercise, movement and activity Exercise, movement and activity can be helpful way to manage pain. A physiotherapist can help you to develop self-management skills to reduce the impact of pain on your life. They might help you create a tailored exercise programme suited to your needs, abilities and goals. Physiotherapy can also help prevent further loss of strength and increase your fitness. Pain management movement videos Visit the living with chronic pain page for more information about exercise and relaxation techniques. Occupational therapy can help you manage your everyday activities around fibromyalgia. The aim is to do this without increasing your pain or overwhelming yourself. Your occupational therapist may suggest new ways to do things. They may be able to support you to continue to work, if you want to. Access to Work has information on how to get or stay in work if you have a health condition or disability. Group support Some pain clinics offer pain management programmes run by a team of specialists. These specialists can include physiotherapists and psychologists. They can provide support to develop coping skills and manage your activity levels. Speak to your GP if you think youd benefit from a pain management programme. Talking therapies Talking therapies can help you manage the stress of living with fibromyalgia. Examples of talking therapies are: cognitive behavioural therapy (CBT) a treatment approach to help you understand the link between how we think and what we do acceptance and commitment therapy (ACT) often used for pain management Medication Medication cant treat fibromyalgia but it can help reduce some symptoms. Speak to your GP or pain specialist to find out the potential benefits and risks. Your GP will likely suggest you try exercise, CBT and physiotherapy first. This is because these treatments are more likely to help. Antidepressants can help some people with fibromyalgia. They help: relieve pain treat sleep problems This can be useful even if you havent been diagnosed with depression. Other medications can be used for the treatment of fibromyalgia symptoms, but theyre likely to be less effective. Speak to your GP, pharmacist or healthcare professional if youre taking medication and you dont feel its helping. Alternative therapies Some people with fibromyalgia try complementary or alternative treatments, like acupuncture or massage. Theres little scientific evidence that these treatments help in the long term. Some people find that certain treatments help them to relax and feel less stressed. This allows them to cope with their condition better. If you decide to use complementary or herbal remedies, check with your GP or healthcare professional first. Some remedies can react unpredictably with other medication, or make it less effective. Read more about herbal medicines Source:\r\n NHS Scotland - Opens in new browser window Last updated: 20 October 2023 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Dont include personal information e.g. name, location or any personal health conditions. Email Address e.g. [email protected] Message Maximum of 500 characters Send feedback Add this page to\n Info For Me Also on NHS inform What is chronic pain? Living with chronic pain Coping with a flare up of chronic pain Other health sites UK Fibromyalgia's support group section Flippin Pain Pain Concern Pain Association Scotland Flippin Pain NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats 2023 NHS 24 v1.1.1.17852"

Farting

Farting | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotlands Service Directory 0 Home Illnesses and conditions Stomach, liver and gastrointestinal tract Farting Farting Farting (flatulence) is passing gas from the digestive system out of the back passage. Its a normal process and something everyone experiences regularly. There are things you can do if you fart a lot or your farts are smelly. Causes of farting When you swallow food, water or saliva, you also swallow small amounts of air. This collects in the digestive system. The body needs to get rid of the build-up by farting or burping. Gases can also build up when you digest food. Causes of excessive farting Excessive farting can be caused by: swallowing more air than usual eating foods that are difficult to digest conditions affecting the digestive system like indigestion or irritable bowel syndrome (IBS) some medicines like non-steroidal anti-inflammatory drugs (NSAIDs) , statins and some laxatives Do not stop or change your medication without speaking to your GP first. Its important that you dont self-diagnose. Speak to a GP if: farting is affecting your life and self help and pharmacy treatments havent worked you have a stomach ache or bloating thatll not go away or comes back you keep getting constipation or diarrhoea you have lost weight without trying youve had blood in your poo for 3 weeks you have signs of an infection like a high temperature, vomiting, chills, joint pain and muscle pain youre unable to control your bowel movements (involuntary pooing) Get advice from a pharmacist A pharmacist can give you advice about excessive or smelly farts. They may be able to recommend something to help like: charcoal tablets special underwear or pads that absorb smells A pharmacist may also be able to tell you if you need to speak to your GP. Find your nearest pharmacy How reduce excessive or smelly farting Do chew food slowly with your mouth closed eat smaller meals, more often drink slowly exercise regularly to improve digestion eat foods that are easy to digest like rice, bananas, citrus fruits and potatoes drink peppermint tea Dont do not chew gum, smoke or suck on pen tops or hard sweets to avoid swallowing excess air do not wear loose-fitting dentures do not drink lots of fizzy drinks and hot drinks do not drink too much beer, wine or fruit juice do not eat lots of foods that are difficult to digest and cause farting like beans, cabbage and lentils do not eat lots of foods containing sorbitol (a sweetener) and fructose (a sugar) as these can cause farting Source: NHS 24 - Opens in new browser window Last updated: 29 May 2023 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Dont include personal information e.g. name, location or any personal health conditions. Email Address e.g. [email protected] Message Maximum of 500 characters Send feedback Add this page to\n Info For Me NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats 2023 NHS 24 v1.1.1.17852

Flu

Flu | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotlands Service Directory 0 Home Illnesses and conditions Infections and poisoning Flu Flu Return to Symptoms Enter age Last Updated: Next Review Date: Review my answers Find your local services Search for a service near you by entering your postcode below. Please input your postcode in the following format: A12 1BC GP Practices Dental Services Pharmacies Opticians Postcode Search NHS inform has more information on this condition. Read more Previous Start guide Review my answers You told us your credentials were: : You said: Based on the information you gave us, we made the following recommendation: Close Keep a copy View PDF Flu (influenza) is a common infectious viral illness. You can catch flu all year round, but its especially common in winter. This is why its also known as seasonal flu. You can catch flu many times because flu viruses change regularly. Your body wont have a natural resistance to the new versions. Flu symptoms Some of the main symptoms of flu include: a sudden high temperature tiredness and weakness a headache general aches and pains a dry, chesty cough sore throat difficulty sleeping loss of appetite diarrhoea or tummy pain feeling sick and being sick chills a runny or blocked nose sneezing The symptoms are similar for children. They may also get pain in their ear and be less active. How long do symptoms last The symptoms of flu usually develop 1 to 3 days after becoming infected. Most people will feel better within a week. But, you may have a lingering cough and still feel very tired for a few more weeks. Flu-like illness self-help guide Complete our self-help guide to check your symptoms and find out what to do next. Phone 999 or go to A&E if you: get sudden chest pain have difficulty breathing start coughing up a lot of blood Phone 111 or ask for an urgent GP appointment if: You or your child have symptoms of flu and: youre worried about your babys or childs symptoms youre 65 or over youre pregnant you have a long-term medical condition for example, diabetes or a condition that affects your heart, lungs, kidneys, brain or nerves you have a weakened immune system for example, because of chemotherapy or HIV your symptoms dont improve after 7 days Get advice from a pharmacist A pharmacist can give you advice about how to treat flu. Find your nearest pharmacy Treating flu at home If you have flu, there are things you can do to help you recover more quickly. Do rest get plenty of sleep keep warm drink lots of water to avoid dehydration take paracetamol or ibuprofen to lower your temperature and treat aches and pains stay off work or school until you feel better Dont do not take paracetamol and flu remedies that contain paracetamol at the same time GPs dont recommend antibiotics for flu. They wont relieve your symptoms or speed up your recovery. Preventing the spread of flu Flu is spread by germs from coughs and sneezes. These can live on hands and surfaces for 24 hours. You can help stop yourself catching flu or spreading it to others with good hygiene measures. Do wash your hands regularly with soap and warm water clean surfaces like your computer keyboard, telephone and door handles regularly use tissues to cover your mouth and nose when you cough or sneeze bin used tissues as soon as possible avoid unnecessary contact with other people while youre infectious stay off work or school until youre feeling better How to wash your hands properly Help to keep germs at bay by washing your hands properly. The difference between flu and a cold It can sometimes be difficult to tell if you have flu or a cold. Flu symptoms: come on quickly usually include fever and aching muscles are more severe Cold symptoms: come on gradually mainly affect your nose and throat are fairly mild, so you can still get around and are usually well enough to go to work Flu vaccine The annual flu vaccine can help reduce your risk of getting flu each year. Its offered every year for free by the NHS to help protect people at risk of flu and its complications. Further information about the flu vaccine for adults Further information about the flu vaccine for children Source: NHS 24 - Opens in new browser window Last updated: 04 December 2023 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Dont include personal information e.g. name, location or any personal health conditions. Email Address e.g. [email protected] Message Maximum of 500 characters Send feedback Add this page to\n Info For Me NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats 2023 NHS 24 v1.1.1.17852

Foetal alcohol syndrome

Alcohol and pregnancy | Ready Steady Baby! 0 Ready Steady Baby Pregnancy Health problems in pregnancy Looking after yourself and your baby Preparing for parenthood Relationships and wellbeing in pregnancy Your antenatal care Your babys development Labour and birth After the birth Assisted birth Getting ready for the birth Giving birth Labour Meeting your new baby Early parenthood Caring for your new baby Getting to know your baby Going home If your babys ill Your growing family Your wellbeing after the birth Other languages and formats Back Ready Steady Baby! Home Ready Steady Baby Pregnancy Looking after yourself and your baby Alcohol and pregnancy Theres no known safe limit of drinking during pregnancy. Some people will tell you that having the odd drink when youre pregnant is okay. The safest option is to stop drinking when youre trying to get pregnant or as soon as you know youre pregnant. How alcohol can harm your baby Your babys developing all the way through your pregnancy. Alcohol can be harmful at any stage. Drinking alcohol: damages your babys developing cells which can affect how their brain and organs develop and how they look makes it more likely youll have a miscarriage, or your baby will be born early or underweight can cause fetal alcohol spectrum disorder Even small amounts of alcohol can cross over from your body into your baby. The exact level of alcohol exposure that can lead to harm is not known with certainty, but the more you drink, the greater the possible harm. Drinking a lot in a single occasion (sometimes called binge drinking) is especially harmful Fetal alcohol spectrum disorder (FASD) If you drink while pregnant your baby could develop fetal alcohol spectrum disorder (FASD). This is a term used to describe a range of alcohol-related birth defects. About 3 in every 100 children and young people in the UK have FASD, but its preventable by avoiding alcohol when pregnant or planning a pregnancy. FASD may not always be detected at birth but can cause problems later in life, including: problems with hyperactivity, impulsivity, and attention learning and behavioural difficulties experiencing difficulty in social interaction, personal care, making sense of the world, and staying safe sensory difficulties such as being sensitive to, and distressed by, certain patterns of light, sound, or touch vulnerability to victimisation and bullying Nows the time to stop drinking Lots of pregnancies arent planned, so you might not have known you were pregnant for a while and may have drunk alcohol in that time. The first and most important thing you can do now is to stop drinking alcohol completely. When you go to your first antenatal appointment, your midwife will ask you whether you drink alcohol and if so how much. Be honest with your midwife or GP if you have been drinking during pregnancy you can speak safely and openly to them. There are lots of organisations available to provide information, help and support . Sometimes drinking alcohol can be a response to other problems in your life, including money worries or mental health problems. Getting help with other issues may make it easier to cut down or stop drinking. Read more about the support to available to help with the cost of living Read advice about dealing with low mood, anxiety, phobias and stress Stopping drinking when pregnant For lots of women, stopping drinking when pregnant can be difficult sometimes harder than they thought. The social pressure to have a drink can be huge and can make it harder to say no. With the right support and a bit of planning, you can do it. Talking to your midwife is the first step towards getting the right support for you and your baby. Support your partner Dads and partners can support a healthy, alcohol-free pregnancy by: not drinking alcohol around their partner trying activities that dont involve alcohol you could go swimming or go for a walk trying non-alcoholic alternatives such as mocktails, smoothies, and flavoured and fizzy water If you need help and support, visit Scotlands Service Directory or our where to get help page. Further information, other languages and alternative formats Translations and alternative formats of this information are available from Public Health Scotland . If you need a different language or format, please contact [email protected]. Ready Steady Baby leaflet in Arabic, Polish, Simplified Chinese (Mandarin) and Ukrainian Source: Public Health Scotland - Opens in new browser window Last updated: 14 December 2023 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Dont include personal information e.g. name, location or any personal health conditions. Email Address e.g. [email protected] Message Maximum of 500 characters Send feedback Add this page to\n Info For Me Also on NHS inform Alcohol Other health sites NOFAS: Alcohol and pregnancy Find local alcohol services Enter a place or postcode NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats 2023 NHS 24 v1.1.1.17852

Food poisoning

Food poisoning | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotlands Service Directory 0 Home Illnesses and conditions Infections and poisoning Food poisoning Food poisoning Food poisoning is an illness caused by eating contaminated food. Its not usually serious and most people get better within a few days without treatment. In most cases, food is contaminated by bacteria or a virus like: campylobacter the most common cause of food poisoning salmonella Escherichia coli (E. coli) norovirus listeria Food Standards Scotland has further information about bacteria and viruses that can cause food poisoning. Symptoms of food poisoning Symptoms of food poisoning include: feeling sick (nausea) being sick (vomiting) diarrhoea, which may contain blood or mucus stomach cramps and abdominal pain a lack of energy and weakness loss of appetite a high temperature of 38C or above (fever) aching muscles chills The symptoms of food poisoning usually begin within 1 to 2 days of eating contaminated food. They can also start a few hours later or several weeks later. What to do if you have food poisoning Do stay off school or work until you have not been sick or had diarrhoea for at least 2 days rest drink lots of water to prevent dehydration you can sip it if this is easier consider speaking to your pharmacist about an oral rehydration solution (ORS) eat when you feel up to it try small, light meals eat bland foods like toast, crackers, banana and rice until you feel better avoid alcohol, caffeine, fizzy drinks, spice and fatty foods they may make you feel worse Speak to a GP if you: have a weak immune system for example, because of medication, cancer treatment or HIV have severe symptoms are pregnant dont start to see improvements to your symptoms after a few days are unable to keep down any fluids because youre vomiting repeatedly have symptoms of severe dehydration, like confusion, a rapid heartbeat, sunken eyes and passing little or no urine are over 60 think your baby or young child has food poisoning have a long-term underlying condition, like inflammatory bowel disease (IBD), diabetes or kidney disease How you get food poisoning Food poisoning is caused by eating something thats been contaminated with germs. Any type of food can cause food poisoning. Food can be contaminated if its not cooked or reheated thoroughly not stored correctly for example, its not been frozen or chilled left out for too long handled by someone whos ill or hasnt washed their hands eaten after its use by date not reheating cooked food well enough Further information on preparing and cooking food safely Preventing infection when youre ill Do try to keep contact with vulnerable people to a minimum, for example the very young or elderly wash your hands with soap and warm water often clean surfaces, toilet seats, flush handles, basins and taps often make sure everyone in the household has their own towels and flannels wash the laundry of the infected person on the hottest washing machine setting Source: NHS 24 - Opens in new browser window Last updated: 29 January 2024 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Dont include personal information e.g. name, location or any personal health conditions. Email Address e.g. [email protected] Message Maximum of 500 characters Send feedback Add this page to\n Info For Me Also on NHS inform Preparing and cooking food safely Other health sites FSA: Find your local environmental health officer FSA: food hygiene ratings Food Standards Scotland: Food safety and hygeine NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats 2023 NHS 24 v1.1.1.17852

Functional neurological disorder (FND)

Functional neurological disorder (FND) | NHS inform | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotlands Service Directory 0 Home Illnesses and conditions Brain, nerves and spinal cord Functional neurological disorder Functional neurological disorder Functional neurological disorder (FND) describes a problem with how the brain receives and sends information to the rest of the body. Its often helpful to think of your brain as a computer. In someone who has FND, theres no damage to the hardware, or structure, of the brain. Its the software, or program running on the computer, that isnt working properly. The problems that cause FND are going on in a level of the brain that you cannot control. It includes symptoms like arm and leg weakness and seizures. Other symptoms like fatigue or pain are not directly caused by FND, but are often found alongside it. Symptoms of FND FND can have many symptoms that can vary from person to person. Some people may have few symptoms, and some people may have many. A diagnosis of FND should be made because you have one or more clinical features that a specialist can recognise as typical of FND. It shouldnt be made just because scans or tests for other neurological conditions that have similar symptoms are normal. What is a clinical feature? A clinical feature is a distinctive way that your symptom presents that is unique to FND. For example, it could be that your eyes close during seizures, or that limb weakness briefly disappears during certain physical tests. Clinical features are what specialists use to identify FND from other neurological conditions with similar symptoms. Functional limb weakness Functional limb weakness is when a leg or an arm doesnt work properly. In FND, this happens because of a problem with how the nervous system is functioning. It can cause a range of symptoms, including: problems walking heaviness down one side dropping things feeling like a limb isnt part of you Functional limb weakness can often look a symptoms of a stroke or multiple sclerosis. If you have FND, any scans you have will show no damage to the brain to explain the weakness. A specialist will diagnose functional limb weakness based on specific clinical features (symptoms) they find when they examine you. Read more about functional limb weakness Functional seizures A functional seizure (also called a dissociative seizure) is an episode where someone loses either their awareness of, or their ability to interact with, their surroundings. It may look like an epileptic seizure or a faint. A functional seizure can appear as: uncontrolled shaking suddenly going motionless and unresponsive staring without responding to surroundings Some people are aware that seizures are about to happen, while others experience them without warning. A specialist will ask you and your friends or family about what happens during a seizure, and will look at any video footage you can provide. Theyll use this evidence to decide if its epilepsy , a faint or a functional seizure. Read more about functional seizures Functional tremor Tremor is uncontrollable shaking of part of the body. Its most often found in the arms and legs. Functional tremor can come and go throughout the day, and change in speed and strength. A specialist will diagnose functional tremor based on specific features of your symptoms that they find when they examine you. Read more about functional tremor Functional dystonia Functional dystonia is a type of muscle spasm. It causes a part of the body to become stuck in an unusual position. This can be for a short or a long period of time. Someone with functional dystonia will often present with curled fingers, a clenched hand, or an ankle that turns in. Read more about functional dystonia Functional gait disorder Functional gait disorder describes the problems walking that you may experience as part of FND. You may find you have a dragging leg, that you feel unsteady when walking, or that you make excessive movements when walking. A specialist will diagnose functional gait disorder based on clinical features, like the way your walking changes when doing different activities. Read more about functional gait disorder Functional facial spasm Functional facial spasm is when there are muscle spasms in the face. These can lead to problems like a narrowing of the eye or the pulling of the mouth or jaw upwards, downwards or to the side. Read more about functional facial spasm Functional tics A tic is a fast repetitive movement or sound that happens suddenly. Functional tics can be a symptom of FND. Functional tics can look similar to the tics in Tourettes syndrome. A specialist will look at the clinical features of your tics to make a diagnosis. Its quite common to have both functional tics and Tourettes syndrome. Functional jerks and twitches A symptom of FND can be jerks or twitches, which is when someone makes sudden movements. Everyone experiences random jerks occasionally, like when you jolt awake as youre falling asleep. In FND, however, these uncontrolled jerks and twitches can become much more frequent. Read more about functional jerks and twitches Functional drop attacks Functional drop attacks are when someone falls to the ground suddenly, without losing consciousness. Read more about functional drop attacks Functional sensory symptoms A symptom of FND can be numbness, pins and needles, or a feeling that a limb isnt part of your body. Read more about functional sensory symptoms Functional cognitive symptoms Problems with your memory or concentration can be a symptom of FND. You might find that you: lose track while doing things, for example being unable to remember why you went into a room go blank, for example when trying to recall your pin number lose track during conversations misplace important things, like your keys or phone forget words Its normal to experience these things occasionally. For someone with functional cognitive symptoms, these things happen so often that they interfere with work and home life. The cognitive symptoms of FND can sometimes be mistaken for dementia. Specialists will look for features that are typical of functional cognitive symptoms when diagnosing FND. Read more about functional cognitive symptoms Functional speech and swallowing difficulties Functional speech and swallowing difficulties can be a symptom of FND. You might experience: slurred speech a new stutter difficulties finding the right word unintentionally mixing words up whispering or hoarse speech (dysphonia) difficulty swallowing, including feeling like theres something stuck in your throat A specialist will diagnose functional speech and swallowing difficulties based on specific features. Read more about functional speech and swallowing difficulties Persistent postural perceptual dizziness (PPPD) PPPD (sometimes called functional dizziness, triple PD or 3PD) can be a symptom of FND. The dizziness in PPPD is typically experienced constantly, and gets worse while walking or in crowded environments. There are many causes of dizziness. Most people with PPPD have another cause of dizziness at the same time. A specialist will diagnose PPPD based on specific features when they assess you. Read more about PPPD Functional visual symptoms Visual symptoms can be a part of FND. You may experience changes to your vision, like: blurred vision double vision photophobia (sensitivity to light) reduced vision A specialist will diagnose functional visual symptoms based on specific features that they find when they examine you. Read more about functional visual symptoms Dissociative symptoms Dissociative symptoms are common in FND, although there are many other causes. These symptoms can be hard to describe, but are often described as feeling: that your body is disconnected from you that your body doesnt belong to you disconnected from the world around you spaced out that you are floating that you are having an out-of-body experience there but not there You may also be able to hear whats going on around you, but not be able to respond. These experiences are called dissociation, and can link into other FND symptoms. Read more about dissociative symptoms There are other symptoms or conditions that are commonly associated with FND. These include: chronic pain , including fibromyalgia , back and neck pain, and complex regional pain syndrome persistent fatigue sleep problems including insomnia (not sleeping enough) and hypersomnia (sleeping too much) migraines and other types of headache and facial pain irritable bowel syndrome and other problems with the function of your stomach and bowel anxiety and panic attacks depression post-traumatic stress disorder chronic urinary retention despite all tests being normal (which may be diagnosed as Fowlers syndrome) dysfunctional breathing What causes FND? We know that the symptoms of FND happen because theres a problem with how the brain is sending and receiving messages to itself and other parts of the body. Using research tools, scientists can see that certain circuits in the brain are not working properly in people with FND. However, theres still a lot of research to be done to understand how and why FND happens. Why does FND happen? FND can happen for a wide range of reasons. Theres often more than one reason, and the reasons can vary hugely from person to person. Some of the reasons why the brain stops working properly in FND include: the brain trying to get rid of a painful sensation a migraine or other neurological symptom the brain shutting down a part or all of the body in response to a situation it thinks is threatening In some people, stressful events in the past or present can be relevant to FND. In others, stress is not relevant. The risk of developing FND increases if you have another neurological condition. Read more about how and why FND happens. Diagnosing FND When diagnosing FND, your healthcare provider will carry out an assessment to see if there are typical clinical features of FND. Your healthcare provider may still choose to test for other diseases and conditions before diagnosing FND. This is because many conditions share the same symptoms and, in around a quarter of cases, FND is present alongside another neurological condition. Someone can have both FND and conditions like sciatica, carpal tunnel syndrome, epilepsy, or multiple sclerosis (MS). The diagnosis of FND, however, should be given because you have the clinical features of FND. It shouldnt be given just because theres no evidence of other conditions or illnesses. Because the symptoms of FND are not always there, your healthcare provider may ask you to video your symptoms. This will allow them to see what your symptoms look like. Treatments FND is a really variable condition. Some people have quite short-lived symptoms. Others can have them for many years. There are treatments available that can manage and improve FND. These treatments are all forms of rehabilitation therapy, which aims to improve your ability to carry out every day activities. Many of these treatments are designed to retrain the brain. Some people with FND benefit a lot from treatment and may go into remission. Other people continue to have FND symptoms despite treatment. Physiotherapy Specialised physiotherapy can be useful in treating FND. It helps to remind the body how it should move. It can also help you build up strength and stamina you may have lost. Read more about physiotherapy for FND Occupational therapy Occupational therapy can be helpful in treating FND. An occupational therapist will work with you to plan your treatment goals, and gradually build your confidence and ability to reach them. Read more about occupational therapy for FND Psychological therapy Psychological therapy can be helpful to many people with FND, even those without stress in their lives. It can help you gain a better understanding of FND and its relationship to your personal circumstances. There are specific psychological techniques which can help you gain better control over movement or seizure symptoms. Psychological therapy can also help you learn to manage low mood, anxiety and past traumatic events, as well as other psychological problems (if present). Not everyone with FND will need psychological therapy. Read more about psychological therapy for FND Speech, language and swallowing therapy Speech and language therapists are available to help if youre struggling with speaking or swallowing. They have a range of techniques to try, designed to help with specific problems. These might include helping you to shape certain sounds, or to practice breathing patterns as you try to talk. Read more about speech and language therapy for FND Medication Medication can play a role in treating the some of the problems associated with FND, like pain, depression and anxiety. Your healthcare provider can help decide if medication is right for you. There are many types of medication that can make FND worse, including opiates like morphine, dihydrocodeine or codeine. It may be worth discussing your current medications with your healthcare provider. Do not stop taking any medicine thats been prescribed without checking with your GP or healthcare provider first. You could make yourself very ill. Read more about treating FND FND in children and young people FND is broadly the same condition in children and young people. Its unusual for it to occur under the age of 10. It becomes more common through the teenage years. The treatment for FND in children and young people is similar to adults. Its especially important for families and schools to learn about the condition, so they can respond in the most helpful way. Where to find support If youve been diagnosed with FND there are sources of information, charities and support groups that can help you. The Neurosymptoms FND Guide has more detailed information. Theres also an app available with further details about the condition. My FND is an app that allows you to learn about your symptoms. It helps you track them, and offers advice for managing them. FND Hope UK is a charity that raises awareness of FND. It provides further information, resources, and support services for those with FND. FND Action is a charity that provides information on FND and support for those with a diagnosis. Source:\r\n Scottish Government - Opens in new browser window Last updated: 07 March 2024 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Dont include personal information e.g. name, location or any personal health conditions. Email Address e.g. [email protected] Message Maximum of 500 characters Send feedback Add this page to\n Info For Me Other health sites Neurosymptoms FND Guide My FND FND Hope UK FND Action NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats 2023 NHS 24 v1.1.1.17852

Fungal nail infection

Fungal nail infection | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotlands Service Directory 0 Home Illnesses and conditions Skin, hair and nails Fungal nail infection Fungal nail infection Many people develop a fungal nail infection at some point in their life. Its not usually serious, but can be unpleasant and difficult to treat. The infection develops slowly and causes the nail to become discoloured, thickened and distorted. Toenails are more frequently affected than the fingernails. The medical name for a fungal nail infection is onychomycosis. A fungal nail infection can cause the nail to become thick, yellow and brittle. https://dermnetnz.org/ Signs and symptoms of a fungal nail infection A fungal nail infection may not cause any obvious symptoms at first. As it progresses, the infection can cause: discolouration of the nail it may turn white, black, yellow or green thickening and distortion of the nail it may become an unusual shape or texture and be difficult to trim pain or discomfort particularly when using or placing pressure on the affected toe or finger brittle or crumbly nails pieces may break off and come away completely Sometimes the skin nearby may also become: infected itchy cracked red swollen What causes a fungal nail infection Most fungal nail infections occur as a result of the fungi that cause athletes foot infecting the nails. These fungi often live harmlessly on your skin, but they can sometimes multiply and lead to infections. The fungi prefer warm, dark and moist places like the feet. Youre more likely to get a fungal nail infection if you: dont keep your feet clean and dry wear shoes that cause your feet to get hot and sweaty walk around barefoot in places where fungal infections can spread easily, like communal showers, locker rooms and gyms have damaged your nails have a weakened immune system have certain other health conditions, like diabetes , psoriasis or peripheral arterial disease Fungal nail infections can be spread to other people, so you should take steps to avoid this if you have an infection. Speak to your GP or pharmacist if: youre bothered by the appearance of a nail with a fungal nail infection the fungal nail infection is causing problems like pain or discomfort Treating a fungal nail infection A fungal nail infection is unlikely to get better without treatment. However, if youre not bothered by it you might decide its not worth treating because treatment: can take a long time can cause side effects isnt always effective Treatment may also be unnecessary in mild cases of fungal nail infection. Its also unlikely to cause any further problems so you may feel its not worth treating. For more severe or troublesome fungal nail infections, antifungal medication may be recommended. Antifungal medication Antifungal medication comes in tablets or a special paint you apply directly to the nail. A small sample of the infected nail may need to be taken and sent off for testing before treatment starts, to confirm that you do have a fungal infection. If the treatment is working, you should see a new healthy nail start to grow from the base of nail over the course of a few months. The old infected nail should begin to grow out and can be gradually clipped away. Antifungal treatments are thought to be effective in treating about 60 to 80% of fungal nail infections. It can take between 6 and 18 months for the appearance of the affected nail to return to normal, and in some cases the nail may not look the same as before the infection. Antifungal tablets Terbinafine and itraconazole are the 2 medicines most commonly prescribed for fungal nail infections. These usually need to be taken once or twice a day for several months to ensure the infection has completely cleared up. If you stop taking the medication too early, the infection may return. Possible side effects of antifungal tablets can include: headache itching diarrhoea loss of sense of taste a rash Antifungal tablets are currently not licensed to be sold over the counter. This is because these tablets have many listed side effects, contraindications and need to be taken for several months. Antifungal nail paint If you prefer not to take antifungal tablets, your GP or pharmacist may suggest you try antifungal nail paint instead. Nail paint isnt generally considered to be as effective as tablets because it can be difficult for it to reach the deeper layers of the nail. However, it doesnt usually cause any side effects. Like antifungal tablets, antifungal nail paint also normally needs to be used for several months to ensure that the infection has cleared up. Speak to your GP if new, healthy nail doesnt start to grow after a few weeks of treatment. Keep using the treatment until your GP says you can stop. Stopping too early could result in the infection returning. Softening and scraping away the nail As it can take a long time for antifungal medication to work, some people may prefer to use a treatment that involves softening and removing infected parts of nail over a few weeks. Treatment kits are available from pharmacies that contain a 40% urea paste, plasters and a scraping device. The paste softens the infected parts of the nail, allowing them to be scraped away so they can be gradually replaced with healthy nail. To use the treatment: wash the affected area and dry it thoroughly carefully apply the paste to the infected nails cover the nails with plasters and leave them for 24 hours wash the paste off the next day and scrape away the softened parts of the nail repeat this process each day for 2 to 3 weeks Once no more infected parts of the nail can be removed, ask your pharmacist for antifungal nail paint to prevent re-infection as the nail regrows over the next few months. Removing the nail A procedure to remove affected nails completely isnt usually necessary, but may be recommended if the infection is severe or painful and other treatments havent helped. If your nail is surgically removed, a new nail should eventually grow back in its place. However, it could take a year or more for the nail to grow back completely. Laser treatment Laser treatment is a possible option if you have a fungal nail infection thats particularly stubborn. The laser emits high doses of light energy, which are used to destroy the fungus. Early research suggests the treatment may be helpful in treating fungal nail infections, but theres currently not enough evidence to recommend it as a routine treatment. If you want to try laser treatment, youll have to pay for it privately because its not available on the NHS. Be aware that the treatment may need to be repeated several times for up to a year, so it could get very expensive. How to prevent fungal nail infections Whether or not you decide to have treatment, you should still follow self-help advice to help stop the condition getting worse or spreading to others. Do keep your hands and feet clean and dry wear well-fitting shoes made of natural materials and clean cotton socks these will allow your feet to breathe clip your nails to keep them short dont share clippers or scissors with other people replace old footwear that could be contaminated with fungi treat athletes foot as soon as possible to avoid the infection spreading to your nails ensure your towels are washed regularly make sure any equipment is properly sterilised between uses if you visit a nail salon Dont do not share towels and socks with other people do not walk around barefoot in public pools, showers, and locker rooms special shower shoes are available to protect your feet Source: NHS 24 - Opens in new browser window Last updated: 07 November 2023 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Dont include personal information e.g. name, location or any personal health conditions. Email Address e.g. [email protected] Message Maximum of 500 characters Send feedback Add this page to\n Info For Me Other health sites BAD: fungal infections of the nails NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats 2023 NHS 24 v1.1.1.17852

Gallbladder cancer

Gallbladder cancer - Illnesses & conditions | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotlands Service Directory 0 Home Illnesses and conditions Cancer Cancer types in adults Gallbladder cancer Gallbladder cancer Gallbladder cancer is very rare. There are a number of different types of gallbladder cancer,depending on the cells affected. Over 85% of gallbladder cancers are adenocarcinoma, which means thecancerstarted in the gland cells lining the gallbladder. Cancer that starts in the skin-like cells that line the gallbladder is known as squamous cell cancer. The Cancer Research UK website has more information about thedifferent types of gallbladder cancer . Cancer of the gallbladder is more common in women than men, with around 7 out of 10 cases diagnosed in women. Its also more common in older people, particularly those over 70 years of age. The gallbladder The gallbladder is a small, pear-shaped organ thats located underneath the liver. Its main purpose is to store and concentrate bile. Bile is a liquid produced by the liver that helps to digest fats. It passes from the liver through a series of channels (bile ducts) into the gallbladder, where its stored. Over time, bile becomes more concentrated, which makes it better at digesting fats. The gallbladder releases bile into the digestive system when its needed. The gallbladder is a useful but not essential organ, which can be safely removed without interfering with your ability to digest food. Symptoms of gallbladder cancer In the early stages, gallbladder cancer doesnt cause symptoms, whichmeans it could be at an advanced stage by the time its diagnosed. Symptoms that occur at a later stage can include: abdominal (stomach) pain feeling sick jaundice (yellowing of the skin and whites of the eyes) These symptoms could be linked toa number of conditions and may not be related to gallbladder cancer. However,if you have these symptoms, you should speak to your GP so they can investigate whats causing them. Other possible symptoms of gallbladder cancer can include loss of appetite, unexplained weight lossand a swollen stomach. What causes gallbladder cancer? In gallbladder cancer, abnormal cells grow within the gallbladder. Its not known why this happens, but certain things are thought to increase your chances of developing the condition. Gallbladder cancer is more common in older people, and your chances of developing it increase with age. Lifestyle factors such as obesity , smoking and an unhealthy diet are believed to increase the risk of gallbladder cancer. However, theres not enough evidence to show a firm link between diet and gallbladder cancer. There are also a number of conditions that can increase your chances of developing gallbladder cancer. For example, gallstones ,cholecystitis(inflammation of the gallbladder) and diabetes have been closely linked to the condition. If you have a family history of gallstones, cholecystitis, or gallbladder cancer, youre more likely to develop these conditions yourself. The Cancer Research UK website has more information about the risks and causes of gallbladder cancer . Diagnosing gallbladder cancer Your GP will examine you and ask about your symptoms. If they suspect gallbladder cancer, they may refer you to a specialist, usually a gastroenterologist (a doctor who specialises in conditions of the digestive system). Thespecialist will ask about your medical history and check to see whether the lymph glands in your neck and groin are swollen. You may also have some initial tests, including: blood tests an ultrasound scan a computerised tomography (CT) scan If these tests reveal anything abnormal in or around your gallbladder, further tests may be arrangedto helpconfirm whether you have gallbladder cancer. These mayinclude: an endoscopic retrograde cholangiopancreatography (ERCP) a magnetic resonance cholangiopancreatography (MRCP) biopsy and fine needle aspiration (FNA) The Cancer Research UK website has more information about tests for gallbladder cancer . Treating gallbladder cancer The main treatment for gallbladder cancer is surgery to remove the gallbladder and possibly some of the surrounding tissue. Chemotherapy and radiotherapy are also sometimes used, either on their own or in combination with surgery. The treatment programme thats most suitable for you will depend on: the type of gallbladder cancer you have the stage of your cancer your overall level of health As with all cancers, the chances of survival depend on how far the condition has advanced when it is diagnosed. The Cancer Research UK website has more information about treatinggallbladder cancer and the stages and outlook for gallbladder cancer . Source: NHS 24 - Opens in new browser window Last updated: 13 November 2023 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Dont include personal information e.g. name, location or any personal health conditions. Email Address e.g. [email protected] Message Maximum of 500 characters Send feedback Add this page to\n Info For Me Other health sites Cancer Research UK: Gallbladder cancer Macmillan Cancer Support: Gallbladder cancer Search for cancer support services near you Enter a place or postcode NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats 2023 NHS 24 v1.1.1.17852

Gallstones

Gallstones | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotlands Service Directory 0 Home Illnesses and conditions Stomach, liver and gastrointestinal tract Gallstones Gallstones About gallstones Symptoms of gallstones Causes of gallstones Diagnosing gallstones Treating gallstones Complications of gallstones Preventing gallstones About gallstones Gallstones are small stones, usually made of cholesterol, that form in the gallbladder. In most cases they dont cause any symptoms and dont need to be treated. However, if a gallstone becomes trapped in a duct (opening) inside the gallbladder it can trigger a sudden intense abdominal pain that usually lasts between 1and 5hours. This type of abdominal pain is known as biliary colic. Some people with gallstonescan alsodevelop complications, such as inflammation of the gallbladder ( cholecystitis ), which can cause: persistent pain jaundice a fever When gallstones cause symptoms or complications, its known as gallstone disease or cholelithiasis. Read more about: symptoms of gallstones complications of gallstones The gallbladder The gallbladder is a small, pouch-like organ found underneath the liver. Its main purpose is to store and concentrate bile. Bile is a liquid produced by the liver to help digest fats. Its passed from the liver through a series of channels, known as bile ducts, into the gallbladder. The bile is stored in the gallbladder and over time it becomes more concentrated, which makes it better at digesting fats. The gallbladder releases bile into the digestive system when its needed. What causesgallstones? Gallstones are thought to develop because of an imbalance in the chemical make-up of bile inside the gallbladder. In most cases the levels of cholesterol in bile become too high and the excess cholesterol forms into stones. Gallstones are very common. Its estimated that more than 1in every 10 adults in the UKhas gallstones, although onlya minorityofpeople develop symptoms. Youre more at risk of developing gallstones if youre: overweightor obese female, particularly if youve had children 40 or over (the risk increases as you get older) Read more about: causes of gallstones preventing gallstones Treating gallstones Treatment is usually only necessary if gallstones are causing: symptoms such as abdominal pain complications such as jaundice or acute pancreatitis In these cases, keyhole surgery to remove the gallbladder may be recommended.This procedure,known as a laparoscopic cholecystectomy , is relatively simpleto perform and has a low risk of complications. You can lead a perfectly normal life without a gallbladder. Your liver will still produce bile to digest food, butthe bile will just drip continuously into the small intestine, rather thanbuild up in the gallbladder. Read more about: treating gallstones diagnosing gallstones Outlook Most cases of gallstone disease are easily treated with surgery.Very severe cases can be life-threatening, especially in people who are already in poor health. However, deaths from gallstone diseaseare rare in the UK. Symptoms of gallstones Most cases of gallstones dont cause any symptoms. But if a gallstone blocks one of the bile ducts, it can cause sudden, severe abdominal pain, known as biliary colic. Other symptoms may developif the blockage is more severe ordevelops in another part of the digestive system. Abdominal pain (biliary colic) Gallstonescan causesudden, severe abdominal pain that usually lasts 1to 5hours(although it can sometimes last just a few minutes). The pain can be felt: in the centre of your abdomen (tummy) just under the ribs on your right-hand side it may spread from hereto your side or shoulder blade The pain is constant and isnt relieved when you go to the toilet, pass wind or are sick.Its sometimes triggered by eating fatty foods, butmay occur at any time of dayand it may wake you up during the night. Biliary colic doesnt happen often. After an episode of pain, it may be several weeks or months before you experience another episode. Some people also have periods where they sweat excessively and feel sick or vomit. Whengallstones cause episodes of biliary colic, it is known as uncomplicated gallstone disease. Other symptoms In a small number of people, gallstones can cause more serious problems if they obstruct the flow of bile for longer periods or move into other organs (such as the pancreas or small bowel). If this happens,youmay develop: a high temperature of 38C (100.4F) or above more persistent pain a rapid heartbeat yellowing of the skin and whites of the eyes (jaundice) itchy skin diarrhoea chills or shivering attacks confusion a loss of appetite Doctors refer to this more severe condition as complicated gallstone disease. Read more about the complications of gallstones . When to seek medical advice If you think you may be experiencing biliary colic, you should make an appointment with your GP. Contact your GP immediately for advice if you develop: jaundice abdominal pain lasting longer than eight hours a high temperature and chills abdominal pain so intense that you cant find a position to relieve it Ifits not possible to contact your GP immediately, phone your local out-of-hours or NHS 24s 111 service. Causes of gallstones Gallstones are thought to be caused by an imbalance in the chemical make-up of bile inside the gallbladder. Bile is a liquid produced by the liver to aid digestion. Its still unclear exactly what leads to this imbalance, but gallstones can form if: there are unusually high levels of cholesterol inside the gallbladder (about 4in every 5gallstones are made up of cholesterol) there are unusually high levels of a waste product called bilirubin inside the gallbladder (about 1in every 5gallstones is made up of bilirubin) These chemical imbalances cause tiny crystals to develop in the bile. These can gradually grow (often over many years) into solid stones that can be as small as a grain of sand or as large as a pebble. Sometimes only 1stone will form, but there are often several at the same time. Whos at risk? Gallstones are more common if you: are female, particularly if youve had children,are taking the combined Pill, or are undergoing high-doseoestrogen therapy are overweight or obese are aged 40 years or older (the older you are, the more likely you are to develop gallstones) have a condition that affects the flow of bile such as cirrhosis (scarring of the liver), primary sclerosing cholangitis, or obstetric cholestasis have Crohns disease or irritable bowel syndrome (IBS) have a close family member whos also had gallstones have recently lost weight (from eitherdieting or weight-loss surgery) are taking an antibiotic called ceftriaxone Diagnosing gallstones Gallstones may be discovered during tests for a different condition, as they often dont cause any symptoms. If you do have symptoms of gallstones ,make an appointment with your GP so they can try to identify the problem. Seeing your GP Your GP will ask about your symptoms in detail and maycarry out the Murphys sign test to help determine if your gallbladder is inflamed. During this test, yourGP places their hand or fingers on the upper-right area of your tummy and asks you to breathe in. If you find this painful, it usuallymeans your gallbladder is inflamed and you may need urgent treatment. Your GP may also recommend having blood tests to look for signs of infection, or to check if your liver is working normally.If gallstones have moved into your bile duct, the liver may not be able tofunction properly. Further tests If your symptoms and test results suggest you may have gallstones, youll usually be referred for further tests. You may be admitted to hospital for tests the same day if your symptoms suggest you have a more severe form of gallbladder disease. Ultrasound scan Gallstones can usually be confirmed using an ultrasound scan, which uses high frequency sound waves to create an image of the inside of the body. The type of ultrasound scan used for gallstonesis similar to the scan used during pregnancy, where a small handheld device called a transducer is placed onto your skin and moved over your upper abdomen. Sound waves are sent from thetransducer, through your skin and into your body. They bounce back off the body tissues, forming an imageon a monitor. This is a painless procedure that usually takes about 10 to 15 minutes to complete. When gallstones are diagnosed, there may be some uncertainty about whether any stones have passed into the bile duct. Gallstones in the bile duct are sometimes seen during an ultrasound scan.If theyre not visible but yourtestssuggest the bile duct may be affected, you may need an MRI scan or a cholangiography. MRI scan A magnetic resonance imaging (MRI) scan may be carried out to look for gallstones in the bile ducts. This type of scan uses strong magnetic fields and radio waves to produce detailed images of the inside of the body. Cholangiography A procedure called a cholangiography can give further information about the condition of your gallbladder. A cholangiography uses a dye that shows up on X-rays . The dyemay be injected into your bloodstream or injected directly into your bile ducts during surgery or using anendoscopepassed through your mouth. After the dye has been introduced, X-ray images are taken. Theyll reveal any abnormality in your bile or pancreatic systems. If your gallbladder and bile systems are working normally, the dye will be absorbed in the places its meant to go (your liver, bile ducts, intestines and gallbladder). If a blockage is detected during this test, your doctor may try to removeit at this point using an endoscope. This is known asan endoscopic retrograde cholangio-pancreatography (ERCP). See treating gallstones for more information about ERCP. CT scan A computerised tomography (CT) scan may be carried out to look for any complications of gallstones, such as acute pancreatitis . This type of scan involves taking a series of X-rays from many different angles. CT scans areoften donein an emergency to diagnose severe abdominal pain. Treating gallstones Your treatment plan for gallstones depends on how the symptoms are affecting your daily life. If you dont have any symptoms, a policy of active monitoring is often recommended. This means you wont receive immediate treatment, but you should let your GP know if you notice any symptoms. As a general rule, the longer you go without symptoms, the less likely it is that your condition will get worse. You may need treatment if you have a condition that increases your risk ofdeveloping complications, such as: scarring of the liver ( cirrhosis ) high blood pressure inside the liver this is known as portal hypertension and is often a complication of alcohol-related liver disease diabetes Treatment may also be recommended if a scan shows high levels of calcium inside your gallbladder, as this can lead to gallbladder cancer in later life. If you have episodes of abdominal pain (biliary colic), treatment depends on how the pain affects your daily activities. Ifthe episodes aremild and infrequent, you may be prescribed painkillers to control further episodes and given advice abouteating a healthy diet to help control the pain. If your symptoms are more severe and occur frequently,surgery to remove the gallbladderis usually recommended. The gallbladder isnt an essential organ andyou can lead a perfectly normal life without one.Some people may experience symptoms of bloating and diarrhoea after eating fatty or spicy food. If certain foods do trigger symptoms, you may wish to avoid them in the future. Keyhole surgery to remove the gallbladder If surgery is recommended, youll usually have keyhole surgery to remove your gallbladder. This is known as a laparoscopic cholecystectomy. Duringa laparoscopic cholecystectomy, 3or 4small cuts are made in your abdomen. One larger cut (about 2cm to 3cm) will be by the belly button and the others (each 1cm or less) will be on the right side of your abdomen. Your abdomen is temporarily inflated using carbon dioxide gas. This is harmless and makes it easier for the surgeon to see your organs. Alaparoscope (long thin telescope with a tiny light and video camera at the end) is inserted through one of the cuts in your abdomen. This allows your surgeon to view the operation on a video monitor.Your surgeon will then remove your gallbladder using special surgical instruments. If its thought there may be gallstones in the bile duct, an X-ray or ultrasound scan of the bile duct is also taken during the operation. If gallstones are found, they may be removed during keyhole surgery. If the operation cant be done this way or an unexpected complication occurs, it may have to be converted to open surgery. After the gallbladder has been removed, the gas in your abdomen escapes through the laparoscope and the cuts are closed with dissolvable stitches and covered with dressings. Laparoscopic cholecystectomies areusually performed under a general anaesthetic , which means youll be asleep during the procedure and wont feel any pain while its carried out. The operation takes 60 to 90 minutes and you can usually go home the sameday.Full recovery typically takes around 10 days. Single-incision keyhole surgery Single-incision laparoscopic cholecystectomy is a newer type of keyhole surgery used to remove the gallbladder. During this type of surgery, only one small cut is made, which means youll only have onebarely visible scar. However, single-incision laparoscopic cholecystectomies havent been carried out as often as conventional laparoscopic cholecystectomies, so there are still some uncertainties about it. Access to this type of surgery is also limited because it needs an experienced surgeon with specialist training. The National Institute for Health and Care Excellence (NICE) has more information on single-incision laparoscopic cholecystectomy . Open surgery Alaparoscopic cholecystectomy may not always be recommended, for example if you: are in the third trimester (the last three months) of pregnancy are extremely overweight have an unusual gallbladder or bile duct structure that makes akeyhole procedure difficult and potentially dangerous In these circumstances, an open cholecystectomy may be recommended. During this procedure, a 10cm to 15cm (4in to 6in) incision is made in your abdomen underneath the ribs so the gallbladder can be removed.Thisis done under general anaesthetic, so youll be asleep and wont feel any pain. Open surgery is just as effective as laparoscopic surgery, but it does have a longer recovery time and causes more visible scarring. Most people have to stay in hospital for up to 5days and it typically takes 6weeks to fully recover. Endoscopic retrograde cholangio-pancreatography (ERCP) An endoscopic retrograde cholangio-pancreatography (ERCP) is a procedure that can be used to remove gallstones from the bile duct. The gallbladder isnt removed during this procedure, so any stones in the gallbladder will remain unless removed using the surgical techniques mentioned above. ERCP is similar to a diagnostic cholangiography (see diagnosing gallstones for more information), where an endoscope (long, thin flexible tube with a camera at the end) is passed through your mouth down to where the bile duct opens into the small intestine. However, during ERCP theopening of the bile ductis widened with a small incision or an electrically heated wire. The bile duct stones are then removed or left to pass into your intestine and out of your body. Sometimes a small tube called a stent is permanently placed in the bile duct to help the bile and stones pass. An ERCP is usually carried out under sedation, which means youll be awake throughout the procedure but wont experience any pain. The ERCP procedurelasts about 30 minutes on average, but can take from 15 minutes to over an hour.You may need to stay overnight in hospital after the procedure so you can be monitored. Medication to dissolve gallstones If yourgallstones are small and dont contain calcium, it may be possible to take ursodeoxycholic acidtablets to dissolve them. However, these arentprescribed very often because: theyrerarely very effective they need to be taken for a long time (up to 2years) gallstones can recur once treatment is stopped Side effects of ursodeoxycholic acid are uncommon and are usually mild. The most commonly reported side effects are feeling sick, being sick and itchy skin. The use of ursodeoxycholic acid isnt usually recommended for pregnant or breastfeeding women. Sexually active women should use either a barrier method of contraception , such as a condom , or a low-dose oestrogen contraceptive pill while taking ursodeoxycholic acid, as it may affect other types of oral contraceptive pills. Ursodeoxycholic acid tablets are occasionally also prescribed as a precaution against gallstones if its thought youre at risk of developing them. For example, you may be prescribed ursodeoxycholic acid if youve recently had weight loss surgery, as rapid weight loss can cause gallstones to grow. Complications of gallstones A small number of people with gallstones may develop serious problems if the gallstones cause a severe blockage or move into another part of the digestive system. Inflammation of the gallbladder (acute cholecystitis) In some cases of gallstone disease a bile duct can become permanently blocked, which can lead to a build-up of bile inside the gallbladder. This can cause the gallbladder to become infected and inflamed. The medical term for inflammation of the gallbladder is acute cholecystitis. Symptoms include: pain in your upper abdomen that travels towards your shoulder blade (unlike biliary colic, the pain usually lasts longer than five hours) a high temperature (fever) of 38C (100.4F) or above a rapid heartbeat An estimated 1in 7people with acute cholecystitis also experience jaundice (see below). Acute cholecystitis is usually treated first with antibiotics to settle the infection and then keyhole surgery to remove the gallbladder . This operation can be more difficult when performed as an emergency and theres a higher risk of it being converted to an open procedure. Sometimes asevere infection can lead to a gallbladder abscess (empyema of the gallbladder). Antibiotics alone dont always treat these and they may need to be drained. Occasionally a severely inflamed gallbladdercan tear, leading toperitonitis(inflammation of the inside lining of the abdomen).If this happens, you may need to have antibiotics given directly into a vein (intravenous antibiotics) and surgery may be required to remove a section of the lining if part of it becomes severely damaged. Read more about acute cholecystitis . Jaundice If a gallstone passes out of the gallbladder into the bile duct and blocks the flow of bile, jaundice occurs. Symptoms of jaundice include: yellowing of the skin and eyes dark brown urine pale stools itching Sometimes the stone passes from the bile duct on its own. If it doesnt, the stone needs to be removed. See treating gallstones . Infection of the bile ducts (acute cholangitis) If the bile ducts become blocked, theyre vulnerable to infection by bacteria. The medical term for a bile duct infection is acute cholangitis. Symptoms of acute cholangitis include: pain in your upper abdomen that travels towards your shoulder blade a high temperature jaundice chills confusion itchy skin generally feeling unwell Antibiotics will help treat the infection, but its also important to help the bile from the liver to drain with anendoscopic retrograde cholangio-pancreatography (ERCP). Read treating gallstones for more information. Acute pancreatitis Acute pancreatitis may develop when a gallstone moves out of the gallbladder and blocks the opening (duct) of the pancreas, causing it to become inflamed. The most common symptom of acute pancreatitis is a sudden severe dull pain in the centre of your upper abdomen, around the top of your stomach. The pain of acute pancreatitis often gets steadily worse until it reaches a constant ache. The ache may travel from your abdomen and along your back and may feel worse after you have eaten. Leaning forward or curling into a ball may help to relieve the pain. Other symptoms of acute pancreatitis can include: feeling sick being sick diarrhoea loss of appetite a high temperature (fever) of 38C (100.4F) or above tenderness of the abdomen less commonly, jaundice Theres currently no cure for acute pancreatitis, so treatment focuses on supporting the functions of the body until the inflammation has passed. This usually involves admission to hospital so you can be given: fluids into a vein (intravenous fluids) pain relief nutritional support oxygen through tubes into your nose With treatment,most people with acute pancreatitis improve within a week and are well enough to leave hospital after 5 to 10 days. Read more about acute pancreatitis . Cancer of the gallbladder Gallbladder cancer is a rare but serious complication of gallstones. An estimated 660 cases of gallbladder cancer are diagnosed in the UK each year. Having a history of gallstones increases your risk of developing gallbladder cancer.Approximately 4out of every 5people who have cancer of the gallbladder also have a history of gallstones. However, people with a history of gallstones have a less than one in 10,000 chance of developing gallbladder cancer. If you have additional risk factors, such as a family history of gallbladder cancer or high levels of calcium inside your gallbladder, it may be recommended that your gallbladder be removed as a precaution, even if your gallstones arent causing any symptoms. The symptoms of gallbladder cancer are similar to those of complicated gallstone disease, including: abdominal pain high temperature (fever) of 38C (100.4F) or above jaundice Gallbladder cancer can be treated with a combination of surgery, chemotherapy and radiotherapy . Gallstone ileus Another rare but serious complication of gallstones is known as gallstone ileus. This is where the bowel becomes obstructed by a gallstone. Gallstone ileus can occur when an abnormal channel, known as a fistula, opens up near the gallbladder. Gallstones are then able to travel through the fistula and can block the bowel. Symptoms of gallstone ileus include: abdominal pain being sick swelling of the abdomen constipation A bowel obstruction requires immediate medical treatment. If its not treated, theres a risk that the bowel could split open (rupture). This could cause internal bleeding and widespread infection. If you suspect you have an obstructed bowel, contact your GP as soon as possible. If this isnt possible, phone the NHS 24 111 service . Surgery is usually required to remove the gallstone and unblock the bowel. The type of surgery you receive depends on where in the bowel the obstruction has occurred. Preventing gallstones From the limited evidence available, changes to your diet and losing weight (if youre overweight) may help prevent gallstones. Diet Because of the role cholesterol appears to play in the formation of gallstones, it is advisable to avoid eating too many foods with a high saturated fatcontent. Foods high in saturated fat include: meat pies sausages and fatty cuts of meat butter, ghee and lard cream hard cheeses cakes and biscuits food containing coconut or palm oil A healthy, balanced diet is recommended. This includes plenty of fresh fruit and vegetables (at least 5portions a day) and wholegrains. Theres also evidence that regularly eating nuts, such as peanuts or cashews, can help reduceyour risk of developing gallstones. Drinking small amounts of alcohol may alsohelp reduce your risk of gallstones. However, you shouldnt regularly drink more than 14 units of alcohol a week as this can lead to liver problems and other health conditions. Regularly drinking any amount of alcohol can increase the risk to your health. Read more about: high cholesterol how to lower your cholesterol healthy eating Losing weight Being overweight, particularly being obese, increases the amount of cholesterol in your bile, which increases your risk of developing gallstones. You should control your weight by eating a healthy diet and taking plenty of regular exercise. However, avoid low-calorie, rapid-weight-loss diets. Theres evidence they can disrupt your bile chemistry and increase your risk of developing gallstones. A more gradual weight loss plan is recommended. Read more about losing weight and getting started with exercise . Source: NHS 24 - Opens in new browser window Last updated: 13 December 2023 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Dont include personal information e.g. name, location or any personal health conditions. Email Address e.g. [email protected] Message Maximum of 500 characters Send feedback Add this page to\n Info For Me NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats 2023 NHS 24 v1.1.1.17852

Ganglion cyst

Ganglion cyst | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotlands Service Directory 0 Home Illnesses and conditions Muscle, bone and joints Conditions Ganglion cyst Ganglion cyst About ganglion cysts About ganglion cysts Ganglion cysts are soft, gel-like masses that often change size. They tend to be smooth and round, and are: the most common type of swelling in the hand, wrist and foot harmless and can safely be left alone If you have a ganglion, try to stay positive. Theres a lot you can do to help yourself. What causes ganglion cysts? A ganglion cyst starts when the fluid leaks out of a joint or tendon tunnel and forms a swelling beneath the skin. The cause of the leak is generally unknown, but may be due to trauma or underlying arthritis. How common are they? Ganglion cysts are 3 times more common in women than men between 20 and 40 years of age. Types of ganglion cysts Ganglions can form: at the back of the wrist these typically occur in young adults and often disappears without treatment at the front of the wrist these may occur in young adults, but also seen in older people with arthritis at the base of the finger (flexor tendon sheath) these usually occur in young adults on the finger (mucoid cyst) these usually occur in middle-aged or older people Approximately 80% of ganglions are found in the wrist. Ganglion cyst symptoms If you have a ganglion cyst the swelling can become noticeable, but often there are no symptoms at all. Sometimes a ganglion can cause pain and limit movement in your joint. Some people are also concerned about the cysts appearance. Most symptoms settle with time. How theyre diagnosed To diagnose a ganglion cyst, a healthcare professional will ask you about it and examine your wrist and hand. Giving a diagnosis is usually straightforward. However, scans may be helpful if the diagnosis is uncertain. Treating a ganglion cyst About 50% of ganglions disappear on their own without treatment. In the early stages you should wait to see if this happens. You wont need treatment unless the cyst is painful. Medication Many people take medication to cope with their pain and symptoms, and help them remain active. You may be prescribed pain medication to ease the pain. Make sure you take any medication as prescribed, and get advice from a GP, pharmacist or suitably trained healthcare professional. Surgery If the ganglion hasnt reduced in size after 6 months or is causing significant functional difficulty and/or pain, you may be referred for further help and possible surgery. Surgery is considered if it causes significant pain or restricts movement in your joint. However, theres a chance it will come back even after surgery. Ganglion cyst at the back of the wrist Draining this ganglion can reduce the swelling but it often returns. Problems after surgery include: persistent pain loss of wrist movement painful trapping of nerve branches in the scar Theres a 10% chance of it coming back again after surgery. Ganglion cyst at the front of the wrist Draining this ganglion may be useful, but it can be dangerous as the cyst is often close to the artery at the wrist (where you can feel the pulse). Problems after surgery include: persistent pain loss of wrist movement trapping of nerve branches in the scar For these reasons, many surgeons advise against operating on these cysts. Theres a 30 to 40% chance of it coming back again after surgery. Ganglion cyst at the base of the finger These ganglions feel like a dried pea at the base of the finger, and can cause pain when gripping. Problems after surgery include: persistent pain loss of finger movement painful trapping of nerve branches in the scar Theres a small chance of it coming back again after surgery. Finger ganglion cyst These ganglions are associated with wearing out of the end joint of a finger. Pressure from the cyst may cause a furrow in the fingernail. Occasionally the cyst fluid leaks through the thin overlying skin. Problems after surgery include: infection stiffness and pain from the worn out joint Theres a 10% chance of it coming back again after surgery. Work If you have a ganglion cyst try to stay at or get back to work as soon as possible. You dont need to be fully pain and symptom free to return to work. Research shows the longer youre off work the less likely you are to return. Source: MSK Expert Panel - Opens in new browser window Last updated: 24 February 2023 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Dont include personal information e.g. name, location or any personal health conditions. Email Address e.g. [email protected] Message Maximum of 500 characters Send feedback Add this page to\n Info For Me NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats 2023 NHS 24 v1.1.1.17852

Gastroenteritis

Gastroenteritis | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotlands Service Directory 0 Home Illnesses and conditions Stomach, liver and gastrointestinal tract Gastroenteritis Gastroenteritis Gastroenteritis is a very common condition that causes diarrhoea and vomiting. Its usually caused by a bacterial or viral tummy bug. It affects people of all ages, but is particularly common in young children. Most cases in children are caused by a virus called rotavirus. Cases in adults are usually caused by norovirus (the winter vomiting bug) or bacterial food poisoning . Gastroenteritis can be very unpleasant, but it usually clears up by itself within a week. You can normally look after yourself or your child at home until youre feeling better. Try to avoid going to your GP, as gastroenteritis can spread to others very easily. Phone 111 or your GP if youre concerned or need any advice. Symptoms of gastroenteritis The main symptoms of gastroenteritis are: sudden, watery diarrhoea feeling sick vomiting, which can be projectile a mild fever Some people also have other symptoms, such as a loss of appetite, an upset stomach , aching limbs and headaches. The symptoms usually appear up to a day after becoming infected. They typically last less than a week, but can sometimes last longer. What to do if you have gastroenteritis If you experience sudden diarrhoea and vomiting, the best thing to do is stay at home until youre feeling better.Theres not always a specific treatment, so you have to let the illness run its course. You dont usually need to get medical advice, unless your symptoms dont improve or theres a risk of a more serious problem. There are things you can do to help ease your symptoms. Do drink plenty of fluids to avoid dehydration; you need to drink more than usual to replace the fluids lost from vomiting and diarrhoea water is best, but you could also try fruit juice and soup take paracetamol for any fever or aches and pains get plenty of rest if you feel like eating, try small amounts of plain foods, such as soup, rice, pasta and bread use special rehydration drinks made from sachets bought from pharmacies if you have signs of dehydration, such as a dry mouth or dark urine take anti-vomiting medication (such as metoclopramide) and/or antidiarrhoeal medication (such as loperamide) if you need to some types are available from pharmacies, but check the leaflet that comes with the medicine; you can also ask your pharmacist or GP for advice about whether theyre suitable Read further information about treating dehydration Gastroenteritis can spread very easily. You should wash your hands regularly while youre ill and stay off work or school until at least 48 hours after your symptoms have cleared, to reduce the risk of passing it on. When to get medical advice You dont normally need to see your GP if you think you have gastroenteritis, as it should get better on its own. Visiting your GP practice can put others at risk, so its best to phone 111 or your GP if youre concerned or feel you need advice. Phone 111 or your GP practice if: you have symptoms of severe dehydration , such as persistent dizziness , only passing small amounts of urine or no urine at all, or if youre losing consciousness you have bloody diarrhoea youre vomiting constantly and are unable to keep down any fluids you have a fever over 38C (100.4F) your symptoms havent started to improve after a few days in the last few weeks youve returned from a part of the world with poor sanitation you have a serious underlying condition, such as kidney disease , inflammatory bowel disease or a weak immune system, and have diarrhoea and vomiting Your GP may suggest sending off a sample of yourpoo to a laboratory to check whats causing your symptoms. Antibiotics may be prescribed if this shows you have a bacterial infection. Looking after a child with gastroenteritis You can look after your child at home if they have diarrhoea and vomiting. Theres not usually any specific treatment and your child should start feeling better in a few days. You dont normally need to get medical advice unless their symptoms dont improve or theres a risk of a more serious problem. There are things you can do to help ease your childssymptoms. Do encourage them to drink plenty of fluids as they need to replace the fluids lost from vomiting and diarrhoea water is generally best; avoid giving them fizzy drinks or fruit juice, as they can make their diarrhoea worse babies should continue to feed as usual, either with breast milk or other milk feeds make sure they get plenty of rest let your child eat if theyre eating solids and feel hungry try small amounts of plain foods, such as soup, rice, pasta and bread give them paracetamol if they have an uncomfortable fever or aches and pains young children may find liquid paracetamol easier to swallow than tablets use special rehydration drinks made from sachets bought from pharmacies if theyre dehydrated your GP or pharmacist can advise on how much to give your child Dont give your child antidiarrhoeal and anti-vomiting medication, unless advised to by your GP or pharmacist. Make sure you and your child wash your hands regularly while your child is ill. Keep themaway from school or nursery until at least 48 hours after their symptoms have cleared. Getting medical advice for your child You dontusually need to see your GP if you think your child has gastroenteritis, as it should get better on its own, and taking them to a GP practice can put others at risk. Phone 111 or your GP practice if: Youre concerned about your child, or they: have symptoms of dehydration , such as passing less urine than normal, being unusually irritable or unresponsive, pale or mottled skin, or cold hands and feet have blood in their poo or green vomit are vomiting constantly and areunable to keep down any fluids or feeds have had diarrhoea for more than a week have been vomiting for 3 days or more have signs of a more serious illness, such as a high fever (over 38C or 100.4F), shortness of breath, rapid breathing, a stiff neck, a rash that doesnt fade when you roll a glass over it or a bulging fontanelle (the soft spot on a babys head) have a serious underlying condition, such as inflammatory bowel disease or a weak immune system, and have diarrhoea and vomiting Your GP may suggest sending off a sample of your childs poo to a laboratory to confirm whats causing their symptoms. Antibiotics may be prescribed if this shows they have a bacterial infection. How gastroenteritis is spread The bugs that cause gastroenteritis can spread very easily from person to person. You can catchthe infectionif small particles of vomit or poo from an infected person get into your mouth, such as through: close contact with someone withgastroenteritis they may breathe out small particles of vomit touching contaminated surfaces or objects eating contaminated food this can happen if an infected person doesnt wash their hands before handling food, or you eat food that has been in contact with contaminated surfaces or objects, or hasnt been stored and cooked at the correct temperatures A person withgastroenteritis is most infectious from when their symptoms start until48 hours after all their symptoms have passed, although they may also be infectious for a short time before and after this. Preventing gastroenteritis Its not always possible to avoid gettinggastroenteritis, but following this advice can help stop it spreading. Do stay off work, school or nursery until at least 48 hours after the symptoms have passed you or your child should also avoid visiting anyone in hospital during this time ensure you and your child wash your hands frequently and thoroughly with soap and water, particularly after using the toilet and before preparing food dont rely on alcohol hand gels, as theyre not always effective disinfect any surfaces or objects that could be contaminated its best to use a bleach-based household cleaner wash contaminated items of clothing or bedding separately on a hot wash flush away any poo or vomit in the toilet or potty and clean the surrounding area practice good food hygiene: make sure food is properly refrigerated, always cook your food thoroughly, and never eat food that is past its use-by date Dont do not rely on alcohol hand gels, as theyre not always effective dont share towels, flannels, cutlery or utensils while you or your child is ill Take extra care when travelling to parts of the world with poor sanitation, as you could pick up a stomach bug. For example, you may need to boil tap water before drinking it. Young children can have the rotavirus vaccination when theyre 2to 3months old, which can reduce their risk of developing gastroenteritis. Source: NHS 24 - Opens in new browser window Last updated: 13 December 2023 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Dont include personal information e.g. name, location or any personal health conditions. Email Address e.g. [email protected] Message Maximum of 500 characters Send feedback Add this page to\n Info For Me Also on NHS inform Self-help guide: Diarrhoea Self-help guide: Abdominal pain Dehydration Preparing and cooking food safely Other health sites fitfortravel: Norovirus NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats 2023 NHS 24 v1.1.1.17852

Gastro-oesophageal reflux disease (GORD)

"Gastroesophageal reflux disease | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotlands Service Directory 0 Home Illnesses and conditions Stomach, liver and gastrointestinal tract Gastro-oesophageal reflux disease (GORD) Gastro-oesophageal reflux disease (GORD) About gastro-oesophageal reflux disease (GORD) Symptoms of GORD Causes of GORD Diagnosing GORD Treating GORD Complications of GORD About gastro-oesophageal reflux disease (GORD) Gastro-oesophageal reflux disease (GORD) is a common condition, where acid from the stomach leaks up into the oesophagus (gullet). It usually occurs as a result of the ring of muscle at the bottom of the oesophagus becoming weakened. Read more about the causes of GORD . GORD causes symptoms such as heartburn and an unpleasant taste in the back of the mouth. It may just be an occasionalnuisance for some people, but forothers it can bea severe, lifelongproblem. GORDcan often becontrolled with self-help measures and medication. Occasionally, surgery to correct the problem may be needed. Thistopic focuses on GORD in adults. Symptoms of GORD Symptoms of GORD can include: heartburn (an uncomfortable burning sensation in the chest that often occurs after eating) acid reflux (where stomach acid comes back up into your mouth and causes an unpleasant, sourtaste) oesophagitis(a sore, inflamed oesophagus) bad breath bloating and belching feeling or being sick pain when swallowing and/or difficulty swallowing Read more about the symptoms of GORD . What to do if you have GORD You canoften controlthe symptoms of GORD by making somelifestyle changes andtaking over-the-counter medication. Read treatments for GORD for more information. You dont necessarily need to see your GP if you only have symptoms occasionally. Ask your pharmacist for advice on treatments. When to see your GP Visit your GP if youre worried about your symptoms, or if: you have symptoms several times a week over-the-counter medications arent helping your symptoms are severe you have difficulty swallowing you have possible signs of a more serious problem, such as persistent vomiting,vomiting blood orunexplained weight loss Your GP will usually be able to diagnose GORD based on your symptoms, although theymay refer youfor some tests. Read more about diagnosing GORD . Treatments for GORD The main treatments for GORD are: self-help measures this includes eating smaller but more frequent meals, avoiding any foods or drinks that trigger your symptoms, raising the head of your bed, and keeping to a healthy weight over-the-counter medicines ask your pharmacist to recommend anantacidor analginate stronger prescription medicines includingproton-pump inhibitors (PPIs)and H2-receptor antagonists (H2RAs) You may only need to take medication whenyou experience symptoms, although long-term treatment may be needed if the problem continues. Surgery to stop stomach acid leakinginto your oesophagus may be recommended if medication isnt helping, or you dont want to take medication on a long-term basis. Read more about the treatments for GORD . Complications of GORD If you have GORD for a long time, stomach acid can damage your oesophagus and cause further problems. These include: ulcers(sores)on the oesophagus thesemay bleed and make swallowing painful the oesophagus becoming scarred and narrowed this can make swallowing difficult and may require an operation to correct it changes in the cells lining the oesophagus (Barretts oesophagus) very occasionally, oesophageal cancer can develop from these cells, so you may need to be closely monitored Read more about the complications of GORD . Symptoms of GORD The main symptoms of gastro-oesophageal reflux disease (GORD) are heartburn and acid reflux. Heartburn Heartburn is an uncomfortableburning sensation in the chest. Its usually felt just below your breastbone, but can spread up to the throat in some people. Thediscomfort is usually worse after eating, or when bending over or lying down. Acid reflux Acid reflux is where acidand otherstomach contents arebrought back up (regurgitated)into your throat and mouth. It usually causes an unpleasant, sour taste at the back of your mouth. Othersymptoms If you have GORD, you may also experience: a sore, inflamed oesophagus (oesophagitis) bad breath bloating and belching feeling or being sick difficulty swallowing , whichmay feellike a piece of food is stuck low down in your throat pain when swallowing a sore throat and hoarseness a persistent cough or wheezing, which may be worse at night tooth decay and gum disease If you also have asthma , the symptoms may get worse as a result of stomach acid irritating your airways. Causes of GORD Gastro-oesophageal reflux disease (GORD) is usually caused by the ring of muscle at the bottom of the oesophagus (gullet) becoming weakened. Normally, this ring of muscleopens to let food into your stomach and closes tostopstomach acid leaking back up into your oesophagus. But for people with GORD, stomach acid is able to pass back up into the oesophagus. This causes symptoms of GORD , which can include heartburn and acid reflux. Its not always clear what causes thisring of muscleto become weakened, but certain things can increase the risk ofit happening. Whos most at risk of GORD? The following factors mayincrease your risk of developing GORD: being overweight or obese this can place increased pressure on your stomach and weaken themuscles at the bottom of the oesophagus eating large amounts of fatty foods the stomach takes longer toget ridof stomach acid after digesting a fatty meal and the resulting excess acid may leak up into the oesophagus smoking, alcohol, coffee or chocolate these may relax the muscles at the bottom of the oesophagus pregnancy temporary changes in hormone levelsand increased pressure on your stomach during pregnancy can cause GORD hiatus hernia when part of your stomach pushes up through your diaphragm (thin sheet of muscle between the chest and tummy) gastroparesis when the stomach takes longer toget ridof stomach acid, which meansexcess acid can leak up into the oesophagus certain medicines some medicines can cause GORD or make the symptoms worse, includingcalcium-channel blockers (used to treat high blood pressure ),nitrates (used to treat angina ) and non-steroidal anti-inflammatory drugs (NSAIDs) stress GORD can sometimes affect several members of the same family and its been suggested that the genes you inherit from your parents may also affect your chances ofdeveloping the condition. Diagnosing GORD Your GP will often be able to diagnosegastro-oesophageal reflux disease (GORD) based on your symptoms. They may prescribe medication to treat it without needing to carry out any tests. Read more about treating GORD . When tests may be needed Youll usually only need to bereferred for tests in hospital if: your GP is unsure whether you have GORD your symptoms are persistent, severe or unusual prescription medications arent controlling your symptoms your GP thinks you might benefit from surgery you have signs of a potentially more severe condition, such as difficulty swallowing orunexplained weight loss Tests can help to confirm the diagnosis of GORD, check for other possible causes of your symptoms and determine whether you may be suitable for surgery. Tests for GORD Tests you may have include: anendoscopy abarium swallow or barium meal test manometry 24-hour pH monitoring blood tests Endoscopy Anendoscopy is a procedure where the inside of your body is examined using an endoscope, which is a long, thin, flexible tube witha light and camera at one end. The endoscope will be gently inserted into your mouth and down your throat. The procedure is usually carried out while youre awake, but you may be given a sedative to help you relax. The camera can showif the surface of your oesophagus (gullet) has been damaged by stomach acid, although this doesnt happen to everyone with GORD. Barium swallow or barium meal A barium swallow, or barium meal, is a test to assess your swallowing ability and look for any blockages or abnormalities in your oesophagus. You are first given some barium solution, then some X-rays are taken.Barium is a harmless substance that shows up clearly on X-rays as it passes through your digestive system. Youll be asked not toeat anything for a few hours before the procedure. Afterwards, youll be able to eat and drink normally, although you may need to drink more water to help flush the barium out of your body. Manometry Manometry is used to assess how well the ring of muscle at the end of your oesophagus is working, by measuring the pressure in your oesophagus. This can rule out other possible causes of your symptoms andcan help determine whether surgery would be suitable. During the procedure,a small tube will be passed up your nose and then down into your oesophagus. The tube contains pressure sensors that can detect the pressure in the oesophagus. 24-hour pH monitoring It may be necessary to measure the acidity level (pH) in your oesophagus to confirm a diagnosis of GORD if nothing is found during an endoscopy. The acidity level is measured over 24 hours, using a thin tube containing a sensor thats passed up your nose and down your oesophagus. This is usually connected to a recording device worn on your waist. Youll be asked to press a button on the recorder every time you become aware of your symptoms and to record your symptoms in a diary. You should eat as you normally would during the test to ensure an accurate result. Blood tests Sometimes a blood test may be carried out to check for anaemia , which can be a sign of internal bleeding. Treating GORD Heartburn and gastro-oesophageal reflux disease (GORD) can often be treated with self-help measures and over-the-counter medicines. If these dont help, your GP can prescribe stronger medication or refer you to a specialist to discuss whether surgery may be an option. Self-help You may find the following measures can help reduce heartburn and other symptoms of GORD: eat smaller and more frequent meals, rather than 3large meals a day dont eat or drink alcohol within 3or 4hours before going to bed, and avoid having your largest meal of the day in the evening avoid anything you think triggers your symptoms common triggers includecoffee, chocolate, tomatoes, alcohol,and fatty or spicy food dont wear tight clothing clothes that are tight around your tummy may make your symptoms worse raise the head of your bedbyup to 20cm (8 inches) placing a piece of wood or blocks underneath one end of your bedmay reduce symptoms at night; dont just use extra pillows, as this can put a strain on your tummy tryto relax stress can make heartburn and GORD worse, so learning relaxation techniques may help if youre often feeling stressed maintain a healthy weight if youre overweight, losing weight mayhelpreduce your symptoms stop smoking smoke can irritate your digestive system andmay makeyour symptoms worse If youre taking medication for other health conditions, check with your GP to find out whether they could be contributing to your symptoms. Differentmedicines may be available, but dont stop taking any prescribed medication without consulting your GP first. Medication A number of different medications can be used to treat symptoms of GORD. Over-the-counter medicines Over-the-counter heartburn and GORD medicines are available from pharmacies without a prescription. The main types are: antacids theseneutralise the effects of stomach acid alginates theseproduce a coating that protects the stomach and oesophagus (gullet) from stomach acid low-dose proton-pump inhibitors andH2-receptor antagonists see below for more information about these These medicines arent suitable for everyone, so you should check the leaflet first. Ask a pharmacist for advice if youre not sure. Proton-pump inhibitors (PPIs) If your symptoms dont get better despite trying self-help measures and over-the-counter medicines, your GP may prescribe a PPI. These work by reducing the amount of acidproduced by your stomach. Youll usually be given enough medication to last a month. Go back to your GP if they donthelp or your symptoms return after treatment finishes.Some people need to takePPIs on a long-term basis. The possible side effects of PPIs are usually mild. They include headaches, diarrhoea or constipation , feeling sick, abdominal pain , dizzinessand a rash. Your GP will prescribe the lowest dose that they think will control your symptoms to reduce the risk of side effects. H2-receptor antagonists (H2RAs) If PPIs dont control your symptoms, a medicine known as a H2RA may be recommended for you to take alongside them on a short-term basis, or as an alternative. Like PPIs, H2RAs reduce the amount of acid produced byyour stomach. Side effects of H2RAs are uncommon, but caninclude diarrhoea, headaches, dizziness, arash and tiredness. Surgery and procedures Surgery may be an option if: the above treatments dont help,arent suitable for you, orcause troublesome side effects you dont want to take medication on a long-term basis The main procedure used is calleda laparoscopic Nissen fundoplication (LNF).Alternativetechniques have been developed more recently,although these arent yet widely available. Laparoscopic Nissen fundoplication (LNF) LNF is a type of laparoscopic or keyhole surgery. This means its carried out using special surgical instruments inserted through small cuts (incisions) in the skin. The procedure is used to tighten the ring of muscle at the bottom of the oesophagus,which helps to stop acid leaking up from the stomach. Its carried out in hospital under general anaesthetic . Most people need to stay in hospital for 2or 3days after the procedure. Depending on your job, you may be able to return to work within 3to 6weeks. For the first 6weeks after surgery, you should only eat soft food, such as mince, mashed potatoes or soup. Some people experience problems with swallowing, belching and bloating after LNF,but these should get better with time. Newer operations and procedures In the last few years, several new techniques for treating GORD have been developed. The National Institute for Health and Care Excellence (NICE) says these procedures appear to be safe, butnot muchis known about their long-term effects. These techniques include: Endoscopic injection of bulking agents where special filler is injected into the area between the stomach and oesophagus to makeit narrower. Endoluminal gastroplication where folds are sown into the ring of muscles at the bottom of the oesophagus to restrict how far it can open. Endoscopic augmentation with hydrogel implants where implants containingspecialgelare placedinto the area between the stomach and oesophagus to make it narrower. Endoscopic radiofrequency ablation where a tiny balloon is passed down to the bottom ofthe oesophagus and electrodes attached to it are used to heat it and make it narrower. Laparoscopic insertion of a magnetic bead band (LINX) where a ring of magnetic beads are implanted around the lower part of the oesophagus to strengthen it and help keep it closed when not swallowing. Speak to your surgeon about these techniques for more information. Complications of GORD A number of possible complications can occur as a result of having gastro-oesophageal reflux disease (GORD) for a long time. Oesophageal ulcers Thestomach acid that leaks into the oesophagus in people with GORD can damage the lining ofthe oesophagus (oesophagitis), which can cause ulcers to form. These ulcers can bleed, causing pain and making it difficult to swallow. Medications used to treat GORD, such as proton pump inhibitors (PPIs), can help ulcers heal by reducing the amount of acid that leaks into the oesophagus. Read more about treatments for GORD . Scarred and narrow oesophagus Repeated damage to the oesophagus by stomach acid can also cause it to become scarred and narrowed. This is known as oesophageal stricture and itcan make swallowing difficult and painful. If this happens,a procedure to widen the oesophagus using a small balloon or other widening device may be recommended. Barretts oesophagus Repeated episodes of GORD can sometimes lead to changes in the cells in thelining of your lower oesophagus. This is known as Barretts oesophagus. Its estimated that about 1 in every 10 people with GORD will develop Barretts oesophagus, usuallyafter many years. Barretts oesophagus doesnt usually cause noticeable symptoms other than those caused by GORD. However, theres a small risk that the changed cells could become cancerous in the future (see below). Your doctor may suggest having an endoscopyevery few years to check for this. Oesophageal cancer Its estimated that 1 in every 10 to 20 people withBarretts oesophagus will develop oesophageal cancer within 10 to 20 years. Symptoms of oesophageal cancer include: difficulty swallowing unexplained weight loss persistent indigestion hoarseness a persistent cough and/orcoughing blood vomiting Speak to your doctorif you experience any swallowing difficulties, or any other unusual or persistent symptoms. Surgery to remove the cancer can be carried out if itsdiagnosed at an early stage. Read more about treatments for oesophageal cancer . Source: NHS 24 - Opens in new browser window Last updated: 13 December 2023 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Dont include personal information e.g. name, location or any personal health conditions. Email Address e.g. [email protected] Message Maximum of 500 characters Send feedback Add this page to\n Info For Me Also on NHS inform Hiatus hernia Indigestion Other health sites Macmillan Cancer Support: Barrett's oesophagus NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats 2023 NHS 24 v1.1.1.17852"

Genital herpes

Genital herpes | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotlands Service Directory 0 Home Illnesses and conditions Sexual and reproductive Genital herpes Genital herpes Genital herpes is a sexually transmitted infection (STI) caused by a virus called herpes simplex virus (HSV). There are 2 different types of the virus. Both of which affect the genitals. Genital herpes causes painful blisters and sores on and around the genitals. It can also sometimes cause problems if you have it for the first time during pregnancy. Symptoms of genital herpes Most people with the herpes virus dont notice any symptoms and dont know they have it. So its important to get tested if you think youre infected. If you do get symptoms, it takes usually 2 to 12 days after contact for them to appear. Some people dont get symptoms until months or sometimes years later. Once you have the herpes infection, the virus stays in your body. It can lie dormant for long periods but can reactivate in the area that was originally infected. If this happens, the sores and blisters can reappear. This is known as a recurrent episode of genital herpes. This first episode of genital herpes may last from 2 to 4 weeks. Repeated episodes are not usually as severe, or long, as the first and you may never have a repeat episode. Symptoms of the first infection include: spots or red bumps around the genital area pain inside the vagina, head of penis or anus vaginal discharge pain peeing or being unable to pee fever flu-like symptoms, backache, headache and a temperature mild swelling of the lymph glands in the groin, armpits and neck If you have a recurrent infection, your symptoms may include: a tingling or burning sensation before blisters appear painful red blisters, which soon burst to leave ulcers pain inside the vagina, head of penis or anus When to get medical advice Speak to your GP practice or midwife if: youre pregnant and think you have genital herpes Testing for genital herpes If you think you might have genital herpes, get tested for free by: contacting your GP practice for an appointment booking an appointment at your local sexual health service Your doctor or nurse may be able to diagnose by looking at symptoms such as blisters, sores and ulcers. If you have visible blisters, your doctor or nurse may take a swab for testing. This is to check if its herpes and what type. The swab can also test for another STI which causes blisters called syphilis . The genital herpes swab tests are very reliable, though if the ulcer is too dry then it may be less likely to find a positive result. Treatment for genital herpes Genital herpes can be treated with antiviral medication. The symptoms of genital herpes can be treated, although it could keep coming back. Symptoms of recurrent genital herpes will usually clear up without any treatment. Some people experience recurrences of genital herpes. In these cases, a longer course of tablets should stop any recurrent episodes. You can talk to your GP or nurse about which treatment options are right for you. As theres no screening test for herpes, partners should only have a test if they also have symptoms. How genital herpes are passed on You can get genital herpes: from skin to skin contact with the infected area (including vaginal, anal and oral sex) when there are no visible sores or blisters if a cold sore touches your genitals or face kissing (if the person has a cold sore on their face) by sharing sex toys with someone who has herpes Sometimes herpes can be passed on when your sexual partner has no visible sores or symptoms. This is because the virus can become active on the skin without causing any visible blisters or sores. This is sometimes called asymptomatic shedding. This risk goes down during the first months after you catch herpes and is not likely after two years. However, it is more common when people are still having frequent recurrences. Very rarely, herpes is passed to a newborn baby during childbirth. This is only likely to happen if a mother has her first episode of herpes after week 26 of the pregnancy. When women have had herpes longer than three months, normal delivery is expected even if there are symptoms at the time of delivery. How to prevent genital herpes The best way to reduce your risk of STIs is to practice safer sex . This means using a condom for vaginal, anal and oral sex. If your partner has herpes, avoiding sex when they have visible sores reduces your risk of getting herpes. Other STIs If youve been diagnosed with herpes its recommended that you are tested for all STIs including: chlamydia gonorrhoea syphilis HIV This is even more important if you have recurrent episodes. Find your local sexual health clinic Source: Scottish Government - Opens in new browser window Last updated: 26 February 2024 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Dont include personal information e.g. name, location or any personal health conditions. Email Address e.g. [email protected] Message Maximum of 500 characters Send feedback Add this page to\n Info For Me NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats 2023 NHS 24 v1.1.1.17852

Genital symptoms

Managing genital symptoms | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotlands Service Directory 0 Home Illnesses and conditions Sexual and reproductive Managing genital symptoms Managing genital symptoms Not all symptoms that you may experience around your genitals are caused by a sexually transmitted infection (STI). Symptoms can be caused by a variety of natural changes in your body as well as infections that are not sexually transmitted. Phone 111 if you: Become very ill and have: severe pain a high temperature nausea and/or vomiting Symptoms to discuss with sexual health services Ulcers on the genitals Single ulcers (sores) could be a sign of a recent infection of syphilis , especially if there is no pain. Painful ulcers may be due to herpes, other infections or recent trauma. It can help to take a photo of your ulcer so you can show the sexual health clinician at your appointment. If you think you have mpox (monkeypox) or youve come into contact in the last 21 days with someone who has mpox, you should phone your local service before you attend in person. Pelvic pain There are many causes of pain in the lower tummy. For example issues of the bowel or urinary tract and many gynaecological conditions. Some STIs such as gonorrhoea , or chlamydia , can very occasionally spread up into the womb and cause pelvic pain and/or deep pain during sex. If you have pain like this and think you have been at risk of an STI then you should contact your local service . If there is any possibility that you could be pregnant, take a pregnancy test. Discharge from the end of the penis Whether you have discomfort peeing or not, discharge from the end of the penis could mean that you have an STI such as chlamydia or gonorrhoea . Book a consultation online or contact your local sexual health service for advice. Pain, swelling or inflammation around the testicles Gonorrhoea and chlamydia usually affect just the urinary tract. But sometimes infection can spread to the testicle and/or the epididymis (the small tube part next to the testicle). This will cause painful swelling for which you should get treatment urgently. Book a consultation online or phone for advice\u200b\u200b. Multiple painful genital ulcers Having multiple genital ulcers could indicate genital herpes which is the same virus that causes cold sores. Herpes is an extremely common virus. It sometimes causes symptoms which are mostly self-limiting. This means your immune system will deal with this itself, but it can take a few days for symptoms to settle. Sometimes the ulcers are itchy before they become sore. There may be pain when peeing because this stings the ulcers. Milder cases can be diagnosed and treated by your GP. If youre worried about your symptoms, you could also contact your local sexual health service for advice. Further information about herpes simplex viruses Symptoms that arent usually a sign of anything serious Spots or lumps on the genitals Sometimes hair follicles (the tiny pockets from where each hair grows) around the genitals or groin area can become inflamed. This is called folliculitis. It may be more common if you shave the area. At first it may look like a small pimple. It may be itchy, and sore but in most cases it will resolve on its own. If you have any concerns contact your local sexual health service . Another common cause of new spots or lumps on your genitals is warts. Another possible cause is molluscum. Sometimes, teenagers notice lumps that are completely normal. If you think that the lumps you have noticed are likely to be genital warts they might clear up ontheir own. One third of warts disappear within 6 months. Your GP practice may be able to prescribe treatment for you or refer you to a sexual health clinic if treatment doesnt work. Sexual health services available may vary across Scotland. Itching Genital skin can be sensitive. Itching is often a sign that youre doing something, or using a product, thats irritating the skin. If itching is your only symptom, it isnt often related to an STI. Itching around or inside the vagina is often due to thrush . You can get treatment over the counter at your local pharmacy . Change in vaginal bleeding pattern If youve changed your method of contraception , then you might notice a change in your bleeding pattern. This should settle but if you have any concerns, talk to your contraception provider. Chlamydia can sometimes cause bleeding after sex or between periods. If you have had unprotected sex with a new sexual partner and notice this type of bleeding, then get tested for STIs . Change in vaginal discharge Read about what to do if you have a change in your vaginal discharge Genital washing advice Do use a soap substitute (emollient) to add moisture instead of soap these are available from pharmacies use non-soap bath additives such as unfragranced bath oil instead of bubble bath treat athletes foot straight away to prevent it spreading to your genital area when you pull your underwear on if you have a penis with a foreskin, always remember to pull back the foreskin gently but fully when washing and dry gently with a towel before replacing the foreskin Dont do not use soap on or near your genital area, it can be drying do not let products like shampoo or conditioner run onto your genital skin do not use bubble baths, essential oils or soap or shower gels in the bath as theyll get onto the genital skin and may cause irritation do not use wet wipes on the genital skin do not use feminine washing products even if they say they are pH balanced as they disrupt healthy bacteria in the vagina do not douche (wash out the vagina with water or other products) as it damages the healthy vaginal organisms and changes their natural balance do not use fabric softeners Source: Scottish Government - Opens in new browser window Last updated: 27 February 2024 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Dont include personal information e.g. name, location or any personal health conditions. Email Address e.g. [email protected] Message Maximum of 500 characters Send feedback Add this page to\n Info For Me Also on NHS inform Book a sexual health appointment online Find your nearest sexual health service Enter a place or postcode NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats 2023 NHS 24 v1.1.1.17852

Genital warts

Genital warts | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotlands Service Directory 0 Home Illnesses and conditions Sexual and reproductive Genital warts Genital warts Genital warts are a common sexually transmitted infection (STI). They are caused by a virus called Human Papilloma Virus (HPV). Symptoms of genital warts It can take a few weeks or months for genital warts to appear after becoming infected. Genital warts are usually small, rough lumps on the skin. They can appear: around the vagina and on the penis around the anus on the skin between the genitals and the anus Genital warts may: appear on their own or in a group (groups of warts can look like a cauliflower) feel soft or firm be white, red, skin-coloured, or darker than the surrounding skin They dont usually cause symptoms but can sometimes be painful, itchy or bleed. When to get medical advice Speak to your GP practice or local sexual health clinic if you have: 1 or more painless lumps or growths around your vagina, penis or anus itching or bleeding from your genitals or anus a sexual partner (s) who has genital warts Testing for genital warts The test for genital warts involves an examination of the genital area. If you think you might have genital warts, get checked for free by: contacting your GP practice for an appointment booking an appointment at your local sexual health service Warts must be diagnosed by a doctor or nurse. Treatment for genital warts Treatment for genital warts is not always needed. They sometimes disappear on their own within 6 months. If treatment is recommended, itll be prescribed by your doctor. Your doctor or nurse may advise you to avoid sex while youre having treatment for genital warts. The type of treatment youll be offered depends on what your warts are like. Your doctor or nurse will discuss this with you. Treatment options include: cream or liquid freezing surgery Cream or liquid You can usually apply this to the warts yourself a few times a week for several weeks. Freezing A doctor or nurse freezes the warts with liquid nitrogen, usually every week for 4 weeks. Surgery A doctor or nurse can cut or burn the warts off. This is usually only recommended if the warts are not responding or are too large for cream or freezing. Side effects of these treatments include: bleeding wound infection scarring Genital warts and pregnancy Genital warts are not usually harmful during pregnancy. During pregnancy, genital warts may: multiply and get bigger (they may be removed if theyre very big) become more easily irritated be passed on to the baby during childbirth, but this is very rare (the HPV virus can cause infection in the babys throat or genitals) Most creams, liquids and ointments used to treat genital warts are not recommended during pregnancy. Freezing can be used but its often not very successful. Genital warts usually disappear on their own within 6 weeks after childbirth. How genital warts are passed on You can get genital warts from skin to skin contact. Other ways of getting genital warts include: unprotected vaginal, anal, or oral sex (sex without a condom) sharing sex toys with an infected person How to prevent genital warts The best way to reduce your risk of STIs is to practice safer sex . This means using a condom for vaginal, anal, and oral sex, and when sharing sex toys. You can get warts even if you use condoms, as a condom does not cover the whole genital area. The HPV vaccination will reduce your risk of getting HPV virus which causes warts. However, it doesnt treat warts once you have them. HPV and cancer Genital warts are not cancer and dont cause cancer. Theyre caused by a different strain of HPV. HPV vaccination is offered to every person aged 11 to 13. The vaccine can protect against cervical cancer also protects against genital warts. The HPV vaccine is also offered to men who have sex with men (MSM) and trans people aged up to 45 years . If you didnt have the vaccine at school and dont fulfill the above criteria, you can pay for the vaccine privately. Other STIs If youve been diagnosed with genital warts its recommended that youre tested for all STIs including: chlamydia gonorrhoea syphilis HIV Source: Scottish Government - Opens in new browser window Last updated: 06 March 2024 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Dont include personal information e.g. name, location or any personal health conditions. Email Address e.g. [email protected] Message Maximum of 500 characters Send feedback Add this page to\n Info For Me Find your local sexual health clinic Enter a place or postcode NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats 2023 NHS 24 v1.1.1.17852

Germ cell tumours

"Germ cell tumours | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotlands Service Directory 0 Home Illnesses and conditions Cancer Cancer types in children Germ cell tumours Germ cell tumours Most children who develop germ cell tumours will be cured. More children than ever are surviving childhood cancer. There are new and better drugs and treatments, and we can now also work to reduce the after-effects of having had cancer in the past. Its devastating to hear that your child has cancer. At times it can feel overwhelming but there are many healthcare professionals and support organisations to help you through this difficult time. Understanding more about the cancer your child has and the treatments that may be used can often help parents to cope. Your childs specialist will give you more detailed information, and if you have any questions, its important to ask the specialist doctor or nurse who knows your childs individual situation. Germ cell tumours can appear at any age. They develop from cells that produce eggs or sperm so germ cell tumours can affect the ovaries or testes. However, its possible for a germ cell tumour to develop in other parts of the body. As a baby develops during pregnancy, the cells producing eggs or sperm normally move to the ovaries or testes. However, occasionally they can settle in other parts of the body where they can develop into tumours. The most common places for this to happen are the bottom of the spine (sacrococcygeal), the brain, chest, and abdomen. Germ cell tumours are sometimes given different names based on their characteristics. These include yolk-sac tumours, germinomas, embryonal carcinomas, mature teratomas and immature teratomas. They may be non-cancerous (benign) or cancerous (malignant). Malignant tumours have the ability to grow and spread to other parts of the body. Benign tumours do not spread but may cause problems by pressing on nearby tissue and organs. Immature teratomas fall between benign and malignant. They can spread within the abdomen but not beyond, and can be removed with an operation. Causes The cause of germ cell tumours is unknown but research into the causes of different cancers is ongoing. Signs and symptoms The symptoms depend on where the tumour develops. Usually it starts with a lump that can either be felt or causes other symptoms. How germ cell tumours are diagnosed Different tests may be needed to diagnose a germ cell tumour. Usually, the doctor will remove a sample of tissue from the lump (a biopsy ) for examination under a microscope to find out if it is a cancer or not. CT or MRI scans may be used to see the exact position of a tumour within the body. Chest X-rays may be taken to see if theres a tumour in the lungs. Germ cell tumours often produce proteins called tumour markers that can be measured in the blood. The ones that are produced by germ cell tumours are alpha-fetoprotein (AFP) and human chorionic gonadotrophin (HCG). Your child will have blood tests to check these tumour markers when they are being diagnosed. The doctors will continue to check these during treatment and after treatment is over. Sometimes a germ cell tumour can be diagnosed with a tumour marker and scan results so that a biopsy isnt necessary. This is particularly so if surgery is not needed for treatment, for example if the tumour is in the brain. Staging The stage of a cancer describes its size and whether it has spread from where it started. Knowing the stage helps doctors to decide on the most appropriate treatment. Generally cancer is divided into 4 stages: stage 1 the cancer is small, has not spread and has been completely removed stages 2 and 3 the cancer is larger and may not have been completely removed, or may have spread to nearby organs stage 4 the cancer has spread to other parts of the body Cancer that has spread to distant parts of the body and formed new tumours is known as secondary or metastatic cancer. Treatment The treatment your child will have usually depends on a number of factors, including the size, position and stage of the tumour. It usually includes either surgery or chemotherapy, or a combination. A benign tumour can be cured if it is removed by surgery. It may mean removing a testicle or an ovary if this is where the tumour started. If the tumour is malignant and can be completely removed with surgery, chemotherapy is not always needed, especially if it began in the testis or ovary. If the tumour cannot be removed easily or has spread, your child will be given chemotherapy. Chemotherapy is the use of anti-cancer (cytotoxic) drugs to destroy cancer cells. Germ cell tumours are very sensitive to chemotherapy. Its usually given as injections and drips (infusions) into a vein. A combination of drugs is usually given every 3 weeks for 3 or 5 months. The length of time chemotherapy is given for depends on the position of the tumour, the level of AFP, and whether or not the tumour has spread. Treatment of malignant germ cell tumours in the brain is a little different. Although they are very sensitive to chemotherapy, treatment with radiotherapy is also needed. Radiotherapy is the use of high-energy rays to destroy cancer cells. Unlike germ cell tumours elsewhere in the body, its not always necessary to remove germ cell tumours in the brain with surgery. Side effects of treatment Treatment often causes side effects, and your childs doctor will discuss these with you before treatment starts. The operation your child has will be individually planned to try to reduce any possible problems. The surgeon and specialist nurse will discuss this with you. The side effects of chemotherapy usually gradually improve when treatment is over and many of them can be well controlled. The side effects of treatment depend on the drugs used but can include: feeling sick (nausea) and being sick (vomiting) hair loss increased risk of infection bruising and bleeding tiredness diarrhoea Late side effects A small number of children may develop long-term side effects of treatment, sometimes many years later. These are not common but may include problems with how the kidneys or lungs work and some hearing loss. Your childs specialist doctor or nurse will tell you more about any possible late side effects. If your child has only one ovary or testis removed, theyll usually still be able to have children in the future. Clinical trials Many children have their treatment as part of a clinical research trial. Trials aim to improve our understanding of the best way to treat an illness, usually by comparing the standard treatment with a new or modified version. Specialist doctors carry out trials for childrens cancers. If appropriate, your childs medical team will talk to you about taking part in a clinical trial and will answer any questions you have. Written information is often provided to help explain things. Taking part in a research trial is completely voluntary, and youll be given plenty of time to decide if its right for your child. Treatment guidelines Sometimes, clinical trials are not available for your childs tumour. This may be because a recent trial has just finished, or because the tumour is very rare. In these cases, you can expect your doctors and nurses to offer treatment which is agreed to be the most appropriate, using guidelines which have been prepared by experts across the country. The Childrens Cancer and Leukaemia Group (CCLG) is an important organisation which helps to produce these guidelines. Follow-up care Your child will continue to have regular blood tests during and after treatment, to check their levels of AFP and HCG. If the levels rise, this indicates that the tumour might have come back and further treatment is needed. If you have specific concerns about your childs condition and treatment, its best to discuss them with your childs doctor, who knows the situation in detail. Your feelings As a parent, the fact that your child has cancer is one of the worst situations you can be faced with. You may have many emotions, such as fear, guilt, sadness, anger and uncertainty. These are all normal reactions and are part of the process that many parents go through at such a difficult time. Its not possible to address here all of the feelings you may have. However, the CCLG booklet Children & Young Peoples Cancer; A Parents Guide talks about the emotional impact of caring for a child with cancer and suggests sources of help and support. Your child may have a variety of powerful emotions throughout their experience with cancer. The Parents Guide discusses these further and talks about how you can support support your child. Source: Children's Cancer and Leukaemia Group - Opens in new browser window Last updated: 14 November 2023 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Dont include personal information e.g. name, location or any personal health conditions. Email Address e.g. [email protected] Message Maximum of 500 characters Send feedback Add this page to\n Info For Me Search for cancer support services near you Enter a place or postcode NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats 2023 NHS 24 v1.1.1.17852"

Glandular fever

Glandular fever | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotlands Service Directory 0 Home Illnesses and conditions Infections and poisoning Glandular fever Glandular fever About glandular fever Symptoms of glandular fever Causes of glandular fever Treating glandular fever Complications of glandular fever About glandular fever Glandular fever is a type of viral infection that mostly affects young adults. Its also known asinfectious mononucleosis, or mono. Common symptoms include: a high temperature (fever) a severely sore throat swollen glands in the neck fatigue (extreme tiredness) While the symptoms of glandular fever can be very unpleasant, most of them should pass within 2 to 3 weeks. Fatigue, however, can occasionally last several months. Read moreabout the symptoms of glandular fever . When to seek medical advice You should contact your GP if you suspect that you or your child has glandular fever. While there is little your GP can do in terms of treatment, they can provide advice and support to help you control your symptoms and reduce the risk of passing the infection on to others. You should go to your local accident and emergency (A&E) department or phone 999 for an ambulance if you have glandular fever and you: develop a rasping breath (stridor) or have any breathing difficulties find swallowing fluids difficult develop intense abdominal pain These symptoms can be a sign of a complication of glandular fever that may need to be treated in hospital. Fever in adults self-help guide Complete this guide to assess your symptoms and find out if you should visit A&E, your GP, pharmacist or treat your condition at home. Self-help guide: Fever in adults What causes glandular fever? Glandular fever is caused by the Epstein-Barr virus (EBV). This virus is found in the saliva of infected people and can be spread through: kissing glandular fever is often referred to as the kissing disease exposure to coughs and sneezes sharing eating and drinking utensils, such as cups, glasses and unwashed cutlery EBV may be found in the saliva of someone who has had glandular fever for several months after their symptoms pass, and some people maycontinue to have the virus in their saliva on and off for years. If you have EBV, its a good idea to take steps to avoid infecting otherswhile you are ill,such as not kissing other people, but theres no needno need toavoid all contact with othersas the chances of passing on the infection are generally low. Read more about the causes of glandular fever . Who is affected? Glandular fever can affect people of all ages, but most cases affect teenagers and young adults. Most EBV infections are thought to occur during childhood and cause onlymild symptoms, or no symptoms at all. However, if a person develops an EBV infection during early adulthood, they can develop glandular fever. Once you have had glandular fever, its unlikely you will develop it again. This is because people develop lifelong immunity after the initial infection. How glandular fever is diagnosed Todiagnose glandular fever, your GP will first askabout your symptoms before carrying out a physical examination. Theyll look for signs of glandular fever, such as swollen glands, tonsils, liver and spleen. Your GP may also recommend a blood test to help confirm the diagnosis and rule out infections that can cause similar symptoms, such as cytomegalovirus (CMV), rubella, mumpsand toxoplasmosis. How glandular fever is treated There is no cure for glandular fever. But there are simple treatments and measures that can help reduce the symptoms while you wait for your body tocontrol the infection. These include: drinking plenty of fluids taking over-the-counter painkillers, such as paracetamol or ibuprofen getting plenty of rest andgradually increasing your activity as your energy levels improve Occasionally, antibiotics or corticosteroids may be used if you develop complications of glandular fever. Some people with particularly severe symptoms may need to be looked after in hospital for a few days. Read more about treating glandular fever . Possible complications Complications associated with glandular fever are uncommon, but when they do occur they can be serious. They can include: further infections of other areas of the body, including the brain, liverand lungs severe anaemia (a lack of oxygen-carrying red blood cells) breathing difficulties as a result of the tonsils becomingsignificantly swollen a ruptured (burst) spleen, which may need to be treated with surgery Read more about the complications of glandular fever . Symptoms of glandular fever Symptoms of glandular fever are thought to take around 1 to 2 months to develop after infection with the Epstein-Barr virus (EBV). Main symptoms Themost commonsymptoms of the condition are: a high temperature (fever) a sore throat this is usually more painful than any you may have had before swollen glands in your neck and possibly in other parts of your body, such as under your armpits fatigue (extreme tiredness) Other symptoms Glandular fever can also cause: a general sense of feeling unwell aching muscles chills sweats loss of appetite pain around or behind your eyes swollen tonsils and adenoids (small lumps of tissue at the back of the nose), which may affect your breathing the inside of your throat to become very red and ooze fluid small red or purple spots on the roof of your mouth a rash swelling or puffiness around your eyes a tender or swollen tummy jaundice(yellowing of the skin and whites of the eyes) Some of these symptoms may develop a few days before the main symptomsmentioned above. How the condition progresses Most symptoms of glandular fever willusually resolve within 2 or 3 weeks.Your throat will normally feel mostsorefor 3 to 5 days after symptoms start before gradually improving, and your fever will usually last 10 to 14 days. Fatigue is the most persistent symptom andoften lasts a few weeks, although some people may feel persistently fatigued for several months after the other symptoms have passed. When to seek medical advice You should contact your GP if you suspect that you or your child has glandular fever. While there is little your GP can do in terms of treatment other than provide advice and support, blood tests may be needed to rule out less common but more serious causes of your symptoms, such as hepatitis(a viral infection that affects the liver). You should go to your local accident and emergency (A&E) departmentor phone 999 for an ambulanceif you have glandular fever and you: develop a rasping breath (stridor) or have any breathing difficulties find swallowing fluids difficult developintense abdominal pain If you have these symptoms, you may need to be looked after in hospital for a few days. Read more about treating glandular fever . Causes of glandular fever Glandular fever is caused by the Epstein-Barr virus (EBV). EBV is most often spread through the saliva of someone who carries the infection. For example, it can be spread through: kissing glandular fever is sometimes referred to as the kissing disease sharing food and drinks sharing toothbrushes exposure to coughs and sneezes Small children may be infected by chewing toys that have been contaminated with the virus. When you come into contact with infected saliva, the virus can infect the cells on the lining of your throat. The infection is then passed into your white blood cells before spreading through the lymphatic system. This is a series of glands (nodes) found throughout your body that allows many of the cells that your immune system needs to travel around the body. After the infection has passed, people develop lifelong immunity to the virus and most wont develop symptoms again. Many people are first exposed to EBV during childhood, when the infection causes few symptoms and often goes unrecognised before it eventually passes. Young adults may be most at risk of glandular fever because they might not have been exposed to the virus when they were younger, and the infection tends to produce more severe symptoms when youre older. EBV carriers Not everyone who can pass on EBV will have symptoms themselves. These are known as asymptomatic carriers. Some people can have the virus in their saliva for a few months after recovering from glandular fever, and may continue to have the virus in their saliva on and off for years. This is because the virus remains inactive in the body for the rest of your life after you have been exposed to it. For most people, the inactive virus wont cause any symptoms. However, there is a chance of the virus periodically becoming reactivated, which may mean it re-enters the saliva. This reactivation may be without any symptoms, or itmay cause symptoms to recur for a short time. Treating glandular fever There is currently no cure for glandular fever, but the symptoms should pass within a few weeks. There are things you can do to help control your symptoms. Fluids Drink plenty of fluids(preferably water or unsweetened fruit juice) to avoid dehydration . Avoid alcohol, as this couldharm your liver, which may already be weakened from the infection. Painkillers Painkillers available over the counter, such as paracetamol or non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen , can help reduce pain and fever. Children under 16 years old should not take aspirin because there is a small riskit could trigger a rare but serious health condition calledReyes syndrome. Regularly gargling with a solution of warm, salty water may also help relieve your sore throat . Rest Take plenty of rest while you recover from glandular fever. Complete bed rest is no longer recommended because itmay make the fatigue last longer. You should gradually increase your activities as your energy levels return, but avoid activities you cannot manage comfortably. For the first month after your symptoms begin, avoid contact sports or activities that put you at risk of falling. This is because you may have a swollen spleen thatits more vulnerable to damage, and a sudden knock could cause it to burst (rupture). Preventing the spread of infection There is no need to be isolated from others if you have glandular feveras most people will already be immune to the Epstein-Barr virus (EBV). You can return to work, college or school as soon as you feel well enough. Theres little risk of spreading the infection to others as long as you follow commonsense precautions while you are ill, such as not kissing other people or sharing utensils. Its also important tothoroughly clean anything that may have been contaminated by saliva until you have recovered. Antibiotics and steroids Antibiotics are not effective in treating glandular fever because they have no effect on viruses,but theymay be prescribed if you also develop a bacterial infection ofyour throat or lungs (pneumonia) . A short course of corticosteroids may also be helpful if: your tonsils are particularly swollenandare causing breathing difficulties you have severe anaemia (a lack of oxygen-carrying red blood cells) you haveproblems affecting your heart, such as pericarditis (inflammation of the sac that surrounds the heart) you haveproblems affecting your brain or nerves, such as encephalitis Read more aboutthe complications of glandular fever . Hospital treatment Most people are able to recover from glandular feverat home, but hospital treatment may be necessary for a few days if you or your child: develop a rasping breath (stridor) or have any breathing difficulties find swallowing fluids difficult develop intense abdominal pain Treatment in hospital may involve receiving fluids or antibiotics directly into a vein (intravenously), corticosteroid injections and pain relief. Ina small number ofcases, emergency surgery to removethe spleen (splenectomy) may be needed if it ruptures. Complications of glandular fever Most people with glandular fever will recover in 2 or 3 weeks and wont experience any further problems. However, complications can develop in a few cases. Prolonged fatigue More than1 in every 10 people with glandular fever will experience prolonged fatigue, which lasts for 6 months or more after the initial infection. Its not known why fatigue lasts longer in some people. Some experts think it may be a form of chronic fatigue syndrome (CFS) . This is a poorly understood condition that causes persistent fatigue and a range of other symptoms, such as headaches and joint pain. Adopting a gradual exercise plan to rebuild your strength and energy levels may helpprevent and reduce prolonged fatigue. Reduction inblood cells In a few cases, glandular fever can lead to a reduction in some blood cells. It can reduce levels of: red blood cells (anaemia)this can make you feel tired and out of breath white blood cells (neutropenia)this can make you more prone to developing a secondary infection platelets this can make you bruise and bleed more easily In most cases, the reduction in thenumber of blood cells is small and only causes mild symptoms. These problems should get better by themselves within a few weeks or months. Ruptured spleen Around half of people who develop glandular fever will have a swollen spleen. This does not present any immediate health problems, butthere is a small risk of it rupturing (bursting). The main sign of a ruptured spleen issharp pain in the left of the tummy (abdomen). Go toyour local accident and emergency (A&E) department or phone 999 for an ambulance if you have glandular fever and you develop intense abdominal pain. The risk of the spleen rupturing is small, occurring in just1 in every 500 to 1,000 cases of glandular fever, but it can be life threatening because it may cause severe internal bleeding. In some cases,emergency surgery may be required to remove an enlarged orruptured spleen(splenectomy). A ruptured spleen usually occurs as a result of damage caused by vigorous physical activities, such as contact sports. Its therefore very important to avoid these activities for at least a month after the symptoms of glandular fever begin. Be particularly careful during the second and third week of your illness, as this is when the spleen is most vulnerable. Neurological complications In less than1 in every 100 cases, the Epstein-Barr virus (EBV) can affect the nervous system and trigger a range of neurological complications, including: Guillain-Barr syndrome where the nerves become inflamed, causing symptoms such as numbness, weaknessand temporary paralysis Bells palsy wherethe muscles on one side of the face becometemporarily weak or paralysed viral meningitis an infection of the protective membranes that surround the brain and spinal cord; although unpleasant,viral meningitisis much less serious than bacterial meningitis, which is life threatening encephalitis an infection of the brain These complications will often need specific treatment, but more than four out of every five people with them will make a full recovery. Secondary infection In a small number of cases, the initial infection weakens your immune system and allows bacteria to infect parts of the body. This is called a secondary bacterial infection. Possible secondary infections that can develop during glandular fever include serious conditions such as pneumonia (infection of the lung) andpericarditis (infection of the sac that surrounds the heart). Secondary infections usually occur in people who have a very weak immune system, such as people with HIV or AIDS , or those having chemotherapy . If you have a weakened immune system and you develop glandular fever, as a precaution you may be referred to hospital for specialist treatment. This willallow foryour health to be carefully monitored and any secondary infections to be treated. Source: NHS 24 - Opens in new browser window Last updated: 04 December 2023 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Dont include personal information e.g. name, location or any personal health conditions. Email Address e.g. [email protected] Message Maximum of 500 characters Send feedback Add this page to\n Info For Me Also on NHS inform Self-help guide: Fever in adults Other health sites Lab Tests Online UK NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats 2023 NHS 24 v1.1.1.17852

Gonorrhoea

Gonorrhoea | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotlands Service Directory 0 Home Illnesses and conditions Sexual and reproductive Gonorrhoea Gonorrhoea British Sign Language | | Polski | Romn | slovenina Gonorrhoea is a sexually transmitted infection caused by bacteria. Infection usually occurs in the genitals but can affect the throat, eyes and anus. Symptoms of gonorrhoea Many people with gonorrhoea wont notice any symptoms. If you do get symptoms, its usually between 1 to 14 days after getting the infection. Symptoms of gonorrhoea may include: green or yellow fluid coming out of the penis pain or a burning sensation when peeing discomfort and swelling of the testicles increased discharge from the vagina pain in the lower tummy, particularly during sex bleeding in between periods or after sex Gonorrhoea can also infect the throat, eyes or anus. You may experience pain or discharge in these areas. Gonorrhoea in the throat usually has no symptoms. Having the infection during pregnancy can result in giving birth to the baby early (premature birth). Gonorrhoea can be passed on to the baby during birth and can result in eye infections in the infant. When to get medical advice Speak to your GP practice or midwife if: youre pregnant and think you have gonorrhoea Testing for gonorrhoea If you think you might have gonorrhoea, get tested for free by: booking an appointment at your local sexual health service (if you have symptoms) contacting your GP practice for an appointment (if you have symptoms) ordering a home test kit (if you do not have symptoms) Services available may vary depending on where you live. What does a gonorrhoea test involve? The test for gonorrhoea is simple, painless and very reliable. It involves sending a sample from the area of the body thought to be infected to a lab for analysis. You usually dont have to be examined by a doctor or nurse and can often collect the sample yourself. The 2 main ways the sample can be collected are: using a swab a small cotton bud is gently wiped over the area that might be infected, such as inside the vagina, throat, or inside the anus urine sample (if you have a penis) this is more accurate if its at least 1 or 2 hours after you last peed People who have had anal or oral sex may have a swab taken from their anus or throat. Some sexual health clinics may be able to carry out rapid tests and give you your test results straight away. Otherwise, youll have to wait up to 2 weeks to get the results. If you have gonorrhoea, your partner will be offered testing and treatment. Treatment for gonorrhoea Antibiotics will treat the gonorrhoea infection. These can be given in pill form or as an injection. Some strains of gonorrhoea are becoming resistant to antibiotics. This can make it more difficult to treat. You may be tested again 3 weeks later to check the antibiotics have worked. If theres a high chance you have gonorrhoea, you may be given treatment before you get your results back. You may also be offered treatment if your partner (s) is found to have gonorrhoea. Tell the doctor or nurse if you: are pregnant think you might be pregnant are breastfeeding This may make a difference to the antibiotic youre prescribed. If your infection is untreated you may pass it on to other sexual partners. If gonorrhoea is left untreated in women, it can spread to the womb and cause a serious condition called pelvic inflammatory disease (PID) . This is a major cause of ectopic pregnancy and infertility in women. If men are not treated, the infection may spread to the testicles and cause discomfort. This could affect your fertility. Do not have sex until you and your partner have both finished the treatment. You should also wait until youve had the results of the 2 week test to prevent being infected again. How gonorrhoea is passed on Gonorrhoea is passed through unprotected vaginal, anal or oral sex (without a condom). It can also be passed on by: sharing sex toys that arent washed or covered with a new condom each time theyre used infected semen or vaginal fluid getting into your eye it can also be passed to a newborn during childbirth Reducing the risk of gonorrhoea The best way to prevent all sexually transmitted infections is to practice safer sex . This means using a condom for vaginal, anal or oral sex. Other STIs If you have been diagnosed with gonorrhoea you should get tested for all STIs including: syphilis HIV chlamydia Find your local sexual health clinic Source: Scottish Government - Opens in new browser window Last updated: 26 February 2024 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Dont include personal information e.g. name, location or any personal health conditions. Email Address e.g. [email protected] Message Maximum of 500 characters Send feedback Other languages and formats British Sign Language | | Polski | Romn | slovenina British Sign Language | | Polski | Romn | slovenina Add this page to\n Info For Me Also on NHS inform Book a sexual health appointment online Gonorrhoea (BSL) Gonorrhoea (Chinese) Gonorrhoea (Polish) Gonorrhoea (Romanian) Gonorrhoea (Slovak) NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats 2023 NHS 24 v1.1.1.17852

Gout

Gout | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotlands Service Directory 0 Home Illnesses and conditions Muscle, bone and joints Conditions Gout Gout About gout Causes of gout Symptoms of gout Diagnosing gout Treating gout Complications of gout About gout Gout is a type of arthritis in which small crystals form inside and around the joints. It causes sudden attacks of severe pain and swelling. Its estimated that between one and two in every 100 people in the UKare affected by gout. The condition mainly affects men over 30 and women after the menopause . Overall, gout is more common in men than women. Gout can be extremely painful and debilitating, but treatments are available to help relieve the symptoms and prevent further attacks. Signs and symptoms of gout Any joint can be affected by gout, but it usually affects jointstowards the ends of the limbs, such as the toes, ankles, knees and fingers. Signs and symptoms of gout include: severe pain inone or morejoints the joint feeling hot and very tender swelling in and around the affected joint red, shiny skin over the affected joint Symptoms develop rapidlyover a few hours and typically lastthree to 10 days. After this time the pain should pass and the jointshould return to normal. Almost everyone with gout will experience further attacks at some point, usually within a year. Read more about the symptoms of gout . When to see your GP See your GP if you suspect you have gout and it hasnt been previously diagnosed, particularly if the pain keeps getting worse and you also have a high temperature (fever). Its important that a diagnosis is confirmed because other conditions that require urgent treatment, such as an infected joint, can sometimes cause similar symptoms. If youve already been diagnosed with gout and you have an attack, see your GP if any medication youve been prescribed (see below) doesnt start working within a couple of days. Read more about diagnosing gout . What causes gout? Gout is caused by a build-up of a substance called uric acid in the blood. If you produce too much uric acid or your kidneys dont filter enough out, it can build up and cause tiny sharp crystals to form in and around joints. These crystals can cause the joint to become inflamed (red and swollen) and painful. Things that may increase your chances of getting gout include: obesity , high blood pressure and/or diabetes having a close relative with gout kidney problems eating foods that causea build-up of uric acid, such as red meat, offal and seafood drinking too much beeror spirits Read more about the causes of gout . Treatments for gout If you have gout, treatment is available from your GP to: relieve symptomsduring an attack this can be done using ice packs and by taking medications such as non-steroidal anti-inflammatory drugs (NSAIDs), colchicine or corticosteroids preventfurther attacks through a combination oflifestyle changes, such as losing weight or changing your diet, and taking medicationthat lowers uric acidlevels, such asallopurinol With treatment, many people are able to reduce their uric acid levels sufficiently to dissolve the crystals that cause gout and as a result have no further attacks. However, lifelong treatment is usually required. Read more about treating gout . Can gout cause further problems? Sometimes gout can lead to further problems, particularly if its left untreated. These can include: kidney stones small firm lumps of uric acid crystals under the skin called tophi permanent joint damage Read more about the complications of gout . Whats pseudogout? Pseudogout isa similar condition to gout,but usuallyaffects the knee joint first. Its a form of arthritis that causes pain, stiffness, tenderness, redness, warmth and swelling in one or more of your joints commonly the knee or wrist. Causes of gout Gout is caused by small crystals forming in the joints, resulting in severe pain, tenderness and swelling. These crystals can grow when a waste product called uric acid starts to build up to high levels inthe body. Uric acid Uric acid is created when the body breaks down chemicals known as purines. If your kidneys dont filter out enough uric acid, or your body is producing unusually high levels of it, it can build up in the body and turn into microscopic crystals. These crystals usually form in and around the joints, possibly because the temperature in these areas is slightly lower than the rest of the body. If they get into the space between joints, the crystals can cause painful inflammation (redness and swelling). What can increase your risk? A high level of uric acid in the blood is the main factor that increases your risk of developing gout. However, its still uncertain why some people with a high level of uric acid in the blood develop gout, while others with an equally high level dont. Other factors that may increase your risk of developing gout are outlined below. Medical conditions Some underlying medical conditions can increase your risk of developing gout, including: high blood pressure diabetes kidney disease high levels of fat and cholesterol in your blood obesity metabolic syndrome(acombination of diabetes, high blood pressure and obesity) psoriasis (a skin condition that causes red, flaky, crusty patches of skin covered with silvery scales) osteoarthritis Medication Certain medications can increase your uric acid levels and your risk of developing gout. These include: diuretics (water tablets) used to treat high blood pressure or an abnormal build-up of fluid in your body certainmedicines used to treat high blood pressureincluding beta-blockers and ACE inhibitors low-dose aspirin used to reduce the risk of blood clots niacinused to treat high cholesterol ciclosporin used to treat conditions such aspsoriasis some chemotherapy medicines Diet Uric acid is created when the body breaks down purines. Eating foods that contain a high level of purines can increase your risk of gout. Foods naturally high in purines include: red meat such as beef, lamb and pork seafood especially shellfish and oily fish offal such as liver, kidneys and heart Alcohol Alcoholic drinks can raise the level of uric acid in the blood. Beer, fortified wines like port, and spirits do this more than wine. Moderate consumption of wine one or two glasses a day shouldnt significantly increase your risk of gout. Sugary drinks Certain sugary drinks may also increase your risk of gout. Some research hasfound that drinking sugar-sweetened soft drinks and drinks with high levels of fructose (a naturally occurring sugar found in manyfruits)had anincreased risk of gout. Family history Studies have shown that gout often runs in families. Aroundone in five people with gout have a close family member with the condition. Symptoms of gout The main symptom of gout is a sudden attack of severe pain in one or more joints, typically your big toe. Other symptoms can include: the joint feeling hot and very tender, to the point ofbeing unable to bear anything touching it swelling in and around the affected joint red, shiny skin over the affected joint peeling, itchy and flaky skin as the swelling goes down The intense pain can make getting around difficult. Even the light pressure of a bed cover or blanket can be unbearable. Which jointscan beaffected? Gout can affect almost any joint and can occur in more than one joint at the same time. The joints towards the ends of the limbs tend to be affected more often, including the: toes particularly the big toe joint midfoot (where your shoelaces sit) ankles knees fingers wrists elbows If gout is left untreated, itslikely to affect more joints over time. Pattern of symptoms Attacksof gout tend to: occur at night, although they canhappen at any time developquickly over a few hours last between three and 10 days after this time, the affected joint should start to return to normal, but the problem can persist if treatment isnt started early come backyou mayexperience attacks every few months or years become more frequent over time if not treated Its difficult to predict how often attacks will occur and when exactly they will happen. When to seek medical advice See your GP if you suspect you have gout and it hasnt been previously diagnosed. Contact your GP immediately or call the 111 serviceif you have both: severe, worsening joint pain and swelling a high temperature (fever) of 38C (100.4F) or above This could mean you have an infection inside the joint (septic arthritis). If youve alreadybeen diagnosed with gout and you have an attack, see your GP ifany medication youve been prescribed doesnt start working within a couple ofdays. Read more about diagnosing gout and treating gout . Diagnosing gout Your GP may suspect gout based on your symptoms. Sometimes further tests will be needed to confirm the diagnosis and rule out other possible causes. Seeing your GP See your GP if you experience symptoms of gout for the first time. Your GP willask aboutyour symptoms andmedical history, and examine the affected area, to help make a diagnosis. Theymay also ask you about your diet, particularly your intake of beer, spirits and foods high in purines, such as red meat and seafood. Further tests Many conditions can cause gout-like symptoms. Your GP may be unable to make a firm diagnosis straight away and you may be referred for further tests. These will either confirm the diagnosis of gout or rule out other conditions. Joint fluid test A sample of fluid may be taken from the affected joint.The fluid can be checked for the small crystals that cause gout,and it can be tested for infection to rule out septic arthritis. Blood test A blood test known as aserum uric acid testmay be used to measure the amount of uric acid in your blood. A high level or uric acid is often associated with gout. Its sometimes best to wait until two to four weeks after an attack of gout before this test is carried out, as the level of uric acid in your blood is often not raised at the time of an attack. This is because the level of uric acid in your blood can drop when uric acid crystals form in the joints. X-ray An X-ray is rarely used to diagnose gout because the condition isnt usually detectable using this method. However, an X-ray is sometimes used to help rule out similar conditions that affect the joints, such as chondrocalcinosis (a build-up of calcium crystals in the joints) or to assess whether there has been any joint damage due to repeated or persistent attacks of gout. Ultrasound scan An ultrasound scan of an affected joint is a simple and safe investigation thats increasingly used to detect crystals in the joints. It can also detect crystalsdeepin the skin that arent obvious during a physical examination. Treating gout Treatment for gout includes pain relief to help you cope with a gout attack, as well as medication and lifestyle changes to prevent further attacks. Pain relief for a gout attack What to do during an attack You should: take any medication youve been prescribed as early as possible after you notice an attack (see below) this should start to have an effect within two or three days rest and raise the limb avoid knocking or damaging the affected joint keep the joint cool remove surrounding clothing and apply an ice pack, such as a bag of frozen peas wrapped in a towel ensure youre well hydrated Apply the ice pack to your joint for around 20 minutes. Dont apply ice directly to your skin and dont apply it for more than 20 minutes at a time because this could damage the skin. If necessary, you can keep reapplying an ice pack to your skin during an attack, but you should wait until your skin has returned to a normal temperature first. NSAIDs Non-steroidal anti-inflammatory drugs (NSAIDs) are usually recommended as the firsttreatment for gout. They work by reducing pain and inflammation during an attack. NSAIDs used to treat gout include naproxen, diclofenac and etoricoxib. If youve been prescribed NSAIDs, its a good ideato have them with you at all times so you can use them at the first sign of a gout attack. Continue to take your medication throughout the attack and for 48 hours afterwards. Your GP may also prescribe a medication called a proton pump inhibitor (PPI), to take alongside your NSAID. Thisreduces the risk of the NSAID causing indigestion , stomach ulcers and bleeding from the stomach. Colchicine If youre unable to take NSAIDs or if NSAIDs are ineffective, a medicine calledcolchicine can be used instead. Colchicine reduces some of the swelling and pain associated with a gout attack. Its best to have it with you at all times so you can use it at the first sign of a gout attack. Your GP will tell you how long to take it for and how often. When taken in high doses, side effects of colchicine include feeling sick, abdominal (tummy) pain and diarrhoea . Corticosteroids Corticosteroids are sometimes used to treat severe cases of gout if other treatments dont work or youre unable to take an NSAID or colchicine. A short course of steroid tablets often provides relief, but they cant be used long-term in high doses as they cause side effects, including: weight gain thinning of the bones ( osteoporosis ) easy bruising muscle weakness Corticosteroids can also be given by injection to provide rapid pain relief. This can be either into a muscle, a vein or directly into the affected joint. Medication and lifestyle changes to prevent further attacks You can reduce your chances of having further gout attacks by taking medication and making lifestyle changes toreduce the level ofuric acid in your body. Medication Medication to reduce uric acid levels known as urate-lowering therapy (ULT) is usually recommended if you have recurrent attacks of gout or you have complications of gout . Most people with gout will eventually need to have ULT, so you may want to discuss the advantages and disadvantages of this treatment with your doctor as soon as youve been diagnosed with gout. They should explain that while ULT can significantly reduce your risk of having further attacks, the medication needs to be taken on a daily basis for the rest of your life and theres a small risk of side effects. If you decide to start ULT, a medicine called allopurinol is usually tried first. If this isnt suitable or doesnt work, other medications may be used instead. These medications are described below. Allopurinol Allopurinolhelps reduce the production of uric acid. It can help prevent gout attacks, although it wont help relieve symptoms during an attack. Allopurinol is a tablettaken once a day.When you first start taking it, your dose will be adjusted to make sure the level of uric acid in your blood is low enough. Regular blood tests will be needed to monitor this until themost effective dose is found. Allopurinol can sometimes cause a gout attack soon after you start taking it and itcan take up to a year or two before no further attacks occur. Its important to persevere with treatment even if you do have attacks during this time. To helprelieve attacks, your doctor will prescribe one of the pain relieving medications described above to take alongside your allopurinol at first. Most people taking allopurinol wont experience any significant side effects. However, side effects can include: a rash this is usually mild and goes away on its own, but it can be a sign of anallergy; if you develop a rash, stop taking the medication immediately and contact your GP for advice indigestion headaches diarrhoea Febuxostat Like allopurinol, febuxostatis a medication taken once a day thatreduces the bodys production of uric acid. Its often used if allopurinol isnt suitable or causes troublesome side effects. As with allopurinol, febuxostat can make your symptoms worse when you first start taking it. Your doctor will initially prescribe one of the pain relieving medications described in case you experience attacks. Side effects of febuxostat can include: diarrhoea feeling sick headaches arash Othermedications Less commonly used ULT medications include benzbromarone and sulfinpyrazone. These types of medication tend to only be used if people are unable to take allopurinol or febuxostat. They need to be prescribed under the supervision of a specialist. Lifestyle changes Certain lifestyle changes can also help reduce your risk of experiencing further attacks of gout, including: avoiding foods containing high levels of purine (the chemical involved in the production of uric acid), such as red meat, offal, oily fish, seafood and foods containing yeast extract. avoiding sugary drinks and snacks these are associated with an increased risk of gout maintaining a healthy weight follow a balanced diet ; dont crash diet or tryhigh-protein, low-carbohydrate diets taking regular exercise try activities that dont put too much strain on your joints, such as swimming drinking plenty of water keeping yourself well hydrated will reduce the risk of crystals forming in your joints cutting down on alcohol avoid beer and spirits in particular and dont binge drink Theres some evidence to suggest that taking regular vitamin C supplements can reduce gout attacks, although the effectmay only be small. Talk to your GP first if youre thinking about taking vitamin C supplements, as they arent suitable or safe for everyone. Complications of gout Complications of gout can include small lumps forming under the skin (tophi), joint damage and kidney stones. These are more likely to occur if gout is left untreated. Tophi Gout is caused by a chemical called uric acid forming small crystals in and around the joints. These crystals also oftenbuild upunder the skin and form small white or yellow lumps known as tophi. Tophi are usually painless, but they can form in awkward places, such as at the ends of your fingers and around your toes.Sometimes they can makeeveryday tasks such as preparing food or getting dressed difficult. They can alsocan become inflamed and produce a toothpaste-like discharge. Tophi can develop anywhere in the body, but usually form on the: toes heels knees fingers ears forearms elbows It normally takes several years after the first attack of gout for tophi to develop, but some people develop them even before experiencing an attack. Theyre usually a sign of severe gout and a good reason to start treatment to reduce the level or uric acid in your body . Successful treatment will prevent the tophi from getting any bigger, and long term treatment often gradually shrinks them. If you have very large or painful tophi, they may have to be surgically removed. Joint damage Without treatment, gout attacks may become more frequent and prolonged, and your likelihood of developing permanent joint damage will increase. In the most serious cases, surgery may be required to repair or replace a damaged joint. Kidney stones Occasionally, high levels of uric acid canlead to the formation of kidney stones . Some kidney stones interfere with the flow of urine, resulting in pain when you pass urine, and can make you feel that you need to pass urine more often. You may be prescribed medication to make your urine less acidic, which should help dissolve any kidney stones that have developed. Read more about treating kidney stones . Psychological and emotionaleffects Gout can also affect your mood, work and home life. The severe pain that gout causes can make it difficult to do everyday tasks and to get around, which in turn can lead to feelings of depression or anxiety . If gout is affecting your mood or making everyday life difficult, talk to your GP. They will be able to offer treatment and support. There are also a number of organisations that offer information and advice for people who have gout, including Versus Arthritis . Source: MSK Expert Panel - Opens in new browser window Last updated: 19 October 2023 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Dont include personal information e.g. name, location or any personal health conditions. Email Address e.g. [email protected] Message Maximum of 500 characters Send feedback Add this page to\n Info For Me Also on NHS inform Corticosteroids Arthritis Other health sites The Pain Toolkit Versus Arthritis: gout Versus Arthritis: NSAIDS NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats 2023 NHS 24 v1.1.1.17852

Gum disease

Gum disease | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotlands Service Directory 0 Home Illnesses and conditions Mouth Gum disease Gum disease About gum disease Symptoms of gum disease Causes of gum disease Treating gum disease Complications of gum disease About gum disease If you have a dental problem you should, in the first instance always phone the dental practice that you normally attend . If you are not registered with any dental practice thenyou should read our advice on dental emergencies . Gum disease is a very common condition where the gums become swollen, sore or infected. Most adults in theUK have gum disease to some degree andmost people experience it at least once. Its much less common in children. If you have gum disease, yourgums may bleed whenyou brush your teeth and you may have bad breath. This early stage of gum disease is known as gingivitis. If gingivitis isnt treated, a condition called periodontitis can develop. This affects more tissues that support teeth andhold them in place. Ifperiodontitisisnt treated, the bone in your jawmay be damaged and small spaces can open upbetween the gum and teeth.Your teeth can become loose and may eventually fall out. Read more about the symptoms of gum disease . What causes gum disease? Gum disease is caused by a build-up of plaque on the teeth. Plaque is a sticky substance that contains bacteria. Some bacteria in plaqueare harmless, but some are harmful for the health of your gums. If you dont remove plaque from your teeth by brushing them, itbuilds up and irritates your gums. This can lead to redness with bleeding, swelling and soreness. Read more about the causes of gum disease. Seeing your dentist You should make an appointment to see your dentist if your gums are painful,swollenor if they bleed when you brush your teeth. Find a dentist near you . Your dentistcan carry out a thorough dental examination to check the health of your gums, which may involve inserting a thinmetal stick with a bend in one end(periodontal probe) beside your teeth. In some cases, a number of X-rays may be needed to check the condition of your teeth and jaw bone. Preventing and treating gum disease Mild cases of gum disease can usually be treated by maintaining a good level of oral hygiene. This includes brushing your teeth at least twice a day and flossing regularly. You should also make sure you attend regular dental check-ups. In most cases, your dentist or dental hygienist will be able to give your teeth a thorough clean and remove any hardened plaque (tartar). Theyll also be able to show you how to clean your teeth effectively to help prevent plaque building up in the future. If you have severe gum disease, youllusually need to have further medical and dental treatment and, in some cases, surgery may need to be carried out.This will usually be performed by a specialist in gumproblems (periodontics). Read more about treating gum disease and keeping your teeth clean . Dental check-ups Its importantto have regular dentalcheck-ups so any problems with your teeth and gums can be detected and treated early. If youve never had gum disease and have good oral health, you may only need to visit your dentist every 1 to 2 years for a check-up. You may need to visit your dentist more frequently if youve had problems with gum disease in the past. At each appointment your dentist will advise when you need your next appointment. If you have an increased risk of developing gum problems for example, if you smoke or have diabetes you may be advised to visit your dentist more often so your teeth and gums can be closely monitored. Complications of gum disease If you have untreated gum disease that develops into periodontitis, it can lead to further complications, such as: gum abscesses (painful collections of pus) receding gums loose teeth loss of teeth Read more about the complications of gum disease . Symptoms of gum disease Healthy gums should be pink, firm and keep your teeth securely in place. Your gums shouldnt bleed when you touch or brush them. Gum disease isnt alwayspainful and you may be unaware you have it. Its important to have regular dental check-ups . Early symptoms The initial symptoms of gum disease can include: red and swollengums bleeding gums after brushing or flossing your teeth This stage of gum disease is called gingivitis. Advanced symptoms Ifgingivitis is untreated, the tissues and bone that support the teeth can also become affected. This is known asperiodontitis, or periodontal disease. Symptoms of periodontitis can include: bad breath (halitosis) anunpleasanttaste in your mouth loose teeth that can make eating difficult gum abscesses (collections of pus thatdevelop under your gums orteeth) Acute necrotising ulcerative gingivitis In rare cases, a condition calledacute necrotising ulcerative gingivitis (ANUG) can develop suddenly. The symptoms of ANUG are usually more severe than those of gum disease and can include: bleeding, painful gums painful ulcers receding gums inbetween your teeth bad breath a metallic taste in your mouth excess saliva in your mouth difficulty swallowing or talking a high temperature (fever) When to see a dentist You should make an appointment to see your dentist if you think you may have gum disease or ANUG. If you dont currently have a dentist, search for a dentist near you . Read more about treating gum disease . Causes of gum disease Gum disease can be caused by a number of factors, but poor oral hygiene is the most common cause. Poor oral hygiene, such as not brushing your teeth properly or regularly, can cause plaqueto build up on your teeth. Plaque Your mouth is full of bacteria thatcombine with saliva to form a sticky film known as plaque, whichbuilds up on your teeth. When you consume food and drink high in carbohydrates (sugary or starchy foods), bacteria in plaque turn carbohydrates into the energy they need, producing acid at the same time. Over time, acid in plaque begins to break down your tooths surface and causes tooth decay. Other bacteria in plaquecan alsoirritate your gums, making them inflamed and sore. Plaque is usually easy to remove by brushingand flossingyour teeth, but it can harden and form a substance calledtartarif its not removed.Tartar sticks much more firmly to teeth than plaque and can usually only be removed by a dentist or dental hygienist. Who is most at risk? As well as poor oral hygiene,a number of things can increase your risk of developing problems with your gums. These include: smoking your age gum diseasebecomes more common as you get older a family history of gum disease diabetes a lifelong condition that causes a persons blood sugar levels to become too high a weakened immune system for example,because ofconditions such as HIV and AIDS orcertain treatments, such as chemotherapy malnutrition a condition that occurs when a persons diet does not contain the right amount of nutrients stress Treating gum disease The best way to treat gum disease is to practise good oral hygiene, although additional dental and medical treatments are sometimes necessary. Oral hygiene Good oral hygiene involves: brushing your teeth for about 2 minutes last thing at night before you go to bed and on one other occasion everydayit doesnt matter if you use an electric or manual toothbrush but some people find it easier to clean their teeth thoroughly with an electric toothbrush using toothpaste that containsthe right amount of fluoride (a natural mineral that helps protect against tooth decay ) flossing your teeth regularlypreferably daily, before brushing your teeth not smoking regularly visiting your dentist at least once every 1 to 2 years, but more frequently if necessary See the teeth cleaning guide for more information and advice about how to keep your teeth clean. Mouthwash Antiseptic mouthwashes containing chlorhexidine or hexetidine are available over the counter from pharmacies. However,theres some debate about whether usingmouthwash isnecessary for people with healthy gums. Your dentist may recommend using mouthwash if it helps control the build-up of plaque (the sticky substance that forms when bacteria collects on the surface of your teeth). Your dentist will be able to adviseyou about which type of mouthwash is most suitable and how to use it. Chlorhexidine mouthwash can stain your teeth brown if you use itregularly. Rinse your mouth thoroughly between brushing your teeth and using a chlorhexidine mouthwash because some ingredients in toothpaste can prevent the mouthwash working. Dental treatments Some of the dental treatments described below may also be recommended if you have gum disease. Scale and polish To remove plaque and tartar (hardened plaque) that can build up on your teeth, your dentist may suggest that you have your teeth scaled and polished. This is a professional clean usually carried out at your dental surgery by a dental hygienist. The dental hygienist will scrape away plaque and tartar from your teeth using special instruments, then polish your teeth to remove marks or stains. If a lot of plaque or tartar has built up, you may need to have more than one scale and polish. The price of a scale and polish can vary depending on what needs to be carried out, so ask your dental hygienist how much it will cost beforehand. Root planing In some cases of gum disease, root planing (debridement) may be required. This is a deep clean under the gums that gets rid of bacteria from the roots of your teeth. Before having the treatment, you may need to have a local anaesthetic (painkilling medication) to numb the area. You may experience some pain and discomfort for up to 48 hours after having root planing. Further treatment If you have severe gum disease, you may need further treatment, such as periodontal surgery. In some cases, its necessary to remove the affected tooth. Your dentist will be able to tell you about the procedure needed and how its carried out. If necessary, they can refer you to a specialist. If youre having surgery or root planing, you may be given antibiotics (medication to treat infections). Your dentist will tell you whether this is necessary. Acute necrotising ulcerative gingivitis Acute necrotising ulcerative gingivitis (ANUG) should always be treated by a dentist. However, if you see your GP before visiting a dentist, they may provide you with some treatment while you wait to see your dentist. As well as oral hygiene advice and dental treatments, treatments for ANUG may also include antibiotics, painkillers anddifferent types of mouthwash. Antibiotics Treatment with antibiotics , such as metronidazole or amoxicillin, may be recommended if you have ANUG.Youll usually have to take these for 3 days. Amoxicillin isnt suitable for people allergic to penicillin. Metronidazole can react with alcohol, causing you to feel very unwell. You shouldnt drink alcohol while youre taking metronidazole and for 48 hours after you finish the course of treatment. Other side effects of metronidazole and amoxicillin can include nausea (feeling sick), vomiting and diarrhoea . Painkillers Paracetamol and ibuprofen are the most commonly prescribed painkillers.Theyre also available over the counter from pharmacies. They may help reduce pain and discomfort. However, paracetamol and ibuprofen arent suitable for everyone, so read the manufacturers instructions before taking them. Mouthwash Mouthwash containing chlorhexidine or hydrogen peroxide may be prescribed to treat ANUG. Some chlorhexidine mouthwashes are also available over the counter, though they may not be as effective as a hydrogen peroxide mouthwash. You should always read the instructions before using mouthwash. Some types may need to be diluted in water before theyre taken. Complications of gum disease If you develop gingivitis and dont have the plaque or tartar (hardened plaque) removed from your teeth, the condition may get worse and lead to periodontitis. You may develop further complicationsif you dont treat periodontitis (where the tissue that supports teeth is affected),including: recurrent gum abscesses (painful collections of pus) increasing damage to the periodontal ligament(the tissue that connects the tooth to the socket) increasing damage to and loss of the alveolar bone (the bone in the jaw that contains the sockets of the teeth) receding gums loose teeth loss of teeth Acute necrotising ulcerative gingivitis If you have acute necrotising ulcerative gingivitis (ANUG) and itsnot treated, it can cause more severe complications. The infection can spread to all areas of your gums and the alveolar bone surrounding your teeth. This can lead to: the gums between your teeth being completely destroyed large ulcers (open sores) leaving permanent holes in your gums loose and unstable teeth If ANUG isnt properly treated the first time you have it, youre more likely to have recurring cases inthe future. This can cause persistent bad breath (halitosis) and bleeding gums, as well as gradually receding gums. In rare cases, ANUG can lead to gangrene affecting the lips and cheeks. This occurs when tissue starts to die and waste away. If you developgangrene, you may needto have the dead tissue removed. Other complications Gum disease has also been associated with an increased riskfora number of other health conditions, including: cardiovascular disease lung infections if affected during pregnancy, premature labour and having a baby with a low birth weight However, while people with gum disease may have an increased risk of these problems, there isnt currently any clear evidence that gum disease directly causes them. Source: NHS 24 - Opens in new browser window Last updated: 05 December 2023 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Dont include personal information e.g. name, location or any personal health conditions. Email Address e.g. [email protected] Message Maximum of 500 characters Send feedback Add this page to\n Info For Me Also on NHS inform Dental abscess NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats 2023 NHS 24 v1.1.1.17852

Haemorrhoids (piles)

Haemorrhoids (piles) | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotlands Service Directory 0 Home Illnesses and conditions Stomach, liver and gastrointestinal tract Haemorrhoids (piles) Haemorrhoids (piles) About haemorrhoids Diagnosing haemorrhoids Treating haemorrhoids Surgery for haemorrhoids About haemorrhoids Haemorrhoids, also known as piles, are swellings containing enlarged blood vessels that are found inside or around the bottom (the rectum and anus). In many cases,haemorrhoids dont cause symptoms, and some peopledont even realise they have them. However, when symptoms do occur, they may include: bleeding after passing a stool (the blood is usually bright red) itchy bottom a lump hanging down outside of the anus, which may need to be pushed back in after passing a stool a mucus discharge after passing a stool soreness, redness and swelling around your anus Haemorrhoids arent usually painful, unless their blood supply slows down or is interrupted. When to seek medical advice See your GP ifyou have persistent or severe symptoms of haemorrhoids. You should always get any rectal bleeding checked out, so your doctor can rule out more potentially serious causes. The symptoms of haemorrhoids often clear up on their own or with simple treatments that can be bought from a pharmacy without a prescription. However, speak to your GP if your symptoms dont get better or if you experience pain or bleeding. Your GP can often diagnose haemorrhoids using a simple internal examination of your back passage, although they may need to refer you to a colorectal specialist for diagnosis and treatment. Some people with haemorrhoids are reluctant to see their GP. However, theres no need to be embarrassed, because GPs are very used to diagnosing and treating haemorrhoids. Read more about diagnosing haemorrhoids . What causeshaemorrhoids? The exact cause of haemorrhoids is unclear, buttheyre associated with increased pressure in theblood vessels in and around your anus. This pressure can cause the blood vessels in your back passage to become swollen and inflamed. Many cases are thought to be caused by too much straining on the toilet, due to prolonged constipation this is often due to a lack offibre in a persons diet. Chronic (long-term) diarrhoea can also make you more vulnerable to getting haemorrhoids. Other factors that might increase your risk of developing haemorrhoids include: being overweight or obese age as you get older, your bodys supporting tissues get weaker, increasing your risk of haemorrhoids beingpregnant which can place increased pressure on your pelvic blood vessels, causing them to enlarge (read more about common pregnancy problems ) having a family history of haemorrhoids regularly lifting heavy objects apersistent cough or repeated vomiting sitting down for long periods of time Preventing and treating haemorrhoids Haemorrhoid symptoms oftensettle down aftera few days, without needing treatment. Haemorrhoids that occur during pregnancy often get better after giving birth. However, making lifestyle changes to reduce the strain onthe blood vessels in and around your anus is often recommended. These can include: graduallyincreasing the amount of fibre in your diet good sources of fibre include fruit, vegetables, wholegrain rice, wholewheat pasta and bread, pulses and beans, seeds, nuts and oats drinking plenty of fluid particularly water,but avoiding orcutting down on caffeine and alcohol not delaying going to the toilet ignoring the urge to empty your bowels can make your stools harder and drier, which can lead to straining when you do go to the toilet avoiding medication that causes constipation such as painkillers that contain codeine losing weight (if youre overweight) exercising regularly can help prevent constipation, reduce your blood pressure and help you lose weight These measures can also reducethe risk of haemorrhoids returning, or even developingin the first place. Medication that you apply directly to your back passage (known as topical treatments) or tablets bought from a pharmacy or prescribed by your GP may ease your symptoms and make it easier for you to pass stools. There are various treatment options for more severe haemorrhoids. One of these options is banding, which is a non-surgical procedure where a very tight elastic band is put around the base of the haemorrhoid to cut offits blood supply. The haemorrhoid should fall offafter about a week. Surgery carried out under general anaesthetic (where youre unconscious) is sometimesused toremove or shrinklarge or external haemorrhoids. Read more about treating haemorrhoids and surgery for haemorrhoids . Diagnosing haemorrhoids Your GP can diagnose haemorrhoids (piles) by examining your back passage to check for swollen blood vessels. Some people with haemorrhoids are reluctant to see their GP. However, theres no need to be embarrassed all GPs are used to diagnosing and treating piles. Its important to tell your GP about all of your symptoms for example, tell them if youve recently lost a lot of weight, if your bowel movements have changed, or if yourstools have become dark or sticky. Rectal examination Your GP may examine the outside of your anus to see if you have visible haemorrhoids, and they may also carry out an internal examination called adigital rectal examination (DRE). During a DRE, your GP will wear gloves and use lubricant. Using their finger, theyllfeel for any abnormalities in your back passage. A DRE shouldnt be painful, but you may feel some slight discomfort. Proctoscopy In some cases, further internal examination using a proctoscope may be needed. A proctoscope is a thin hollow tube with a light on the end thats inserted into your anus. This allowsyour doctor to see your entire anal canal (the last section of the large intestine). GPs are sometimes able to carry out a proctoscopy. However, not all GPs have the correct training or access to the right equipment, so you may need togo to ahospital clinicto have the procedure. Types of haemorrhoids After youve had a rectal examination or proctoscopy, your doctor will be able todetermine what type of haemorrhoids you have. Haemorrhoids can develop internally or externally. Internal haemorrhoids develop in the upper two-thirds of your anal canal and external haemorrhoids in the lower third (closest to your anus). The nerves in thelower part can transmit pain messages, while the nervesin the upper partcant. Haemorrhoids can be further classified, depending on their size and severity. They can be: first degree small swellings that develop on the inside lining of the anus and arent visible from outside the anus second degree larger swellings that may come out of your anus when you go to the toilet, before disappearing inside again third degree one or more small soft lumps that hang down from the anus and can be pushed back inside(prolapsing and reducible) fourth degree larger lumps that hang down from the anus and cant be pushed back inside(irreducible) Its useful for doctors to know what typeand size of haemorrhoid you have, as they can then decide on the best treatment. Read more about treating haemorrhoids . Treating haemorrhoids Haemorrhoids (piles) often clear up by themselves after a few days. However, there are many treatments that can reduce itching and discomfort. Making simple dietary changes and not straining on the toilet are often recommended first. Creams, ointments and suppositories(which youinsert into your bottom) are available from pharmacies without a prescription. They can be used to relieve any swelling anddiscomfort. If more intensive treatment is needed, the type will depend on where your haemorrhoids are in your anal canal the lower third (closest to your anus)or the upper two-thirds. The lower third contain nerves which can transmit pain, while the upper two-thirds do not. Non-surgical treatments for haemorrhoidsin the lower part of the canalare likely to be very painful, because the nerves in this area can detect pain. In these cases, haemorrhoid surgery will usually be recommended. The various treatments forhaemorrhoids are outlined below. Dietary changes and self care If constipation is thought to be the cause ofyour haemorrhoids, you need tokeep your stools soft and regular, so that you dont strain when passing stools. You can do this by increasing the amount of fibre in your diet. Good sources of fibre include wholegrain bread, cereal, fruit and vegetables. You should alsodrink plenty of water and avoid caffeine (found in tea, coffee and cola). When going to the toilet, you should: avoid straining to pass stools, because it may make your haemorrhoids worse usemoist toilet paper,rather than dry toilet paper, or baby wipesto clean your bottomafter passing a stool pat the areaaround your bottom, rather than rubbing it Read more about preventing constipation . Medication Over-the-counter topical treatments Various creams, ointments and suppositories(which are inserted into your bottom) are available from pharmacies without a prescription. They can be used to relieve any swelling anddiscomfort. These medicinesshould only be used for five to seven days at a time. If you use themfor longer, they may irritate the sensitive skin around your anus.Any medication should be combined with the diet and self-care advice discussed above. Theres no evidence to suggest that one method is more effective than another. Ask your pharmacist for advice about which product is most suitable for you, and always read the patient information leaflet that comes with your medicine before using it. Dont use more than one product at once. Corticosteroid cream If you have severe inflammation in and around your back passage, your GPmay prescribe corticosteroid cream , whichcontains steroids. You shouldnt use corticosteroid cream for more than a week at a time, because it can make the skin around your anus thinner and the irritation worse. Painkillers Common painkilling medication, such as paracetamol , can help relieve the pain of haemorrhoids. However, if you have excessive bleeding, avoid using non-steroid anti-inflammatory drugs (NSAIDs), such as ibuprofen , because it can make rectal bleeding worse. You should also avoid using codeine painkillers, because they can cause constipation. Your GP may prescribe products that contain local anaesthetic to treat painful haemorrhoids. Like over-the-counter topical treatments, these should only be used for a few days, because they can make the skin aroundyour back passage more sensitive. Laxatives If youre constipated, your GP may prescribe a laxative . Laxatives are a type of medicine that can help you empty your bowels. Non-surgical treatments If dietary changes and medication dont improve your symptoms,your GP may refer you to a specialist. They can confirm whether you have haemorrhoids and recommend appropriate treatment. If you have haemorrhoids in the upper part of your anal canal, non-surgical procedures such as banding and sclerotherapy may be recommended. Banding Bandinginvolves placinga very tight elastic band around the base of your haemorrhoids to cut off theirblood supply. The haemorrhoids should then fall offwithin about a week of having the treatment. Banding is usually a day procedure that doesnt need ananaesthetic, and most people can get back to their normal activities the next day. You may feel some pain or discomfort for a day or so afterwards. Normal painkillers are usually adequate, but your GP can prescribe something stronger, if needed. You may not realise that your haemorrhoids have fallen off, as they should pass out of your body when you go to the toilet. Ifyou notice some mucus discharge within a week of the procedure, itusually means that the haemorrhoids have fallen off. Directly after the procedure, you may notice blood on the toilet paper after going to the toilet.This is normal, but there shouldnt be a lot of bleeding. If you pass a lot of bright red blood orblood clots (solid lumps of blood), go toyour nearest accident and emergency (A&E) department immediately. Ulcers (open sores) can occur at the site of the banding, although these usually heal without needing further treatment. Injections (sclerotherapy) A treatment called sclerotherapy may be used as an alternative to banding. During sclerotherapy,achemical solution is injected into the blood vessels in your back passage. This relieves pain by numbing the nerve endings at the site of the injection. It also hardens the tissue of the haemorrhoid so that a scar is formed. After about 4to 6weeks, the haemorrhoid should decrease in size or shrivel up. After the injection, you should avoid strenuous exercise for the rest of the day.You may experience minor pain for a while and may bleed a little. You should be able to resume normal activities, including work, the day after the procedure. Electrotherapy Electrotherapy, also known as electrocoagulation, is anotheralternative to bandingfor people withsmallerhaemorrhoids. During the procedure, adevice called a proctoscope is inserted into the anus to locatethe haemorrhoid.An electric current is then passed through a small metal probe thats placed at the base of the haemorrhoid, above the dentate line. The specialistcan control the electric current using controls attached to the probe. The aim of electrotherapyis to cause the blood supplying the haemorrhoid to coagulate (thicken), which causes the haemorrhoid to shrink. If necessary, more than one haemorrhoid can be treated during each session. Electrotherapycan either be carried out on outpatient basis using a low electric current, or a higher dose can be given while the person is under a general anaesthetic or spinal anaesthetic. You may experience some mild pain during or after electrotherapy, but in most cases this doesnt last long.Rectal bleeding is another possibleside effect of the procedure, but this is usuallyshort-lived. Electrotherapyis recommended by the National Institute for Health and Care Excellence (NICE), and has been shown to be an effective method of treating smaller haemorrhoids. It can also be usedas an alternative to surgery fortreating larger haemorrhoids, but theres less evidence of its effectiveness. Surgery Although most haemorrhoids can be treated using the methods described above, around 1 in every 10 people will eventually need surgery. Surgery is particularly useful for haemorrhoids that have developed below the dentate line because, unlike non-surgical treatments, anaesthetic is used to ensure you dont feel any pain. There are many different types of surgery that can be used to treat haemorrhoids, but they all usually involve either removing the haemorrhoids or reducing their blood supply, causing them to shrink. Read more about surgery for haemorrhoids . Surgery for haemorrhoids Surgery may be recommended if other treatments for haemorrhoids (piles) havent worked, or if you have haemorrhoids that arent suitable for non-surgical treatment. There are many different surgical procedures for piles. Haemorrhoidectomy A haemorrhoidectomy is an operation to remove haemorrhoids. Its usually carried out under general anaesthetic , which means youll be unconscious during the procedure and wont feel any pain while its carried out. A conventional haemorrhoidectomy involves gently opening the anus so the haemorrhoids can be cut out. Youll need to take a week or so off work to recover. Youll probably experience significant pain after the operation, but you will be given painkillers. You may still have pain a few weeks after the procedure, which can also be controlled with painkillers. Seek medical advice if you have pain that continues for longer. After having a haemorrhoidectomy, theres around a 1 in 20 chance of the haemorrhoids returning, which is lower than with non-surgical treatments. Adopting or continuing a high-fibre diet after surgery is recommended to reduce this risk. Haemorrhoidal artery ligation Haemorrhoidal artery ligation is an operation to reduce the blood flow to your haemorrhoids. Its usually carried out under general anaesthetic and involves inserting a small ultrasound probe into your anus. The probe produces high-frequency sound waves that allow the surgeon to locate the vessels supplying blood to the haemorrhoid. Each blood vessel is stitched closed to block the blood supply to the haemorrhoid, which causes the haemorrhoid to shrink over the following days and weeks. The stitches can also be used to reduce prolapsing haemorrhoids (haemorrhoids that hang down from the anus). The National Institute for Health and Care Excellence (NICE) recommends haemorrhoidal artery ligation as a safe andeffective alternative to a haemorrhoidectomy or stapled haemorrhoidopexy (see below). It causes less pain and, in terms of results, a high level of satisfaction has been reported. The recovery time after having haemorrhoidal artery ligation is also quickercompared with other surgical procedures. Theres a low risk of bleeding, pain when passing stools, or the haemorrhoid becoming prolapsed after this procedure, but these usually improve within a few weeks. Stapling Stapling, also known as stapled haemorrhoidopexy, is an alternative to a conventional haemorrhoidectomy. Its sometimes used to treat prolapsed haemorrhoids and is carried out under general anaesthetic. The procedure isnt carried out as often as it used to be, because it has a slightly higher risk of serious complications than the alternative treatments available. During the operation, part of the anorectum (the last section of the large intestine), is stapled. This means the haemorrhoids are less likely to prolapse and it reduces the supply of blood to the haemorrhoids, which causes them to gradually shrink. Stapling has a shorter recovery time than a traditional haemorrhoidectomy, and you can probably return to work about a week afterwards. It also tends to be a less painful procedure. However, after stapling, more people experience another prolapsed haemorrhoid compared with having a haemorrhoidectomy. There have also been a very small number of serious complications following the stapling procedure, such as fistula to vagina in women (where a small channel develops between the anal canal and the vagina) or rectal perforation (where a hole develops in the rectum). Other treatments Other treatment options are available, including freezing and laser treatment. However, the number of NHS or private surgeons who perform these treatments is limited. General risks of haemorrhoid surgery Although the risk of serious problems is small, complications can occasionally occur after haemorrhoid surgery. These can include: bleeding or passingblood clots,whichmay happen a week or so after the operation infection, whichmay lead to a build-up of pus (known as an abscess) you may be given a short course of antibiotics after surgery to reduce this risk urinary retention (difficulty emptying your bladder) faecal incontinence (the involuntarily passing ofstools) anal fistula(a small channel that develops between the anal canal and surface of the skin, near the anus) stenosis (narrowing of the anal canal) this risk is highest if you have treatment on haemorrhoids that have developed in a ring around the lining of the anal canal These problems canoften be treated with medication or more surgery. Ask your surgeon to explain the risks in more detail before deciding to have surgery. When to seek medical advice Seek medical advice from the hospital unit where the surgery was carried out, or from your GP, if you experience: excessive bleeding a high temperature (fever) problems urinating worsening pain or swelling around your anus If youre unable to contact the hospital or your GP, phone NHS 24s 111 service for advice or visit your nearest accident and emergency (A&E) department. Source: NHS 24 - Opens in new browser window Last updated: 13 December 2023 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Dont include personal information e.g. name, location or any personal health conditions. Email Address e.g. [email protected] Message Maximum of 500 characters Send feedback Add this page to\n Info For Me Also on NHS inform Constipation Other health sites NICE: Circular stapled haemorrhoidectomy NICE: electrotherapy for treating haemorrhoids NICE: haemorrhoidal artery ligation NICE: stapled haemorrhoidopexy NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats 2023 NHS 24 v1.1.1.17852

Hand, foot and mouth disease

Hand, foot and mouth disease | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotlands Service Directory 0 Home Illnesses and conditions Infections and poisoning Hand, foot and mouth disease Hand, foot and mouth disease Hand, foot and mouth disease is a common infection that causes mouth ulcers and spots on the hands and feet. Its most common in young children particularly those under10 but can affect older children and adults as well. Hand, foot and mouth disease can be unpleasant, but it will usually clear up by itself within 7 to 10 days. You can normally look after yourself or your child at home. The infection is not related to foot and mouth disease, which affects cattle, sheep and pigs. Symptoms of hand, foot and mouth disease The symptoms of hand, foot and mouth disease usually develop between 3 and 5 days after being exposed to the infection. The first symptoms may include: a high temperature (fever),usuallyaround 38Cto 39C (100.4-102.2F) a general sense of feeling unwell loss of appetite coughing abdominal (tummy)pain a sore throat and mouth Mouth ulcers After1 or 2 days, red spots appear on the tongue and inside the mouth. These quickly develop into larger yellow-grey mouth ulcers with red edges. The ulcers can be painful and make eating, drinking and swallowing difficult. They should pass within a week. Spotty rash and blisters Soon after the mouth ulcers appear, youll probably notice a rash made up of small, raised red spots on the skin. These typically develop on the fingers, the backs or palms of the hand, the soles of the feet, and occasionally on the buttocks and groin. The spotsmay then turn into small blisters with a grey centre. Thespots and blisters can sometimes beitchy or uncomfortable and typicallylast up to 10days. What to do if you or your child has hand, foot and mouth disease If you have hand, foot and mouth disease, the best thing to do is to stay at home until youre feeling better. Theres no cure for it, so you have to let it run its course. There are things you can do to help ease your or your childs symptoms. Do drink plenty of fluids to avoid dehydration water or milk are ideal; it may help to give a baby smaller but more frequent bottle or breast milk feeds eat soft foods such as mashed potatoes, yoghurt and soups if eating and swallowing is uncomfortable avoid hot, acidic or spicy foods and drinks take over-the-counter painkillers, such as paracetamol or ibuprofen, to ease a sore throat and fever aspirin shouldnt be given to children under the age of 16; paracetamol is best if youre pregnant try gargling with warm, salty water to relieve discomfort from mouth ulcers its important not to swallow the mixture, so this isnt recommended for young children alternatively, use mouth gels, rinses or sprays for mouth ulcers these are available from pharmacies, but arent routinely recommended, and some arent suitable for young children; ask your pharmacist for advice and make sure you read the instructions first You should keep your child away from nursery or school until theyre feeling better.Adults with the condition should stay away from work until theyre feeling better. When to get medical advice You dont usually need medical attention if you think you or your child has hand, foot and mouth disease. The infection will usually pass in 7 to 10 days, and there isnt much your doctor can do. Antibiotics wont helpas hand, foot and mouthdisease is caused by a virus. If youre unsure whether you or your child has hand, foot and mouth disease, you can phone 111 or your GP for advice. Get medical advice if: your child is unable or unwilling to drink any fluids your child has signs of dehydration ,such asunresponsiveness, passing small amounts of urine or no urine at all, or cold hands and feet your child develops fits (seizures), confusion, weakness or a loss of consciousness your child is underthree months old and has a temperature of 38C (101F) or above, or is between 3 and 6 months old and has a temperature of 39C (102F) or above the skin becomes very painful, red, swollen and hot, or theres a discharge of pus the symptoms are getting worse or havent improved after 7 to 10 days Get advice from your GP if youre pregnant and youbecome infected within a few weeks of your due date. Infection in pregnancy is usually nothing to worry about, but theres a small chance it could make your baby ill if youre infectedshortly before you give birth. Read more about the risks of hand, foot and mouth disease in pregnancy How hand, foot and mouth disease spreads Someonewith hand, foot and mouth disease is most infectious from just before their symptoms start until theyre feeling better. The infection can be spread by close person to person contact and contact with contaminated surfaces. The virus is found in: the droplets in the coughs and sneezes of an infected person you can become infected if you get these on your hands and then touch your mouth, or if you breathe in the droplets an infected persons poo if an infected person doesnt wash their hands properly after going to the toilet, they can contaminate food or surfaces an infected persons saliva or fluid from their blisters you can become infected if this gets in your mouth The infection is caused by anumber of different viruses, so its possible to get it more than once. Mostpeople develop immunity to these viruses as they get older. Preventing hand, foot and mouth disease Its not always possible to avoid getting hand, foot and mouth disease, but following this advice can help stop the infection spreading. Do stay off work, school or nursery until you or your child are feeling better theres usually no need to wait until the last blister has healed, provided youre otherwise well use tissues to cover your mouth and nose when you cough or sneeze and put used tissues in a bin as soon as possible wash your hands with soap and water often particularly after going to the toilet, coughing, sneezing or handling nappies, and before preparing food disinfect any surfaces or objects that could be contaminated its best to use a bleach-based household cleaner wash any bedding or clothing that could have become contaminated separately on a hot wash Dont do not share cups, utensils, towels and clothes with people who are infected Source: NHS 24 - Opens in new browser window Last updated: 29 May 2023 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Dont include personal information e.g. name, location or any personal health conditions. Email Address e.g. [email protected] Message Maximum of 500 characters Send feedback Add this page to\n Info For Me Also on NHS inform Blisters Mouth ulcer NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats 2023 NHS 24 v1.1.1.17852

Hay fever

Hay fever | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotlands Service Directory 0 Home Illnesses and conditions Immune system Hay fever Hay fever Return to Symptoms Enter age Last Updated: Next Review Date: Review my answers Find your local services Search for a service near you by entering your postcode below. Please input your postcode in the following format: A12 1BC GP Practices Dental Services Pharmacies Opticians Postcode Search NHS inform has more information on this condition. Read more Previous Start guide Review my answers You told us your credentials were: : You said: Based on the information you gave us, we made the following recommendation: Close Keep a copy View PDF Hay fever is a common allergic condition. It affects up to 1 in 5 people at some point in their life. Youll experience hay fever symptoms if you have an allergic reaction to pollen. Pollen is a fine powder released by plants as part of their reproductive cycle. It contains proteins that can cause the nose, eyes, throat and sinuses to become swollen, irritated and inflamed. You can have an allergy to: tree pollen, released during spring grass pollen, released during the end of spring and beginning of summer weed pollen, released late autumn Many people find their symptoms improve as they get older. Hay fever self-help guide Complete our self-help guide to check your symptoms and find out what to do next. Symptoms The symptoms of hay fever include: frequent sneezing runny or blocked nose itchy, red or watery eyes (allergic conjunctivitis ) an itchy throat, mouth, nose and ears cough , caused by postnasal drip (mucus dripping down the throat from the back of the nose) Less commonly, you may also experience: the loss of your sense of smell (anosmia) facial pain (caused by blocked sinuses) headaches earache tiredness and fatigue If you have asthma , your asthma symptoms may get worse when you have hay fever. Treatment Theres currently no cure for hay fever. But most peoplecan relieve symptoms with treatment, at least to a certain extent. The most effective way to control hay fever would be to avoid exposure to pollen. However, its very difficult to avoid pollen, particularly during the summer months. Treatment options for hay fever include: antihistamines which help to prevent an allergic reaction corticosteroids (steroids) which help to reduce inflammation and swelling When to get professional advice If you have hay fever, you can get advice and treatment from a pharmacist. Find your nearest pharmacy Hay fever can often be controlled using over-the-counter medication from your pharmacist. Speak to your GP if: your symptoms are getting worse your symptoms do not improve after taking medicines from the pharmacy youre experiencing persistent complications of hay fever, such as worsening asthma or repeated episodes of sinusitis For severe and persistent hay fever, theres also a type of treatment called immunotherapy. It involves being exposed to small amounts of pollen over time. This builds resistance to pollens allergic effects. But it can take many months or even years to work. Whos affected You can get hay fever at any age. But it usually begins in childhood or during the teenage years. Its more common in boys than girls. In adults, men and women are equally affected Youre more likely to develop hay fever if you have a family history of allergies , particularly asthma or eczema . Self-help tips Its sometimes possible to prevent the symptoms of hay fever by taking some basic precautions. Do wear wraparound sunglasses to stop pollen getting in your eyes when youre outdoors take a shower and change your clothes after being outdoors to remove the pollen on your body stay indoors when the pollen count is high (over 50 grains per cubic metre of air) apply a small amount of Vaseline (petroleum gel) to the nostrils to trap pollen Complications Hay fever doesnt pose a serious threat to health. But it can have a negative impact on your quality of life. Very severe hay fever may disrupt your productivity at school or work. Inflammation of the sinuses ( sinusitis ) is another common complication of hay fever. Children may also develop a middle ear infection (otitis media) as a result of hay fever. Source: NHS 24 - Opens in new browser window Last updated: 05 May 2023 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Dont include personal information e.g. name, location or any personal health conditions. Email Address e.g. [email protected] Message Maximum of 500 characters Send feedback Add this page to\n Info For Me Also on NHS inform Allergic rhinitis Corticosteroids Allergies Other health sites Pollen calendar Manage your hayfever Asthma and lung UK: Pollen Yellow Card Scheme Met Office: pollen forecast Allergy UK: hay fever Find your nearest pharmacy Enter a place or postcode NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats 2023 NHS 24 v1.1.1.17852

Head and neck cancer

Head & neck cancer - Illnesses & conditions | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotlands Service Directory 0 Home Illnesses and conditions Cancer Cancer types in adults Head and neck cancer Head and neck cancer Definition Head and neck cancer is a relatively uncommon type of cancer. There are more than 30 areas within the head and neck where cancer can develop, including the: mouth (including the lips) voice box (larynx) throat (pharynx) salivary glands nose and sinuses area at the back of the nose and mouth (nasopharynx) Oesophageal (gullet) cancer , thyroid cancer , brain tumours and eye cancer dont tend to be classified as a head and neck cancer. Mouth cancer Mouth cancer is the most common type of head and neck cancer. It can affect a number of areas in and around the mouth, including the: lips tongue inside of the cheeks floor or roof of the mouth gums Symptoms of mouth cancer can include persistent mouth ulcers and/or a lump in your mouth, both of which may be painful. Read more about mouth cancer . Laryngeal cancer Laryngeal cancer develops in the tissue of the larynx (voice box). Symptoms of laryngeal cancer can include: a change in the voice, such as persistent hoarseness difficulty or pain when swallowing noisy breathing shortness of breath a persistent cough a lump or swelling in your neck Read more about laryngeal cancer . Throat cancers Doctors dont tend to use the term throat cancer, as the throat (pharynx) includes many different parts that can be affected by cancer. The main areas that can be affected are the: oropharynx the part of the throat at the back of the mouth hypopharynx the part of the throat connecting the oropharynx to the gullet and windpipe nasopharynx the part of the throat that connects the back of the nose to the back of the mouth (see below) The most common symptoms of cancer in the oropharynx or hypopharynx include a lump in the neck, a persistent sore throat and difficulty swallowing. Macmillan Cancer Support has more information about oropharyngeal cancer . Salivary gland cancer Salivary glands produce saliva, which keeps your mouth moist and helps withswallowing and digestion. There are 3 main pairs of salivary glands. They are the: parotid glands located between your cheeks and your ears sublingual glands located under your tongue submandibular glands located under each side of your jawbone Salivary gland cancer most commonly affects the parotid glands. The main symptom of salivary gland cancer is a lump or swelling on or near your jaw, or in your mouth or neck, although the vast majority of these lumps are non-cancerous. Other symptoms can include numbness in part of your face and drooping on one side of your face. To read more about salivary gland cancer, visit Cancer Research UK and Macmillan Cancer Support . Nose and sinus cancer Nose and sinus cancer affects the nasal cavity (above the roof of your mouth) and the sinuses (the small, air-filled cavities inside the bones of the nose and within the cheekbones and forehead). The symptoms of nose and sinus cancer are similar to viral or bacterial infections, such as the common cold or sinusitis , and include: a persistent blocked nose, which usually only affects one side nosebleeds a decreased sense of smell mucus running from the nose or down the throat Read more about nose and sinus cancer . Nasopharyngeal cancer Nasopharyngeal canceraffects the part of the throat that connects the back of the nose to the back of the mouth. Its one of the rarest types of head and neck cancer in the UK. Symptoms can include: a lump in the neck, due to the cancer spreading to the lymph nodes (pea-sized lumps of tissue that make up part of the immune system)in the neck a blocked or stuffy nose nosebleeds hearing loss (usually only in one ear) Read more about nasopharyngeal cancer . Source: NHS 24 - Opens in new browser window Last updated: 13 November 2023 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Dont include personal information e.g. name, location or any personal health conditions. Email Address e.g. [email protected] Message Maximum of 500 characters Send feedback Add this page to\n Info For Me Also on NHS inform Mouth cancer Thyroid cancer Laryngeal (larynx) cancer Nasopharyngeal cancer Nasal and sinus cancer Other health sites Cancer Research UK: Head and neck cancer Macmillan Cancer Support: Head and neck cancers National Association of Laryngectomee Clubs Search for cancer support services near you Enter a place or postcode NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats 2023 NHS 24 v1.1.1.17852

Head lice and nits

Head lice and nits | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotlands Service Directory 0 Home Illnesses and conditions Skin, hair and nails Head lice and nits Head lice and nits Head lice are tiny insects that live in hair. Nits are the empty egg cases attached to hair that head lice hatch from. Head lice are a common problem, particularly in school children aged 4 to 11. Theyre largely harmless, but can live in the hair for a long time if not treated and can be irritating and frustrating to deal with. Head lice nits and bites. https://dermnetnz.org/ Signs of head lice Head lice can be difficult to spot, even when the head is closely inspected. Theyre very small whitish or grey-brown insects that range from the size of a pinhead to the size of a sesame seed. Less reliable signs of head lice include: small white eggs or nits (egg cases) in the hair behind the ears or at the back of the neck an itchy scalp a rash on the back of the neck feeling as though something is moving in the hair How to spot head lice The only way to be sure someone has head lice is to find a live louse by combing their hair with a special fine-toothed comb. This is called detection combing. You can buy detection combs from your local pharmacy , supermarket or online. Combs with flat-faced teeth spaced 0.2 to 0.3mm apart are best for removing head lice, although combs with smaller gaps can be used to remove eggs and nits (egg cases) after treatment. Detection combing can be carried out on dry or wet hair. Dry combing takes less time, but wet combing is more accurate because washing with conditioner stops head lice from moving. Wet detection combing To use the wet detection method: wash the hair with ordinary shampoo apply plenty of conditioner use an ordinary, wide-toothed comb to straighten and untangle the hair once the comb moves freely through the hair without dragging, switch to the louse detection comb make sure the teeth of the comb slot into the hair at the roots, with the edge of the teeth lightly touching the scalp draw the comb down from the roots to the ends of the hair with every stroke, and check the comb for lice each time remove lice by wiping the comb with tissue paper or rinsing it work through the hair, section by section, so that the whole head of hair is combed through do this at least twice to help ensure you havent missed any areas continue until you find no more lice If you find head lice, you should check the rest of your family. Treat everyone found to have head lice on the same day. Dry detection combing To use the dry detection method: use an ordinary, wide-toothed comb to straighten and untangle the hair once the comb moves freely through the hair without dragging, switch to the louse detection comb make sure the teeth of the comb slot into the hair at the roots, with the edge of the teeth lightly touching the scalp draw the comb down from the crown to the ends of the hair with every stroke look for lice as the comb is drawn through the hair. If you see a louse, trap it against the face of the comb with your thumb to stop if being repelled by static electricity comb each section of hair 3 or 4 times before moving on to the next section continue until the whole head has been combed through How to get rid of head lice and nits Treatments to get rid of head lice are available to buy from pharmacies, supermarkets and online. The main treatments are: lotions and sprays wet combing Everyone with head lice in your household should be treated on the same day. If a treatment doesnt work the first time, you can: try it again try a different treatment get advice from your school nurse, health visitor, pharmacist or GP Lotions and sprays for head lice and nits There are several different products that can be applied to the scalp and hair to kill head lice, including: dimeticone 4% lotion or lotion spray applied and left for 8 hours (usually overnight) dimeticone 4% spray gel applied and left for 15 minutes mineral oil and dimeticone spray applied and left for 15 minutes isopropyl myristate and cyclomethicone solution applied and left for 5-10 minutes Some treatments need to be done twice 7 days apart. This makes sure that any newly-hatched lice are killed. Detection combing should usually be done 2 or 3 days after finishing treatment, and again another 7 days after that, to check for any live head lice. Always check the pack or leaflet to see if a product is suitable for you, particularly if: youre pregnant youre breastfeeding your child has head lice and is less than 2 years of age Your pharmacist can recommend a suitable treatment and advise you on how to use it correctly if necessary. When to get professional advice Your pharmacist can advise you about treatments for head lice and nits if youre not sure which is best for you or your child. Make sure you carefully follow the instructions that come with the treatment you choose. Find your nearest pharmacy You can get advice and treatment on head lice and nits directly from a pharmacy. Pharmacies How head lice are spread Head lice are spread by direct head to head contact. They climb from one persons hair to anothers. Head lice: cant fly, jump or swim are very unlikely to be spread by objects like hats, combs and pillows dont have a preference for dirty, clean, short or long hair only affect people cant be caught from animals Once detached from the hair, head lice will usually die within 12 to 24 hours. Preventing head lice Its very difficult to prevent head lice. You may want to consider regular detection combing if youre concerned about your children or yourself. For example, on a weekly basis. Lotions and sprays dont prevent head lice and should only be used if a live louse has been found in your or your childs hair. Staying off work or school and washing clothing and bedding on a hot wash is unnecessary, as its unlikely to help prevent the spread of head lice. Source: NHS 24 - Opens in new browser window Last updated: 18 January 2023 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Dont include personal information e.g. name, location or any personal health conditions. Email Address e.g. [email protected] Message Maximum of 500 characters Send feedback Add this page to\n Info For Me NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats 2023 NHS 24 v1.1.1.17852

Headaches

Headaches | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotlands Service Directory 0 Home Illnesses and conditions Brain, nerves and spinal cord Headaches Headaches Return to Symptoms Enter age Last Updated: Next Review Date: Review my answers Find your local services Search for a service near you by entering your postcode below. Please input your postcode in the following format: A12 1BC GP Practices Dental Services Pharmacies Opticians Postcode Search NHS inform has more information on this condition. Read more Previous Start guide Review my answers You told us your credentials were: : You said: Based on the information you gave us, we made the following recommendation: Close Keep a copy View PDF Most headaches are not serious. In many cases, you can treat your headache at home. Headache self-help guide Complete our self-help guide to check your symptoms and find out what to do next. How you can help yourheadache yourself Do rest take painkillers such as paracetamol or ibuprofen drink plenty of fluids relax (if stress is the cause) take regular exercise When to get professional advice Your local pharmacy can provide: advice about headaches treatments to help relieve headaches Find your local pharmacy Speak to a GP if: treatments recommended by your pharmacist do not relieve your headache your headache is getting worse despite taking painkillers painful or frequent headachesaffect your daily activities or cause you to miss work Phone 111 if: your headache does not go away and gets worse over time your headache is triggeredsuddenly by coughing, laughing, sneezing,changing posture, orphysical effort You have a headache and: a sore scalp jaw pain while chewing you feel weak Phone 999 if: your headache occurs suddenly and is very severe it may feel like a blinding pain your headache occurs after a severe head injury You have an extremely painful headache and: slurred speech or memory loss a very high temperature, feel hot and shivery, and have a stiff neck or a rash drowsiness or confusion vision problems severe pain and redness in one of your eyes Tension headaches Tension headachesare the most common type of headache. Theyre what we think of as normal, everyday headaches.They feel like a constant ache that affects both sides of the head, as though a tight band is stretched around it. Normally, tension headaches are not severe enough to prevent you doing everyday activities. They usually last for 30 minutes to several hours,but can last for several days. What causes a tension headache? The exact cause is unclear, but tension headaches have been linked to things such as: stress poor posture skipping meals dehydration How to treat a tension headache You can usually treat tension headaches with painkillers suchas paracetamol and ibuprofen . Lifestyle changes may also help, for example: getting regular sleep reducing stress staying well hydrated Migraines Migraines are less common than tension headaches.Theyre usually felt as asevere, throbbing pain at the front or side of the head. Some people also have other symptoms, such as: nausea vomiting increased sensitivity to light or sound Migraines can stop you carrying out your normal daily activities.They usually last at least a couple of hours. Some people find they need to stay in bed for days at a time. How to treat migraines Most people cantreat their migraines with over-the-counter medication from the pharmacist. If your migraines are severe, you may need to be prescribed stronger medication by your GP. This may be able to relieve and preventyour migraines. Read further information about migraines Cluster headaches Cluster headaches are a rare type of headache. They occur in clusters for a month or two at a time around the same time of year. Cluster headaches are excruciatingly painful. They cause intense pain around one eye, and often occur with other symptoms, such as a: watering or red eye blocked or runny nose Pharmacy medications dont usually ease the symptoms of a cluster headache.Your GP can prescribe specific treatments to ease the pain and help prevent further attacks. Medication and painkiller headaches Some headaches are a side effect of taking a particular medication. Frequent headaches can also be caused by taking too many painkillers. This is known as a painkiller or medication-overuse headache. A medication-overuse headache will usually get better within a few weeks once you stop taking the painkillers that are causing it. But, pain may get worse for a few days before it starts to improve. Hormone headaches Headaches in women are often caused by hormones, and many women notice a link with their periods. The combined contraceptive pill ,the menopause and pregnancy are also potential triggers. You may be able to help reduce headaches associated with your menstrual cycle by: reducing your stress levels having a regular sleeping pattern making sure you do not miss meals Other causes of headaches Headaches can also have a number of other causes, including: drinking too much alcohol a head injury or concussion a cold or flu temporomandibular disorders problemsaffecting the chewing muscles and the joints between the lower jaw and the base of the skull sinusitis inflammation of the lining of the sinuses carbon monoxide poisoning sleep apnoea a condition where the walls of the throat relax and narrow during sleep, interrupting normal breathing Source: NHS 24 - Opens in new browser window Last updated: 07 March 2024 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Dont include personal information e.g. name, location or any personal health conditions. Email Address e.g. [email protected] Message Maximum of 500 characters Send feedback Add this page to\n Info For Me Other health sites Brain and Spine Foundation: Headache The Migraine Trust National Migraine Centre Find your local pharmacy Enter a place or postcode NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats 2023 NHS 24 v1.1.1.17852

Hearing loss

Hearing loss | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotlands Service Directory 0 Home Illnesses and conditions Ears, nose and throat Hearing loss Hearing loss Hearing loss is a common problem that often develops with age or is caused by repeated exposure to loud noises. Royal National Institute for Deaf People (RNID) estimates that there are more than 10 million (about 1 in 6) people in the UK with some degree of hearing impairment or deafness. Hearing loss can occur suddenly, but usually develops gradually. When to get medical advice Speak to your GP practice if: You or your child are: having problems with your hearing lose your hearing suddenly, in one or both ears Your GP can check for any problems and may refer you to an audiologist (hearing specialist) or an ENT specialist for further tests. Hearing tests are also available on the high street, but you may have to pay for these. Signs of hearing loss Early signs of hearing loss can include: difficulty hearing other people clearly and misunderstanding what they say, especially in group situations asking people to repeat themselves listening to music or watching television with the volume higher than other people need difficulty hearing the telephone or doorbell finding it difficult to tell which direction noise is coming from regularly feeling tired or stressed from having to concentrate while listening If you also hear a ringing, buzzing or hissing sound in your ears, this could be a sign of tinnitus , which is often associated with hearing loss. Signs in babies You should consider seeing your GP if you notice that your baby or toddler: isnt startled by loud noises doesnt turn towards the source of a sound when under 4 months old doesnt say single words by the time theyre 1 year old notices you when they see you, but not when you call their name hears some sounds but not others Signs in children You should consider seeing your GP if you notice that your child: is slow to learn to talk, or theyre not clear when they speak often asks you to repeat yourself or responds inappropriately to a question doesnt reply when you call them often talks very loudly often turns up the volume of the television so its very loud watches other people to copy instructions, because they havent heard What causes hearing loss? Hearing loss is the result of sound signals not reaching the brain. There are 2 main types of hearing loss, depending on where the problem lies: sensorineural hearing loss caused by damage to the sensitive hair cells inside the inner ear or damage to the auditory nerve, which can happen naturally with age or as a result of injury conductive hearing loss when sounds are unable to pass from your outer ear to your inner ear, often because of a blockage such as earwax , glue ear or a build-up of fluid from an ear infection , perforated ear drum or disorder of the hearing bones Its also possible to have both these types of hearing loss. This is known as mixed hearing loss. Some people are born with hearing loss, but most cases develop as you get older. Treatment for hearing loss The way hearing loss is treated depends on the cause and how severe it is. In cases of sensorineural (nerve) hearing loss, there are several options that may help to improve a persons ability to hear and communicate. These include: digital hearing aids which are available through the NHS bone anchored implants suitable for people who are unable to use hearing aids and for some levels of sensorineural hearing loss middle ear implants suitable for some people who are unable to use hearing aids cochlear implants for people who find hearing aids arent powerful enough lip reading and/or sign language such as British Sign Language (BSL) Conductive hearing loss is sometimes temporary and can be treated with medication or minor surgery, if necessary. However, more major surgery may be required to fix the ear drum or hearing bones. How to prevent hearing loss It isnt always possible to prevent hearing loss if you have an underlying condition that causes you to lose your hearing. However, there are several things you can do to reduce the risk of hearing loss from long-term exposure to loud noise. Its possible to reduce your risk of noise-induced hearing loss (hearing loss from loud noise). Do use headphones that block out more outside noise, rather than turning up the volume use ear protection equipment such as ear muffs or ear plugs if you work in a noisy environment, such as a pub, nightclub, a garage workshop or on a building site your employer should provide these use ear-protection equipment at loud concerts and at other events where there are high noise levels, such as motor races be aware of the symptoms of common causes of hearing loss, such as ear infections (otitis media) and Mnires disease speak to your GP practice if you or your child are experiencing hearing problems Dont do not have your television, radio or music on too loud do not insert objects into your ears or your childrens ears this includes fingers, cotton buds, cotton wool and tissue You should also speak to your GP practice if you have signs of an ear infection, such as flu -like symptoms, severe earache , discharge or hearing loss. Source: ENT Scotland - Opens in new browser window Last updated: 28 March 2024 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Dont include personal information e.g. name, location or any personal health conditions. Email Address e.g. [email protected] Message Maximum of 500 characters Send feedback Add this page to\n Info For Me Other health sites GOV.UK: Disabled people British Deaf Association Which? Hearing aid types Hearing Link Hearing Dogs for the Deaf Action on Hearing Loss NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats 2023 NHS 24 v1.1.1.17852

Heart attack

Heart attack | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotlands Service Directory 0 Home Illnesses and conditions Heart and blood vessels Conditions Heart attack Heart attack Phone 999 immediately if: You or someone else has symptoms like: central chest pain or discomfort in the chest that doesnt go away it may feel like pressure, tightness or squeezing pain that radiates down the left arm, or both arms, or to the neck, jaw, back or stomach unconsciousness seizures or fitting difficulty breathing (snoring or rasping) rapid heart beat low or undetectable heart beat chest pain and breathlessness, nausea, sweating or coughing up blood What is a heart attack? A heart attack happens when theres a reduction in blood supply to part of the heart muscle. This lack of blood flow can cause damage to the heart. Sometimes, when chest pain occurs suddenly, its unclear if its due to unstable angina or a heart attack. Until tests confirm the diagnosis, doctors sometimes call this Acute Coronary Syndrome (ACS). Further information on causes and risk factors for a heart attack. Diagnosing a heart attack In order to find out if youre having a heart attack, youll need to have some tests. These tests can include: an electrocardiogram (ECG) to check your hearts rhythm and electrical activity blood tests to check troponin levels, a protein thats released into the blood stream when the heart muscle is damaged an assessment of blood pressure an assessment of blood oxygen levels a chest X-ray an echocardiogram to assess the structure and function of your heart a coronary angiogram to identify any blood vessels that are narrowed or blocked Based on your test results, your clinical team will decide your treatment plan. Treating a heart attack When someone has a heart attack, its important to restore blood flow quickly. Thisll minimise damage to the heart muscle and start to alleviate symptoms. Your treatment plan will depend on: the type of heart attack youve had your individual situation Types of treatment Treatment for a heart attack may consist of: anti-emetics to stop sickness and nausea antiplatelet therapy medication that thins the blood and gets rid of blood clots coronary angioplasty a procedure to widen coronary arteries that are blocked or narrow oxygen therapy to help with your breathing and oxygen levels pain-relieving drugs like morphine reperfusion treatment to help restore blood flow and maintain the hearts pumping action thrombolysis a clot-busting drug to help restore blood flow to your heart People whove had a heart attack will need to take several different types of medication. Your doctor will try to find the best drugs for you with the fewest side effects. Complications of a heart attack Sometimes there are complications following a heart attack. The most common complications after a heart attack are: arrhythmias problems with your hearts natural electrical rhythm heart failure when the heart isnt pumping blood around the body as well as it should Many problems resolve themselves quite quickly. However, sometimes problems linger and can often be helped by medication. Recovering from a heart attack How long you stay in hospital will depend upon your circumstances and treatment. Dont be afraid to ask your medical team about whats happening. On discharge, you should be referred onto a cardiac rehabilitation programme. Cardiac rehabilitation You should receive an assessment to determine your individual goals and needs after a heart attack. Rehabilitation is usually a mix of exercise and education sessions. This helps to provide you with the information, advice and support to: understand your condition and medication recover from your heart attack, procedure or surgery make lifestyle changes to improve your heart health Your cardiac rehabilitation team can also give you advice on practical issues after a heart attack, including: driving mental wellbeing relationships sexual relationships returning to work long term recovery The British Heart Foundation has further information on cardiac rehabilitation. Source: Scottish Government - Opens in new browser window Last updated: 07 February 2024 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Dont include personal information e.g. name, location or any personal health conditions. Email Address e.g. [email protected] Message Maximum of 500 characters Send feedback Add this page to\n Info For Me Also on NHS inform What to do in a heart emergency Chest pain Other health sites British Heart Foundation: Heart attack Chest Heart & Stroke Scotland: Heart attack St John Ambulance: Heart attack NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats 2023 NHS 24 v1.1.1.17852

Heart failure

Heart failure Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotlands Service Directory 0 Home Illnesses and conditions Heart and blood vessels Conditions Heart failure Heart failure Heart failure is a condition where your heart cannot pump blood around your body as well as it should. It does not mean that your heart has stopped working completely, but you may need support to help it to work better and to manage your symptoms. Symptoms of heart failure When the heart is not pumping blood as well as it should, you can experience a range of symptoms. Speak to a GP if you have: breathlessness a persistent cough tiredness or fatigue that occurs even at rest and gets worse with movement swelling in the legs or ankles Causes of heart failure There are many reasons why someone might develop heart failure. These can include: a heart attack coronary heart disease inherited heart disease (for example, cardiomyopathy) high blood pressure (hypertension) heart rhythm or valve abnormalities viral infection damage from the immune system (myocarditis) congenital heart disease amyloidosis Diagnosing heart failure Your doctor will ask you some questions about your symptoms and do an examination. If they think that you might have heart failure, youll be sent for some further tests. Tests to confirm a diagnosis of heart failure may include: blood tests to check for signs of a problem with your heart this may include testing your BNP levels, which increase when the heart is not working well a chest X-ray to check if theres fluid in your lungs or if a lung condition is causing the symptoms an electrocardiogram (ECG) records the electrical activity and rhythms of your heart an echocardiogram checks the pumping action of your heart and the function of the valves in your heart Treating heart failure If you have heart failure, treatments are available to help you manage your symptoms. This can help to improve your quality of life. Your doctor will discuss treatment optionswith you.The best option for you willdepend on your individual circumstances. The standard medicines for treating heart failure are: angiotensin converting enzyme (ACE) inhibitors angiotensin-receptor neprilysin inhibitor (ARNI) angiotensin receptor blockers (ARBs) beta blockers diuretics (water tablets) mineralocorticoid receptor antagonists (MRAs) For some people with severe heart failure, a heart transplant may be recommended. Your doctor will discuss whether this is an appropriate option for you. Managing heart failure Do keep as active as possible keep a healthy weight eat a healthy diet limit alcohol intake stop smoking Support Living with heart failure can bring a lot of uncertainty. Some people might find this difficult. You can get support in dealing with heart failure from: a local support group ask your GP for advice or search Scotlands Service Directory The British Heart Foundation Chest, Heart & Stroke Scotland Further information on heart failure Source: Scottish Government - Opens in new browser window Last updated: 18 October 2023 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Dont include personal information e.g. name, location or any personal health conditions. Email Address e.g. [email protected] Message Maximum of 500 characters Send feedback Add this page to\n Info For Me Other health sites Chest Heart & Stroke Scotland: Heart failure NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats 2023 NHS 24 v1.1.1.17852

Hepatitis A

Hepatitis A | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotlands Service Directory 0 Home Illnesses and conditions Stomach, liver and gastrointestinal tract Hepatitis A Hepatitis A Hepatitis A is a liver infection thats spread in the poo of an infected person. The chance of getting it in the UK is low. Hepatitis A is not usually serious. Most people get better within a couple of months. A hepatitis A vaccine is available on the NHS if youre at increased risk. Symptoms of hepatitis A Some people with hepatitis A, particularly young children, wont have any symptoms. If you do develop symptoms, they tend to occur around 4 weeks after exposure to the hepatitis A virus. Symptoms of hepatitis A include: feeling tired and generally unwell joint and muscle pain a high temperature (fever) loss of appetite feeling or being sick pain in the upper-right part of your tummy a headache , sore throat and cough constipation or diarrhoea a raised, itchy rash (hives) yellowing of the skin and eyes (jaundice) dark pee pale poo itchy skin the upper-right part of your tummy becoming swollen and tender When to get medical advice Speak to your GP practice if: you think you may have been exposed to the hepatitis A virus emergency treatment can help prevent infection if given within a few days of exposure you have symptoms of hepatitis A youre at increased risk of hepatitis A Diagnosing hepatitis A A blood test can check whether you have hepatitis A. It can also rule out other conditions that cause similar symptoms, but which may require treatment to prevent more serious problems. Your friends, family and sexual partners may need to be tested too. Treatments for hepatitis A Theres currently no cure for hepatitis A. It will usually get better its own within a couple of months. Once hepatitis A passes, youll normally be immune to it for life. Things you can do yourself There are things you can do to help your symptoms and prevent the infection spreading to others. Do get plenty of rest take painkillers such as paracetamol or ibuprofen for any aches and pains ask your GP for advice as you may need to take lower doses than normal or avoid certain medications until youve recovered have a cool, airy environment wear loose clothing eat smaller, lighter meals to help reduce feeling sick and vomiting wash your hands with soap and water regularly wash soiled laundry separately on a hot cycle clean the toilet, flush handles and taps more often than usual Dont do not drink alcohol do not have very hot baths or showers do not prepare food for other people, if you can avoid it do not share towels do not go to work or school until at least a week after your jaundice or other symptoms started do not have sex until at least a week after your jaundice or other symptoms started Treatments from your doctor Speak to your GP practice if your symptoms get worse or havent started to improve within a couple of months. They can prescribe medications to help with itchiness, nausea or vomiting, if needed. Long-term hepatitis A Hepatitis A can occasionally last for many months. In rare cases, it can be life-threatening if it causes liver failure. People most at risk include those with other liver problems and elderly people. If liver failure does occur, a liver transplant is usually needed to treat it. How is hepatitis A spread? Hepatitis A is most widespread in parts of the world where standards of cleanliness and food hygiene are poor. You can get the infection from: drinking unclean water eating food thats been washed or grown in unclean water eating food thats been handled by an infected person close contact with someone who has hepatitis A having sex with someone who has the infection particularly if you touch their anus with your fingers, mouth or tongue injecting drugs using unclean equipment Someone with hepatitis A is most infectious from around 2 weeks before their symptoms appear until about 1 week after the symptoms first develop. The hepatitis A vaccine Vaccination is the best way to prevent hepatitis A. The hepatitis A vaccine isnt routinely offered in the UK because the risk of infection is low for most people. Its only recommended for people at increased risk, including: close contacts of someone with hepatitis A people planning to travel to or live in parts of the world where hepatitis A is widespread , particularly if levels of cleanliness and food hygiene are expected to be poor people with any type of long-term (chronic) liver disease men who have sex with other men people who inject illegal drugs people who may be exposed to hepatitis A through their job for example sewage workers, staff at homeless shelters, and people working with monkeys, apes and gorillas Last updated: 19 December 2023 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Dont include personal information e.g. name, location or any personal health conditions. Email Address e.g. [email protected] Message Maximum of 500 characters Send feedback Add this page to\n Info For Me Also on NHS inform Hepatitis C Hepatitis B Other health sites British Liver Trust: hepatitis A Lab Tests Online UK: hepatitis A test fitfortravel: Hepatitis A NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats 2023 NHS 24 v1.1.1.17852

Hepatitis B

Hepatitis B | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotlands Service Directory 0 Home Illnesses and conditions Stomach, liver and gastrointestinal tract Hepatitis B Hepatitis B Hepatitis B is a liver infection thats spread through blood and body fluids. The chance of getting it in the UK is low. It often doesnt cause any symptoms in adults and usually passes in a few months without treatment. In children it often persists for years and may eventually cause serious liver damage. A hepatitis B vaccine is available on the NHS as part of routine child vaccination , or if youre at high risk. Symptoms of hepatitis B Many people with hepatitis B wont have any symptoms. If you do develop symptoms, they tend to occur 2 or 3 months after exposure to the hepatitis B virus. Symptoms of hepatitis B include: tiredness a high temperature (fever) of 38C (100.4F) or above general aches and pains loss of appetite feeling and being sick diarrhoea abdominal pain yellowing of the skin and eyes (jaundice) When to get medical advice Speak to your GP practice if: you think you may have been exposed to the hepatitis B virus emergency treatment can help prevent infection if given within a few days of exposure you have symptoms of hepatitis B youre at high risk of hepatitis B Diagnosing hepatitis B A blood test can check if you have hepatitis B or have had it in the past. The hepatitis B vaccine may also be recommended to reduce your risk of infection. Treatments for hepatitis B Treatment for hepatitis B depends on how long youve been infected for. Emergency treatment If youve been exposed to the virus in the last few days, emergency treatment can help stop you becoming infected. Treatment for acute hepatitis B Acute hepatitis B means youve only had the infection for a few weeks or months. You may only need treatment to relieve your symptoms while your body fights off the infection itself. Treatment for chronic hepatitis B Chronic hepatitis B means youve had the infection for more than 6 months. You may be offered medicines that can keep the virus under control and reduce the risk of liver damage. Chronic hepatitis B often requires: long-term or lifelong treatment regular checks for any further liver problems How is hepatitis B spread? The hepatitis B virus is found in the blood, semen and vaginal fluids and bodily fluids of an infected person. It can be spread by: a mother to her newborn baby, particularly in countries where the infection is common within families (child to child) in countries where the infection is common injecting drugs and sharing needles and other drug equipment, such as spoons and filters having sex with an infected person without using a condom having a tattoo, body piercing, or medical or dental treatment with unsterilised equipment sharing toothbrushes, razors or scissors contaminated with infected blood Hepatitis B is not spread by kissing, holding hands, hugging, coughing, sneezing, or sharing crockery and utensils. How to prevent hepatitis B A vaccine that offers protection against hepatitis B is available for all babies born in the UK on or after 1 August 2017. Its also available for people at high risk of the infection or complications from it. People at high risk of hepatitis B People at high risk of hepatitis B include: babies born to mothers with hepatitis B close family and sexual partners of someone with hepatitis B people travelling to a part of the world where hepatitis B is widespread families adopting or fostering children from high-risk countries people who inject drugs or have a sexual partner who injects drugs people who change their sexual partner often men who have sex with men male and female sex workers people whose job puts them at risk of contact with blood or body fluids, such as nurses, prison staff, doctors, dentists and laboratory staff people with chronic liver disease people with chronic kidney disease people in prison people receiving regular blood or blood products, and their carers Hepatitis B core antibody (anti-HBc) testing NHS Scotland is making the blood supply safer by introducing enhanced hepatitis B screening. This is an additional measure to improve testing for blood donors and further increase the safety of the blood supply chain. NHS Scotland has been conducting this enhanced screening on all donations since April 2022. Only a small number of donors are impacted, however, these donors will no longer be able to donate. Living with hepatitis B As well as medical treatments, there are some things you can do when you have hepatitis B to help ease the symptoms and stop the infection spreading to others. Do eat a healthy and balanced diet rest and stay hydrated take painkillers like paracetamol and ibuprofen ask your doctor for advice about how much paracetamol you should take as you may not be able to take a normal dose keep your room well ventilated, wear loose clothing and avoid hot showers and baths if you feel itchy speak to your doctor if youre thinking of having a baby Dont do not have unprotected sex including anal and oral sex do not drink alcohol this can increase your risk of developing serious liver problems do not share toothbrushes, razors or needles with other people Your close contacts, such as family members, may need to be vaccinated. Complications of hepatitis B Most people do not have any lasting problems after having a hepatitis B infection. In some patients chronic hepatitis B can cause liver damage ( cirrhosis ) and increase your risk of getting liver cancer . It is important that all patients with chronic hepatitis B are followed up in specialist clinics. If required, treatment can control hepatitis B infection, preventing serious complications. Last updated: 28 March 2024 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Dont include personal information e.g. name, location or any personal health conditions. Email Address e.g. [email protected] Message Maximum of 500 characters Send feedback Add this page to\n Info For Me Also on NHS inform Hepatitis C Hepatitis A Other health sites Hepatitis B Foundation NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats 2023 NHS 24 v1.1.1.17852

Hepatitis C

Hepatitis C | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotlands Service Directory 0 Home Illnesses and conditions Stomach, liver and gastrointestinal tract Hepatitis C Hepatitis C Hepatitis C is a liver infection thats spread through blood. It can be cured with treatment. But if left untreated, it can sometimes cause serious and potentially life-threatening damage to the liver over many years. Symptoms of hepatitis C Many people with hepatitis C wont have any symptoms until the liver has been significantly damaged. This means many people have the infection without knowing. Early symptoms (acute hepatitis C) Most people will not have symptoms during the first 6 months of a hepatitis C infection. This stage is known as acute hepatitis C. If symptoms do develop, they usually occur a few weeks after infection. Early symptoms may include: a high temperature (fever) of 38C (100.4F) or above tiredness loss of appetite abdominal pain feeling and being sick yellowing of the skin and eyes (jaundice) Later symptoms (chronic hepatitis C) Symptoms can vary from person to person. They can also go away for long periods of time and then return. Later symptoms may include: feeling tired all the time joint and muscle aches and pain feeling sick brain fog including problems with memory, concentration and mental tasks such as arithmetic mood swings depression or anxiety indigestion or bloating itchy skin abdominal pain When to get medical advice Speak to your GP practice if: you have symptoms of hepatitis C theres a risk youre infected with hepatitis C, even if you dont have symptoms The only way to know for certain if these symptoms are caused by hepatitis C is to get tested. Getting tested for hepatitis C You can get tested for hepatitis C at: your GP practice a sexual health clinic a drug treatment service most substance use recovery services Treatments for hepatitis C Treatment takes 8 to 12 weeks, and usually cures the infection. But you wont be immune to hepatitis C. So you should take steps to reduce your risk of becoming infected again. If the infection is diagnosed early (acute hepatitis), you may not need treatment straight away. Instead, you may have another blood test after a few months to see if your body fights off the virus itself. If the infection continues for several months (chronic hepatitis), treatment will usually be recommended. Things you can do yourself There are things you can do to stop liver damage and prevent the infection spreading to others before you start treatment. Do eat a healthy and balanced diet exercise regularly speak to your doctor if youre thinking of having a baby Dont do not drink alcohol do not smoke do not share toothbrushes, razors, needles or other injecting equipment with other people How is hepatitis C spread? You can become infected with hepatitis C if you come into contact with the blood of an infected person. Some ways the infection can be spread include: injecting drugs and sharing needles and other drug equipment, such as spoons and filters sharing toothbrushes, razors or scissors contaminated with infected blood from a pregnant woman to her unborn baby having sex with an infected person without using a condom if your partner has hepatitis C, you should be tested if you had a blood transfusion in Scotland before September 1991, for example after a traffic accident or during childbirth, you may have been exposed to hepatitis C all donor blood in Scotland has been screened for hepatitis C since September 1991 having a tattoo, body piercing, or medical or dental treatment with unsterilised equipment How to prevent hepatitis C Theres no vaccine for hepatitis C. There are things you can do to reduce your risk of becoming infected. Do use condoms when having anal sex, or sex with a new partner get vaccinated against hepatitis A and hepatitis B if you inject drugs, use a fresh safe injecting kit (available from needle exchanges) every time you inject Dont do not share any drug-injecting equipment including needles, syringes, spoons and filters do not share razors or toothbrushes The risk of getting hepatitis C through vaginal sex is very low. It may be higher if blood is present, such as period (menstrual) blood or from bleeding during anal sex. Complications of hepatitis C If left untreated for many years, hepatitis C can cause liver damage ( cirrhosis ). In severe cases, life-threatening problems such as liver failure or liver cancer can eventually develop. Early treatment of hepatitis C prevents these serious complications, while later treatment reduces the risk. Last updated: 19 December 2023 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Dont include personal information e.g. name, location or any personal health conditions. Email Address e.g. [email protected] Message Maximum of 500 characters Send feedback Add this page to\n Info For Me Also on NHS inform Cirrhosis Hepatitis A Hepatitis B Other health sites British Liver Trust: hepatitis C Hepatitis C Trust NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats 2023 NHS 24 v1.1.1.17852

Hiatus hernia

Hiatus hernia | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotlands Service Directory 0 Home Illnesses and conditions Stomach, liver and gastrointestinal tract Hiatus hernia Hiatus hernia About hiatus hernia Diagnosing hiatus hernia Treating hiatus hernia Complications of hiatus hernia About hiatus hernia A hiatus hernia, or hiatal hernia, is when part of the stomach squeezes up into the chest through an opening (hiatus) in the diaphragm. The diaphragm is a large, thin sheet of musclebetween the chestand the abdomen (tummy). Hiatus hernia and heartburn A hiatus hernia itself rarelyhas any noticeable symptoms. However, it can cause a problem called gastro-oesophageal reflux disease (GORD) . GORD is where stomach acid leaks into the oesophagus (the tube that carries food to the stomach). It can occur if a hiatus hernia prevents the valve at the bottom of the oesophagus from working properly. Your oesophagus can becomeseverely irritated, because its not protected against stomach acid. This can cause symptoms such as heartburn, chest pain, an unpleasant sourtaste in your mouth, and swallowing problems ( dysphagia ). You should see your GP if you have frequent and severe symptoms of GORD . What causes a hiatus hernia? Its not exactly clear what causes hiatus hernia, but it may be the result of the diaphragm becoming weak with age, or pressure on the abdomen. Hiatus hernia can sometimes occur in newborn babies if the stomach or diaphragm doesnt develop properly. Whos affected Hiatus hernia can affect anyone, but its more common in people who are: over 50 years of age overweight pregnant Its estimated that a third of people over 50 have a hiatus hernia. Theres also arare type of hiatus hernia that affects newborn babies, whichis caused by a congenital defect of the stomach or diaphragm. Congenital means that it is present from birth. Types of hiatus hernia There are 2main types of hiatus hernia. They are: sliding hiatus hernias hernias thatmove up and down, in and out of the chest area (more than 80% of hiatus hernias are of this type) para-oesophageal hiatus hernias also called rolling hiatus hernias, where part of the stomach pushes up through the hole in the diaphragm next to the oesophagus (about 5 to 15% of hiatus hernias are of this type) These pagesmainly focus on sliding hiatus hernias. They can usually be diagnosed using an X-ray or an endoscopy, where a long, thin flexible tube with a light and video camera at one end is used to examine the inside of the body. Read more about diagnosing a hiatus hernia . Treating a hiatus hernia Treatment for a sliding hiatus herniausually focuses on relieving the symptoms of GORD, such as heartburn. Lifestyle changes and medication are the preferred treatments. Surgery is usually only recommended as an alternative to long-term medication or if other treatments havent worked. Lifestyle advicemay include: eating smaller, more frequent meals, rather than 3large meals a day avoiding lying down (including going to bed) for 3hours after eating or drinking removing any foods or drinksfrom your dietthat make your symptoms worse If a hiatus hernia isnt causing any noticeable problems, it doesnt usually need to be treated. Surgery is used to repair a para-oesophageal hiatus hernia if theres arisk of serious complications. Read more about treating a hiatus hernia . Further problems Its rare for a hiatus hernia to cause complications,but long-term damageto the oesophaguscaused byleaking stomach acid can lead toulcers, scarring and changes to the cells of the oesophagus,which can increase your risk of oesophageal cancer . Read more about the complications of a hiatus hernia . Diagnosing hiatus hernia A hiatus hernia can usually be diagnosed after a gastroscopy or X-ray. Gastroscopy Agastroscopyis a procedure where theinside of your body is examined using a gastroscope(a long, thin flexible tube with a light and video camera at one end), which sends images to an external monitor. The gastroscope will be inserted into your mouth and down your throat, and will be used to help identify any problems. The procedure may be carried out using a local anaesthetic or a sedative to help you relax. Barium meal X-ray The barium meal X-ray , also called the barium swallow test, is an effective way ofidentifying a hiatus hernia. As part of the test, youll be asked to drink some barium solution. Barium is a non-toxic chemicalthat shows up clearly on anX-ray. Once the barium moves down into your digestive system, a series of X-rays will be taken to identify any problems. If you need to have a barium meal X-ray, you wont be able to eat or drink anything for at least 6hours before the procedure, so that your stomach and duodenum (the top of the small intestine) are empty. You may be given an injection to relax the muscles in your digestive system. Youll be given a white, chalky liquid containing barium to drink while lying down. This will allow the specialist to see your stomach on an X-ray monitor more easily, as well as any ulcers or abnormal growths. Yourbed may be tipped slightly during the test, so that the barium fills all the areas of your stomach. A barium swallow usually takes about 15 minutes to perform. Afterwards, youll be able to eat and drink as normal, although you may need to drink more water to help flush the barium out of your system. You may feel slightly sick after a barium meal X-ray and the barium may cause constipation . Your stools may also be white for a few days afterwards, as the barium passes through your system. Treating hiatus hernia Treatment for a hiatus hernia is usually only necessary if its causing problems. In most cases, people with a hiatus hernia only experience problems if the hernia causes gastro-oesophageal reflux disease (GORD) . GORD can cause symptoms such as heartburn and an unpleasant taste in your mouth. Lifestyle changes and medication are the preferred treatments, although surgery may be used as an alternative to long-term medication, or if other treatments are ineffective. Lifestyle changes There are several things you can do yourself to help relieve symptoms of GORD caused by a hiatus hernia. These include: eating smaller, more frequent meals, rather than three large meals a day avoiding lying down (including going to bed) for at least 3hours aftereating or drinking avoiding drinking during the night removing certainfoodsfrom your diet if you think they make your symptoms worse avoiding alcohol , caffeine, chocolate, tomatoes, fatty foods, spicy foods and acidic foodor drinks, such as citrus fruit juice, if they make your symptoms worse avoiding bending over or stooping, particularly after eating or drinking raising the head of your bed by around 20cm (8 inches) by placing a piece of wood or blocks under it; dont use extra pillows, because this may increase pressure on your abdomen If youre overweight, losing weight may help to reduce the severity and frequency of your symptoms. If you smoke, you should try to give up. Tobacco smoke can irritate your digestive system and may make your symptoms worse. Read about stopping smoking . Medication A number of different medications can be used to treat symptoms of hiatus hernia. These are described below. Antacids Antacid medicinescan relieve some of the symptoms of hiatus hernia.They come in liquid or tablet form andcan be swallowed or chewed. They help to neutralisestomach acid when they reach the oesophagus and stomach by making it less acidic. However, antacid medicines dont work for everyone. Theyre not a long-term solution if symptoms persist or youre in extreme discomfort. Antacids shouldnt be taken at the same time as other medicines, because they can stop other medicines from being properly absorbedby your body. They may also damage the special coating on some types of tablets. Ask your GP or pharmacist for advice. Alginates Alginates are an alternative medicine to antacids. They work by producing a protective coating that shields the lining of your stomach and oesophagus from the effects of stomach acid. H2-receptor antagonists In some cases,a medicine known as an H2-receptor antagonist (H2RA) may be recommended if a hiatus hernia is causing GORD. Examples of H2RAs include cimetidine,famotidine (PepcidTwo) and ranitidine. H2RAs block the effects of the chemical histamine, whichyour bodyuses to produce stomach acid. H2RAs therefore help to reduce the amount of acid in your stomach. Side effects of H2RAs are uncommon. However, possible side effects may include diarrhoea , headaches , tirednessand arash. Some H2RAs are available over the counter at pharmacies. These types of HR2As are taken in a lower dosage than the ones available on prescription. Ask your GP or pharmacist if youre not surewhether these medicines are suitable for you. Proton-pump inhibitors (PPIs) Your GP may prescribe a medication called a proton-pump inhibitor (PPI). PPIs work by reducing the amount of acid produced by your stomach. Examples of thePPIs you may be prescribed include omeprazole, lansoprazole, rabeprazole and esomeprazole. Most people tolerate PPIs well and side effects are uncommon. When they do occur, theyre usually mild and can include headaches, diarrhoea, feeling sick or constipation . To minimise any side effects, your GP will prescribe the lowest possible dose of PPIs they think will be effective. You should let your GP know if the prescribed dose of PPIs doesnt work. A stronger dose may be needed. Surgery Surgery is usually only recommended for a sliding hiatus hernia (hernias that move up and down, in and out of the chest area)if the problem fails to respond to lifestyle changes and medication. You may also want to consider surgery if you have persistent and troublesome symptoms, but dont want to take medication on a long-term basis. Prior to surgery, you may need further investigations to check how well the oesophagus moves (manometry) andhow much acid is being refluxed (24-hour oesopageal pH studies). Laparoscopic nissen fundoplication (LNF) A procedure called a laparoscopic nissen fundoplication (LNF) is one of the most common surgical techniques used to treat GORD and sliding hiatus hernias. LNF is a type of keyhole surgery that involves making a series of small cuts in your abdomen. Carbon dioxide gas is used to inflate your abdomen to give the surgeon room to work in. During LNF,the stomach is put back into the correct position and the diaphragm around the lower part of the oesophagus is tightened. This should prevent any acid moving back out of your stomach. LNF is carried out under general anaesthetic ,so you wont feel any pain or discomfort. The surgery takes 60 to 90 minutes to complete. After having LNF, you should be able to leave hospital after youve recovered from the effects of the general anaesthetic. This is usually within 2to 3days. Depending on the type of job you do, you should be able to return to work within 3to 6weeks. For the first 6weeks after surgery, its recommended that you only eat soft food, such as mince, mashed potatoes or soup. Avoid eating hard food that could get stuck at the site of the surgery, such as toast, chicken or steak. Common side effects of LNF include difficulties swallowing ( dysphagia ), belching, bloating and flatulence . These side effects should resolve over the course of a few months. However, in about 1 in 100 cases they can be persistent. In such circumstances, further corrective surgery may be required. Para-oesophageal hiatus hernia If you have apara-oesophageal hiatus hernia, where the stomach pushes up through the hole in the diaphragm next to the oesophagus, surgery may be recommended to reduce the risk of the hernia becoming strangulated (see complications of a hiatus hernia for more information). Complications of hiatus hernia Complicationsfrom a hiatus hernia are rare, but they can be serious. Hiatus hernias that slide in and out of the chest area (sliding hiatus hernias) can cause gastro-oesophageal reflux disease (GORD) . This is where stomach acid leaks into the oesophagus (gullet). This can damage the oesophagus, increasing the risk of problems. Oesophageal ulcers Damage to the lining of theoesophagus (oesophagitis) caused by stomach acid can lead to the formation of ulcers. The ulcers can bleed, causing pain and making swallowing difficult. Ulcers can usually be successfully treated by controlling the underlying symptoms of GORD . In most cases, over-the-counter medicines called antacidsor alginates are used to treat the condition. Read more about treating GORD . Oesophageal stricture Repeated damage to the lining of your oesophagus can lead to the formation of scar tissue. If the scar tissue is allowed to build up, it can cause your oesophagus to become narrowed. This is known as oesophageal stricture. An oesophageal stricture can make swallowing food difficult and painful. Oesophageal strictures can be treated using a tiny balloon to dilate (widen) the oesophagus. This procedure is usually carried out under a local anaesthetic . Barretts oesophagus and cancer Repeated damage to the oesophagus can also lead to changes in the cells lining your lower oesophagus. This is a condition known as Barretts oesophagus. Barretts oesophagus doesnt usually cause noticeable symptoms, other than those associated with GORD. However, Barretts oesophagus can increaseyour risk of developing oesophageal cancer . If you have persistent reflux symptoms for more than 3weeks, you should talk to your GP because you may need some investigations. Strangulated hernia In some cases, a hiatus hernia causes part of the stomach to push up next to the oesophagus. This is known as a para-oesophageal hiatus hernia. GORD doesnt usually occur in these cases, but theres a risk of the hernia becoming strangulated. Strangulation occurs when the hernia becomes knotted and the blood supply to the area is cut off. Emergency surgery is usually required to correct the problem. Source: NHS 24 - Opens in new browser window Last updated: 13 December 2023 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Dont include personal information e.g. name, location or any personal health conditions. Email Address e.g. [email protected] Message Maximum of 500 characters Send feedback Add this page to\n Info For Me Also on NHS inform Dysphagia (swallowing problems) Stomach ulcer Gastro-oesophageal reflux disease (GORD) Other health sites British Hernia Centre: the anatomy of hernia NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats 2023 NHS 24 v1.1.1.17852

High cholesterol

High cholesterol - Illnesses and conditions | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotlands Service Directory 0 Home Illnesses and conditions Blood and lymph High cholesterol High cholesterol About high cholesterol Causes of high cholesterol Diagnosing high cholesterol Treating high cholesterol Preventing high cholesterol About high cholesterol Cholesterol is a fatty substance known as a lipid. Its vital for the normal functioning of the body. Cell membranes, hormones and vitamin D are created by your body using cholesterol. There are 2 main sources of the cholesterol in your blood: cholesterol in the food you eat cholesterol produced by your liver Having an excessively high level of lipids in your blood (hyperlipidemia) can have an effect on your health. High cholesterol, on its own, doesnt usually cause any symptoms but increases your risk of serious health conditions. About cholesterol Cholesterol is carried in your blood by proteins. When the two combine, theyre called lipoproteins. There are two main types of lipoprotein. High-density lipoprotein (HDL) carries cholesterol away from the cells and back to the liver. From there its either broken down or passed out of the body as a waste product. For this reason, HDL is referred to as good cholesterol and higher levels are better. Low-density lipoprotein (LDL) carries cholesterol to the cells that need it. If theres too much cholesterol for the cells to use it can build up in the artery walls, leading to disease of the arteries. For this reason, LDL is known as bad cholesterol. The amount of cholesterol in the blood, both HDL and LDL , is measured with a blood test . The recommended cholesterol levels in the blood vary between those with a higher or lower risk of developing arterial disease. Why should I lower my cholesterol? Evidence strongly indicates that high cholesterol can increase the risk of: narrowing of the arteries (atherosclerosis) heart attack stroke transient ischaemic attack (TIA) often known as a mini stroke peripheral arterial disease (PAD) This is because cholesterol can build up in the artery wall, restricting the blood flow to your heart, brain and the rest of your body. It also increases the risk of a blood clot developing somewhere in your body. Your risk of developing coronary heart disease also rises as your bloods cholesterol level increases. This can cause pain in your chest or arm during stress or physical activity ( angina ). What causes high cholesterol? Many factors can increase your chances of having heart problems or a stroke if you have high cholesterol. These include: an unhealthy diet in particular, eating high levels of saturated fat smoking a chemical called acrolin, found in cigarettes, stops HDL transporting cholesterol from fatty deposits to the liver, leading to narrowing of the arteries (atherosclerosis) having diabetes or high blood pressure (hypertension) having a family history of stroke or heart disease Theres also an inherited condition called familial hypercholesterolaemia. This can cause high cholesterol even in someone who eats healthily. Read more about the causes of high cholesterol When should my cholesterol levels be tested? Your GP may recommend that you have your blood cholesterol levels tested if you: have been diagnosed with coronary heart disease, stroke or mini stroke (TIA), or peripheral arterial disease (PAD) have a family history of early cardiovascular disease have a close family member who has a cholesterol-related condition are overweight have high blood pressure, diabetes or a health condition that can increase cholesterol levels Read more about how cholesterol is tested What should my cholesterol levels be? Blood cholesterol is measured in units called millimoles per litre of blood, often shortened to mmol/L. As a general guide, total cholesterol levels should be: 5mmol/L or less for healthy adults 4mmol/L or less for those at high risk As a general guide, LDL levels should be: 3mmol/L or less for healthy adults 2mmol/L or less for those at high risk An ideal level of HDL is above 1mmol/L. A lower level of HDL can increase your risk of heart disease. Your ratio of total cholesterol to HDL may also be calculated. This is your total cholesterol level divided by your HDL level. Generally, this ratio should be below four, as a higher ratio increases your risk of heart disease. Cholesterol is only one risk factor. The level at which specific treatment is required will depend on whether other risk factors, such as smoking and high blood pressure, are also present. How can I lower my cholesterol level? The first step in reducing your cholesterol is to maintain a healthy, balanced diet . Its important to keep your diet low in fatty food. You can swap food containing saturated fat for fruit, vegetables and wholegrain cereals. This will also help prevent high cholesterol from returning . Other lifestyle changes, such as taking regular exercise and giving up smoking , can also make a big difference in helping to lower your cholesterol. If these measures dont reduce your cholesterol and you continue to have a high risk of developing heart disease, your GP may prescribe a cholesterol-lowering medication, such as statins . Your GP will take into account the risk of any side effects from statins. The benefit of lowering your cholesterol must outweigh any risks. Read more about how high cholesterol is treated Causes of high cholesterol Many different factors can contribute to high blood cholesterol, including lifestyle factors like smoking, an unhealthy diet and lack of exercise, as well as having an underlying condition, such as high blood pressure or diabetes. Lifestyle Your lifestyle can increase your risk of developing high blood cholesterol. This includes: an unhealthy diet some foods, such as liver, kidneys and eggs, contain cholesterol (dietary cholesterol), butthis has little effect on blood cholesterol: its the total amount of saturated fat in your diet thats more important to watch; read more about preventing high cholesterol lack of exercise or physical activity this can increase your level of bad cholesterol (low-density lipoprotein, or LDL) obesity if youre overweight, its likely that youll have higher levels of LDL cholesterol and triglycerides, and a lower level of high-density lipoprotein (HDL) drinkingexcessive amounts of alcohol regularly drinking large amountsof alcohol can increase your cholesterol and triglyceride levels smoking a chemical in cigarettes called acrolein stops good cholesterol (HDL) transporting cholesterol from fatty deposits to the liver, leading to narrowing of the arteries (atherosclerosis) Underlying conditions People with high blood pressure (hypertension) and diabetes often have high cholesterol. Some other health conditions that can also cause raised levels of cholesterol include: kidney disease liver disease an underactive thyroid gland (hypothyroidism) Treating the underlying condition can help to reduce cholesterol. Other factors There are a number of factors associated with high cholesterol that cant be changed that increase your risk of having a heart attack or stroke . Doctors refer to these as fixed factors. They include: family history of early coronary heart disease (CHD) or stroke youre more likely to have high cholesterol if you have a close male relative (father or brother) aged under 55, or a female relative (mother or sister) aged under 65, whos had CHD or stroke a family history of a cholesterol-related condition for example, having a parent, brother or sister with familial hypercholesterolaemia age the older you are, the greater the likelihood of your arteries narrowing (atherosclerosis) ethnic group people of Indian, Pakistani, Bangladeshi and Sri Lankan descent are at increased risk of having a heart attack sex males are more likely to have heart attacks than females If you have a fixed risk factor, or several fixed risk factors, its even more important to look at your lifestyle and any underlying conditions you may have. Familial hypercholesterolaemia Familial hypercholesterolaemia is the medical term for high cholesterol that runs in families. Its caused by a gene alteration inherited from a parent, rather than an unhealthy lifestyle. People with familial hypercholesterolaemia have raised cholesterol from birth, which can lead to the early development of heart problems, such as atherosclerosis and CHD. In the UK, familial hypercholesterolaemia is thought to affect about 1 in 500 people, which means approximately 120,000 people are thought to be affected. Theres aone in two (50%) chance that a child orbrother or sister of someone with familial hypercholesterolaemia will also have the condition. Read more about the importance of early identification and diagnosis of familial hypercholesterolaemia Diagnosing high cholesterol Blood cholesterol levels are measured with a simple blood test. Getting a cholesterol test A blood sample is taken that will be used to determine the amount of bad cholesterol (low-density lipoprotein, or LDL), good cholesterol (high-density lipoprotein, or HDL) andother fatty substances (triglycerides) in your blood. You may be asked not to eat for 10-12 hours before the cholesterol test, usually including when youre asleep at night. This ensures that all food is completely digested and wont affect the outcome of the test. Your GP or practice nurse can carry out thecholesterol test and will take a blood sample, either using a needle and a syringe or by pricking your finger. A newer type of test that measures non-high-density lipoprotein (non-HDL) is now sometimes used because its thought to be a more accurate way of estimating cardiovascular disease (CVD) risk than LDL. Non-HDL cholesterol is total cholesterol minus HDL cholesterol. Its also not necessary to fast before the test, so itis more convenient. Who should be tested? Your GP may recommend that you have your blood cholesterol levels tested if you: have been diagnosed with coronary heart disease, stroke or mini-stroke (TIA) , or peripheral arterial disease (PAD) are over the age of 40people over 40 should have their estimate of CVD risk reviewed regularly have a family history of early cardiovascular disease for example, if your father or brother developed heart disease or had a heart attack or stroke before the age of 55, or if your mother or sister had these conditions before the age of 65 have a close family member who has a cholesterol-related condition, such as familial hypercholesterolaemia are overweight or obese have high blood pressure or diabetes have another medical condition, such as kidney disease , an underactive thyroid , or an inflamed pancreas (pancreatitis) these conditions can cause increased levels of cholesterol or triglycerides Results After your cholesterol test, your GP or nurse will explain your results and calculate whether you have a high, moderate or low risk of developing heart disease or stroke (cardiovascular disease)within the next 10 years. However, this risk isnt just based on your cholesterol reading. It also takes into account: yourBMI (body mass index) which measures your weight in relation to your height treatable risk factorssuch as high blood pressure (hypertension) , diabetes and other medical conditions your age, sex, family history and ethnicity Based on your results, your GP or nurse will recommend steps you can take to reduce your risk of developing CVD. This may include advice about making lifestyle changes, such as eating more healthilyby increasing your intake of omega-3 fatty acids, for example and doing more exercise. Cholesterol-lowering medication, such as statins , may also be recommended. Read more about treating high cholesterol Familial hypercholesterolaemia People with familial hypercholesterolaemia, or inherited high cholesterol, are at increased risk of developing CVD. In the UK, most of the 120,000 people thought to have the condition are undiagnosed and untreated. As a result of the increased risk of developing CVD, its very important that those with familial hypercholesterolaemia are diagnosed as early as possible and offered appropriate treatment. The National Institute for Health and Care Excellence (NICE) recommends that adults with a total cholesterol level of above 7.5mmol/l before treatment should be assessed forfamilial hypercholesterolaemia. If youve been diagnosed withfamilial hypercholesterolaemia, youll be referred for a specialist assessment, which may include DNA testing to confirm the diagnosis. Appropriate treatment will be recommended and other members of your family who may be affected will also be tested. Youll be closely monitored, and should have a full review at least once a year to check how well your treatment is working and assess any symptoms you may have. Children Children at risk offamilial hypercholesterolaemia will be tested by the time they reach10 years of age. This is because any signs of CVD, such as thickening of the carotid artery wall, will be identifiable by this age. The assessment will be carried out by a specialist with expertise in familial hypercholesterolaemia in children and young people. Early diagnosis offamilial hypercholesterolaemia means its possible to recommend lifestyle changes and other appropriate treatments to reduce the long-term problems associated with high cholesterol and improve long-term health. For further information, see the NICE guidance about familial hypercholesterolaemia Treating high cholesterol If youve been diagnosed with high cholesterol, youll be advised to make changes to your diet and increase your level of exercise. After a few months, if your cholesterol level hasnt dropped, you may be advised to take cholesterol-lowering medication. Changing your diet, stopping smoking and exercising morewill also help to prevent high cholesterol developing. The various treatments for high cholesterol are outlined below. Diet Eating a healthy, balanced diet thats low insaturated fats can reduce your level of bad cholesterol (LDL). Try to avoid or cut down on the following foods, which are high in saturated fat: fatty cuts of meat and meat products, such as sausages and pies butter, ghee and lard cream, soured cream,crme frache and ice cream cheese, particularly hard cheese cakes and biscuits milk chocolate coconut oil, coconut cream and palm oil The government recommends that a maximum of 11% of a persons food energy should come from saturated fat. This equates to no more than: 30g of saturated fat a day for the average man 20gof saturated fat a dayfor the averagewoman Children should have less. Check the labels on the foods youre eating to find out how much saturated fat youre consuming. Omega-3 fatty acids Many experts believe that the fats found in avocados andoily fish, such as mackerel, salmon and tuna, are good for you. These are known as omega-3 fatty acids and high doses can improve (lower) triglyceride levels in some people. However, too much omega-3 fatty acids can contribute to obesity . For people with a high triglyceride level, at least two portions of oily fish a week is thought to be beneficial. However, theres no evidence that taking omega-3 fatty acid supplements has the same benefit. Cholesterol-lowering medication There are several different types of cholesterol-lowering medication that work in different ways. Your GP can advise you about the most suitable type of treatment, and may also prescribe medication to lower high blood pressure (hypertension) if it affects you. The most commonly prescribed medications are outlined below. Statins Statins block the enzyme (a type of chemical) in your liver that helps to make cholesterol. This leads to a reduction in your blood cholesterol level. Youll usually be started on a medication called atorvastatin. Other statins include simvastatin and rosuvastatin. When someone has side effects from using a statin, its described as having an intolerance to it. Side effects of statins include headaches , muscle pain and stomach problems, such as indigestion ,diarrhoea or constipation . Statins will only be prescribed to people who continue to be at high risk of heart disease, because they need to be taken for life.Cholesterol levels start to rise again once you stop taking them. Aspirin In some cases, a low daily dose of aspirin may be prescribed, depending on your age (usually over 40 years old) and other risk factors. Low-dose aspirin can help to prevent blood clots forming, particularly for someone whos had a heart attack , has established vascular disease, or a high risk of developing cardiovascular disease (CVD) . You may also be advised to have periodic blood tests to ensure your liver is functioning well. Ezetimibe Ezetimibe is a medication that blocks the absorption of cholesterol from food and bile juices in your intestines into your blood. Its generally not as effective as statins, but is less likely to cause side effects. You can take ezetimibe at the same time as your usual statin if your cholesterol levels arent low enough with the statin alone. The side effects of this combination are generally the same as those of the statin on its own (muscle pain and stomach problems). You can take ezetimibe by itself if youre unable to take a statin. This may be because you have another medical condition, you take medication that interferes with how the statin works, or because you experience side effects from statins. Ezetimibe taken on its own rarely causes side effects. For more information, you can read the National Institute for Health & Care Excellence (NICE) guidelines about the use of ezetimibe for treating high cholesterol . Preventing high cholesterol You can lower your cholesterol by eating a healthy, balanced diet thats low in saturated fat, exercising regularly, not smoking and cutting down on alcohol. Diet If you have an unhealthy diet thats high in fat, fatty plaques are much more likely to build up in your arteries. This is because fatty foods contain cholesterol. There are two types of fat: saturated and unsaturated. You should avoid foods containing saturated fats, as they will increase the levels of bad cholesterol(low-density lipoprotein, or LDL) in your blood. Foods high in saturated fat include: meat pies sausages and fatty cuts of meat butter ghee a type of butter often used in Indian cooking lard cream hard cheese cakes and biscuits food that contains coconut or palm oil However, its not healthy to completely cut out all types of fat from your diet. Its important to replace saturated fats with unsaturated fats theyve been shown to increase levels of good cholesterol (high-density lipoprotein, or HDL) and reduce any blockage in your arteries. Foods that are high in unsaturated fat include: oily fishsuch as mackerel, salmon and tuna avocados nuts and seeds sunflower, rapeseed and olive oil A low-fat diet including lots of fibre, such as wholegrain rice, bread and pasta, and plenty of fruit and vegetables has also been shown to help lower cholesterol. Fruit and vegetablesare full of vitamins, minerals and fibre, and help keep your body in good condition. Aim to eat five 80g portions of fruit and vegetables every day . Smoking A chemical found in cigarettes called acrolein stops HDL transporting fatty deposits to the liver, leading to high cholesterol and narrowing of the arteries (atherosclerosis). This meanssmoking is a major risk factor for bothheart attacks and strokes . If you decide to stop smoking,your GP can refer you to an NHS Stop Smoking Service, which will provide you with dedicated help and advice about the best ways to give up smoking. You can also call Quit Your Way Scotland on 0800 84 84 84. The specially trained helpline staff can offer you free expert advice and encouragement. If youre committed to giving up smoking but dont want to be referred to a stop smoking service, your GP should be able to prescribe medical treatment to help with any withdrawal symptoms you may experience after giving up. Read more about treatment for quitting smoking Exercise Being active and exercising regularly will increase the levels of HDL in your body by stimulating the body to move fatty deposits to the liver, so they can be broken down. Exercise will also help you maintain a healthy weight, andlose weight if youre overweight.Being overweight can increase the amount of bad cholesterol in your blood. Another benefit of regular physical activity is it will help lower your blood pressure by keeping your heart and blood vessels in good condition. Doing 150 minutes of moderate-intensity exercise every week is recommended to help lower your cholesterol. Walking , swimming and cycling are good examples of this type of exercise. Read more about the recommended physical activity guidelinesfor adults (aged 19-64) and the physical activityguidelinesfor older adults (aged 65 and over) Source: NHS 24 - Opens in new browser window Last updated: 18 March 2024 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Dont include personal information e.g. name, location or any personal health conditions. Email Address e.g. [email protected] Message Maximum of 500 characters Send feedback Add this page to\n Info For Me Also on NHS inform Statins Other health sites British Dietetic Association: Food fact sheets Lab Tests Online: cholesterol test British Heart Foundation British Cardiovascular Society Heart UK NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats 2023 NHS 24 v1.1.1.17852

HIV

HIV symptoms & treatments - Illnesses & conditions | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotlands Service Directory 0 Home Illnesses and conditions Immune system HIV HIV HIV is a long-term health condition that is now very easy to manage. HIV stands for human immunodeficiency virus. The virus targets the immune system and if untreated, weakens your ability to fight infections and disease. Speak to a sexual health service as soon as possible if you think you might have been exposed to HIV. Symptoms of HIV Most people experience a short flu-like illness 2 to 6 weeks after infection, which lasts for 2 weeks. This is known as primary HIV infection. Symptoms of primary HIV infection include: fever (high temperature) sore throat body rash Other symptoms can include: tiredness joint pain muscle pain swollen glands After these symptoms disappear, HIV may not cause symptoms for many years. During this time, HIV continues to be active and causes damage to your immune system. This means many people who have HIV do not know theyre infected. Once the immune system becomes severely damaged symptoms can include: weight loss chronic diarrhoea night sweats skin problems recurrent infections serious life-threatening illnesses Testing for HIV If you think you might have HIV, get tested for free by: booking an appointment at your local sexual health service contacting your GP practice for an appointment ordering a home test kit contacting clinics run by charities such as the Terrence Higgins Trust or Waverley Care Scotland for an appointment contacting local drug dependency services for an appointment Services available may vary depending on where you live. Some private clinics may offer HIV testing, but they may charge. Who should get tested for HIV? Anyone who thinks they may have HIV should get tested. Certain groups of people are at a higher risk and are advised to have regular tests. For example: gay and bisexual men or men who have sex with men should have an HIV test at least once a year, or every 3 months if having sex without HIV PrEP or condoms with new or casual partners women and men from countries with high HIV prevalence, especially from sub-Saharan Africa, should have an HIV test if having sex without using HIV PrEP or condoms with new or casual partners people who inject drugs or have unprotected sex (sex without condoms or HIV PrEP ) with people who inject drugs What does a HIV test involve? The test for HIV is straightforward, highly accurate and is the only way to know if youre infected. It involves taking a sample from the body for analysis. There are 4 main types of HIV test. Blood test Where a sample of blood is taken and sent to a lab for analysis. Results are usually available within a few days. Point of care test A sample of saliva from your mouth or a small spot of blood from your finger is taken. This sample doesnt need to be sent to a lab and the result is available within a few minutes. Anyone who has a reactive point of care test still needs a confirmed laboratory test. Home sampling kit Where you collect a saliva sample or small spot of blood at home and send it off in the post for analysis. Youll be contacted by phone or text with your result in a few days. You can buy them online or from some pharmacies. Anyone who has a reactive home testing kit result is still required to have a laboratory confirmed test. Home testing kit Where you collect a saliva sample or small spot of blood yourself and test it at home. The result is available within minutes. Check that any test you buy has a CE quality assurance mark and is licensed for sale in the UK. Treatment for HIV Antiretroviral medicines are used to treat HIV. They work by stopping the virus multiplying in the body, allowing the immune system to repair itself and prevent further damage. These come in tablet form and must be taken every day. Most people with HIV take a combination of medicines. The goal of HIV treatment is to have an undetectable viral load. This means the level of HIV virus in your body is low enough to not be detected by a test. People who take HIV treatment and whose virus level is undetectable cant pass HIV on to others. Although there is no cure for HIV yet, people living with HIV who take their treatment should have a normal lifespan and good health. Without treatment, people with HIV will eventually become unwell. HIV can be fatal if its not detected and treated in time to allow the immune system to repair. Its extremely important to test for HIV if you think youve been exposed. How HIV is passed on You can get HIV by having unprotected vaginal or anal sex (sex without a condom or not taking HIV PrEP ). It may be possible for HIV to be passed on through unprotected oral sex, but the risk is very low. Other ways of getting HIV include: sharing sex toys that arent washed or covered with a new condom each time theyre used sharing needles, syringes and other injecting equipment from mother to baby before or during birth when the mother isnt taking HIV medication from mother to baby by breastfeeding when the mother isnt taking HIV medication blood transfusion (outside of the UK) Who is most at risk? People who are at higher risk of becoming infected with HIV include people who are not taking HIV PrEP medication and who are: men who have had unprotected anal sex with men women who have had unprotected sex with men who have sex with men people who have had unprotected sex with a person who has lived or travelled in a high HIV prevalence country people who inject drugs people who have had unprotected sex with somebody who has injected drugs people who have caught another sexually transmitted infection (STI) How to prevent HIV Safer sex The best way to reduce your risk of STIs is to practice safer sex . This means using a condom for vaginal, anal and oral sex. If youre having anal sex its important to also use water-based or silicon-based lubricant. HIV Pre-Exposure Prophylaxis (PrEP) Taking HIV PrEP before youre exposed to HIV means theres a drug inside of you to block HIV if it gets into your body, so it cant infect you. HIV Post Exposure Prophylaxis (PEP) If you think you may have recently been exposed to HIV and you havent taken HIV PrEP medication or used a condom, you should take PEP medication. PEP is a form of emergency HIV medication taken by someone who does not have HIV but who has or may have been very recently exposed to HIV. PEP should be taken as soon as possible, but it can be taken up to 72 hours after exposure. The earlier it is taken the more effective it is. PEP is available from sexual health services or out of hours from A&E . If you inject drugs If you inject drugs, you should never share needles or other injecting equipment (including syringes, spoons and swabs). You can get free clean needles and other injecting equipment from your local injecting equipment providers, which are sometimes also called needle exchanges . Other STIs If youve been diagnosed with HIV you should get tested for all STIs and blood borne viruses including: chlamydia gonorrhoea syphilis hepatitis B hepatitis C Find your local sexual health clinic Source: Scottish Government - Opens in new browser window Last updated: 28 March 2024 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Dont include personal information e.g. name, location or any personal health conditions. Email Address e.g. [email protected] Message Maximum of 500 characters Send feedback Add this page to\n Info For Me Also on NHS inform HIV PrEP (Pre-Exposure Prophylaxis) Other health sites Terrence Higgins Trust: My HIV Waverley Care - HIV & Hep C charity NAM: HIV and AIDS HIV i-Base Brook: advice for under 25s Scottish Government: End HIV stigma AVERT: HIV and AIDS NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats 2023 NHS 24 v1.1.1.17852

Hodgkin lymphoma

Hodgkin lymphoma - Illnesses & conditions | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotlands Service Directory 0 Home Illnesses and conditions Cancer Cancer types in adults Hodgkin lymphoma Hodgkin lymphoma About Hodgkin lymphoma Symptoms of Hodgkin lymphoma Causes of Hodgkin lymphoma Diagnosing Hodgkin lymphoma Treating Hodgkin lymphoma Complications of Hodgkin lymphoma About Hodgkin lymphoma Hodgkin lymphoma is an uncommon cancer that develops in the lymphatic system, which is a network of vessels and glands spread throughout your body. The lymphatic system is part of your immune system. Clear fluid called lymph flows through the lymphatic vessels and contains infection-fighting white blood cells, known as lymphocytes. In Hodgkin lymphoma, B-lymphocytes (a particular type of lymphocyte) start to multiply in an abnormal way and begin to collect in certain parts of the lymphatic system, such as the lymph nodes (glands). The affected lymphocytes lose their infection-fighting properties, making you more vulnerable to infection. The most common symptom of Hodgkin lymphoma is a painless swelling in a lymph node, usually in the neck, armpit or groin. Read more about the symptoms of Hodgkin lymphoma . Whos affected? Hodgkin lymphomacan develop at any age, but it mostly affects young adults in their early 20s and older adults over the age of 70. Slightly more men than women are affected. What causes Hodgkin lymphoma? The exact cause of Hodgkin lymphoma is unknown. However, your risk of developing the condition is increased if: youhave a medical condition that weakens your immune system you take immunosuppressant medication youve previously been exposed toa common virus called the Epstein-Barr virus which causes glandular fever You also have an increased risk of developing Hodgkin lymphoma if a first-degree relative (parent, sibling or child) has had the condition. Read more about the causes of Hodgkin lymphoma . How Hodgkin lymphoma is diagnosed The only way to confirm a diagnosis of Hodgkin lymphoma is by carrying out a biopsy . This is a minor surgical procedure wherea sample of affected lymph node tissue is removed and studied in a laboratory. Read more about diagnosing Hodgkin lymphoma . Treatment Hodgkin lymphoma is a relatively aggressive cancer and can quickly spread through the body. Despite this, its also one of the most easily treated types of cancer. Your recommended treatment plan will depend on your general health and age, because many of the treatments can put a tremendous strain on the body.How far the cancer has spread is also an important factor in determining the best treatment. The main treatments used are chemotherapy , followed by radiotherapy or chemotherapy alone. Surgery isnt generally used as a treatment for the condition. Read more about: treatment for Hodgkin lymphoma complications of Hodgkin lymphoma Symptoms of Hodgkin lymphoma The most common symptom of Hodgkin lymphoma is a swelling in the neck, armpit or groin. The swelling is usually painless, although some people find that it aches. The swelling is caused by an excess of affected lymphocytes (white blood cells) collecting in a lymph node (also called lymph glands). Lymph nodes are pea-sized lumps of tissue found throughout the body. They contain white blood cells that help to fight infection. However, its highly unlikely that you have Hodgkin lymphoma if you have swollen lymph nodes , as these glands often swellas a response to infection. Other symptoms Some people with Hodgkin lymphoma also have other more general symptoms. These can include: night sweats unintentional weight loss a high temperature (fever) a persistent cough or feeling of breathlessness persistent itching of the skin all over the body Other symptoms will depend on where in the body the enlarged lymph glands are. For example, if the abdomen (tummy) is affected, you may have abdominal pain or indigestion A few people with lymphoma have abnormal cells in their bone marrow when theyre diagnosed. Thismay lead to: persistent tiredness or fatigue an increased risk of infections excessive bleeding such as nosebleeds ,heavy periods and spots of blood under the skin Insome cases, people with Hodgkin lymphoma experience pain in theirlymph glands when they drink alcohol. When to seek medical advice Speak to your GP if youhave any of these symptoms, particularly if you have persistently swollen glands with no other signs of infection. While the symptoms are unlikely to be caused by Hodgkin lymphoma, it is best to get them checked out. Causes of Hodgkin lymphoma Hodgkin lymphoma is caused by a change (mutation) in the DNA of a type of white blood cell called B lymphocytes, although the exact reason why this happens isnt known. The DNA gives the cells a basic set of instructions, such as when to grow and reproduce. The mutation in the DNA changes these instructions so the cells keep growing, causing them to multiply uncontrollably. The abnormal lymphocytes usually begin to multiply in one or more lymph nodes in a particular area of the body, such as your neck or groin. Over time, its possible for the abnormal lymphocytes to spread into other parts of your body, such as your: bone marrow spleen liver skin lungs Whos most at risk? While thecause of the initial mutation that triggers Hodgkin lymphoma is unknown, a number of factors can increase your risk of developing the condition. These include: having a medical condition that weakens your immune system, such as HIV having medical treatment that weakens your immune system for example, taking medication to suppress your immune system afteran organ transplant being previously exposed to the Epstein-Barr virus (EBV) a common virus that causes glandular fever having previously had non-Hodgkin lymphoma , possibly because of treatment with chemotherapy or radiotherapy being very overweight ( obese )this may be more of a risk factor in women than men Hodgkin lymphoma isnt infectious andisnt thought torun in families. Although yourrisk isincreased if a first-degree relative (parent, sibling or child) has had lymphoma, its not clear if this is because of an inherited genetic faultorlifestyle factors. Hodgkin lymphoma can occur at any age, although most cases are diagnosed in people in their early 20s or 70s. The condition is slightly more common in men than women. Diagnosing Hodgkin lymphoma If you speak to your GP because youre concerned about symptoms of Hodgkin lymphoma, theyll ask about your health and carry out a simple physical examination. If necessary, your GPwill refer you to hospital for further tests. In 2015, the National Institute for Health and Care Excellence (NICE) published guidelines to help GPs recognise the signs and symptoms of Hodgkin lymphoma and refer people for the right tests faster. To find out if you should be referred for further tests for suspected Hodgkin lymphoma, read the NICE 2015 guidelines on Suspected cancer: recognition and referral . If youre referred to hospital, a biopsy will usually be carried out, as this is the only way to confirm a diagnosis of Hodgkin lymphoma. Biopsy A biopsy involves removing some or all of an affected lymph node, which is then studied in a laboratory. Biopsies are small operations that can often be carried out under a local anaesthetic (where the area is numbed). In some cases, the affected lymph node isnt easily accessible and a general anaesthetic may be required (where youre asleep). A pathologist (an expert in the study of diseased tissue) will then check the tissue sample for the presence of cancerous cells. If they find cancerous cells, they can also identify exactly which type of Hodgkin lymphoma you have, which is an important factor in planning your treatment. Further testing If a biopsy confirms a diagnosis ofHodgkin lymphoma, further testing will be needed to check how far the lymphoma has spread. This allows a doctor to diagnose the stage of your lymphoma. Further tests may include: blood tests samples of blood will be taken throughout your diagnosis and treatment to check your general health, the levels of red and white cells and platelets in your blood, and how well organs such as your liver and kidneys are working bone marrow sample another biopsy may be carried out to see if thecancer has spread to your bone marrow; this involves using a long needle to remove a sample of bone marrow from your pelvis and can be done using a local anaesthetic chest X-ray this can check whether the cancer has spread to your chest or lungs computerised tomography (CT) scan this scan takes a series of X-rays that build up a 3D picture of the inside of the body to check the spread of the cancer magnetic resonance imaging (MRI) scan this scanuses strong magnetic fields to build up a detailed picture of areas of your body, to check the spread of the cancer positron emission tomography (PET) scan this scan measures the activity of cells in different parts of the body andcan check the spread of the cancer and the impact of treatment;its usually taken at the same time as a CT scan to show precisely how the tissues of different sites of the body are working Stages of Hodgkin lymphoma When testing is complete, it should be possible to determine the stage of your lymphoma. Staging means scoring the cancer by how far its spread. The main stages of Hodgkin lymphoma are: stage 1 thecancer is limited to one group of lymph nodes, such as your neck or groin nodes either above or below your diaphragm (the sheet of muscle underneath the lungs) stage 2 2 or more lymph node groups are affected, either above or below the diaphragm stage 3 thecancer has spread to lymph node groups above and below the diaphragm stage 4 thecancer has spread through the lymphatic system and is now present in organs or bone marrow Health professionals alsoadd the letters A or B to your stage, toindicate whether or not you have certain symptoms. A is put after your stage if youhave no additional symptoms other than swollen lymph nodes. B is put after your stage if you haveadditional symptoms of weight loss, fever or night sweats. Treating Hodgkin lymphoma Hodgkin lymphoma can usually be treated successfully with chemotherapy alone, or chemotherapy followed by radiotherapy. Your treatment plan Your specific treatment plan will depend on your general health and your age, asmany of the treatments can put a tremendous strain on the body. How far the cancer has spread is also an important factor in determining the best treatment. Discussions about your treatment plan will usually take place with several doctors and other health professionals who specialise in different aspects of treating lymphoma. This is known as a multidisciplinary team (MDT). Your MDT will recommend the best treatment optionsfor you. However, you shouldnt be rushed into making a decision about your treatment plan. Before deciding, you may wish to talk to friends, family and your partner. Treatment options The main treatments for Hodgkin lymphoma are chemotherapy alone, or chemotherapy followed by radiotherapy. In a few cases, chemotherapy may be combined with steroid medication. Surgery isnt generally usedto treat the condition, except for the biopsy used to diagnose it. Overall, treatment for Hodgkin lymphoma is highly effective and most people with the condition are eventually cured. Chemotherapy Chemotherapy is a type of cancer treatment where medicine is used to kill cancer cells. This medication can be given in a number of different ways, depending onthe stage of your cancer. If doctors think your cancer is curable, youll normally receive chemotherapy through a drip directly into a vein (intravenous chemotherapy).If a cure is unlikely, you may only need to take chemotherapy tablets to help relieve your symptoms. Chemotherapy is usually given over a period of a few months on an outpatient basis, which means you shouldnt have to stay in hospital overnight. However, there may be times when your symptoms or the side effects of treatment become particularly troublesome and a longer hospital stay may be needed. Chemotherapy can have several side effects, the most significant of which is potential damage to your bone marrow. This can interfere with the production of healthy blood cells and cause the following problems: fatigue breathlessness increased vulnerability to infection bleeding and bruising more easily If you experience these problems, treatment may need to be delayed so you can produce more healthy blood cells. Growth factor medicines can also stimulate the production of blood cells. Other possible side effects of chemotherapy include: nausea and vomiting diarrhoea loss of appetite mouth ulcers tiredness skin rashes hair loss infertility , which may be temporary or permanent Mostside effects should pass once your treatment has finished.Tell your care team if the side effects become particularly troublesome, as there are treatmentsthat can help. Read more about the side effects of chemotherapy . High-dose chemotherapy If regular chemotherapy is unsuccessful or Hodgkin lymphoma returns after treatment, you may have a course of chemotherapy at a higher dose. However, this intensive chemotherapy destroys your bone marrow, leading to the problems mentioned above. Youllneed a stem cell orbone marrow transplantto replace the damaged bone marrow. Radiotherapy Radiotherapy is most often used to treat early-stage Hodgkin lymphoma, where the cancer is only in one part of the body. Treatment is normally given in shortdaily sessions, Monday to Friday, over several weeks. You shouldnt have to stay in hospital between appointments. Radiotherapy itself is painless, but it can have some significant side effects. These can vary and will be directly related to thepart of your body being treated. For example, treatment to your throat can lead to a sore throat, while treatment to the head can lead to hair loss. Other common side effectsinclude: tiredness nausea and vomiting dry mouth loss of appetite Most side effects are temporary,but theres a risk of long-term problems, including infertility and permanently darkened skin in the treatment area. Read more about: side effects of radiotherapy complications of Hodgkin lymphoma Steroid medication Steroid medication is sometimes used in combination with chemotherapy as a more intensive treatment for advanced cases of Hodgkin lymphoma, orif initial treatment hasnt worked. The steroid medication is given intravenously, usually at the same time as your chemotherapy. Common side effects of steroid medication include: increased appetite, which can lead to weight gain indigestion problems sleeping feeling agitated The side effects of steroid medication usually start to improve once treatment finishes. Rituximab If youre diagnosed with a rare type of Hodgkin lymphoma called lymphocyte-predominant Hodgkin lymphoma, you may have chemotherapy in combination with a medication called rituximab. Rituximab is a type ofbiological therapycalled a monoclonal antibody. Itattaches itself to the surface of cancerous cells and stimulates the immune system to attack and kill the cell. Its given through a drip directly into a vein over the course of a few hours. Side effects of the drug can include: flu -like symptoms, such as headaches , feverand muscle pain tiredness nausea diarrhoea You may be given additional medication to prevent or reduce side effects. Any side effects should improve over time as your body gets used to the medication. Follow-up After your course of treatment ends, youll need to have regular follow-up appointments to monitor your recovery and check for any signs of the cancer returning. These appointments start off being every few weeks or months, but will become gradually less frequent over time. Read further information: Cancer Research UK:treating Hodgkin lymphoma Cancer Research UK:living with Hodgkin lymphoma Macmillan: treating Hodgkin lymphoma Macmillan: living with Hodgkin lymphoma Complications of Hodgkin lymphoma Some people treated for Hodgkin lymphoma experience long-term problems, even if theyve been cured. Weakened immune system Having a weakened immune system is a common complication of Hodgkin lymphoma and it can become more severe while youre being treated. If you have a weak immune system, youre more vulnerable to infections and theres an increased risk of developing serious complications from infections. In some cases, you may be advised to take regular doses of antibiotics to prevent infections. Its also important to report any symptoms of an infection to your GP or care team immediately, as prompt treatment may be needed to prevent serious complications. Symptoms of infection include: a high temperature (fever) headache aching muscles diarrhoea tiredness Vaccination You should make sure that all of your vaccinations are up-to-date. However, its important to speak toyour GP or care team about this, as it may not be safe for you to have live vaccines (vaccines containing a weakened form of the virus or organism being vaccinated against) until several months after your treatment finishes. Examples of live vaccines include the: shingles vaccine BCG vaccine (against tuberculosis) MMR vaccine (against measles, mumps and rubella) Infertility Chemotherapy and radiotherapy for Hodgkin lymphoma can cause infertility. This is sometimes temporary, but it can be permanent. Your care team will estimate the risk of infertility in your specific circumstances and let you know your options. In some cases, it may be possible for men to store samples of their sperm and for women to store their eggs before treatment, so these can be used to try for a baby afterwards. Second cancers People who have had Hodgkin lymphoma are more likely to get lymphoma, leukaemia or other cancers in the future. Chemotherapy and radiotherapy further increase this risk. Second cancers, such as breast cancer or lung cancer , usually develop more than 10 years after youre treated for Hodgkin lymphoma. In rare cases, other types of cancer, such as leukaemia or other lymphomas, develop after only a few years. You can help to reduce your risk of a second cancer by adopting a healthy lifestyle by not smoking, maintaining a healthy weight with a balanced diet, and getting regular exercise. You should report any symptoms that might suggest another cancer to your GP at an early stage and attend any cancer screening appointments youre invited to. Other health problems The risk of developing other health conditions in the future, such as cardiovascular disease and lung disease, is also higher in people who have had Hodgkin lymphoma. You should report unexpected symptoms, such as increased shortness of breath, to your GP for further advice. Source: NHS 24 - Opens in new browser window Last updated: 09 November 2023 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Dont include personal information e.g. name, location or any personal health conditions. Email Address e.g. [email protected] Message Maximum of 500 characters Send feedback Add this page to\n Info For Me Also on NHS inform Radiotherapy Other health sites Cancer Research UK: Hodgkin lymphoma Bloodwise: Hodgkin lymphoma Lymphoma Action Macmillan Cancer Support: Hodgkin lymphoma Search for cancer support services near you Enter a place or postcode NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats 2023 NHS 24 v1.1.1.17852

Hodgkin lymphoma: Children

"Hodgkin lymphoma | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotlands Service Directory 0 Home Illnesses and conditions Cancer Cancer types in children Hodgkin lymphoma: Children Hodgkin lymphoma: Children Hodgkin lymphoma is a type of blood cancer. It can affect children at any age but is more common in older teenagers and young adults. More children than ever are surviving childhood cancer. There are new and better drugs and treatments, and we can now also work to reduce the after-effects of having had cancer in the past. Its devastating to hear that your child has cancer. At times it can feel overwhelming, but there are many healthcare professionals and support organisations to help you through this difficult time. Understanding more about the cancer your child has, and the treatments that may be used, can often help parents to cope. Your childs specialist will give you more detailed information and, if you have any questions, its important to ask the specialist doctor or nurse who knows your childs individual situation. What is Hodgkin lymphoma? Hodgkin lymphoma is a type of cancer that occurs in the lymphatic system. There are 2 main types of Hodgkin lymphoma: classical Hodgkin lymphoma, which affects 95% of patients, and Lymphocyte Predominant Hodgkin Lymphoma (LPHL), which only affects 5% of patients. This information is about classical Hodgkin lymphoma, but it includes a short section about LPHL. The lymphatic system The lymphatic system is part of the immune system, the bodys natural defence against infection and disease. The lymphatic system is made up of the bone marrow, thymus, spleen, and lymph nodes (or lymph glands). Lymph nodes are connected by a network of tiny lymphatic vessels that contain lymph fluid. Lymphomas can start anywhere in the lymphatic system, but Hodgkin Lymphoma is most likely to start in the lymph nodes in the neck. The other areas where lymph nodes are likely to swell are above the collar bone, the armpit, the groin and inside the chest. Glands can swell in these areas as part of the bodys response to infection, not just cancer, which is why a biopsy is needed to diagnose lymphoma. The number of lymph nodes varies from one part of the body to another. In some parts of the body, there are very few lymph nodes, whereas under your arm there may be 20to 50. There are 2 main types of lymphoma: non-Hodgkin lymphoma (NHL) and Hodgkin lymphoma (HL). Although these are both types of lymphoma, there are differences between them, which means they need different treatment. Causes The exact cause of Hodgkin lymphoma is not known. In most people that develop Hodgkin lymphoma, no cause is found. However, there is increasing evidence that infections, such as the virus that causes glandular fever, may play a part in the development of Hodgkin lymphoma, especially in childhood. Poor immunity may also be a risk factor for developing the disease. Very rarely, more than one member of a family may develop Hodgkin lymphoma but it is not inherited from parents and you cannot catch it from another person. Signs and symptoms The first sign of Hodgkin lymphoma is usually a painless swelling of 1 gland, or a group of lymph glands, which continues for some weeks or even months. The first glands that are likely to be affected are in the neck or above the collarbone, most often only on 1 side. However, its important to remember that childrens glands can also become swollen when they have a common infection that causes a sore throat or a cold. If glands in the chest are affected, this can cause a cough or breathlessness. This is caused by the pressure the glands exert on the airways. Sometimes, a child with Hodgkin lymphoma may have a high temperature (fever), night sweats, weight loss or itchy skin. How Hodgkin lymphoma is diagnosed As lymph glands can swell for lots of reasons, a biopsy is carried out to diagnose Hodgkin lymphoma. A biopsy is when a swollen lymph gland is removed and the cells are looked at under a microscope. Its a small operation which is usually done under a general anaesthetic. Sometimes only a small part of the lymph gland has to be removed, which can be done under a local anaesthetic. If Hodgkin lymphoma is diagnosed after the biopsy, further tests are carried out to find out the exact size and position of the lymphoma, and to see whether it has spread beyond the original area. These tests include X-rays, blood tests, CT, MRI and PET scans. Very often, a bone marrow sample will be taken. This is because the lymphoma cells can spread to the bone marrow as well as to other lymph glands. The tests that are carried out are called staging tests. Any tests and investigations that your child needs will be explained to you. The Childrens Cancer and Leukaemia Group (CCLG) has more information about what the tests and scans involve. Staging The stage of Hodgkin lymphoma describes the size and position of the cancer and whether it has spread. Staging is very important because the type of treatment your child receives will depend on the stage of the disease. The staging system for Hodgkin lymphoma is as follows: stage 1 only 1 group of lymph nodes is affected and the lymphoma is only on 1 side of the diaphragm (the sheet of muscle under the lungs that controls breathing) stage 2 2or more groups of lymph nodes are affected, but they are only on 1 side of the diaphragm. stage 3 the lymphoma is in lymph nodes both above and below the diaphragm stage 4 the lymphoma has spread outside the lymph nodes to other organs such as the liver, lungs or bone marrow As well as giving each stage a number, doctors also use a letter code either A, B, or E: A means your child has no symptoms B means your child has 1 or more of the following symptoms: a fever, night sweats or significant weight loss E means that the lymphoma has grown from the lymph gland to extranodal tissue (tissue in places outside the lymph nodes) A number and letter is used in the staging of every child with Hodgkin lymphoma. This helps the doctor decide on a treatment plan for your child. Treatment Children with Hodgkin lymphoma are usually treated with chemotherapy, but sometimes radiotherapy is also needed. The type and amount of treatment given depend on the stage of the disease when it is diagnosed. Your childs doctor will discuss the treatment options with you. Chemotherapy This is the use of anti-cancer (cytotoxic) drugs to destroy cancer cells. It is usual for a combination of drugs to be used, which will often be given every few weeks over a number of months. A combination of drugs is used because each chemotherapy drug works in a different way. Using several drugs together increases the effectiveness of the treatment. It also means lower doses of individual drugs can be used, which may reduce the possibility of long-term side effects. Radiotherapy This is used in less than half of people with Hodgkin lymphoma. It treats cancer by using high energy rays that destroy the cancer cells while doing as little harm as possible to normal cells. Side effects of treatment Treatment for Hodgkin lymphoma can cause side effects, and your childs doctor will discuss these with you before the treatment starts. Any possible side effects will depend on the particular treatment being used and the part of the body that is being treated. Some general side effects of chemotherapy that can occur during treatment include: feeling sick (nausea) and being sick (vomiting) hair loss low blood count which can lead to an increased risk of infection, bruising and bleeding tiredness Changes to your childs sense of taste and changes in their bowel may also happen. If your child has side effects from the treatment it is important to discuss them with your doctor or nurse. They may be able to help reduce them. Late side effects of treatment The cure rate for Hodgkin lymphoma is very high, which means some children may develop side effects many years after treatment. The chance of developing late side effects depends on where the original tumour was, how far it spread, and the type of treatment your child had. These late side effects can affect the normal organs such as the heart, kidneys and lungs. Following treatment for Hodgkin lymphoma, there is a small increase in the risk of developing another cancer in later life. There is also a chance that fertility may be affected. Teenage boys who are diagnosed after puberty should have the option of sperm banking before treatment starts. In this situation, sperm can be stored for possible use in later years. Your childs doctor or nurse will explain more about any possible late side effects. Clinical trials Many children have their treatment as part of a clinical research trial. Trials aim to improve our understanding of the best way to treat an illness, usually by comparing the standard treatment with a new or modified version. The aim of treatment for Hodgkin lymphoma is to cure the cancer with the fewest possible short and long-term side effects. This is particularly important in childhood Hodgkin lymphoma where cure rates are high. Its important to get the balance right between curing the cancer and having the lowest risk of long-term side effects. If appropriate, your childs medical team will talk to you about taking part in a clinical trial and will answer any questions you may have. Written information is often provided to help explain things. Taking part in a research trial is completely voluntary, and youll be given plenty of time to decide whether its right for your child. Treatment guidelines Sometimes, clinical trials are not available for your childs tumour. This may be because a recent trial has just finished, or because the tumour is very rare. In these cases, you can expect your doctors and nurses to offer treatment which is agreed to be the most appropriate, using guidelines which have been prepared by experts across the country. The Childrens Cancer and Leukaemia Group (CCLG) is an important organisation which helps to produce these guidelines. Follow-up care About 90% of children who develop Hodgkin lymphoma are cured. When your child completes treatment, they will then go into a follow-up phase, seeing doctors and nurses in out-patient clinics usually for around five years. Clinic visits will be every 3to 4 months to start with and there will be occasional scans, X-rays, and blood tests done for several years after completing treatment. If the cancer comes back, a different course of treatment can be given. If you have specific concerns about your childs condition and treatment, its best to discuss them with your childs doctor, who knows the situation. Lymphocyte predominant Hodgkin lymphoma (LPHL) This is a rare type of Hodgkin lymphoma that affects around 5% of patients. LPHL usually grows at a slower rate than classical Hodgkin lymphoma and normally requires less intensive treatment. Young people with LPHL may have a single swollen gland or group of swollen glands in one area only, such as the neck or groin. The swollen gland often grows very slowly and may be present for many months before a biopsy and diagnosis happens. The biopsy and staging tests will be carried out as with classical Hodgkin lymphoma. The treatment given will depend on the stage of the disease, but most patients are diagnosed with an early stage of the disease. LPHL is usually treated with surgery or low-dose chemotherapy. It may return many years after treatment, and further treatment may be required, but it is rarely a life-threatening condition. In rare cases, patients have advanced LPHL and receive more intensive chemotherapy. There is also a link between LPHL and developing a more aggressive non-Hodgkin lymphoma . Your feelings As a parent, the fact that your child has cancer is one of the worst situations you can be faced with. You may have many emotions, such as fear, guilt, sadness, anger and uncertainty. These are all normal reactions and are part of the process that many parents go through at such a difficult time. Its not possible to address here all of the feelings you may have. However, the CCLG booklet Children & Young Peoples Cancer; A Parents Guide talks about the emotional impact of caring for a child with cancer and suggests sources of help and support. Your child may have a variety of powerful emotions throughout their experience with cancer. The Parents Guide discusses these further and talks about how you can support your child. Source: Children's Cancer and Leukaemia Group - Opens in new browser window Last updated: 14 November 2023 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Dont include personal information e.g. name, location or any personal health conditions. Email Address e.g. [email protected] Message Maximum of 500 characters Send feedback Add this page to\n Info For Me Search for cancer support services near you Enter a place or postcode NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats 2023 NHS 24 v1.1.1.17852"

Hodgkin lymphoma: Teenagers and young adults

Hodgkin lymphoma: Teenagers and young adults | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotlands Service Directory 0 Home Illnesses and conditions Cancer Cancer types in teenagers and young adults Hodgkin lymphoma: Teenagers and young adults Hodgkin lymphoma: Teenagers and young adults This section is for teenagers and young adults and is about a type of cancer called Hodgkin lymphoma. Treatment for Hodgkin lymphoma has a very good success rate and most people are cured. Hodgkin lymphoma is a cancer of the lymphatic system, which is one of the bodys natural defences against infection. Lymphomas, like all cancers, are a disease of the bodys cells. Normally cells in our body divide and grow in a controlled way. But sometimes cells keep dividing and grow out of control. This is how cancer develops. In lymphomas, white blood cells called lymphocytes become abnormal and grow out of control. These lymphocytes can build up in one part of the body and form a lump (tumour). There are2 main types of lymphoma: Hodgkin lymphoma non-Hodgkin lymphoma (NHL) Although these cancers are both lymphomas, they are different and need different treatments. Your doctors will do tests to find out which type you have. Symptoms One of the most common symptoms is having a painless lump. The lump is caused by swollen lymph nodes. There may be one or more lumps and these may be in your neck, armpit or groin. Lumps can also be inside the body. A commonplace would be inside the chest and this can cause a cough or breathlessness. Some people feel tired and lethargic with lymphoma. Itching of the skin is also quite common. Some people with Hodgkin lymphoma have other symptoms such as high temperatures, very heavy sweats (especially at night) and unexplained weight loss. Doctors call these symptoms B symptoms. Most of the symptoms that people get with lymphoma may also be caused by other illnesses. For example swollen lymph nodes, high temperatures and sweats may be caused by an infection. But if you have any of these symptoms or are worried that you may have Hodgkin lymphoma, go to your GP. Theyll examine you and refer you to a hospital if they think you need to see a specialist doctor. Causes Its not known what causes Hodgkin lymphoma. Research is going on to try to find out. Remember, though, it isnt anything that youve done. Hodgkin lymphoma is one of the most common cancers in young people over the age of 10. About 1 in 6 of all cancers affecting young people between 15 and 24 is a Hodgkin lymphoma. Hodgkin lymphoma isnt infectious and cant be passed on to other people or family members. If youre looking for information about Hodgkin lymphoma in people of all ages, read our general Hodgkin lymphoma section. Source: Macmillan - Opens in new browser window Last updated: 14 November 2023 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Dont include personal information e.g. name, location or any personal health conditions. Email Address e.g. [email protected] Message Maximum of 500 characters Send feedback Add this page to\n Info For Me Other health sites Macmillan Cancer Support: Information and support Search for cancer support services near you Enter a place or postcode NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats 2023 NHS 24 v1.1.1.17852

Huntingtons disease

"Huntington's disease | NHS inform | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotlands Service Directory 0 Home Illnesses and conditions Brain, nerves and spinal cord Huntingtons disease Huntingtons disease Huntingtons disease is a condition that damages nerve cells in the brain causing them to stop working properly. Its passed on (inherited) from a persons parents. The damage to the brain gets worse over time. It can affect movement, cognition (perception, awareness, thinking, judgement) and mental health. Symptoms of Huntingtons disease People can start to show the symptoms of Huntingtons disease at almost any age. Most will develop problems between the ages of 30 and 50. The condition gradually gets worse for around 10-25 years, until the person dies. Early symptoms Behavioural changes are often the first symptoms of Huntingtons disease. These changes often include: a lack of emotions and not recognising the needs of others periods of aggression, excitement, depression , antisocial behaviour and anger apathy causing a person to appear lazy or have a lack of interest in hygiene and self care difficulty concentrating on more than one task and handling complex situations irritability and impulsiveness Speak to your GP if: youre worried you might have early symptoms of Huntingtons disease, especially if theres a history of the condition in your family Later symptoms Further symptoms of Huntingtons might include: psychiatric problems some people develop obsessive behaviours , delusional thoughts or behaviours, stubborness, lack of self awareness, or suicidal thoughts uncontrollable movements of the face, jerking, clicking or fidgety movements of the limbs and body difficulty eating because the mouth and throat muscles dont work properly which can lead to choking and chest infections communication problems difficulty putting thoughts into words and slurring of speech sexual problems a loss of interest in sex or making inappropriate sexual demands balance problems In the later stages of Huntingtons disease, the person will need full nursing care. Death is usually from a secondary cause, like pneumonia or another infection. You might find the palliative care section useful if youre caring for someone whos dying, or if you want to plan your end of life care. Juvenile Huntingtons disease Juvenile Huntingtons disease is a rare form of the condition that can occur in people under the age of 20. Common signs include: a rapid decline in school performance changes in handwriting problems with movement, such as slowness, stiffness, tremor or muscle twitching (similar to the features of Parkinsons disease ) seizures (fits) Causes of Huntingtons disease Huntingtons disease is caused by a faulty gene. Cells in parts of the brain are very sensitive to the effects of the faulty gene. This makes them function poorly and eventually die. A parent with the Huntingtons disease gene has one good copy of the gene and one faulty copy. This means theres a: 50:50 chance that each of their children will develop Huntingtons disease affected children can pass the gene to children they may have 50:50 chance that each of their children wont develop Huntingtons disease unaffected children cant pass the gene to children they may have Its difficult to predict how old a child will be when they develop the condition if they inherit the abnormal gene. In around 3% of cases of Huntingtons disease, theres no obvious family history of the condition. This could be because relatives with the condition died before they were diagnosed with it. In rare cases, its due to a new fault in the gene that causes Huntingtons disease. Diagnosing Huntingtons disease If you have symptoms of Huntingtons disease, your GP will refer you to a specialist clinician. The specialist will ask about your symptoms to: see if its likely you have Huntingtons disease rule out similar conditions Theyll examine you and test your thinking, eye movements, balance and walking. Theyll find out if you have any involuntary movements, such as chorea (fidgety or jerky movements). Tests to diagnose Huntingtons disease You might have genetic testing to confirm if you have Huntingtons disease if: youre showing symptoms of the condition and it runs in your family your doctor strongly suspects you have the condition Diagnosis is based on the doctor recognising a number of factors like neurological examination, family history and genetic testing. Genetic test The children of someone with Huntingtons disease can take a genetic test after the age of 18 to see whether theyve inherited the faulty gene. Its possible to have the gene change and still be healthy when youre tested. This is known as premanifest Huntingtons disease. If theyve inherited the faulty gene, theyll develop Huntingtons disease, but its not possible to work out when. You can ask your GP or neurologist for an appointment at a genetic clinic. Youll receive some counselling and blood samples will be taken. Your DNA from the blood samples will be analysed to see whether you have inherited the faulty gene. Scottish Huntingtons Association has a national youth service to help and support children and young people who are living within a Huntingtons family. Brain scan In the early stages of Huntingtons disease, there may not be any specific changes on the brain scan. A doctor might use a brain scan if theyre concerned there may be other problems in addition to Huntingtons disease. A brain scan may involve having a computerised tomography (CT scan) or a magnetic resonance imaging (MRI) scan . Getting tested in pregnancy If youre pregnant and know you have the Huntingtons disease gene, its possible for your unborn baby to be tested during pregnancy at 11 weeks. You can discuss this with a genetic counselling team. Preimplantation genetic diagnosis Preimplantation genetic diagnosis can be used when one partner is known to have or is at risk of having the faulty gene. It involves having in vitro fertilisation (IVF) treatment. The embryo is genetically tested to make sure it doesnt have the faulty gene before being implanted into the womb. Should I get tested? Not everyone wants to know if theyve inherited the faulty gene. Its a personal choice. Some people say they would rather not know because they want to enjoy their life and they may die of other causes before the condition develops. If youre considering genetic testing, your GP will refer you to a genetic counsellor first. Treating Huntingtons disease Theres no cure for Huntingtons disease. Medication and therapies can help treat some of the symptoms. Speech and language therapy and occupational therapy, can help with communication and day-to-day living. Regular exercise is also very important. People who are active tend to feel much better physically and mentally than those who dont. Medication for Huntingtons disease Most of these medications have side effects, like tiredness. It can sometimes be difficult to tell if the side effects are symptoms of the condition or a result of the medication. Antidepressants to treat depression Antidepressants can help improve mood swings and treat depression . Mood stabilisers to treat irritability or mood swings Mood stabilisers may be considered as a treatment for irritability. Some mood stabilizers cant be used during pregnancy. Medication to suppress involuntary movements Medication can suppress involuntary movements. In the UK, antipsychotic medicines are usually preferred. Antipsychotic medication might help control delusions and violent outbursts, but they can have severe side effects, such as: stiffness and rigidity sedation moving slowly Living with Huntingtons disease Help is available to assist people with Huntingtons disease in their day-to-day life. This might include physiotherapy, occupational therapy and speech therapy. Daily routines such as getting dressed and eating meals can be frustrating and exhausting. The types of help outlined below aim to ease the strain of the condition by improving skills that may deteriorate. Help with communication Speech and language therapy can improve communication skills, and memory. It can help with swallowing problems . Communication aids can sometimes be helpful, as they allow communication without the need for talking. For example, you can point to symbols on a chart to show your mood or whether youre hungry. The family of someone with Huntingtons disease can try alternative ways of communicating if speech is a problem. Help with mealtimes People with Huntingtons disease might need to have a high-calorie diet. A dietitian can help you work out an appropriate diet plan. Food should be easy to chew, swallow and digest. It can be cut into small pieces or pured to prevent choking. Feeding equipment like special straws and non-slip mats can help. At some point, you might be offered a feeding tube that goes into the stomach. If a person doesnt want to be artificially fed, they should tell their family and doctor. They may want to consider making an advance decision (a living will) or a statement of wishes and preferences. Occupational therapy An occupational therapist (OT) can help with day-to-day activities. Your home can be adapted by social services to make life easier for a person with Huntingtons disease. You might also need to think about wheelchair access. Read more about occupational therapy and how it can help. Physiotherapy A physiotherapist can help with mobility and balance. It uses a range of treatments, including manipulation, massage, exercise, electrotherapy and hydrotherapy. You may be referred to a physiotherapist through your GP or social services. Current research Research is underway to find disease-modifying medication and new treatments for Huntingtons disease. Progress has been made in identifying potential ways of slowing down or halting the condition by switching off the faulty gene that causes Huntingtons disease. Speak to your healthcare professional if youre interested in taking part in research for Huntingtons disease. Financial information and support Its worth finding out what benefits you may be entitled to if you have Huntingtons disease, or if youre looking after someone with the condition. The Scottish Huntingtons Association Financial Wellbeing Service provides information, confidential advice and support to people living with Huntingtons disease. You can also contact the Citizens Advice Bureau (CAB) Read more about benefits if you need care, and carers benefits Driving A person diagnosed with Huntingtons disease whos started to experience symptoms should inform the Driver and Vehicle Licensing Agency (DVLA). The condition will affect their ability to drive. The DVLA will write to your doctor, with your permission, to ask for their opinion about your condition. Based on that information, theyll decide whether you can still drive and for how long before another assessment is needed. Theres no need to tell the DVLA if youre carrying the faulty gene but havent yet developed symptoms. You can view the National Care Framework for Huntingtons Disease on the Scottish Huntingtons Association (SHA) website. The SHA employs Huntingtons Disease (HD) Specialists in many areas of Scotland who work as part of multi-disciplinary teams along with HD Clinical Leads , physiotherapy, occupational therapy and speech therapy. Source: Scottish Government - Opens in new browser window Last updated: 14 March 2024 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Dont include personal information e.g. name, location or any personal health conditions. Email Address e.g. [email protected] Message Maximum of 500 characters Send feedback Add this page to\n Info For Me Other health sites Scottish Huntington's Association NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats 2023 NHS 24 v1.1.1.17852"

Hyperglycaemia (high blood sugar)

Hyperglycaemia (high blood sugar) | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotlands Service Directory 0 Home Illnesses and conditions Blood and lymph Hyperglycaemia (high blood sugar) Hyperglycaemia (high blood sugar) Hyperglycaemia (high blood sugar)can affect people with type 1 diabetes and type 2 diabetes , as well as pregnant women with gestational diabetes. It can occasionally affect people who dont have diabetes, but usually only people who are seriously ill, such as those who have recently had a stroke or heart attack , or have a severe infection. Hyperglycaemia shouldnt be confused with hypoglycaemia , which is when a persons blood sugar level drops too low. This information focuses on hyperglycaemia in people with diabetes. Ishyperglycaemia serious? The aim of diabetes treatment is to keep blood sugar levels as near to normal as possible. But if you have diabetes, no matter how careful you are, youre likely to experience hyperglycaemia at some point. Its important to be able to recognise and treat hyperglycaemia, as it can lead to serious health problems if left untreated. Occasional mild episodes arent usually a cause for concern and can be treated quite easily or may return to normal on their own. However, hyperglycaemia can be potentially dangerous if blood sugar levels become very high or stay high for long periods. Very high blood sugar levels can cause life-threatening complications, such as: diabetic ketoacidosis (DKA) a condition caused by the body needing to break down fat as a source of energy, which can lead to a diabetic coma; this tends to affect people with type 1 diabetes hyperosmolar hyperglycaemic state (HHS) severe dehydration caused by the bodytrying to get rid of excess sugar; this tends to affect people with type 2 diabetes Regularly having high blood sugar levels for long periods of time (over months or years) can result in permanent damage to parts of the body such as the eyes, nerves, kidneys and blood vessels. If you experience hyperglycaemia regularly, speak to your doctor or diabetes care team. You may need to change your treatment or lifestyle to keep your blood sugar levels within a healthy range. Symptoms of hyperglycaemia Symptoms of hyperglycaemia in people with diabetestend to develop slowly over a few days or weeks. In some cases, there may be no symptoms until the blood sugar level is very high. Symptoms of hyperglycaemia include: increased thirst and a dry mouth needing topee frequently tiredness blurred vision unintentionalweight loss recurrent infections, such as thrush, bladder infections (cystitis) and skin infections Symptoms of hyperglycaemia can also be due to undiagnosed diabetes, so see your GP if this applies to you. You can have a test to check for the condition. Whatshouldmy bloodsugar level be? When youre first diagnosed with diabetes, your diabetes care teamwill usually tell you what your bloodsugar level is and what you should aim to get it down to. You may be advised to use a testing device to monitor your blood sugar level regularly at home, or you may have an appointment with a nurse or doctor every few months to see what your level is. Target bloodsugar levels differ for everyone, but generally speaking: if you monitor yourself at home a normal target is 4-7mmol/l before eating and under 8.5-9mmol/l two hours after a meal if youre tested every few months a normal target is below 48mmol/mol (or 6.5% on the older measurement scale) What causes high blood sugar? A variety of things can trigger an increase in blood sugar level in people with diabetes, including: stress an illness, such as a cold eating too much, such as snacking between meals a lack of exercise dehydration missing a dose of your diabetes medication, or takingan incorrect dose over-treating an episode of hypoglycaemia (low blood sugar) taking certain medicines, such as steroid medication Occasional episodes of hyperglycaemia can also occur in children and young adultsduring growth spurts. Treating hyperglycaemia If youve been diagnosed with diabetes and you have symptoms of hyperglycaemia, follow the advice your care teamhas givenyou to reduce your blood sugar level. If youre not sure what to do, contact your GP or care team. You may be advised to: change your diet for example, you may be advised to avoid foods that cause yourblood sugar levels to rise, such as cakes or sugary drinks drink plenty of sugar-free fluids this can help if youre dehydrated exercise more often gentle, regular exercise such as walking can often lower your blood sugar level, particularly if it helps you lose weight if you use insulin, adjust your dose your care team can give you specific advice about how to do this You may also be advised to monitor your blood sugar level more closely, or test your blood or urine for substances called ketones (associated with diabetic ketoacidosis). Until your blood sugar level is back under control,watch out for additional symptoms that could be a sign of a more serious condition (see below). When to geturgent medical attention Contactyour diabetes care team immediatelyif you have a high blood sugar level and experience the following symptoms: feeling or being sick abdominal (tummy) pain rapid, deepbreathing signs ofdehydration , such as a headache , dry skin and a weak, rapid heartbeat difficulty staying awake These symptomscould be a sign of diabetic ketoacidosis or a hyperosmolar hyperglycaemic state (see above) and you may need to be looked after in hospital. How to prevent hyperglycaemia There are simple ways to reduce your risk ofsevere or prolonged hyperglycaemia: Be carefulwhat you eat be particularly aware of how snacking and eatingsugary foodsor carbohydrates can affect your blood sugar level. Stick to yourtreatment plan remember to take your insulinor otherdiabetes medications as recommended by your care team. Be as active as possible getting regular exercise can help stop your blood sugar level rising, but you should check with your doctor first if youre taking diabetes medication, as some medicines can lead to hypoglycaemia if you exercise too much Take extra care when youre ill your care team can provide you with some sick day rules thatoutline what you can do to keep your blood sugar level under control during an illness. Monitor your blood sugar level your care team may suggest using a device to check your level at home, so you can spot an increase early and take steps tostop it. Source: NHS 24 - Opens in new browser window Last updated: 17 January 2023 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Dont include personal information e.g. name, location or any personal health conditions. Email Address e.g. [email protected] Message Maximum of 500 characters Send feedback Add this page to\n Info For Me Also on NHS inform Hypoglycaemia (low blood sugar)r Type 2 diabetes Other health sites Diabetes.co.uk: hyperglycaemia Diabetes UK: hypos and hypers NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats 2023 NHS 24 v1.1.1.17852

Hyperhidrosis

Hyperhidrosis | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotlands Service Directory 0 Home Illnesses and conditions Skin, hair and nails Hyperhidrosis Hyperhidrosis About hyperhidrosis Causes of hyperhidrosis Treating hyperhidrosis Complications of hyperhidrosis About hyperhidrosis Hyperhidrosis is a common condition in which a person sweats excessively. The sweating may affect the whole of your body, or it may only affect certain areas.Commonly affected areas includethe: armpits palms of your hands soles of your feet face and chest groin Both sides of the body are usually affected equally for example, both feet or both hands. The sweating doesnt usually pose a serious threat toyour health, but it can be embarrassing and distressing. It can also have a negative impact on your quality of life and may lead tofeelings of depression and anxiety . Read more about the complications of hyperhidrosis . What is excessive sweating? There are no guidelines to determine what normal sweating is, but if you feel you sweattoo muchandyour sweatinghas started to interfere with your everyday daily life, you may have hyperhidrosis. For example, you may have hyperhidrosis if: youavoid physical contact, such as shaking hands,because youfeel self-conscious about your sweating you dont take part in activities, such as dancing or exercise, for fear they will make your sweating worse excessive sweating is interfering with your job for example, you have difficulty holding tools or using a computer keyboard youre having problems with normal daily activities, such as driving youre spending a significant amount of timecoping withsweating for example, frequently showering and changing your clothes you become socially withdrawn and self-conscious When to see your GP Visit your GP if you feel that your sweating is interfering with your daily activities, or you suddenly start sweating excessively. Many people with hyperhidrosis are too embarrassed to seek medical help or believe that nothing can be done to improve it.Buttreatment isavailable. Also visit your GP if you arehavingnight sweats, because it can sometimes be a sign of something more serious. Your GP will usually be able to diagnose hyperhidrosis based on your symptoms, although occasionally you may need blood and urine tests tocheck for an underlying cause (see below). What causes hyperhidrosis? In many cases, hyperhidrosis has no obvious cause and is thought to be the result of a problem with the part of the nervous system that controls sweating. This is known as primary hyperhidrosis. Hyperhidrosis that does have an identifiable cause is known as secondary hyperhidrosis. This can have many different triggers, including: pregnancy or the menopause anxiety certain medications low blood sugar ( hypoglycaemia ) an overactive thyroid gland ( hyperthyroidism ) infections Read more about the causes of hyperhidrosis . How hyperhidrosis is treated Excessive sweating can be challenging to treat and it may take a while to find a treatment right for you. Doctors usually recommend starting with the least invasive treatment first, such as powerful antiperspirants.Lifestyle changesmay also help, including: wearing loose and light clothes avoiding triggers, such as alcohol and spicy foods, that could make your sweating worse wearing black or white clothestohelp minimise the signs of sweating If this doesnt help, you may be advised to try treatments such as iontophoresis (the affected area is treated with a weak electric current passed through water or a wet pad), botulinum toxin injections, and even surgery in a few cases. Hyperhidrosis is usually a long-term condition, but some people experience an improvement with time and the treatments available can often keep the problem under control. Read more about treating hyperhidrosis . Who is affected Hyperhidrosis is common. Its been estimated to affect between 1and 3in every 100 people which means there are likely to be hundreds of thousands of people living with it in the UK. Hyperhidrosis can develop at any age, although primary hyperhidrosis typically starts during childhood or soon after puberty. Causes of hyperhidrosis Hyperhidrosis can be divided into 2types, depending on whether an obvious cause can be identified. These are known as primary and secondary hyperhidrosis. Primary hyperhidrosis Hyperhidrosis that has no obvious cause is known as primary hyperhidrosis. Although its not clearwhy itdevelops, its thought to be the result of a problem with part of the nervous system called the sympathetic nervous system, and its possible your genes may also play a role. The sympathetic nervous system The sympathetic nervous system controls most of your bodys functions that do not require conscious thought, such as movement of food through your body and the movement of urine out of your kidneys and into your bladder. The sympathetic nervous system also acts like a thermostat. If it senses you are getting too hot, it will send a signal from your brain to the millions of sweat glands in your body to produce sweat. The sweat cools on your skin and reduces the temperature of your body. A specific type of sweat gland, known as the eccrine glands, appears to be involved in hyperhidrosis. There are more eccrine glands on your armpits, hands, feet and face, which may explain why these areas are often affected by hyperhidrosis. Its thought that in cases of primary hyperhidrosis, the brain sends signals to the eccrine glands, even though there is no need to cool the body. Genes Some cases of primary hyperhidrosis appear torun in families, which suggests a genetic mutation may be the cause. A genetic mutation is where the instructions in your cells become scrambled, which can disrupt the normal workings of the body. Some genetic mutations can be passed down from parents to their children. Secondary hyperhidrosis If a cause of hyperhidrosis can be identified, its known as secondary hyperhidrosis. Secondary hyperhidrosis can have a number of different triggers, including: pregnancy the menopause when a womans monthly periods stop anxiety low blood sugar ( hypoglycaemia ) an overactive thyroid gland ( hyperthyroidism ) obesity certain medications including some antidepressants ,propranolol, pilocarpine, andbethanechol being drunk or high on drugs, or withdrawing from alcohol or drugs if youhave become addicted to them some infections, such as tuberculosis and HIV Parkinsons disease disorders of the blood cells or bone marrow, such as Hodgkin lymphoma (a cancer of the white blood cells) Secondary hyperhidrosis often starts more suddenly than primary hyperhidrosis and tends to affect the whole body. Treating hyperhidrosis Hyperhidrosis can be challenging to treat and it may take a while to find the best treatment for you. Less invasive treatments will usually be recommended first. Lifestyle changes Changing your lifestyle cannot cure primary hyperhidrosis (hyperhidrosis with no obvious cause), but it can improve your symptoms and help your confidence. The advice below may help. Avoidtriggers that you know make your sweating worse, such as spicy foods and alcohol Use antiperspirant frequently, rather than deodorant Avoid wearing tight, restrictive clothing and man-made fibres, such as nylon Wearing black or white clothing canminimise signs of sweating Armpit shields can absorb excessive sweat and protect your clothes Wear socks that absorb moisture, such as thick socks made of natural fibres, or special soles or sports socks designed to absorb moisture Avoid wearing socks made out of man-made materials and change your socks at least twice a day if possible Ideally wearshoes made of leather, andtry to alternate between different pairs of shoes every day Stronger antiperspirants Ifa regular antiperspirant doesntcontrol your sweating, your GP may prescribeor suggesta stronger one for you. Antiperspirant containing aluminium chloride is often used to treat hyperhidrosis. This works by plugging the sweat glands. You will need to apply it at night just before you go to sleep and wash it off in the morning. The most common side effect of aluminium chloride is mild irritation or itching and tingling where it is applied. Using the antiperspirant less frequently can help reduce irritation. Using emollients (moisturisers) regularly and soap substitutes instead of soap may also help. Anticholinergics You may be prescribed a type of medicine called an anticholinergic or antimuscarinic. These work by blocking the effects of a chemical called acetylcholine, which the nervous system uses to activate the sweat glands. Anticholinergics are available as tablets or solutions that are applied to affected areas. Theyre not widely used to treat hyperhidrosis and most types are not licensed to treat it, but some people find them helpful. Propantheline bromide is an anticholinergic medicine licensed for treating hyperhidrosis. However, anticholinergic medicines unlicensed for hyperhidrosis such as oxybutynin and glycopyrronium bromide can also be prescribed if your doctor feels they might help. Possible side effects of anticholinergics include a dry mouth , blurred vision, stomach cramps, constipation and difficulty passing urine. Referral to a dermatologist If lifestyle changes and treatment dont work, your GP may refer you to a dermatologist (a specialist in treating skin conditions) for further treatment, such as iontophoresis, botulinum toxin or surgery. Iontophoresis Iontophoresismay help if you have excessive sweating that affects your hands or feet. It can also be used to treat armpits, although this is usually less effective. Iontophoresis involves treating affected areas of skin with a weak electric current passed through water or a wet pad. This is thought to help block the sweat glands. If your hands and feet need treating, you place them in a bowl of water and a weak electric current is passed through the water. If your armpits need treating, a wet contact pad is placed against each armpit and a current is passed through the pad. The treatment is not painful but the electric current can cause mild, short-lived discomfort and skin irritation. Each session of iontophoresis lasts between 20 and 30 minutes, and you will usually need to have 2to 4sessions a week. Your symptoms should begin to improve after a week or 2, after which further treatment will be required at 1to 4week intervals, depending on how severe your symptoms are. Iontophoresis is often very effective, although you may need to make regular visits to your local hospitals dermatology clinic to receive treatment. Alternatively, iontophoresis kits that you can use at home may be recommended, with prices in the range of 250-500. Botulinum toxin injections Botulinum toxin can be injected into the skin in areas of the body affected by hyperhidrosis. This helps reduce sweating in these areas by blocking the signals from the brain to the sweat glands. Around 15-20 injections are given in the affected areas of the body, such as the armpits, hands, feet or face. The procedure usually takes about 30-45 minutes in total. The effect of the injections usually lasts for several months, after which time the treatment can be repeated if necessary. Potential side effects ofbotulinum toxin injections include: pain, redness or itching where the injections are given nausea, headaches and hot flushes after the injections are given another part of your body sweating more to make up for treated area known as compensatory sweating muscle weakness around the treatment area Most of these side effects are short-lived or will resolve as the effect of the injections wears off. Availability of botulinum toxin on the NHS can vary widely depending on your clinical commissioning group (CCG), and you may only be able to get it privately. Costs for private treatment depend on the part of the body being treated. For example, injecting the forehead can cost around 150, while treating both armpits could cost up to 450 or more. Surgery and other procedures In a few cases where hyperhidrosis is particularly severe and treatmenthasnt been successful, surgery may be recommended. Endoscopic thoracic sympathectomy (ETS) Endoscopic thoracic sympathectomy (ETS) is the most widely used type of surgery to treat hyperhidrosis. Its usually used in cases affecting the palms or armpits. Small incisions are made in the side of the chest and the nerves that control sweating in the affected area are cut or clipped. This means signals can no longer pass along them to the sweat glands. The operation is carried out under general anaesthetic and done on both sides of the body. The National Institute for Health and Care Excellence (NICE) recommends that ETS can be used to treat excessive sweating of the palms or underarms. However, before the procedure is performed, your clinician should explain: ETScarries a risk of serious complications (see below) its very common for excessive compensatory sweating to occur after the procedure, which causes some people to regret the procedure the procedure is not always successful at reducing sweating For this reason, only people with severe hyperhidrosis which hasnt responded to treatment should be considered. Read the full NICE guidelines on endoscopic thoracic sympathectomy for primary hyperhidrosis of the upper limb . Side effects and complications of ETS can also include: sweating of the face and neck after eating food this is known as gustatory sweating and may affect up to half of people who have the procedure bleeding into the chest during surgery air becoming trapped inside the chest (pneumothorax), which can cause chest pain and breathing difficulties damage to the nervous system that causesthe upper eyelid on one side of the body to droop (Horners syndrome) this may be permanent Removing or destroying sweat glands Excessive sweating under the arms may occasionally be treated with a procedure to remove or destroy the sweat glands in the armpits. This can be carried out in a number of ways: making an incision in the armpit and carefully scraping away (curettage) or cutting out (Shelleys procedure) the sweat glands using a probe held above the skin (no incisions are needed), which emits electromagnetic radiation that destroys the sweat glands inserting a laser device under the skin through a small incision and using it to destroy the sweat glands These procedures are generally carried out under local anaesthetic , which means you will be awake but your armpit will be numbed. These procedures can sometimes be a permanent solution to excessive underarm sweating, although they are only carried out by a small number of practitioners. Availability on the NHS is likely to be very limited and you will probably need to pay for private treatment. These procedures dont work for everyone and some of them are relatively new, which means there isnt always evidence about their long-term safety and effectiveness. Treating anxiety Feelings of anxiety are not directly responsible for causing primary hyperhidrosis, but they can make the situation worse and create a vicious cycle. You may feel self-conscious, which can trigger anxiety in certain situations, such as when meeting new people or being in a crowded room. The anxiety can make the sweating worse. If your anxiety is making your sweating worse, a type of talking therapy called cognitive behavioural therapy (CBT)might help. Medication for anxiety is not usually recommended because it can make sweating worse. Complications of hyperhidrosis Hyperhidrosis doesnt usually pose a serious threat to your health, but it can sometimes lead to physical and emotional problems. Fungal infections Hyperhidrosis increases the risk of developing fungal infections, particularlyon the feet mostcommonly fungal nail infections and athletes foot. This is because excessive sweat combinedwith wearing socks and shoes creates an ideal surrounding for fungi to grow. Fungal infections can be treated with antifungal creams. More severe cases may require antifungal tablets or capsules. Skin conditions Excessive sweat can make you more vulnerable tocertain skin conditions, such as: warts small, rough lumps on the skin that are caused by the HPV virus boils swollen red-yellow bumps in the skin that can develop when a hair follicle becomes infected Eczema canalso be made worse by excessive sweating. Body odour Although people with hyperhidrosis sweat a lot, most dont have problems with body odour. This is because hyperhidrosis doesnt usually affect the sweat glands responsible for producing unpleasant-smelling sweat called the aprocrine sweat glands. However, if bacteria are allowed to break down the sweat, it can start to smell unpleasant. Eating spicy food and drinking alcohol can also make sweat secreted from the eccrine smell. This can be prevented or eased by following lifestyle advice, such as frequently using antiperspirant spray and using armpit shields to absorb sweat. See treating hyperhidrosis for more information. Emotional impact The emotional impact of living with hyperhidrosis can be severe. Many people with the condition feel unhappy and, in some cases, depressed. Signs that you may be depressed include: feeling down, depressed, or hopeless during the past month having little interest or pleasure in things during the past month It is important not to neglect your mental health. Make an appointment to see your GP if you think that you may be depressed. Readmore about depression or find out more abouttackling stress, anxiety and depression. Source: NHS 24 - Opens in new browser window Last updated: 19 January 2023 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Dont include personal information e.g. name, location or any personal health conditions. Email Address e.g. [email protected] Message Maximum of 500 characters Send feedback Add this page to\n Info For Me NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats 2023 NHS 24 v1.1.1.17852

Hypoglycaemia (low blood sugar)

Hypoglycaemia (low blood sugar) | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotlands Service Directory 0 Home Illnesses and conditions Blood and lymph Hypoglycaemia (low blood sugar) Hypoglycaemia (low blood sugar) Introduction Symptoms of hypoglycaemia Causes of hypoglycaemia Treating hypoglycaemia Preventing hypoglycaemia Introduction Hypoglycaemia, or a hypo, is an abnormally low level of glucose in your blood (less than four millimoles per litre). When your glucose (sugar)level is toolow, your body doesnt have enough energy to carry out its activities. Hypoglycaemia is most commonly associated with diabetes , and mainly occurs if someone with diabetes takes too much insulin, misses a meal or exercises too hard. In rare cases, its possible for a person who doesnt have diabetesto experience hypoglycaemia. It can be triggered by malnutrition ,binge drinking or certain conditions, such as Addisons disease . Read more about the causes of hypoglycaemia Symptoms of hypoglycaemia Most people will have some warning that their bloodglucose levels are too low, which gives them time to correct them. Symptoms usually occur when blood sugar levels fall below four millimoles (mmol) per litre. Typical early warning signs are feeling hungry, trembling or shakiness, and sweating. In more severe cases, you may also feel confused and have difficulty concentrating. In very severe cases, a person experiencing hypoglycaemia can lose consciousness. Its also possible for hypoglycaemia to occur during sleep, which can cause excess sweating, disturbed sleep, and feeling tired and confused upon waking. Read more about the symptoms of hypoglycaemia Correcting hypoglycaemia The immediate treatment for hypoglycaemia is to have some food or drink that contains sugar, such as dextrose tablets or fruit juice, to correct your blood glucose levels. After having something sugary, you may need to have a longer-acting starchy carbohydrate food, such asa sandwich or afew biscuits. If hypoglycaemia causes a loss of consciousness, an injection of the hormone glucagon can be given to raise blood glucose levels and restore consciousness. This is onlyif an injection is available and the person giving the injection knows how to use it. You should dial 999 to request an ambulance if: a glucagon injection kit isnt available theres nobody trained to give the injection the injection is ineffective after 10 minutes Never try to put food or drink into the mouth of someone whos drowsy or unconsciousas they could choke.This includes some of the high-sugar preparations specifically designed for smearing inside the cheek. Read more about treating hypoglycaemia Preventing hypoglycaemia If you have diabetes that requires treatment with insulin, the safest wayto avoid hypoglycaemia is to regularly check your blood sugar and learn to recognise the early symptoms. Missing meals or snacks or eating less carbohydrate than planned can increase your risk of hypoglycaemia. You should be careful when drinking alcohol as it can alsocause hypoglycaemia, sometimes many hours after drinking. Exercise or activity is another potential cause, and you should have aplan for dealing with this, such as eating carbohydrate before, during or after exercise, or adjusting your insulin dose. You should also make sure you regularly change where you inject insulinas the amount of insulin your body absorbs can differ depending on where its injected. Always carry rapid-acting carbohydratewith you, such as glucose tablets, a carton of fruit juice (one that contains sugar), or some sweets in case you feel symptoms coming on or your blood glucose level is low. Make sure your friends and family know about your diabetes and the risk of hypoglycaemia. It may also help to carry some form of identification that lets people know about your condition in an emergency. When hypoglycaemia occurs as the result ofan underlying condition other than diabetes, the condition will need to be treated to prevent a further hypo. Read more about preventing hypoglycaemia Symptoms of hypoglycaemia The symptoms of hypoglycaemia usually begin when your blood glucose level drops below four millimoles (mmol) per litre. If you have diabetes ,particularly if its treated with insulin, you may be advised to use a small device called a blood glucose meter toregularly check your blood glucose levels. Symptoms can vary from person to person, and its important to be aware of the early warning signs so you can treat them. Signs and symptoms of hypoglycaemia can include: feeling hungry sweating dizziness tiredness (fatigue) blurred vision trembling or shakiness going pale fast pulse or palpitations tingling lips irritability difficulty concentrating confusion disorderly or irrational behaviour, which may be mistaken for drunkenness If hypoglycaemia isnt treated promptly and your blood glucose levels drop low enough, you may become drowsy or even lose consciousness. Most people with insulin-treated diabetes notice that the symptoms of hypoglycaemia change and become less obvious the longer they live with the condition. For some people, the warning symptoms become greatly reduced, putting them at significant risk of having severe episodes where theyre dependent on others for help. Let your diabetes care team know if you develop this problemas your treatment may need to be changed to reduce the risk. Read more about how hypoglycaemia is treated Hypoglycaemia while sleeping Having ahypo while youre asleep is known as nocturnal hypoglycaemia. Its more common in people who treat diabetes with insulin. Although some people find their sleep is disturbed when they experience nocturnal hypoglycaemia,you may only notice the symptoms when you wake up in the morning. The symptoms ofnocturnal hypoglycaemia can include: headache often likened to having a hangover feeling unusually tired in the morning damp sheets or clothing from sweating Causes of hypoglycaemia In most cases, hypoglycaemia affects people with diabetes , although more rarely it can also occur as a result of other underlying conditions. Hypoglycaemia in people with diabetes Overdose of diabetes medication A common cause of hypoglycaemia is taking too much insulin for your current needs. Insulin is a medication that helps control your blood glucose levels. Its commonly used to treat type 1 diabetes and is also recommended for somepeople with type 2 diabetes . A fall in bloodglucose levels can also occur after taking too much oral hypoglycaemia medication, such as sulphonylurea, which causes a release of insulin. This medication is often usedto lower blood glucose levels in people with type 2 diabetes. Exercise, food and alcohol For people with type 1 diabetes, maintaining the correct blood glucose level involves balancinghow muchinsulin you inject, the amount of food you eat, and how much energy you burn during exercise. Hypoglycaemia may occur if youve taken your dose of insulin as usual, but your carbohydrate intake is lower than normal or has been used up more quickly. This may happen if you delay or miss a meal or snack, dont eat enough carbohydrate, or exercise more than usual. People with diabetes whovedrunk too much alcohol, or drank alcohol on an empty stomach, can also get hypoglycaemia. However, its not always possible to identify why a particular episode of hypoglycaemia has occurred, and sometimes it happens for no obvious reason. Hypoglycaemia in people without diabetes Hypoglycaemia even mild casesis very rare in people who dont have diabetes. The possible causes are outlined below. Reactive hypoglycaemia People without diabetes can sometimes experience hypoglycaemia if their pancreas produces too much insulin after a large carbohydrate-based meal. This is known as reactive hypoglycaemia. Its not clear why this happens, although its thought to be more common in people who are overweight or have had gastric bypass surgery. In rare cases, a benign (non-cancerous) tumour in the pancreas may cause an overproduction of insulin, or the tumour itself may use up too much glucose. Other possible causes Other possible causes of hypoglycaemia in people without diabetes are: fasting or malnutrition where not enough nutrients are consumed for your body to function properly binge drinking or heavy drinking of alcohol Addisons disease a disorder of the adrenal glands (two small glands that sit on top of the kidneys) certain medication hypoglycaemia has been known to occur in people taking quinine (for malaria ), salicylates (for rheumatic disease) and propranolol (for high blood pressure ) severe illnesses affecting the liver, kidneys or thyroid gland Treating hypoglycaemia In most cases, you can treat hypoglycaemia yourself when you recognise the symptoms. Treating an episode of hypoglycaemia The immediate treatment for hypoglycaemia is to have some sugary food or drink (about 15 to 20g of rapidly acting carbohydrate) to end the attack. For example, this could be: a glass of fruit juice or non-diet soft drink between three and five dextrose tablets a handful of sweets At first you should avoid fatty foods and drinks, such as chocolate and milk, because they dont usually contain as much sugar and the sugar they do contain may be absorbed more slowly. After having something sugary, you should have a longer-acting carbohydrate food, such as a few biscuits, a cereal bar, a piece of fruit or a sandwich. It will usually take around 15 minutes to recover from a mild episode of hypoglycaemia. If you have a blood glucose meter, measure your blood sugar again after 15 to 20 minutes. If its still too low (below 4mmol), you should have some more sugary food or a drink before testingyour levelsagain in another 15 to 20minutes. When treating someone else with hypoglycaemia, if the above treatment isnt effective, you may be able to help them by applying glucose gel (or honey, treacle or jam if glucose gel isntavailable) to the inside of their cheeks, and gently massaging the outside of their cheeks. It may take 10 to 15 minutes before they feel better. This shouldnt be done if the person is drowsy or unconscious because of the risk of choking. If you have several episodes of hypoglycaemia a week, you should contact your diabetes care team to find out the underlying cause. Your medication may need to be adjusted, or there may be another condition causing hypoglycaemia that needs to be treated. If a person is unconscious If a person loses consciousnessbecause ofsevere hypoglycaemia, they need to be put into the recovery position and given an injection of the hormone glucagon(if they have an injection kit). The injection will raise their blood glucose level. The injection should be carried out by a friend or family member who knows what theyre doing, or by a trained healthcare professional. You should dial 999 to request an ambulance if: a glucagon injection kit isnt available theres nobody available whos trained to give the injection the injection is ineffective after 10 minutes Never try to put food or drink into the mouth of someone whos unconscious asthey could choke. If youre able to give a glucagon injection and the person regains consciousness, they shouldeat some longer-acting carbohydrate food, such as a few biscuits, a cereal bar or a sandwich. You should continue to monitor the person for signs of recurring symptomsin case they need to be treated again. Preventing hypoglycaemia If you have diabetes, sticking to your medication plan and eating regular meals can help prevent hypoglycaemia. Its also important to monitor your blood glucose levels. Monitoring blood glucose Regularlymonitoring your blood glucose levelscan help you keep your blood glucose as normal and stable as possible, and will help you spot the signs and symptoms of hypoglycaemia quickly. Your blood glucose level can vary throughout the day, so you may need to check it several times a day, depending on the treatment youre taking. You canmonitor your blood glucose levels using a blood glucose meter, a small device that measures the concentration of glucose in your blood. Read more about living with type 1 diabetes and living with type 2 diabetes Food and alcohol If you have diabetes, strenuous physical activity can lead to hypoglycaemia. Eating extra carbohydrate-based foods before and during exercise can help reducethe chances of this happening. If youre taking insulin, your doctor may advise you to lower your dose beforeyou dostrenuous physical activity. Alcohol can also affect your bodys ability to release glucose. If you have type 1 diabetes , its recommended that you drink no more than 2 to 3 units of alcohol a day and eat a snack after drinking alcohol. Spotting the signs As hypoglycaemia can develop suddenly, its important to be aware of the symptoms of hypoglycaemia so you can treat it quickly. Tell your family and friends about the signs to look outfor andlet them know how to treat it. People with diabetes are advised to carry a form of identification with them that states their condition so they can be helped quickly and efficiently. Keep treatment with you If youre at risk of hypoglycaemia, you should carry sugary food and drink with you at all times to treat mild cases as soon as possible. If you have diabetes, particularly type 1 diabetes, your doctor may recommend medications such as glucose gelto carry with you. This can be used to treat hypoglycaemia that doesnt respond to normal treatment. If youre being treated with insulin, youll usually be given a kit that contains aninjection of a medication called glucagon. Family members or your carer can be trainedto carry out the injection, which should be used if you lose consciousness because ofsevere hypoglycaemia. Preventing hypoglycaemia at night Its important to avoid recurrent hypoglycaemia during the night (nocturnal hypoglycaemia)as it can reduce the early symptoms of daytime episodes. If you experience nocturnal hypoglycaemia, you can try: keeping something sugary by your bedside having a snack before bedtime, such as biscuits and milk checking your blood glucose levels between 3am and 4am, whenhypoglycaemia is most likely to occur Hypoglycaemia and driving As hypoglycaemia can cause confusion, drowsiness, or even unconsciousness, this can present a significant risk to you or other road users. If you have diabetes that requires treatment with insulin, you must: inform the DVLA and your insurance company test your blood sugar before driving and at regular intervals (at least everytwo hours) while driving avoid driving if your blood glucose is low avoid driving for 45 minutes after treating hypoglycaemia carry rapid-acting carbohydrates with you in the vehicle at all times If you experience hypoglycaemia while driving, pull over and stop as soon as its safe to do so. Remove the keys from the ignition and get out of the drivers seat before treating hypoglycaemia in the normal way. If you have two or more episodes of hypoglycaemia that require assistance in a 12-month period, its a legal requirement to stop driving and inform the DVLA. If youre a group two driver (you hold a licence to drive buses, coaches or lorries), youre legally required to stop driving group two vehicles immediately and inform the DVLA if you have a single episode of hypoglycaemia that requires assistance. Inform your diabetes care team if you start having problems recognising hypoglycaemia or you start to have more regular episodes, evenif there werewarning symptoms and you were able to treat them without assistance. See theGOV.UK website for more information about hypoglycaemia and driving Source: NHS 24 - Opens in new browser window Last updated: 09 November 2023 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Dont include personal information e.g. name, location or any personal health conditions. Email Address e.g. [email protected] Message Maximum of 500 characters Send feedback Add this page to\n Info For Me Also on NHS inform Type 2 diabetes Other health sites Diabetes.co.uk: diabetes and hypoglycaemia Diabetes UK: hypos and hypers NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats 2023 NHS 24 v1.1.1.17852

Idiopathic pulmonary fibrosis

Idiopathic pulmonary fibrosis (IPF) | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotlands Service Directory 0 Home Illnesses and conditions Lungs and airways Idiopathic pulmonary fibrosis Idiopathic pulmonary fibrosis About idiopathic pulmonary fibrosis Symptoms of idiopathic pulmonary fibrosis Causes of idiopathic pulmonary fibrosis Diagnosing idiopathic pulmonary fibrosis Treating idiopathic pulmonary fibrosis About idiopathic pulmonary fibrosis Idiopathic pulmonary fibrosis (IPF) is a condition in which the lungs become scarred and breathing becomes increasingly difficult. Its not clear what causes it, but it usually affects people around 70-75 years of age and is rare in people under 50. Several treatments can help reduce the rate at which IPF gets worse, but theres currently no treatment that can stop or reverse the scarring of the lungs. Symptoms of idiopathic pulmonary fibrosis The symptoms of IPF tend to develop gradually and get slowly worse over time. Symptoms can include: shortness of breath a persistent dry cough tiredness loss of appetite andweight loss rounded and swollenfingertips (clubbed fingers) Many people ignore their breathlessness at first and blame it on getting old or being out of shape. But eventually even light activity such as getting dressed can cause shortness of breath. When to get medical advice See your GP if youve struggled with your breathing for a while or have had a cough for more than three weeks. These symptoms arent normal and shouldnt be ignored. If your GP thinks you could have a lung condition such as IPF, they can refer you to a hospital specialist for tests such as: breathing (lung function) tests blood tests a chest X-ray and computerised tomography (CT) scan a lung biopsy (where a small piece of lung tissue is removed during keyhole surgery so it can be analysed) Read more about the tests for idiopathic pulmonary fibrosis . Causes of idiopathic pulmonary fibrosis In people with IPF,thetiny air sacs in the lungs(alveoli) become damaged and increasingly scarred. This causes the lungsto become stiff and means its difficult for oxygen to get intothe blood. The reason this happens isnt clear. Idiopathic means the cause is unknown. IPF has been linked to: exposure to certain types of dust, such as metal or wood dust viral infections a family history of IPF around 1 in 20 people with IPF has another family member with the condition gastro-oesophageal reflux disease (GORD) smoking But its not known whether some of these factors directly cause IPF. Treatments for idiopathic pulmonary fibrosis Theres currently no cure for IPF, but there are several treatments that can help relieve the symptoms and slowdown its progression. Treatments include: self-care measures such as stopping smoking, eating healthily and exercising regularly medication to reduce the rate at which scarring worsens such as pirfenidone and nintedanib breathing oxygen through a mask you can do this while youre at home and/or while youre out and about pulmonary rehabilitationexercises and advice to help you breathe more easily a lung transplant this is suitable in a few cases,although donor lungs are rare Read more about how idiopathic pulmonary fibrosis is treated . Outlook for idiopathic pulmonary fibrosis IPFgets worse over time, although the speed at which this happens is highly variable. Some people respond well to treatment and remain relatively free of symptoms for many years, while others may get rapidly worse or find the breathlessness debilitating. Other problems can also sometimes develop, including chest infections , pulmonary hypertension and heart failure . Itsvery difficultto predicthow long someone with IPF will survive at the time of diagnosis. Regular monitoring over time can indicate whether its getting worse quickly or slowly. Before the availability of specific treatments like pirfenidone and nintedanib about half of people with IPF lived at least three years from their diagnosis. Around 1 in 5 survived for more than five years. Its hoped these figures will be improved by the availability of new treatments to slow the diseases progression. Symptoms of idiopathic pulmonary fibrosis The most common symptom of idiopathic pulmonary fibrosis (IPF) is shortness of breath, often when physically active, which can get worse over time. At first, many people ignore theirbreathlessness (especially older patients) and blame it on getting old or being out of shape.But as the disease progresses and lung damagebecomes more severe, even light activitylike getting dressed or having a shower can cause breathlessness. Other symptoms of pulmonary fibrosis include: a persistent dry cough tiredness loss of appetite andweight loss In up to half of all cases, there is also a change in the shape of the finger and toenails. This thickening of tissue at the base of the finger and toenails is known as digital clubbing. The exact cause of clubbing is unknown, but it can occur in people with various chest and heart diseases. Secondary conditions The strain IPF can place on your lungs and your heart can trigger a number of secondary conditions, outlined below. Chest infection You will have an increased risk of developing chest and airway infections such as: bronchitis an infection of the airway of the lungs pneumonia an infection of the air sacs of your lungs influenza (flu) Symptoms of a chest infection include: worsening breathlessness chest pain a high temperature (fever) of 38C (100.4F) or above sweating and shivering Pulmonary hypertension Around a third of people with IPF will also go on to develop pulmonary hypertension . Pulmonary hypertension is when blood pressure inside the arteries connecting the lungs to the heart is dangerously high. Symptoms of pulmonary hypertension include: dizziness feeling faint chest pain (angina) a racing heartbeat (tachycardia) Read more about symptoms of pulmonary hypertension . Heart failure Heart failure , where the heart is unable to pump enough blood around the body, can develop when IPF becomes severe. This is due to a combination of factors, including a build-up of blood in the right side of the heart (the side that pumps blood to the lungs), which develops because it is difficult to pump blood through the scarred lung tissue. The poor supply of oxygen from the diseased lungs to the heart muscle also contributes to heart failure. Heart failure can cause various symptoms, including: worsening breathlessness extreme tiredness and weakness swelling in the legs, ankles and feet (oedema) caused by a build-up of fluid Read more about the symptoms of heart failure . Causes of idiopathic pulmonary fibrosis The exact cause of idiopathic pulmonary fibrosis (IPF) is not known. Idiopathic means having no known cause. The current theory is that IPF is triggered when cells that line the lung alveoli (air sacs) become damaged by exposure toone of severalsubstances or viruses. The damaged cells try to repair themselves but the process becomes uncontrolled, resulting in thickening and scarring (fibrosis) of the alveoli and surrounding lung tissue. The amount of oxygen that can pass from the lungs into the blood is then significantly reduced. Triggers A number of factors have been suggested as possible triggers for the initial damage to the cells lining the alveoli. Most experts agree that the two most significant risk factors are: being a smoker or having smoked in the past occupational exposure to certain types of dust jobs that involve working with wood, metal, textile, stone, cattle or farming mayincrease the risk of IPF Other possible risk factors include: viral infections such as the Epstein-Barr virus or hepatitis C gastro-oesophageal reflux disease (GORD) (where the acid from your stomach rises back up into your throat) this may be accidentally inhaled into the lungs, causing damage to the alveoli chronic aspiration where food, drink or saliva enter the lungs and is not coughed back up, often due to a related condition environmental pollutants or dust genetic tendency the condition appears to run in some families but this only seems to be the case in around 5% of people with IPF As IPF is such a rare condition it is hard to estimate how much of an impact these risk factors can have on your chance of developing it. Diagnosing idiopathic pulmonary fibrosis Idiopathic pulmonary fibrosis (IPF) can be hard to diagnose because its symptoms are similar to other lung conditions, such as chronic obstructive pulmonary disease (COPD) . Your GPcan refer you to hospital specialists for a number of tests to help rule out other conditions and confirm the diagnosis. The checks and tests you may have include: Medical history and examination Breathing and blood tests Chest X-ray and CT scan Bronchoscopy Lung biopsy Medical history and examination Your doctor will ask about your medical history and whether there are other factors that could be causing a problem with your lungs, such as whether you: smoke or have smoked in the past have been exposed to harmful substances at work, such as asbestos haveother medical conditions They may also: check the sound of your breathing through a stethoscope a crackling sound can suggest lung scarring (fibrosis) look at your fingers to see if the ends are swollen (finger clubbing) ask you to walk around for a few minutes to see if you become breathless Breathing and blood tests Lung function tests (also called pulmonary function tests) assess how well your lungs work and can help indicate what the problem may be. These tests measure: how quickly you can move air in and out of your lungs how much airyour lungscan hold how wellyour lungstransfer oxygen into your blood andremove carbon dioxide from it (this can be checked using a blood test ) A commonly used lung function test is spirometry. During the test, you breathe into a mouthpiece thats attached to a monitor. Chest X-ray and CT scan A chest X-ray doesnt show the lungs in much detail, but it can help doctors spot some more obvious problems that could be causing your symptoms,such as cancer or a build-up of fluid. If IPF is suspected, the chest x-ray will be followed by a computerised tomography (CT) scan . A CT scan is similar to an X-ray,but lots more images are taken and these are put together by a computer to create a more detailed image of your lungs. This can help your doctor spot signs of scarring in your lungs. Bronchoscopy If doctors still arent sure what the problem is after the tests described above, they may suggest having abronchoscopy. This is a test where a narrow, flexible tube with a camera (bronchoscope) is passed down into your airways. Your doctor can then look for anything abnormal and can take small tissue samples for testing. Youll usually be awake for a bronchoscopy and it may cause coughing. Local anaesthetic will be used to numb your throat so it doesnt hurt and you may also be given a sedative injection which will make you feel sleepy during the procedure. Lung biopsy If other tests arent conclusive, a lung biopsy may need to be carried out. This involves keyhole surgery to remove a small sample of lung tissue so it can be analysed for signs of scarring. The procedure is performed under a general anaesthetic (where youre asleep).Your surgeon makes several small incisions (cuts) in your side and an endoscope (a thin tube with a camera and a light at the end) is inserted into the area between the lungs and the chest wall. The surgeon can see the lung tissue through the endoscope and is able obtain a small sample. Treating idiopathic pulmonary fibrosis Theres currently no cure for idiopathic pulmonary fibrosis (IPF). The main aim of treatment is to relieve the symptoms as much as possible and slow down its progression. The main treatments are: Self-care Medication Oxygen support Pulmonary rehabilitation Lung transplant As the condition becomes more advanced, end of life (palliative) care will be offered. Self-care There are several things you can do to stay as healthy as possible if you have IPF. These include: stopping smoking if you smoke exercise regularly and stay as fit as you can eat a healthy, balanced diet make sure yougettheannual flu jaband one-offpneumococcal vaccination these infections can be more serious if you have a lung condition try to keep away from people with chest infections and colds whenever possible Medication There are two medications that can help slow down the progression of IPF in some people:pirfenidone and nintedanib. Some people also take a medication calledN-acetylcysteine, although its benefits are uncertain. Pirfenidone Pirfenidone helps to slow the development of scarring in the lungs by reducing the activity ofthe immune system. Its normally taken as capsules three times a day. Its recommended if breathing tests have shownyour lung capacity is 50-80% of what would normally be expected. If your condition gets worse despite takingpirfenidone and your lung capacity falls by 10% or more within a year,the medication will usuallybe stopped. Side effects of pirfenidone can include: feeling sick tiredness diarrhoea indigestion a rash caused byexposure to sunlight For further information see, theNational Institute for Health and Care Excellence (NICE) guidelines on pirfenidone for idiopathic pulmonary fibrosis . Nintedanib Nintedanib is a newer medication that can also help slow down scarring of the lungs in some people with IPF.Its normally taken as capsules twice a day. Likepirfenidone, it may beused if you havea lung capacity 50-80% of what would normally be expected and should be stopped if your lung capacity falls by 10% or more in a year while taking it. Side effects ofnintedanib can include: diarrhoea feeling and being sick abdominal (tummy) pain loss of appetite and weight loss For further information, see the NICE guidelines on nintedanib for idiopathic pulmonary fibrosis . N-acetylcysteine N-acetylcysteine is whats known as an antioxidant. Itsavailable from many health shopsand is usually taken as tablets. There is some limited evidence to suggest itmay reduce the amount of scar tissue in the lungs, althoughother studies have not shown any benefit. If youre considering taking N-acetylcysteine, you should check with your specialist firstas it may not be safe or suitable for everyone with IPF. Oxygen support IPF can causelevels of oxygen inyour blood fall, which can make you feel more breathless. If this happens, oxygen treatmentcan help with your breathing and allow you to be more active. Oxygen is taken through nasal tubes or a maskattached to a small machine. This device provides a much higher level of oxygenthan the air. The tubes from the machine are long, so youll be able to move around your home while connected. Read further about home oxygen treatment . Portable oxygendevices that you can usewhile youre out and about are also available. Pulmonary rehabilitation Pulmonary rehabilitation is used for many long-term lung conditions and aims to help patients come to terms with their condition, learn the best ways to deal with it and improve their ability to function on a daily basis withoutsevere breathlessness. Courses in pulmonary rehabilitation are usually held locally and may involve: education about pulmonary fibrosis physical activity breathing exercises advice on nutrition psychological support a social support network Lung transplant If your condition continues to get worse despite treatment, your specialist may recommend a lung transplant . The decision to have a transplant will be based on: how bad your condition is how quickly your condition is getting worse your age and general health how much your condition is likely to improve after a transplant whether a donor lung is available A lung transplant can significantly improve life expectancy in people with IPF, although its a major procedure that puts a great strain on the body. Few people with idiopathic pulmonary fibrosis are suitable candidates for a transplant and donor lungs are scarce. Palliative care If youre told there is nothing more that can be done to treat your IPF or you decide to decline treatment, your GP or care team will provide you with support and treatment to relieve your symptoms. This is called palliative care. You can choose to receive palliative care: at home in a care home in hospital in a hospice Your doctor or care team should work with you to establish a clear plan based on your wishes. For further information see End of life care . Source: NHS 24 - Opens in new browser window Last updated: 13 February 2023 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Dont include personal information e.g. name, location or any personal health conditions. Email Address e.g. [email protected] Message Maximum of 500 characters Send feedback Add this page to\n Info For Me Also on NHS inform Asbestos-related compensation claims NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats 2023 NHS 24 v1.1.1.17852

Impetigo

Impetigo | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotlands Service Directory 0 Home Illnesses and conditions Infections and poisoning Impetigo Impetigo About impetigo Symptoms of impetigo Causes of impetigo Treating impetigo Complications of impetigo Preventing impetigo About impetigo Impetigo is a common and highly contagious skin infection that causes sores and blisters. Its not usually serious and often improves within a week of treatment or within a few weeks without treatment. Impetigois the most common skin infection in young children in the UK, but it can affect people of all ages. Symptoms of impetigo There are 2 types of impetigo: non-bullous impetigo the most common type bullous impetigo Non-bullous impetigo The symptoms of non-bullous impetigo begin with the appearance of red sores usually around the nose and mouth but other areas of the face and the limbs can also be affected. The sores quickly burst leaving behind thick, golden crusts typically around 2cm across. The appearance of these crusts is sometimes likened to cornflakes stuck to the skin. After the crusts dry, they leave a red mark that usually fades without scarring. The time it takes for the redness to disappear can vary between a few days and a few weeks. The sores arent painful, but they may be itchy. Its important not to touch or scratch the sores because this can spread the infection to other parts of the body, and to other people. Other symptoms, such as a high temperature (fever) and swollen glands , are rare but can occur in more severe cases. Bullous impetigo The symptoms of bullous impetigo begin with the appearance of fluid-filled blisters (bullae) which usually occur on the central part of the body between the waist and neck, or on the arms and legs. The blisters are usually about 1cm to 2cm across. The blisters may quickly spread, before bursting after several days to leave a yellow crust that usually heals without leaving any scarring. The blisters may be painful and the area of skin surrounding them may be itchy. As with non-bullous impetigo, its important not totouch or scratch the affected areas of the skin. Symptoms of fever and swollen glands are more common in cases of bullous impetigo. When to get professionaladvice Pharmacy First Scotland: Impetigo treatment from your local pharmacy Adults and children over 2 years with impetigo can get advice and treatment directly from a pharmacy. Find your local pharmacy on Scotlands Service directory. Search for a pharmacy near you Impetigo isnt usually serious and can be treated by a pharmacist. Your pharmacist may recommend that you contact your GP practice if required. Causes of impetigo Impetigo occurs when the skin becomes infected with bacteria, usually eitherStaphylococcus aureus orStreptococcus pyogenes. The bacteria can infect the skin in 2 main ways: through a break in otherwise healthy skin such as a cut , insect bite or other injury this is known as primary impetigo through skin damaged by another underlying skin condition, such as head lice , scabies or eczema this is known as secondary impetigo The bacteria can be spread easily through close contact with someone who has the infection, such as through direct physical contact, or by sharing towels or flannels. As the condition doesnt cause any symptoms until 4 to 10 days after initial exposure to the bacteria, its often easily spread to others unintentionally. Children and peoplewith diabetes or a weakened immune system either due to a condition such as HIV or a treatment such as chemotherapy are most at risk of developing impetigo. Treating impetigo Impetigousually gets better without treatment in around 2 to 3 weeks. However, treatment is often recommended because it can reduce the length of the illness to around seven to 10 days and canlower therisk of the infection being spread to others. The main treatments prescribed are antibiotic creams or antibiotic tablets. These usually have to be used for around a week. Read about treating impetigo . Preventing the spread of impetigo During treatment, its important to take precautions to minimise the risk of impetigo spreading to other people or to other areas of the body. Most people are no longer contagious after 48 hours of treatment or once their sores have dried and healed. Its important tostay away from work, school, nursery or playgroup until thispoint. The advice below can alsohelp to prevent the spread of the infection: do not share flannels, sheets or towels with anyone who has impetigo wash them at a high temperature after use wash the sores with soap and water and cover them loosely with a gauze bandage or clothing avoidtouching or scratching the sores, or letting others touch them it may help to ensure your nails are kept clean and short avoid contact with newborn babies, preparing food, playing contact sports, or going to the gym until the risk of infection has passed wash your hands frequently particularly after touching infected skin washable toys should also be washed wipe non-washable soft toys thoroughly with a cloth that has been wrung out in detergent and warm water and allowed to dry completely If you think that the infection has spread to someone else, make sure theyre seen by a pharmacist as soon as possible. Preventing recurrentimpetigo Toreduce the risk of impetigo returning, make sure any cuts, scratches or bites are kept clean. Ensure any condition that causes broken skin, such as eczema, is treated promptly. If you develop impetigo frequently, your doctor may suggest taking a swab from around your nose to see if you carry staphylococcal bacteria. These bacteria can live in the noses of some people without causing problems, although they can lead to impetigo if they infect broken skin nearby. If youre found to carry these bacteria,you may be prescribed an antisepticnasal cream to apply several times a day for 5 to 10 days in an attempt to clear the bacteria and reduce the chances of impetigo recurring. Complications of impetigo Complications of impetigo are rare, but they can sometimes occur and can be serious. Tell your pharmacist if you have impetigo and your symptoms change or get worse. Some complications associated with impetigo include: cellulitis an infection of the deeper layers of the skin and underlying tissue scarlet fever a rare bacterial infection that causes a fine, pink rash across the body guttate psoriasis a non-infectious skin condition that can develop in children and teenagers after a bacterial infection septicaemia (a type of sepsis ) a bacterial infection of the blood Staphylococcal scalded skin syndrome (SSSS)a serious skin condition that looks like the skin has been scalded with boiling water post-streptococcalglomerulonephritis an infection of the small blood vessels in the kidneys In very rare cases,impetigo may lead to some scarring, particularly if you scratch at the blisters, crusts or sores Symptoms of impetigo Impetigo does not cause any symptoms until 4 to 10 days after you first become infected. This means that people can easily pass the infection on to others without realising it. There are 2 main types of impetigo, known as non-bullous and bullous impetigo, which have different symptoms. Most people with impetigo have the non-bullous type. Non-bullous impetigo The symptoms of non-bullous impetigo begin with the appearance of red sores usually around the nose and mouth but other areas of the face and the limbs can also be affected. The sores quickly burst leaving behind thick, golden crusts typically around 2cm across. The appearance of these crusts is sometimes likened to cornflakes stuck to the skin. After the crusts dry, they leave a red mark that usually heals without scarring. The time it takes for the redness to disappear can vary between a few days and a few weeks. The sores are not painful, but they may be itchy. It is important not to touch, or scratch, the sores because this can spread the infection to other parts of your body, and to other people. Other symptoms, such as a high temperature (fever) and swollen glands , are rare but can occur in more severe cases. Bullous impetigo The symptoms of bullous impetigo begin with the appearance of fluid-filled blisters (bullae) which usually occur on the trunk (the central part of the body between the waist and neck) or on the arms and legs. The blisters are usually about 1cm to 2cm across. The blisters may quickly spread, before bursting after several days to leave a yellow crust that usually heals without leaving any scarring. The blisters may be painful and the area of skin surrounding them may be itchy. As with non-bullous impetigo, it is important that you do not touch or scratch the affected areas of the skin. Symptoms of fever and swollen glands are more common in cases of bullous impetigo. Causes of impetigo Impetigo occurs when the skin becomes infected with bacteria, usually either Staphylococcus aureus or Streptococcus pyogenes. These bacteria can infect the skin in 2 ways: through a break in otherwise healthy skin, such asa cut, insect bite or other injury this is known as primary impetigo through skin damaged by another underlying skin condition, such as head lice , scabies or eczema this is known as secondary impetigo The bacteria can be spread easily through close contact with someone who has the infection, such as through direct physical contact, or by sharing towels or flannels. As the condition does not cause any symptoms until 4 to 10 days after initial exposure to the bacteria, it is often easily spread to others unintentionally. Impetigo stops being infectious after 48 hours of treatment starting or after the sores have stopped blistering or crusting. Increased risk In addition to the situations mentioned above, there are a number of other factors that can increase your chances of developing impetigo. These include: being a child impetigo is thought to be more common in children because their immune system has not yet fully developed and because they tend to spend time in places where the infection can easily be spread, such as schools and nurseries having diabetes being a carrier of Staphylococcus aureus bacteria these bacteria can live in the noses of some people without causing problems, but they can sometimes cause impetigo if they get into damaged skin nearby warm and humid weather impetigo tends to be more common during the summer months in the UK, possibly because the warm and moist weather is a better environment for the bacteria to grow and/or because the skin is more likely to be exposed to insect bites and cuts at this time of year having a weakened immune system, either due to a condition such as HIV or a treatment such as chemotherapy Treating impetigo Impetigo isnt usually serious and often clears up without treatment after 2 to 3 weeks. Treatment is often recommended as it can help clear up the infection in around 7 to 10 days and reduce the risk of the infection being passed on to others. If impetigo is confirmed, it can usually be effectively treated with antibiotics . If the infection is being caused by an underlying skin condition, such as eczema , this may also need to be treated. Antibiotic cream For mild cases of impetigo that cover a small area, antibiotic cream is often recommended. This usually needs to be applied 3 or 4 times a day for 7 days. Before applyingthe cream, wash anyaffected areas of skin with warm, soapy water and try to clean off any crusts that have developed. To reduce the risk of spreading the infection, its also important that youwash your hands immediately after applying the cream or, if available, wear latex gloves while applying the cream. Side effects of antibiotic cream can include: irritation redness itchiness in the area where the cream is applied If symptoms havent improvedafter seven days of starting treatment,ask your pharmacist about other possible treatment options. Antibiotic tablets Antibiotic tablets may be prescribedif the infection is more severe and widespread, orif the symptoms dont improve after using antibiotic cream. These usually need to be taken 2 to 4 times a day for 7 days. If a course of oral antibiotics is prescribed for you or your child, its very important that the course is finished even if the symptoms clear up before youve takenallthe tablets. Common side effects of oral antibiotics include: feeling sick vomiting diarrhoea Speak to your pharmacist if your symptoms havent improved after 7 days of treatment with antibiotic tablets. Further testing and treatment Further tests are usually only required in cases where the infection is severe or widespread, doesnt respond to treatment, or keeps recurring. In these circumstances, your GP may refer you to a dermatologist (skin specialist) for further tests or they may take a swabof the affected skinthemselves for testing. This can help to rule out or confirm other skin conditions that may be responsible for your symptoms and can detect whether you carry one of the types of bacteria responsible for theinfection inside your nose. If your doctor thinks you may keep gettingimpetigo because you naturally have these bacteria inside your nose, they may prescribe you an antiseptic nasal cream to try to clear the bacteria. Complications of impetigo Complications of impetigo are rare, but they can sometimes occur and can be serious. Tell your pharmacist if you have impetigo and your symptoms change or get worse. Cellulitis Cellulitis occurs when the infection spreads to a deeper layer of skin. It can cause symptoms of red, inflamed skin with fever and pain. It can usually be treated with antibiotics, andpainkillers can be used to relieve pain. Guttate psoriasis Guttate psoriasis is a non-infectious skin condition that can develop in children and teenagers after a bacterial infection. It is usually more common after a throat infection, but some cases have been linked to impetigo. Guttate psoriasis causes small, red, droplet-shaped, scaly patches on the chest, arms, legs and scalp. Creams can be used to control the symptoms and in some casesthe condition will disappear completely after a few weeks. Scarlet fever Scarlet fever is a rare bacterial infection that causes a fine, pink rash across the body. Associated symptoms of infection, such as nausea, pain and vomiting, are also common.The condition is usually treated with antibiotics. Scarlet fever is not usually serious but it is contagious. Therefore, its important to isolate an infected child and avoid close physical contact. Keep your child away from school and other people untilthey havebeen takingantibiotics for at least 24 hours. Septicaemia Septicaemia (a type of sepsis ) is a bacterial infection of the blood. It can cause: diarrhoea cold, clammy skin a high temperature (fever) rapid breathing vomiting low blood pressure (hypotension) confusion feeling faint and dizzy losing consciousness Septicaemia is a life-threatening condition and requires immediate treatment with antibiotics in hospital. Scarring In rare cases, impetigo may lead to some scarring. However, this is more often the result of someone scratching at blisters, crusts or sores. The blisters and crusts themselves should not leave a scar if left to heal. The red mark left after the crusts and blisters clear up should also disappear by itself. The time it takes for the redness to disappear can vary between a few days and a few weeks. Staphylococcal scalded skin syndrome Staphylococcal scalded skin syndrome (SSSS) is a serious skin condition in which one of the causes of impetigo Staphylococcus bacteria releases a toxin (poison) that damages the skin. This leads to extensive blistering that looks like the skin has been scalded with boiling water. Other symptoms of SSSS include: painful skin a high temperature (fever) large areas of skin peeling off or falling away redness of the skin which usually spreads across the entire body SSSS usually requires immediate treatment in hospital with antibiotics given directly into a vein (intravenously). Post-streptococcal glomerulonephritis Post-streptococcal glomerulonephritis is an infection of the small blood vessels in the kidneys. Its a very rare complication of impetigo. The symptoms of post-streptococcal glomerulonephritis include: a change in the colour of your urine to a reddish-brown or cola colour swelling of the abdomen (tummy),face, eyes, feet and ankles a rise in blood pressure visibleblood in your urine a reduction in the amount of urine you would normally produce People with post-streptococcal glomerulonephritis will usually require immediate hospital treatment so their blood pressure can be carefully monitored and controlled. Post-streptococcal glomerulonephritis can be fatal in adults, although deaths in children are rare. Preventing impetigo As impetigo is a highly contagious condition, it is important to take precautions to reduce the risk of the infection spreading. Stoppingthe infection spreading To help to prevent the spread of the infection to other people or to other areas of the body you should: stay away from work, school, nursery or playgroup until the sores have dried up, blistered or crusted over, or until 48 hours after starting treatment not share flannels, sheets or towels with anyone who has impetigo, and wash them at a high temperature after use wash the sores with soap and water, and cover them loosely with a gauze bandage or clothing if possible avoidtouching the sores, or letting others touch them, whenever possible not scratch the affected areas it may help to ensure your or your childs nails are kept clean and short to reduce the risk of further damage caused by scratching avoid contact with newborn babies, preparing food, playing contact sports, or going to the gym until the risk of infection has passed (when the rash has crusted over, or after at least 48 hours of treatment with antibiotics) wash your hands frequently, particularly after touching infected skin washable toys should also be washed, and wipe non-washable soft toys thoroughly with a cloth that has been wrung out in detergent and warm water and allowed to dry completely If you think that the infection has spread to someone else, make sure theycontact their pharmacist as soon as possible. Preventing re-infection Toreduce the risk of impetigo returning, make sure any cuts, scratches or bites are kept clean, and ensure any condition that causes broken skin, such as eczema, is treated promptly. If you develop impetigo frequently, your doctor may suggest taking a swab from around your nose to see if you carry staphylococcal bacteriainside your nose. These bacteria can live in the noses of some people without causing problems, although they can lead to impetigo if they infected broken skin nearby. If you are found to carry these bacteria,you may be prescribed an antiseptic nasal cream to apply several times a day for 5 to 10 days in an attempt to clear the bacteria and reduce the chances of impetigo recurring. Source: NHS 24 - Opens in new browser window Last updated: 04 December 2023 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Dont include personal information e.g. name, location or any personal health conditions. Email Address e.g. [email protected] Message Maximum of 500 characters Send feedback Add this page to\n Info For Me Also on NHS inform Antibiotics Other health sites BAD: impetigo Search for a pharmacy near you Enter a place or postcode NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats 2023 NHS 24 v1.1.1.17852

Indigestion

Indigestion | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotlands Service Directory 0 Home Illnesses and conditions Stomach, liver and gastrointestinal tract Indigestion Indigestion About indigestion Symptoms of indigestion Causes of indigestion Diagnosing indigestion Treating indigestion Complications of indigestion About indigestion Indigestion can be pain or discomfort in your upper abdomen (dyspepsia) or burning pain behind the breastbone (heartburn). Dyspepsia and heartburn may occur together or on their own. Symptoms usually appear soon after eating or drinking. Common associated symptoms include: feeling full or bloated feeling sick (nausea) belching bringing up (regurgitating) fluid or food into the gullet (oesophagus) Indigestion is a common problem that affects many people, but in most cases its mild and only occurs occasionally. Read more about the symptoms of indigestion . Why it happens Indigestionmay becaused by stomach acid coming into contact with the sensitive, protective lining of the digestive system (mucosa). The stomach acid breaks down the lining, leading to irritation and inflammation, which can be painful. The majority of people with indigestion dont have inflammation in their digestive system. Therefore, their symptoms are thought to be caused by increased sensitivity of the mucosa (to acidity or stretching). In most cases indigestion is related to eating, although it can betriggered by other factors such as smoking, drinking, alcohol, pregnancy, stressor taking certain medications. Read more about the causes of indigestion . Treating indigestion at home Most people are able totreat indigestion with simple changes to theirdiet and lifestyle, or with a number of different medications, such as antacids. Read more about the treatment of indigestion . Very rarely,a seriousunderlying health condition is the cause of indigestion. If this is suspected, thenfurther investigation such as an endoscopywill be required. When to get professional advice Pharmacy First Scotland: Indigestion treatment from your pharmacy If you have symptoms of indigestion you can get treatment directly from a pharmacy. Find your local pharmacy on Scotlands Service Directory. Search for a pharmacy near you Most people will not need to seek medical advice for their indigestion. However, your pharmacist may advise you see your GP if youhave recurring indigestion and any of the following apply: you are 55 years old or over you have lost a lot of weight without meaning to you have increasing difficulty swallowing (dysphagia) you have persistent vomiting you have iron deficiency anaemia you have a lump in your stomach you have blood in your vomit orblood in your stools This is because these symptomsmay be a sign of an underlying health condition, such as a stomach ulcer or stomach cancer . You may need to be referred for an endoscopyto rule out any serious cause. An endoscopy is a procedure where the inside of the body is examined using an endoscope (a thin, flexible tube that has a light and camera on one end). Severe indigestion can cause long-term problems with parts of your digestive tract, such as scarring of the oesophagus or the passage from your stomach. Read more about the possible complications of severe indigestion . Symptoms of indigestion The main symptom of indigestion is pain or a feeling of discomfort in your upper abdomen (dyspepsia). People often experience the associated feeling of burning behind the breastbone (heartburn), but this may occur on its own. These symptomsusually come on soon after eating or drinking, although there can sometimes be a delay between eating a meal and experiencing indigestion. Heartburn is caused by acid that passes from your stomach into your gullet (oesophagus). If you have indigestion, you may also have symptoms such as: feeling uncomfortably full or heavy belching or flatulence (passing wind) bringingfood or fluidback up from your stomach (reflux) bloating feeling sick (nausea) vomiting Causes of indigestion Indigestion has a number of different causes, but its rarely due to a serious, underlying condition. Its normal for your stomach to produce acid, but sometimes this acid can irritate the lining of your stomach, the top part of your bowel (duodenum) or your gullet (oesophagus). This irritation can be painful and often causes a burning sensation. Indigestion may also be due to the lining of your digestive system being overly sensitive to acid, or the stretching caused by eating. Indigestion can also be triggered or made worseby other factors. Medications You may have indigestion if you take certain types of medication. Some medicines, such as nitrates (taken to widen your blood vessels) relax the oesophageal sphincter (ring of muscle between your oesophagus and your stomach), which allows acid to leak back up. Other medicines, such as non-steroidal anti-inflammatory drugs ( NSAIDs ), can affect your digestive tract and causeindigestion. Donot take NSAIDs, such as aspirin and ibuprofen, if you have stomach problems, such as a stomach ulcer , or have had this in the past. Children under 16 years of age should not take aspirin. Never stop taking a prescribed medication unless you aretold to do so by your GP or another qualified healthcare professional who is responsible for your care. Obesity If you are very overweight, you are more likely to experience indigestion because of increased pressure inside your stomach (abdomen). The increased pressure, particularly after a large meal, may lead to acid reflux into the oesophagus. Stress or anxiety If you regularly experience feelings of stress or anxiety, this can contribute to symptoms of indigestion. Readsome relaxation tips to relieve stress. Hiatus hernia A hernia occurs when an internal part of the body, such as an organ, pushes through a weakness in the surrounding muscle or tissue wall. A hiatus hernia occurs when part of your stomach pushes up into your diaphragm (the sheet of muscle under your lungs).It may partially block refluxed stomachacid clearing from your oesophagus, leading to heartburn. Helicobacter pylori infection Helicobacter infection is very common. It may lead to stomach ulcers or, rarely, stomach cancer. In most cases, however, itdoes not cause any symptoms at all. Some people may get bouts of indigestion from helicobacter infection and, in these cases, getting rid of the bug with antibiotics (eradication) will help. However, many cases of indigestion are not caused by helicobacter, and in these cases eradication will not get rid of symptoms. Gastro-oesophageal reflux disease (GORD) Gastro-oesophageal reflux disease (GORD) is a common condition and one of the main causes of recurring indigestion. Its caused by acid reflux, whichoccurs when the oesophageal sphincter fails to prevent stomach acid from moving back up into your oesophagus. A little bit of acid reflux is normal and rarely cause any symptoms. It becomes GORD when large amounts of reflux occur, and the sensitive lining of your oesophagus may get inflamed by repeated irritation from stomach acid. This can lead to heartburn, the sensation of regurgitation or painful swallowing. Stomachulcers A stomach ulcer is an open sore that develops on the inside lining of your stomach (a gastric ulcer) or small intestine (a duodenal ulcer). If you have astomach ulcer, you may have indigestion as a symptom. Stomachulcers formwhen stomach acid damages the lining in your stomach or duodenum wall. In most cases, the lining is damaged as a result of an H pylori infection. Stomach cancer In rare cases, recurring bouts of indigestion can be a symptom of stomach cancer . Cancer cells in your stomach break down the protective lining, allowing acid to come into contact with your stomach wall. Diagnosing indigestion For most people, indigestion (dyspepsia) is mild and infrequent, and does not require treatment from a healthcare professional. However, if you have indigestion regularly, or if it causes you severe pain or discomfort, see your pharmacist. They will ask about your indigestion symptoms, as well as: any other symptoms you have whichmay indicate an underlying health condition any medication you are taking as some medications can cause indigestion your lifestyle as some lifestyle factors, such as smoking, drinking alcohol or being overweight, can cause indigestion Depending on the type of indigestion symptoms you have, your pharmacist may recommend you see your GP to investigate your condition further. This is because indigestion can sometimes be a symptom of an underlying condition or health problem, such as a Helicobacter pylori (H pylori) bacterial infection. Further investigations Endoscopy You may be referred to hospital to have an endoscopy. An endoscopy is a procedure used to examine the inside of your body using an endoscope a thin, flexible tube, about the width of your little finger, with a light and a camera on one end. The camera is used to relay images of the inside of your body to aTV monitor. An endoscopy is not often needed to diagnose indigestion, but your GP may suggest that you have one if: they need to examine the inside of your abdomen in more detail you have had treatment for indigestion that has not worked you have any serious symptoms of indigestion Taking certain medicines for indigestion can hide some of the problems that could otherwise be spotted during an endoscopy. Therefore, for at least two weeks before your endoscopy, you will need to stop taking proton pump inhibitors (PPIs) and H2-receptor antagonists. Read more about treatments for indigestion . Your GP may also recommend changing other medications that may be causing your indigestion. However, only stop taking medication if you are advised to do so by your GP or another healthcare professional responsible for your care. Diagnosing H pylori infection If your GP thinks that your symptoms may be due to an infection with H pylori bacteria, you may need to have a test for it, such as: a stool antigen test a pea-sized stool (faeces) sample will be tested for H pylori bacteria a breath test a blood test a blood sample will be tested for antibodies to H pylori bacteria (antibodies are proteins produced by the body to fight infection) Antibiotics and PPIs can affect the results of a urea breath test or a stool antigen test. Therefore, these tests may need to be delayed until two weeks after you last used a PPI, and 4 weeks after you last used an antibiotic. Diagnosing other conditions If your GP thinks that your indigestion symptoms may be caused by another underlying medical condition, you may need to have some further tests to rule this out. For example, abdominal pain and discomfort can also be caused by conditions affecting the bile ducts in your liver. Your bile ducts are a series of tubes that carry bile (fluid used by the digestive system to break down fats) from the liver to the gallbladder (a pouch that holds bile) and the bowel. If your GP thinks that you may have such a condition, they may suggest you have a liver function test, which is a type of blood test used to assess how well your liver is working. You may also need to have an abdominal ultrasound. An ultrasound scan uses high-frequency sound waves to create an image of the inside of your body. Treating indigestion Treatment for indigestion (dyspepsia) will vary, depending on what is causing it and how severe your symptoms are. If you have been diagnosed with an underlying health condition, you may want to read our information on: treating gastro-oesophageal reflux disease (GORD) treating astomach ulcer Diet and lifestyle changes If you only have indigestion occasionally, you may not need to see your pharmacist or GP for treatment. It may be possible to ease your symptoms by making a few simple changes to your diet and lifestyle, summarised below. Healthy weight Being overweight puts more pressure on your stomach, making it easier for stomach acid to be pushed back up into your gullet (oesophagus). This is known as acid reflux, and is one of the most common causes of indigestion. If you are overweight or obese, it is important to lose weight safely and steadily through regular exercise and by eating a healthy, balanced diet. Read advice on losing weight . Stop smoking If you smoke, the chemicals you inhale in cigarette smoke may contribute to your indigestion. These chemicals can cause the ring of muscle that separates your oesophagus from your stomach to relax, causing acid reflux. Read more about quitting smoking , or speak to your GP or pharmacist. You can also phone the Quit Your Way Scotland service on 0800 84 84 84. Diet and alcohol Make a note of any particular food or drink that seems to make your indigestion worse, and avoid these if possible. This may mean: eating less rich, spicy and fatty foods cutting down on drinks that contain caffeine such as tea, coffee and cola avoiding or cutting down on alcohol At bedtime If you tend to experience indigestion symptoms at night, avoid eating for three to four hours before you go to bed. Going to bed with a full stomach means there is an increased risk that acid in your stomach will be forced up into your oesophagus while you are lying down. When you go to bed, use a couple of pillows to prop your head and shoulders up or, ideally,raise the head of your bed by a few inches by putting something underneath the mattress. The slight slope that is created should help to prevent stomach acid moving up into your oesophagus while you are asleep. Stress or anxiety If you regularly experience feelings of stress or anxiety, this can contribute to symptoms of indigestion. Read some relaxation tips to relieve stress . Changing current medication Your pharmacist may recommend making changes to your current medication if they think it could be contributing to your indigestion. As long as it is safe to do so, you may need to stop taking certain medications, such as aspirin or ibuprofen. Where required, your pharmacist may advise you see your GP to prescribe an alternative medication that will not cause indigestion. However, never stop taking any medication without consulting your pharmacist or GP first. Immediate indigestion relief If you have indigestion that requires immediate relief, your pharmacist can advise you about the best way to treat this. As well as lifestyle changes and reviewing your current medication, your GP may prescribe or recommend: antacid medicines alginates Antacids Antacids are a type of medicine that can provide immediate relief for mild to moderate symptoms of indigestion. They work by neutralising the acid in your stomach (making it less acidic), so that it no longer irritates the lining of your digestive system. Antacids are available in tablet and liquid form. You can buy them over the counter from most pharmacies without a prescription. The effect of an antacid only lasts for a few hours at a time, so you may need to take more than one dose. Always follow the instructions on the packet to ensure you do not take too much. It is best to take antacids when you are expecting symptoms of indigestion, or when they start to occur, such as: after meals at bedtime This is because antacids stay in your stomach for longer at these times and have more time to work. For example, if you take an antacid at the same time as eating a meal, it can work for up to three hours. In comparison, if you take an antacid on an empty stomach, it may only work for 20 to 60 minutes. Read moreaboutantacids, including possible interactions with other medicines and side effects. Alginates Some antacids also contain a medicinecalled an alginate. This helps relieve indigestion caused by acid reflux. Acid reflux occurs when stomach acid leaks back up into your oesophagus and irritates its lining. Alginatesform a foam barrier that floats on the surface of your stomach contents, keeping stomach acid in your stomach and away from your oesophagus. Your pharmacist may suggest that you take an antacid that contains an alginate if you experience symptoms of acid reflux or if you have GORD. Take antacids containing alginates after eating, because this helps the medicine stay in your stomach for longer. If you take alginates on an empty stomach, they will leave your stomach too quickly to be effective. Treating persistent indigestion If you have indigestion that is persistent or recurring, treatment with antacids and alginates may not be effective enough to control your symptoms. Your pharmacist may recommend a different type of medication, which willbe prescribed at the lowest possible dose to control your symptoms. Possible medications include: proton pump inhibitors (PPIs) H2-receptor antagonists Your pharmacist may advise you to see your GP who may also test you for the Helicobacter pylori (H pylori) bacteria (see Indigestion diagnosis ) and prescribe treatment for this if necessary. Proton pump inhibitors (PPIs) PPIs restrict the acid produced in your stomach. The medication istaken as tablets and if you are over 18, you can buy some types of PPIs over the counter in pharmacies, but these should only be used for short-term treatment. PPIs may enhance the effect of certain medicines. If you are prescribed a PPI, your progress will be monitored if you are also taking other medicines, such as: warfarin a medicine that stops the blood clotting phenytoin a medicine to treat epilepsy If your ingestion is persistent, your pharmacist might advise you to see your GP. If your GP refers you for an endoscopy (a procedure that allows a surgeon to see inside your abdomen), you will need to stop taking a PPI at least 14 days before the procedure. This is because PPIs can hide some of the problems that would otherwise be spotted during the endoscopy. PPIs can sometimes cause side effects. However, they are usually mild and reversible. These side effects may include: headaches diarrhoea constipation feeling sick (nausea) vomiting flatulence stomach pain dizziness skin rashes H2-receptor antagonists H2-receptor antagonists are another type of medication that your pharmacist or GP may suggest if antacids, alginates and PPIs have not been effective in controlling your indigestion. There are four H2-receptor antagonists: cimetidine famotidine nizatidine ranitidine These medicines work by lowering the acidity level in your stomach. Your GP may prescribe any one of these four H2-receptor antagonists, although ranitidine is available from pharmacies under the Pharmacy First Scotland service. H2-receptor antagonists are usually taken in tablet form. As with PPIs, you will need to stop taking H2-receptor antagonists at least 14 days before having an endoscopy if this has been arranged through your GP. This isbecause they can hide some of the problems that could otherwise be spotted during the endoscopy. Helicobacter pylori (H pylori) infection If your indigestion symptoms are caused by an infection with H pylori bacteria, you will need to have treatment to clear the infection from your stomach. This should help relieve your indigestion, because the H pylori bacteria will no longer be increasing the amount of acid in your stomach. H pylori infection is usually treated using triple therapy (treatment with three different medications). Your GP will prescribe a course of treatment containing: two different antibiotics (medicines to treat infections that are caused by bacteria) a PPI You will need to take these medicines twice a day for seven days. You must follow the dosage instructions closely to ensure that the triple therapy is effective. In up to 85% of cases, one course of triple therapy is effective in clearing an H pylori infection. However, you may need to have more than one course of treatment if it does not clear the infection the first time. Complications of indigestion In most cases, indigestion (dyspepsia) is mild and only occurs occasionally. However, severe indigestion can cause complications, some of which are outlined below. Oesophageal stricture Indigestion is often caused by acid reflux, which occurs when stomach acid leaks back up into your gullet (oesophagus) and irritates its lining. If this irritation builds up over time, it can cause your oesophagus to become scarred. The scarring can eventually lead to your oesophagus becoming narrow and constricted (known as oesophageal stricture). If you have oesophageal stricture, you may have symptoms such as: difficulty swallowing (dysphagia) food that becomes lodged in your throat chest pain Oesophageal stricture is often treated using surgery to widen your oesophagus. Pyloric stenosis Like oesophageal stricture, pyloric stenosis is caused by long-term irritation of the lining of your digestive system from stomach acid. Pyloric stenosis occurs when the passage between your stomach and your small intestine (known as the pylorus) becomes scarred and narrowed. This causes vomiting and prevents any food you eat from being properly digested. In most cases, pyloric stenosis is treated using surgery to return the pylorus to its proper width. Barretts oesophagus Repeated episodes of gastro-oesophageal reflux disease (GORD) can lead to changes in the cells lining your lower oesophagus. This is a condition known as Barretts oesophagus. It is estimated that 1 in 10 people with GORD will develop Barretts oesophagus. Most cases of Barretts oesophagus first develop in people aged 50 to 70 years old. The average age at diagnosis is 62. Barretts oesophagus does not usually cause noticeable symptoms other than those associated with GORD. The concern is that Barretts oesophagus is a pre-cancerous condition. This means that while changes in the cells are not cancerous, there is a small risk they could develop into cancer in the future. This would then trigger the onset of oesophageal cancer . Source: NHS 24 - Opens in new browser window Last updated: 13 December 2023 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Dont include personal information e.g. name, location or any personal health conditions. Email Address e.g. [email protected] Message Maximum of 500 characters Send feedback Add this page to\n Info For Me Also on NHS inform Stomach ulcer NSAIDs Gastro-oesophageal reflux disease (GORD) Search for a pharmacy near you Enter a place or postcode NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats 2023 NHS 24 v1.1.1.17852

Ingrown toenail

Ingrown toenail | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotlands Service Directory 0 Home Illnesses and conditions Skin, hair and nails Ingrown toenail Ingrown toenail An ingrown toenail develops when the sides of the toenail grow into the surrounding skin. Symptoms of ingrown toenail An ingrown toenail often affects the big toe, either on one or both sides. The nail curls and pierces the skin which becomes red, swollen and tender. Other possible symptoms include: pain if pressure is placed on the toe inflammation of the skin at the end of the toe a build-up of fluid (oedema) in the area surrounding the toe an overgrowth of skin around the affected toe (hypertrophy) bleeding white or yellow pus coming from the affected area Get help from a pharmacist If you have an ingrown toenail, you can ask a pharmacist about: treatments to help ease the pain and prevent an infection whether you need to see a GP Find your nearest pharmacy Speak to your GP practice if: treating your ingrown toenail at home is not helping your toe is painful and swollen with pus coming out of it you have a very high temperature or you feel hot or shivery you have diabetes and an ingrown toenail foot problems can be more serious if you have diabetes Causes of an ingrown toenail A number of things can cause an ingrown toenail to develop, including: badly cut toenails cutting your toenails too short, or cutting the edges, will encourage the skin to fold over your nail and the nail to grow into the skin wearing tight-fitting shoes, socks or tights this places pressure on the skin around your toenail and the skin may be pierced if its pressed on to your toenail sweaty feet if the skin around your toenails is soft, its easier for your nail to pierce it and embed itself within it injury for example, stubbing your toe can sometimes cause an ingrown toenail to develop natural shape of the nail the sides of curved or fan-shaped toenails are more likely to press into the skin surrounding the nail A fungal nail infection can cause your toenail to thicken or widen. Treatment for ingrown toenails Left untreated, an ingrown toenail can become infected. Its important that you: Do keep your feet clean by washing them regularly with soap and water change your socks regularly cut your toenails straight across to stop them digging into the surrounding skin gently push the skin away from the nail using a cotton bud (this may be easier after using a small amount of olive oil to soften the skin) wear comfortable shoes that fit properly Surgery for ingrown toenail Surgery may be recommended if your toenail doesnt improve. Depending on the severity of your symptoms, this may involve removing part or all of your toenail. Partial nail avulsion Partial nail avulsion removes part of your toenail and is the most common operation for treating ingrown toenails. Its about 98% effective. A local anaesthetic is used to numb your toe and the edges of your toenail are cut away. A chemical called phenol is applied to the affected area to prevent the nail growing back and becoming ingrown in the future. A course of antibiotics may be prescribed if your nail is infected, and any pus will be drained away. Total nail avulsion Total nail avulsion completely removes your toenail. This may be necessary if your nail is thick and pressing into the skin surrounding your toe. After your toenail has been removed, youll have an indentation where your nail used to be. However, its perfectly safe for you not to have a toenail. After surgery After toenail surgery, your toe will be wrapped in a sterile bandage. This will help stem any bleeding and prevent infection. Rest your foot and keep it raised for 1to 2days after the operation. To help reduce the pain, you may need to take a painkiller like paracetamol . You may also need to wear soft or open-toed shoes for the first few days after surgery. Preventing ingrown toenails Taking care of your feet will help prevent foot problems like ingrown toenails. Its important to cut your toenails properly (straight across, not at an angle or down the edges). Wash your feet every day, dry them thoroughly and use foot moisturiser. You can also use a foot file or pumice stone to remove hard or dead skin. Wearing shoes that fit properly will help to ensure your feet remain healthy. You should also change your socks (or tights) every day. Visit your GP practice or a podiatrist as soon as possible if you develop problems with your feet. Source: NHS 24 - Opens in new browser window Last updated: 05 April 2024 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Dont include personal information e.g. name, location or any personal health conditions. Email Address e.g. [email protected] Message Maximum of 500 characters Send feedback Add this page to\n Info For Me NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats 2023 NHS 24 v1.1.1.17852

Inherited heart conditions

Inherited heart conditions - Illnesses & conditions | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotlands Service Directory 0 Home Illnesses and conditions Heart and blood vessels Conditions Inherited heart conditions Inherited heart conditions An inherited heart disease is one which has been passed on through your parents genes. Inherited cardiac conditions (ICC) is an umbrella term covering a wide variety of relatively rare diseases of the heart. They are also referred to as genetic cardiac conditions. ICCs are caused by a fault also known as a mutation in one or more of our genes. If someone has a faulty gene, theres a 50/50 chance it can be passed on to your children. The effects of these conditions on you and your family can be enormous. These conditions can in some cases become life-threatening. Around 500 young people die every year in the UK as a result of a genetic heart disorder. These conditions do not always have symptoms, so you can be unaware you have the conditions. Sadly, this can sometimes mean that the first time a family is aware of being affected is after a sudden cardiac death (SCD). However, great improvements are being made in the detection of ICCs and also how you can live with your condition. There are effective treatments which allow you to lead a normal life. Family history Its very important to draw a medical family tree with an appropriate health professional. This can help to paint a picture to see if you have or have had any other family members with the same condition. The family tree is sometimes known as a pedigree. Signs and symptoms Sometimes people dont experience many signs and symptoms, but the main symptoms of familial arrhythmia are: palpitations fainting or blackouts (also known as syncope or near faint) The majority of children and young adults with syncope have a normal heart disease and no major heart rhythm problem. However, its really important to speak to your GP or health professional if you or a member of your family have suffered unexplained fainting, especially if its happened more than once. Different inherited heart conditions Familial cardiomyopathies These include: Hypertrophic Cardiomyopathy (HCM) idiopathic or familial Dilated Cardiomyopathy (DCM) Arrhythmogenic right ventricular cardiomyopathy (ARVC) restrictive cardiomyopathy Familialarrhythmias These include: Long QT syndrome (LQTS) Brugada syndrome Catecholaminergic Polymorphic Ventricular Tachycardia (CPVT) Short QT Syndrome (SQTS) Marfan syndrome Marfan syndrome is an inherited or genetic condition that affects the bodys connective tissues. Connective tissues provide support and structure to other tissue and organs. There is a 50/50chance that someone with Marfan syndrome will have a child with the condition, but Marfan syndrome is relatively rare around 1 in 5,000 people have the syndrome. You can get more information from Marfan Foundation Sudden Arrhythmic Death Syndrome (SADS) This is a condition which means there was an unexplained underlying familial heart rhythm that was not detected until there was an investigation following a death. British Heart Foundation has information on Sudden Arrythmic Death Syndrome and on genetic cardiac conditions and procedure following a sudden death . Cardiac Risk in the Young (CRY) has information on sudden cardiac death . Read about what to do in an emergency , in case you have a heart emergency. Treatments Different conditions require different treatments or interventions, which include: changes to your lifestyle medication implantable cardioverter defibrillators (ICDs) see heartsurgery heart transplantation (in rare cases) see heartsurgery See our section on Treatments Sport Sport and physical activity have many benefits. However, vigorous levels of exercise can be dangerous for people with inherited cardiac conditions. Research is, at present,still exploringwhat level of activity is right for the individual affected by an inherited cardiac condition, especially if theyre ayoung person. If you want to find out more, speak to your cardiologist. Cardiomyopathy UK has some general advice. See our Living with a heart condition sectionfor general advice on various aspects of living with a heart condition, likebenefits, driving and going on holiday. Support Living with an inherited cardiac condition can be distressing for both those with the condition and their families. There is support available through psychological help and genetic counselling. Genetic services in Scotland are managed by specialist hospital doctors in four regional centres: Aberdeen phone 01224 552120 Dundee phone 01382 632330 Edinburgh phone 0131 537 1116 Glasgow phone 0141 354 9235 These regional services have access to: specialist cardiologists geneticists specialist nursing genetic counselling These cardiac-genetic services link with the smaller hospitals in their regions. Genetic testing is done for arrhythmias in Aberdeen and for cardiomyopathies in Edinburgh. You may need to visit your family doctor to obtain a referral to a specialist service. Network for Inherited Cardiac Conditions Scotland (NICCS) NICCS is a National Managed Clinical Network (NMCN). It was set up to help coordinate services for people with or suspected of having inherited cardiac conditions. Its part of the NHS and aims to improve services for inherited cardiac conditions (ICCs). The NICCS brings together experts from across Scotland. Those in the network include: heart specialists geneticists genetic counsellors pathologists specialist nurses public representatives other experts The NICCS website has resources for people affected by inherited cardiac conditions. This includes a patient forum made up of patients, family members and organisations with an interest in ICCs. If youd like to get involved in NICCS, visit their website or email [email protected] Source: Chest Heart & Stroke Scotland - Opens in new browser window Last updated: 06 March 2024 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Dont include personal information e.g. name, location or any personal health conditions. Email Address e.g. [email protected] Message Maximum of 500 characters Send feedback Add this page to\n Info For Me Other health sites British Heart Foundation: Inherited heart conditions Marfan Foundation Cardiac Risk in the Young NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats 2023 NHS 24 v1.1.1.17852

Insomnia

Insomnia | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotlands Service Directory 0 Home Illnesses and conditions Mental health Insomnia Insomnia British Sign Language (BSL) Introduction Causes Self-help tips Treatments Introduction Insomnia is difficulty getting to sleep or staying asleep for long enough to feel refreshed the next morning. Its a common problem thought to regularly affect around one in every three people in the UK, and is particularly common in elderly people. If you have insomnia, you may: find it difficult to fall asleep lie awake for long periods at night wake up several times during the night wake up early in the morning and not be able to get back to sleep not feel refreshed when you get up find it hard to nap during the day, despite feeling tired feel tired and irritable during the day and have difficulty concentrating Occasional episodes of insomnia may come and go without causing any serious problems, but for some people it can last for months or even years at a time. Persistent insomnia can have a significant impact on your quality of life. It can limit what youre able to do during the day, affect your mood, and lead to relationship problems with friends, family and colleagues. How much sleep do I need? There are no official guidelines about how much sleep you should get each night because everyone is different. On average, a normal amount of sleep for an adult is considered to be around seven to nine hours a night. Children and babies may sleep for much longer than this, whereas older adults may sleep less. Whats important is whether you feel you get enough sleep, and whether your sleep is good quality. Youre probably not getting enough good-quality sleep if you constantly feel tired throughout the day and its affecting your everyday life. What causes insomnia? Its not always clear what triggers insomnia, but its often associated with: stress and anxiety a poor sleeping environment such as an uncomfortable bed, or a bedroom thats too light, noisy, hot or cold lifestyle factors such as jet lag, shift work, or drinking alcohol or caffeine before going to bed mental health conditions such as depression and schizophrenia physical health conditions such as heart problems,other sleep disorders and long-term pain certain medicines such as some antidepressants , epilepsy medicines and steroid medication Read more about the causes of insomnia What you cando about it There are a number of things you can try to help yourself get a good nights sleep if you have insomnia. These include: setting regular times for going to bed and waking up relaxing before bed time try taking a warm bath or listening to calming music using thick curtains or blinds, an eye mask and earplugs to stop you being woken up by light and noise avoiding caffeine, nicotine, alcohol, heavy mealsand exercise for a few hours before going to bed not watching TV or using phones, tablets or computers shortly beforegoing to bed not napping during the day writing a list of your worries, and any ideasabouthow tosolve them, before going to bed to help you forget aboutthem until the morning Some people find over-the-counter sleeping tablets helpful, but they dont address the underlying problem and can have troublesome side effects. Read more self-help tips for insomnia When to see your GP Make an appointment to see your GP if youre finding it difficult to get to sleep or stay asleep and its affecting your daily life particularly if it has been a problem for a month or more and the above measures have not helped. Your GP may ask you about your sleeping routines, your daily alcohol and caffeine consumption, and your general lifestyle habits, such as diet and exercise. They will also check your medical history for any illness or medication that may be contributing to your insomnia. Your GP may suggest keeping a sleep diary for a couple of weeks to help them gain a better understanding of your sleep patterns. Each day, make a note of things such as the time you went to bed and woke up, how long it took you to fall asleep, and the number of times you woke up during the night. Treatments forinsomnia Your GP will first try to identify and treat any underlying health condition, such as anxiety, that may be causing your sleep problems. Theyll probably also discuss things you can do at home that may help to improve your sleep. In some cases, a special type of cognitive behavioural therapy (CBT)designed for people with insomnia (CBT-I) may be recommended. This is a type of talking therapy that aims to help you avoid the thoughts and behaviours affecting your sleep. Its usually the first treatment recommended and can help lead to long-term improvement of your sleep. Prescription sleeping tablets are usually only considered as a last resort and should be used for only a few days or weeks at a time. This is because they dont treat the cause of your insomnia and are associated with a number of side effects. They can also become less effective over time. Read more about treating insomnia Causes Insomnia can be triggered by a number of possible factors, including worry and stress, underlying health conditions, and alcohol or drug use. Sometimes its not possible to identify a clear cause. Stress and anxiety Some people develop insomnia after a stressful event, such as a bereavement, problems at work, or financial difficulties. The problem can continue long after the event has passed because they start to associate going to bed with being awake. This develops into an anxiety about sleep itself. Having more general worriesfor example, about work, family or healthare also likely to keep you awake at night. These can cause your mind to start racing while you lie in bed, which can be made worse by also worrying about not being able to sleep. Poor sleep routine andsleeping environment You may struggle to get a good nights sleep if you go to bed at inconsistent times, nap during the day, or dont wind down before going to bed. A poor sleeping environment can also contribute to insomniafor instance, an uncomfortable bed or a bedroom thats too bright, noisy, hot or cold. Lifestyle factors Drinking alcohol before going to bed and taking certain recreational drugs can affect your sleep, as can stimulants such as nicotine (found in cigarettes) and caffeine (found in tea, coffee and energy drinks). These should be avoided in the evenings. Changes to your sleeping patterns can also contribute to insomniafor example, because of shift work or changing time zones after a long-haul flight (jet lag). Mental health conditions Underlying mental health problems can often affect a persons sleeping patterns, including: mood disorders such as depression or bipolar disorder anxiety disorders such as generalised anxiety, panic disorder or post-traumatic stress disorder psychotic disorders such as schizophrenia Physical healthconditions Insomnia can also be caused by underlying physical conditions, including: heart conditions such as angina or heart failure respiratory conditions such as chronic obstructive pulmonary disease (COPD) or asthma neurologicalconditions such as Alzheimers disease or Parkinsons disease hormonal problems such as an overactive thyroid joint or muscle problems such as arthritis problems with the genital or urinary organs such as urinary incontinence or an enlarged prostate sleep disorders such as snoring and sleep apnoea , restless legs syndrome ,narcolepsy, night terrors and sleepwalking long-term pain In women, childbirth can sometimes lead to insomnia. Medication Some prescriptions or over-the-counter medications can cause insomnia as a side effect. These include: certain antidepressants epilepsy medicines medicines for high blood pressure , such as beta-blockers steroid medication non-steroidal anti-inflammatory drugs (NSAIDs) stimulant medicines used to treat attention deficit hyperactivity disorder (ADHD) or narcolepsy some medicines used to treat asthma, such as salbutamol, salmeterol and theophylline Check the leaflet that comes with any medication youre taking to see if insomnia or sleeping difficulties are listed as a possible side effect. Self-help tips Insomnia can often be improved by changing your daytime and bedtime habits or by improving your bedroom environment. Making small changes may help you to get a good nights sleep. Try some of the methods below for a few weeks to see if they help. See your GP if youre still having difficulty getting to sleep after trying these techniques. Daytime habits Set a specific time for getting up each day. Try to stick to this time, seven days a week, even if you feel you havent had enough sleep. This should help you sleep better at night. Dont take a nap during the day. Take daily exercise, such as 30 minutes walking or cycling . But dont exercise for at least four hours before going to bed, because this may make it more difficult to fall asleep. Bedtime habits Stop drinking tea and coffee for a few hours before bedtime. Avoid drinking alcohol and smoking, particularly shortly before going to bed. Dont eat a big meal just before bedtime. Only go to bed when youre feeling tired. If necessary, go to bed later than usual if it means you might be able to fall asleep more quickly. Dont use back-lit devices shortly before going to bed, including televisions, phones, tablets and computers. Try to create a relaxing bedtime routine, such as taking a bath, listening to soft music, and drinking a warm, milky drink every night. These activities will be associated with sleep and will cause drowsiness. Avoid regularly using over-the-counter sleeping tablets. It is not clear how effective these are, they dont tackle the underlying problem, and have potential side effects. Read more about treatments for insomnia . Dont lie in bed feeling anxious about lack of sleep. Instead, get up, go to another room for about 20 minutes and do something else, such as reading or listening to soft music, before trying again. Avoid watching the clock because it will only make you anxious about how long its taking you to fall asleep. Write a list of your worries and any ideas to solve them before going to bed. This may help you forget about them until the morning. Bedroom environment Use thick blinds or curtains or wear an eye mask if the early morning sunlight or bright street lamps affect your sleep. Make sure your bedroom is at a comfortable temperature for sleeping. Wear ear plugs if noise is a problem. Dont use your bedroom for anything other than sleeping or sex. Avoid watching television, making phone calls, eating or working while youre in bed. Make sure your mattress is comfortable and that you have a pillow you like, as well as adequate bedding for the time of year. Treatments Insomnia will often improve by making changes to your bedtime habits. If these dont help, your GP may be able to recommend other treatments. If youve had insomnia for more than four weeks, your GP may recommend cognitive and behavioural treatments or suggest a short course of prescription sleeping tablets as a temporary measure. If its possible to identify an underlying cause of your sleeping difficulties, treating this may be enough to return your sleep to normal. The various treatments forinsomnia are outlined below. Good sleeping habits Your GP will be able to advise you about what you can do at home to help you sleep. This is known as sleep hygiene and includes: establishing fixed times for going to bed and waking up creating a relaxing bedtime routine only going to bed when you feel tired maintaining a comfortable sleeping environment thats not too hot, cold, noisy or bright not napping during the day avoiding caffeine, nicotine and alcohol late at night avoiding eating a heavy meal late at night Read more about self-help tips forinsomnia Cognitive and behavioural treatments If changing your sleeping habits doesnt help, your GP may be able to refer you for a type of cognitive behavioural therapy (CBT)thats specifically designed for people with insomnia (CBT-I). The aim ofCBT-I is to change unhelpful thoughts and behaviours that may be contributing to your insomnia. Itsan effective treatment for many people and can have long-lasting results. CBT-Imayinclude: stimulus-control therapy which aims to help you associate the bedroom with sleep and establish a consistent sleep/wake pattern sleep restriction therapy limiting the amount of time spent in bed to the actual amount of time spent asleep, creating mild sleep deprivation; sleep time is then increased as your sleeping improves relaxation training aims to reduce tension or minimise intrusive thoughts that may be interfering with sleep paradoxical intention you try to stay awake and avoid any intention of falling asleep; its used if you have trouble getting to sleep, but not maintaining sleep biofeedback sensors connected to a machine are placed on your body to measure your bodys functions, such as muscle tension and heart rate; the machine produces pictures or sounds to help you recognise when youre not relaxed CBT-I issometimes carried out by a specially trained GP. Alternatively, you may be referred to a clinical psychologist. The therapy may be carried out in a small group with other people who have similar sleep problems, or one-to-one with a therapist. Self-help books and online courses may also be used. Sleeping tablets Sleeping tablets (hypnotics) are medications that encourage sleep. In the past, they were frequently used to help with insomnia, but theyre used much less often nowadays. They will generally only be considered: if your insomnia is severe as a temporary measure to help ease short-term insomnia if the good sleep habits and cognitive and behavioural treatments mentioned above dont help Doctors are usually reluctant to recommend sleeping tablets in the long-term because they just mask the symptoms without treating the underlying cause. They can also cause potentially dangerous side effects, such as drowsiness the following morning, and some people become dependent on them. If they are recommended, you should have the smallest effective dose possible for the shortest time (usually no more than two to four weeks). Over-the-counter sleeping pills A number of sleeping tablets are available to buy over the counter (OTC) from pharmacies. These are usually a type ofantihistamine medicine that causes you to feel drowsy. Taking OTC sleeping tablets regularly isnt usually recommended if you have insomnia, because its not clear how effective they are, they dont tackle the underlying cause of your sleeping difficulties and they can cause side effects. In particular, they can cause you to feel drowsy the next morning, which can make activities such as driving and operating machinery dangerous. Speak to your GP for advice if you find yourself needing to take OTC sleeping tablets regularly. Benzodiazepines Benzodiazepines are prescription medicines that can reduce anxiety and promote calmness, relaxation and sleep. Your GP may prescribe them for a short time if you have severe insomnia or its causing extreme distress. Examples of benzodiazepines include temazepam, loprazolam, lormetazepam, diazepam and nitrazepam. Long-term treatment with benzodiazepines isnt usually recommended because they can become less effective over time and some people become dependent upon them. They can also cause a number of side effects, including: drowsiness anddizziness, which can persist into the next day finding it difficult to concentrate or make decisions depression feeling emotionally numb irritability You should avoid driving if you feel drowsy, dizzy, or unable to concentrate or make decisions, as you may not be able to do so safely. Z-drugs Zdrugs are a newer type of medicine that work in a similar way to benzodiazepines and are similarly effective. They include zaleplon, zolpidem and zopiclone. As with benzodiazepines, long-term treatment with Zdrugs isnt normally recommended because they can become less effective over time and some people become dependent on them. Theyre usually only prescribed for a maximum of two to four weeks. Side effects of Z-drugs can include: drowsiness and dizziness, which can persist into the next day feeling and being sick diarrhoea increasedsnoring and breathing problems during sleep dry mouth confusion Zdrugs can also sometimes cause psychiatric reactions, such as delusions,nightmares and hallucinations. Contact your GP if you experience any of these effects. Read the National Institute for Health and Care Excellence (NICE) guidance on zaleplon, zolpidem and zopiclone for the short-term management of insomnia for more information. Melatonin (Circadin) For adults aged 55 or over, a medication called Circadin is sometimes used to help relieve insomnia for a few weeks. It contains a naturally occurring hormone called melatonin, which helps to regulate the sleep cycle. Circadin is usually only recommended for three weeks at first, but it can be continued for a total of 13 weeks if it helps. Common side effects of Circadin include: headaches cold-like symptoms back pain joint pain Treatments that arent recommended The following treatments arent normally recommended for insomnia, because its not clear how effective they are and they can sometimes cause side effects: antidepressants (unless you also have depression) chloral hydrate clomethiazole barbiturates herbal remedies, such as valerian extract complementary and alternative therapies, such asacupuncture, hypnotherapy and reflexology Source: NHS 24 - Opens in new browser window Last updated: 03 May 2023 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Dont include personal information e.g. name, location or any personal health conditions. Email Address e.g. [email protected] Message Maximum of 500 characters Send feedback Other languages and formats British Sign Language (BSL) British Sign Language (BSL) Add this page to\n Info For Me Also on NHS inform Sleep problems and insomnia self-help guide Get help with your mental health Insomnia (BSL) Mind to Mind Coping with money worries NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats 2023 NHS 24 v1.1.1.17852

Iron deficiency anaemia

Iron deficiency anaemia - Illnesses & conditions | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotlands Service Directory 0 Home Illnesses and conditions Nutritional Iron deficiency anaemia Iron deficiency anaemia About iron deficiency anaemia Causes of iron deficiency anaemia Diagnosing iron deficiency anaemia Treating iron deficiency anaemia Complications of iron deficiency anaemia About iron deficiency anaemia Iron deficiency anaemia is a condition where a lack of iron in the body leads to a reduction in the number of red blood cells. Iron is used to produce red blood cells, whichhelp store and carry oxygen in the blood. If you have fewer red blood cells than is normal, your organs and tissues wont get as much oxygen as they usually would. There are several different types of anaemia, and each one has a different cause. Iron deficiency anaemia is the most common type. Other types of anaemia can be caused by a lack of vitamin B12 or folate in the body read more about vitamin B12 and folate deficiency anaemia . Symptoms of iron deficiency anaemia Many people with iron deficiency anaemia only have a few symptoms. The severity of the symptoms largely depends on how quickly anaemia develops. You may notice symptoms immediately, or they may develop gradually if your anaemia is caused by a long-term problem, such as a stomach ulcer . The most common symptomsinclude: tiredness and lack of energy (lethargy) shortness of breath noticeable heartbeats(heart palpitations) a pale complexion Less common symptomsinclude: headache hearing sounds that come from inside the body, rather than from an outside source (tinnitus) an altered sense of taste feeling itchy a sore orabnormally smooth tongue hair loss a desire to eat non-food items, such as ice, paper or clay (pica) difficulty swallowing (dysphagia) painful open sores (ulcers) on the corners of your mouth spoon-shaped nails When to see your GP See your GP if you experience symptoms of iron deficiency anaemia. They should be able to diagnose the condition using a simple blood test . Read more about diagnosing iron deficiency anaemia What causes iron deficiency anaemia? There are many things that can lead to a lack of iron in the body. In men and post-menopausal women, the most common cause is bleeding in the stomach and intestines. This can be caused by a stomach ulcer, stomach cancer , bowel cancer , or by takingnon-steroidal anti-inflammatory drugs (NSAIDs). In womenof reproductive age,heavy periods and pregnancy are the most common causes of iron deficiency anaemia as your body needs extra iron for your babyduring pregnancy. Unless youre pregnant, its rare for iron deficiency anaemia to be caused just by a lack of iron in your diet. However, if you do lack dietary iron, it may mean youre more likely to develop anaemia than if you have one of the problems mentioned above. Read more about the causes of iron deficiency anaemia How iron deficiency anaemia is treated Treatment for iron deficiency anaemia involves taking iron supplements toboost thelow levels ofiron in your body. This is usually effective, and the condition rarely causeslong-term problems. Youll need to be monitored every few months to check the treatment is working and your iron levels have returned to normal. The underlying cause will need to be treated so you dont get anaemia again. Increasing the amount of iron in your diet may also be recommended. Good sources of iron include: dark-green leafy vegetables, such as watercress and curly kale iron-fortified cereals or bread brown rice pulses and beans nuts and seeds meat, fish andtofu eggs dried fruit, such as dried apricots, prunes and raisins Read more about treating iron deficiency anaemia Further problems If iron deficiency anaemia is left untreated, it can make you more susceptible to illness and infection, as a lack of iron affectsthe bodys natural defence system(the immune system). Severe iron deficiency anaemia may increase your risk of developing complications that affect the heart or lungs, such as an abnormally fast heartbeat (tachycardia) or heart failure , where your heart is unable to pump enough blood around your body at the right pressure. Pregnant women with severe or untreated anaemia also have a higher risk of complications before and after birth. Read more about the complications of iron deficiency anaemia Causes of iron deficiency anaemia Iron deficiency anaemia occurs when the body doesnt have enough iron, leading to the decreased production of red blood cells. Red blood cells carry oxygen around the body. A lack of iron can be caused by several factors. Some of the most common causes of iron deficiency anaemia areoutlined below. Monthly periods In women of reproductive age,periods are themost common cause of iron deficiency anaemia. Usually, only women with heavy periods develop iron deficiency anaemia. If you have heavy bleeding over several consecutive menstrual cycles, its known as menorrhagia. Pregnancy Its also very common for women to develop iron deficiency during pregnancy. This is because your body needs extra ironto ensure your baby has a sufficient blood supply and receives necessary oxygen and nutrients. Some pregnant women require an iron supplement, whileothers may need to increase the amount of iron in their diet. Read more about vitamins and minerals in pregnancy Gastrointestinal blood loss The gastrointestinal tract is the part of the body responsible for digesting food. It contains the stomach and intestines. Bleeding in the gastrointestinal tract is the most common cause of iron deficiency anaemia in men, as well as women whove experienced the menopause (when monthly periods stop). Most people with gastrointestinal bleeding dont notice any obvious blood in their stools and dont experience any changes in their bowel habits. Somecauses of gastrointestinal bleeding are described below. Non-steroidal anti-inflammatory drugs Non-steroidal anti-inflammatory drugs (NSAIDs) can cause bleeding in the stomach. Ibuprofen and aspirin are two commonly prescribed NSAIDs. If your GP thinks your medication is causing gastrointestinal bleeding, they can prescribe a less harmful medicine. However, dont stop taking a medicine youve been prescribed unless your GP advises you to. Stomach ulcers The acid in your stomach, which helps your body digest food, can sometimes eat into your stomach lining. When this happens, the acid forms an open sore (an ulcer). This is also known as a stomach ulcer or a peptic ulcer. Stomach ulcers can cause the stomach lining to bleed, which can lead to anaemia. In some cases, the bleedingcan cause you tovomit blood or pass blood in your stools. However, if the ulcer bleeds slowly, you may nothave any symptoms. Gastrointestinal cancer Ina fewcases, gastrointestinal bleeding can be caused by cancer, usually stomach cancer or bowel cancer . When trying to establish the cause of anaemia, your GP will check for possible signs of cancer. If your GP suspects cancer, youll be referred to a gastroenterologist (a specialist in treating digestive conditions) for a more thorough examination. This means that if cancer is found, it can be treated as quickly as possible. If youre 60 years old or over and have iron deficiency anaemia, your GPshould refer youto a specialist to rule out bowel cancer. Your appointment with the specialist should be within two weeks of your GP referring you. Angiodysplasia Gastrointestinal bleeding can also be caused by a condition called angiodysplasia. This isthe resultofabnormal, fragile superficialblood vessels in the gastrointestinal tract, which can cause bleeding. Chronic kidney disease People with chronic kidney disease (CKD) often develop iron deficiency anaemia. Most people with CKD who have iron deficiency anaemia will be given iron supplement injections, although daily tabletsmay betried first. You can read more about treating anaemia in people with CKD on the National Institutefor Health and Care Excellence (NICE) website. Other causes Other conditions or actions that cause blood loss and may lead to iron deficiency anaemia include: inflammatory bowel diseasea condition that causes redness and swelling (inflammation) in the digestive system, such as Crohns disease and ulcerative colitis oesophagitis inflammation of the gullet (oesophagus)caused by stomach acid leaking through it schistosomiasis an infection caused by parasites, mainly found in sub-Saharan Africa blood donationdonating a large amount of blood may lead to anaemia trauma a serious accident, such as a car crash, may cause you to lose a large amount of blood nosebleeds having regular nosebleeds may lead to anaemia, althoughthis is rare haematuria (blood in your urine) but this rarely causes anaemiaand may be a symptom of another condition Malabsorption Malabsorption is when your body cant absorb iron from food, and is another possible cause of iron deficiency anaemia. This may happen if you have coeliac disease , a common digestive condition where a person has an adverse reaction to gluten, or surgery to remove all or part of your stomach (gastrectomy). Lack of iron in your diet Unless youre pregnant, its rare for iron deficiency anaemia to be caused solely by a lack of iron in your diet. However, a lack of dietary iron can increase your risk of developing anaemia if you also have any of the conditions mentioned above. Some studies suggest vegetarians or vegans are more at risk of iron deficiency anaemia because of the lack of meat in their diet. If you are vegetarian or vegan,it is possible to gain enough iron by eating other types of food, such as: beans nuts dried fruit, such as dried apricots wholegrains, such as brown rice fortified breakfast cereals soybean flour most dark-green leafy vegetables, such as watercress and curly kale If youre pregnant, you may need to increase the amount of iron-rich food you consume during pregnancy to help prevent iron deficiency anaemia. Read more about vegetarian and vegan diets Diagnosing iron deficiency anaemia See your GP if you experience symptoms of iron deficiency anaemia , such as tiredness, shortness of breath and heart palpitations. A simple blood test can usually confirm the diagnosis. Your GP may also carry out a physical examination and ask you a number of questions to help determine the cause of your anaemia. Blood test To diagnose iron deficiency anaemia, a blood sampleis taken from a vein in your arm and a full blood countis made. This meansall the different types of blood cells in the sample will be measured. If you have anaemia: your levels of haemoglobin a substance that transports oxygen will be lower than normal youll have fewer red blood cells, which contain haemoglobin, than normal your red blood cells may be smaller and paler than usual Your GP may also test for a substance called ferritin, a protein that stores iron. If your ferritin levels are low, it means there isnt much iron stored in your body and you mayhave iron deficiency anaemia. Read more about blood tests Vitamin B12 and folate deficiency If your GP thinks your anaemia may be the result of a vitamin B12 and folate deficiency, the levels of these substances may be tested. Folate works with vitamin B12 to help your body produce red blood cells. Vitamin B12 and folate deficiencyanaemia is more common in people who are over the age of75. Finding the cause To determine the underlying cause of your anaemia, your GP may ask questions about your lifestyle and medical history. For example, they may ask you about: your diet to see what you typically eat and whether this includes any iron-rich foods any medicines you take to see if youve been regularly taking a type of medicine that can cause bleeding from the stomach and intestines (gastrointestinal bleeding), such as ibuprofen or aspirin your menstrual pattern if youre a woman, your GP may ask if youve been experiencing particularly heavy periods your family history youll be asked if your immediate family has anaemia ora history of gastrointestinal bleeding or blood disorders Irondeficiency anaemia is common during pregnancy. If youre pregnant, your GP will usually only look for an alternative cause if a blood test has identified a particularly low haemoglobin level, or if your symptoms or medical history suggest your anaemia may be caused by something else. Physical examination Aphysical examination will usually only be needed if the cause of your iron anaemia deficiency hasnt been identified by examining your medical history and asking you about your symptoms. In such cases, your GP may: examine your stomach (abdomen) to check for any physical signs of gastrointestinal bleeding look for signs of heart failure , such asswollen anklesheart failure can have some similar symptoms to iron deficiency anaemia Two other possible types of physical examination you may have are explained below. Rectal examination Arectal examination is usually only needed if youre bleeding from your bottom. Itsa common procedure that can help your GP find out if theres something in your gastrointestinal tract thats causing bleeding. Your GP will insert a lubricatedglovedfinger into your bottom to feel for any abnormalities. A rectal examination isnt something to be embarrassed about, as its a procedure your GP will be used to doing. It shouldnt cause significant pain, but it may cause some slight discomfort this will only last for a minute. Pelvic examination Women may have a pelvic examination if their GP thinks heavy menstrual bleeding (menorrhagia) may be the cause of their anaemia. During a pelvic examination, your GP will examine your vulva and labia (external sex organs) for signs of bleeding or infection. They may also examine you internally. This will involve your GP inserting lubricated gloved fingers into your vagina to feel whether yourwomb (uterus)is tender or enlarged. A pelvic examination wont be carried out without your consent(permission), and you can choose to have someone with you. Referral to a specialist In some cases, your GP may refer you to a gastroenterologist, a specialist in treating digestive conditions. Theyll carry out a more thorough examination. For example, you may be referred to a gastroenterologist if your GP cant identify a cause and you have a particularly low haemoglobin level, or if your GP thinks theres a possibility your symptoms could be caused by stomach cancer or bowel cancer , although this is unlikely. If youre a woman with heavy periods, you may be referred to a gynaecologist if you dont respond to treatment with iron supplements. Treating iron deficiency anaemia Treatment for iron deficiency anaemia usually involves taking iron supplements and changing your diet to increase your iron levels, as well as treating the underlying cause. Iron supplements Your GP will prescribe an iron supplement to restore the iron missing from your body. The most commonly prescribed supplement is ferrous sulphate,which is takenas a tablet, usually twice a day. Some people canexperience side effects when taking iron supplements, including: abdominal (tummy) pain constipation or diarrhoea heartburn feeling sick black stools (faeces) These side effects should settle down over time. However, your GP may recommend taking the tablets with food or shortly after eating if you have troublesome side effects. Your GP may also advise you to only take one or two tablets a day, instead of three, if youre finding side effects difficult to cope with. If you cant take ferrous sulphate because you get severe side effects, you may be prescribed a different iron supplement called ferrous gluconate. This supplement should cause fewer side effects because it contains a less concentrated dose of iron. However, it may take longer for the iron levels in your body to be restored. Ina fewcasesfor example, if you have chronic kidney disease (CKD) iron injections may be recommended instead of tablets. As with all medications,its important to store iron supplements out of the reach of children. An overdose of iron supplements in a young child can be fatal. Dietary advice If a lack of iron in your diet is thought to be contributing to your iron deficiency anaemia, your GP will tell you how to up your intake. Iron-rich foods include: dark-green leafy vegetables, such aswatercress and curly kale iron-fortified cereals or bread brown rice pulses and beans nuts and seeds white and red meat fish tofu eggs dried fruit,such asdried apricots, prunes and raisins Your diet should include foods from all the major food groups to ensure itshealthy and balanced. In particular,food and drink containing vitamin Care importantas vitamin C helps your body absorb iron. However, consuming large amounts of some foods and drinks, as well as certainmedicines,may make it harder for your body to absorb iron. These include: tea and coffee calciumfound indairy products, such as milk antacidsandproton pump inhibitors (PPIs)medications usedto relieve indigestion wholegrain cerealsalthough wholegrains are a good source of iron themselves, they contain phytic acid, which can stop your body absorbing iron from other foods and pills You may be referred to a nutrition specialist called a dietitian if youre finding it difficult to include iron in your diet. Theyll be able to give you detailed, personalised advice about how you canimprove your diet. Treating the underlying cause Your GP will also need to ensurethe underlying cause of your anaemia is treated soit doesnt happen again. For example, ifnon-steroidal anti-inflammatory drugs (NSAIDs) are causing bleeding in your stomach, your GP may prescribe a different medicine to help minimise the risk of stomach bleeding. Heavy periods canbe treated withmedication or in particularly severe cases surgery. Monitoring Your GP will ask you to return two to four weeks after youve started takingiron supplements to check how well youve responded to the treatment. Youll have a blood test to check your haemoglobin levels. If yourblood test results show an improvement, youll be asked to continue taking iron supplements and return in two to fourmonths for another blood test. Once your haemoglobin levels and red blood cells are normal, your GP will usually recommend continuing totake iron supplements for three months to help build up the iron levels in your body. After this, you should be able to stop taking the supplements, depending on the cause of your iron deficiency anaemia. Your condition will be monitored every three months over the course of a year, and again a year later. Continuing treatment Sometimes after a persons iron levels have been replenished, they start to fall again. This could happen if you dont get enough iron in your diet, youre pregnant, or you have consistently heavy periods. In such cases, you may be prescribed an ongoing iron supplement to help stop your anaemia returning. This will usually be a tablet, which youll have to take once a day. If treatment is ineffective If your iron levels dont improve, your GP will ask how regularly youve been taking your iron supplements. Some people are put off taking the medication because of the side effects. However, your condition wont improve if you dont take the supplements. If youve been taking the supplements as prescribed and your iron levels still havent improved, your GP may refer you to a specialist for an assessment. Complications of iron deficiency anaemia Iron deficiency anaemia rarely causes serious or long-term complications, although some people with the condition find it affects their daily life. Somecommon complications are outlined below. Tiredness Iron deficiency anaemia can make you feel tired and lacking in energy (lethargic). This may result in you being less productive at work, andyou may find it difficult to stay awakeornot feel able to exercise regularly. Increased risk of infections Research has showniron deficiency anaemia can affect your immune system the bodys natural defence system. This increases your vulnerability to infection. Heart and lung problems Adults with severe anaemia may be at risk of developing complications that affect their heart or lungs. For example, you may develop tachycardia , which isan abnormally fast heartbeat,or heart failure , where the heart fails to pump enough blood around your body at the right pressure. Pregnancy complications Pregnant women with severe anaemia have an increased risk of developing complications, particularly during and after birth. They may also develop postnatal depression , which some women experience after having a baby. Research suggests babies born to mothers who have untreated anaemia are more likely to: be born prematurelybefore the 37th week of pregnancy have a low birth weight have problems withiron levels themselves do less well in mental ability tests Restless legs syndrome Some cases of restless legs syndrome are thought to be caused by iron deficiency anaemia. Doctors often refer to this as secondary restless legs syndrome. Restless legs syndromeis a common condition that affects the nervous system, andcauses an overwhelming, irresistible urge to move the legs. It also causes an unpleasant feeling in the feet, calves and thighs. Restless legs syndrome caused by iron deficiency anaemiacan usually be treated with iron supplements. Source: NHS 24 - Opens in new browser window Last updated: 21 November 2023 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Dont include personal information e.g. name, location or any personal health conditions. Email Address e.g. [email protected] Message Maximum of 500 characters Send feedback Add this page to\n Info For Me Also on NHS inform Vitamin B12 or folate deficiency anaemia Stomach ulcer Other health sites NICE: Heavy menstrual bleeding (1) NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats 2023 NHS 24 v1.1.1.17852

Irritable bowel syndrome (IBS)

Irritable bowel syndrome (IBS) | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotlands Service Directory 0 Home Illnesses and conditions Stomach, liver and gastrointestinal tract Irritable bowel syndrome (IBS) Irritable bowel syndrome (IBS) Learn about what IBS is and how it can be managed What is IBS? Irritable bowel syndrome (IBS) is a common, long-term condition of the digestive system. The condition is often lifelong, although the symptoms may change over time. With the right strategies, IBS can be successfully managed. IBS does not pose a serious threat to your physical health and does not increase your chances of developing cancer or other bowel-related conditions. The exact cause of IBS is unknown. Many causes have been suggested but none have been proven to lead to IBS. IBS symptoms The symptoms of IBS vary between individuals and affect some people more severely than others. Symptoms can become worse, often during times of stress or after eating certain foods. You may find some of the symptoms of IBS ease after going to the toilet and moving your bowels. Main symptoms The most common symptoms of IBS are: abdominal (stomach) pain and cramping, which may be relieved by moving your bowels a change in your bowel habits such as diarrhoea , constipation or sometimes both bloating and swelling of your stomach excessive wind ( flatulence ) occasionally experiencing an urgent need to move your bowels Less common syptoms Other less common symptoms may also be experienced, such as: lack of energy (lethargy) feeling sick heartburn The symptoms of IBS can also have a significant impact on a persons day-to-day life and, as a result, some people may experience symptoms of low mood and stress. See your GP if: you think you have IBS type symptoms, so they can try to identify the cause youre feeling anxious or experiencing a change in your mood as this can worsen IBS symptoms See your GP urgently if: You have other symptoms, including: a change in your bowel habits that has lasted for more than 6 weeks, especially if you are over 50 years of age unexplained weight loss a swelling or lump in your stomach or back passage bleeding from your back passage These can sometimes be a sign of a potentially more serious condition. You should also tell your GP if you have these symptoms and a family history of bowel cancer or ovarian cancer . Diagnosing IBS There are no specific tests for IBS. Many cases can be diagnosed based on your symptom history and your GP will undertake some routine blood and stool tests to rule out other conditions. As the symptoms of IBS are similar to other conditions such as coeliac disease and inflammatory bowel disease, it is important to rule these out. It is important not to make any dietary changes until these tests have been done. This is particularly important for the blood test for coeliac disease as the result can be affected by your diet. Private allergy testing (for example hair sampling) is not a reliable way to test for allergies or intolerances. If you are concerned, please talk to your GP. Managing irritable bowel syndrome (IBS) Learn about things that can help IBS symptoms IBS and your mental health Learn about the link between IBS and mental health and what can help Irritable bowel syndrome (IBS) (BSL) What IBS is and how its treated in British Sign Language (BSL) NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats 2023 NHS 24 v1.1.1.17852

Itching

Itchy skin | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotlands Service Directory 0 Home Illnesses and conditions Skin, hair and nails Itchy skin Itchy skin Itching is an unpleasant sensation that compels a person to scratch the affected area. Learn about causes and treatments of itching. About itchy skin Common causes of itchy skin, how to ease it and when to see your GP Causes of itchy skin Common causes of itchy skin, including allergies, skin conditions and other conditions Treatments for itchy skin The types of treatments available to help itchy skin NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats 2023 NHS 24 v1.1.1.17852

Itchy bottom

Itchy bottom | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotlands Service Directory 0 Home Illnesses and conditions Skin, hair and nails Itchy bottom Itchy bottom Itchy bottom is a strong urge to scratch the skin around your bottom (anus). The anus is the opening at the lower end of the digestive system, where solid waste leaves your body. Causes of itchy bottom The cause of itchy bottom isnt always known. If it gets better quickly without treatment, it may be the result of a short term issue. For example, sweating more in hot weather. Its rare for an itchy bottom alone to be a sign of something more serious. If an itchy bottom lasts longer, you may be able to get an idea of the cause from other symptoms you have. But, you should not self-diagnose. Speak to your GP if youre worried. An itchy bottom thats worse at night can be caused by threadworms. This is often the case for children. You cant take medicine for threadworms if youre: pregnant breastfeeding a child under 2 This means you should speak to a GP, midwife or health visitor instead. Conditions with itchy bottom Sometimes an itchy bottom can be a symptom of another problem or condition. This includes: skinconditions like eczema or psoriasis if you have itching elsewhere on the body too threadworms (especially in children) symptoms will get worse at night and there will be worms in poo (they look like bits of thread) haemorrhoids (piles) swellings in and around the anus, as well as pain and blood when pooing bowel incontinence or diarrhoea can cause poo leaking or pooing you can not control sexually transmitted infection (STI) like genital warts can cause sores, swelling and irritation ringworm can cause sores, swelling and irritation Some long-term medications can also cause an itchy bottom. For example, steroid creams or peppermint oil. When to get help A pharmacist can often help to treat an itchy bottom. You can ask if they have a private area to discuss your symptoms. They can suggest treatments like: creams and ointments to relieve itching medication if the symptoms are caused by threadworms Find your nearest pharmacy Speak to your GP if: You have an itchy bottom that: doesnt get better after 3 to 4 days keeps coming back makes you anxious or depressed affects your sleep is painful is accompanied by other symptoms, like itching elsewhere on your body You should also speak to a GP if your itchy bottom is caused by an underlying condition like piles. What to expect at your GP appointment Your GP might need to check your bottom (a rectal examination) to help find out whats causing your itching. You may feel awkward, but this is nothing to be embarrassed or worried about. Its one of the most common examinations GPs carry out. At your appointment, your GP may ask: whether you use creams, powders or soaps around your bottom how long you have had the itching whether the itching gets worse at night or after eating certain foods if you have any other symptoms Your GP will decide on the best treatment for you depending on whats causing your symptoms. They may suggest: things you can do yourself to ease an itchy bottom a stronger medication, cream or ointment How to ease an itchy bottom yourself Do use soft toilet tissue bath or shower daily have shorter, cooler showers and baths keep your bottom clean and dry wear loose-fitting cotton underwear change your underwear daily only put underwear on when your bottom is completely dry use a light duvet at night so you dont get too hot gently wash and dry your bottom after pooing and before bed keep your fingernails short to stop your skin from being damaged by scratching wear cotton gloves while sleeping to avoid damaging the skin if you scratch wear stockings instead of tights eat foods with fibre (fruit, vegetables and wholegrains) to help produce regular, solid poo Dont do not wear tight clothing do not use scented soaps, bubble bath or perfumes do not use scented powders near your bottom do not scratch if you can do not eat food or drink that makes your itching worse, for example caffeine, alcohol, citrus fruit or spicy foods Source: NHS 24 - Opens in new browser window Last updated: 01 March 2024 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Dont include personal information e.g. name, location or any personal health conditions. Email Address e.g. [email protected] Message Maximum of 500 characters Send feedback Add this page to\n Info For Me NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats 2023 NHS 24 v1.1.1.17852

Kaposis sarcoma

"Kaposi's sarcoma - Illnesses & conditions | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotlands Service Directory 0 Home Illnesses and conditions Cancer Cancer types in adults Kaposis sarcoma Kaposis sarcoma Kaposis sarcoma is a rare type of cancer caused by a virus. It can affect the skin and internal organs. Its mainly seen in people with a poorly controlled or severe HIV infection. It canalso affect some people who have a weakened immune system for another reason, as well as people who havea genetic vulnerability to the virus. Signs and symptoms The most common initial symptom is the appearance of small, painless, flat and discoloured patches on the skin or inside the mouth. Theyre usually red or purple and look similar to bruises. Over time, the patches may grow into lumps known as nodules and may merge into each other. Internal organs can also be affected, including thelymph nodes, lungs and the digestive system, whichcan cause symptoms such as: uncomfortable swelling in the arms or legs (lymphoedema) breathlessness , coughing up bloodand chest pain nausea, vomiting, stomach pain and diarrhoea The rate at which symptoms progress depends on the type of Kaposis sarcoma you have.Most types get worse quickly in a matter of weeks or months without treatment, but some progress very slowly over many years. When to seek medical advice You should speak to your GP if you have any worrying symptoms you think could be caused by Kaposis sarcoma.If you have HIV, you can also contact your local HIV clinicif you have any concerns. Your doctor will ask about your symptoms and examine your skin to look for the characteristic discoloured patches. If they suspect Kaposis sarcoma, they will refer you for further tests to confirm the diagnosis. These tests may include: an HIV test a blood test to confirm whether or not you have HIV (if you havent already been diagnosed with the condition) a skin biopsy where a small sample of cells is removed from an affected area of skin andchecked for Kaposis sarcoma cells anendoscopywhere a thin, flexible tube called an endoscope is passed down your throat to see if your lungs or digestive system are affected a computerised tomography (CT)scan to see ifyour lymph nodes or other parts of your body are affected What causes Kaposis sarcoma? Kaposis sarcoma is caused by a virus called the human herpesvirus 8 (HHV-8), also known as the Kaposis sarcoma-associated herpesvirus (KSHV). This virus is thought to bespread during sex, through saliva, or from a mother to her baby during birth. HHV-8 is a relatively common virus and the vast majority of people who have it will not develop Kaposis sarcoma.It only seems to cause cancer in some people with a weakened immune system and in some people who havea genetic vulnerability to the virus. A weakened immune system allows the HHV-8 virus to multiply to high levels in the blood, which increases the chance it will cause Kaposis sarcoma. Thevirusappears to alter the genetic instructions that control cell growth. This means some cells reproduce uncontrollably and form lumps of tissue known as tumours. Types of Kaposis sarcoma and their treatment There are 4 main types of Kaposis sarcoma. These types affect different groups of people and are treated in different ways. HIV-related Kaposis sarcoma Although its not as common as it used to be, Kaposis sarcoma is still one of the main types of cancer to affect people with HIV. HIV-related Kaposis sarcoma can progress very quickly if not treated. However, it can usually be controlled by taking HIV medication known as combination antiretroviral therapy (cART) to prevent HIV multiplying and allow the immune system to recover. The immune system can then reduce the levels of HHV-8 in the body. Read more about treating HIV . Some people may also require treatment with radiotherapy (where high-energy rays are usedto destroy cancer cells) or chemotherapy (where powerful medications are used to destroy cancer cells), depending on the site and extent of the cancer and what symptoms its causing. Classic Kaposis sarcoma Classic Kaposis sarcoma mainly affects middle-aged and elderly men of Mediterranean or Ashkenazi Jewish descent. Ashkenazi Jews are descended from Jewish communities that lived in central and eastern Europe. Most Jewish people inthe UKare Ashkenazi Jews. Its thought people who develop classic Kaposis sarcoma were born with a genetic vulnerability to the HHV-8 virus. Unlike the other types of Kaposis sarcoma,the symptoms of classic Kaposis sarcoma progress very slowly over many years and are usuallylimited to the skin. Immediate treatment isnt usually required because, in many cases, the condition doesnt affectlife expectancy. Youll usually be monitored carefully and only treated if the symptoms get significantly worse. Radiotherapy isoften used if treatment is required, although smallskin patches or nodules may be removed using minor surgery or cryotherapy (freezing). Transplant-related Kaposis sarcoma Transplant-related Kaposis sarcoma is a rare complication of an organ transplant.It occurs because the immunosuppressant medication used to weaken the immune system and help prevent the body rejecting the new organ can allow a previous HHV-8 infection to reactivate, which means levels of the virus increase as it starts multiplying again. Transplant-related Kaposis sarcoma can be aggressive and usually needs to be treated quickly. Itsnormally treated by reducing or stopping the immunosuppressants, if this is possible. If this is unsuccessful, radiotherapy or chemotherapy may be used. Endemic African Kaposis sarcoma Endemic African Kaposis sarcoma is common in parts of Africa and is one of the most widespread types of cancer in that region. Although this type of Kaposis sarcoma is classified separately from HIV-related Kaposis sarcoma, many cases may actually result from an undiagnosed HIV infection. All suspected cases thereforemust have an HIV test, as the most effective treatment in these cases is HIV medication. In cases not caused by HIV infection, this type of Kaposis sarcoma may be the result of a genetic vulnerability to HHV-8. These cases are usually treated with chemotherapy, although sometimes radiotherapy may be used. Outlook With proper treatment, Kaposis sarcoma can usually be controlled for many years. Deaths from the condition are uncommon in the UK. The discoloured patches of skin will often shrink and fade with treatment, although they may not ever disappear completely. A complete cure for any type of Kaposis sarcoma isnt always possible, and theres a chance the condition could recur in the future. If you think this is happening, contact your HIV clinic, hospital specialist or GP as soon as possible. Source: NHS 24 - Opens in new browser window Last updated: 13 November 2023 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Dont include personal information e.g. name, location or any personal health conditions. Email Address e.g. [email protected] Message Maximum of 500 characters Send feedback Add this page to\n Info For Me Other health sites Cancer Research UK: Kaposi's sarcoma Macmillan Cancer Support: Kaposi's sarcoma Search for cancer support services near you Enter a place or postcode NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats 2023 NHS 24 v1.1.1.17852"

Kidney cancer

Kidney cancer - Illnesses & conditions | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotlands Service Directory 0 Home Illnesses and conditions Cancer Cancer types in adults Kidney cancer Kidney cancer About kidney cancer Symptoms of kidney cancer Causes and risk factors of kidney cancer Diagnosing kidney cancer Treating kidney cancer Preventing kidney cancer About kidney cancer Kidney cancer is the eighth most common cancer in adults in the UK. Signs and symptoms of kidney cancer can include: blood in your urine a constant pain in your side, just below the ribs a lump or swelling in the kidney area (on either side of the body) Speak to your GP as soon as possible if you experience any of these symptoms. They will examine you and may refer you to a specialist clinic for further tests. In around half of all cases of kidney cancer, there are no symptoms, and the condition is detected during tests for other unrelated conditions. Read more about the symptoms of kidney cancer and diagnosing kidney cancer . The kidneys and cancer The kidneys are 2 bean-shaped organs located on either side of the body, just underneath the ribcage. Their main role is to filter out waste products from the blood, in addition to producing urine. Only 1 of the kidneys is usually affected by cancer. The human body is made up of billions of cells, which normally grow and multiply in an orderly way, with new cells being created only when and where theyre needed. In cancer, this orderly process goes wrong and cells begin to grow and multiply uncontrollably. Exactly what triggers this growthis unknown. However, there are certain risk factors that can increase the chances of the condition developing, such as smoking and obesity . Kidney cancer most frequently affects people over 50 years of age and is more common among men. Read more about the causes of kidney cancer . Types of kidney cancer Many different types of cancer can affect the kidneys. The most common type is renal cell carcinoma (RCC), which accounts formore than 80%of all kidney cancers. Rarer types of kidney cancer include: transitional cell cancer develops in the lining of the kidneys and usually affects men who are 50 years of age or over Wilms tumour a rare type of kidney cancer that affects children This topic focuses on RCC. Read theCancer Research UKwebsite for more information about transitional cell cancer and Wilms tumour . Treating kidney cancer The earlier kidney cancer is diagnosed, the easier it is to treat. How its treated will depend on the size and spread of the cancer. Surgery to remove the cancerous cells is usually the first course of action. Unlike most other cancers, chemotherapy isnt very effective at treating kidney cancer. However, non-surgical treatments are available, such as radiotherapy or targeted therapies. These are most commonly used in the more advanced stages of kidney cancer, when the cancer has spread beyond the kidney. Read more about treating kidney cancer . Preventing kidney cancer As the causes of kidney cancer arent fully understood, its not possible to fully prevent it. However, leading a healthy lifestyle may reduce the chances of developing the condition. A combination of a healthy diet and regular exercise will help to avoid becoming overweight or obese, which is a significant risk factor for kidney cancer. If youre overweight or obese, you can lose weight and maintain a healthy weight by combining regular exercise with a calorie-controlled diet. Read more about treating obesity . Symptoms of kidney cancer Most cases of kidney cancer dont cause any symptoms in the early stages. The most common symptoms of mid- to advanced-stage kidney cancer are: blood in your urine (haematuria) the amount of blood is usually high enough to change the colour of your urine to a reddish or dark brown colour apersistentpain in your side, just below the ribs a lump or swelling in the area of yourkidneys (on either side of the body) However, in around half of all cases, the cancer causes no symptoms and is only detected during a routine ultrasound scan . Less common symptoms of kidney cancer include: extreme tiredness (fatigue) or anaemia unintentional weight loss a high temperature of 38C (100.4F) or above night sweats a general sense of feeling unwell swelling of the veins in the testicles (in men) loss of appetite high blood pressure (hypertension) When to seek medical advice Speak to your GP immediately if you have pain or a swelling or lump in your kidney area (on either side of your body, just below your ribcage). You should also speak to your GP if youhave blood in your urine. Although its highly unlikely to be caused by kidney cancer, it couldbea symptom of a less serious condition that still requires treatment, such as a kidney stone or bladder stone. Causes and risk factors of kidney cancer The exact cause of kidney cancer is unknown, but there are risk factors that can increase the chances of developing the condition. The3main risk factors for kidney cancer are: obesity smoking family history and genetics Obesity Obesity isa significant risk factor for kidney cancer. Theres a strong link between someonesbody mass index (BMI) and their risk of developing kidney cancer. Read more about how BMI is calculated ,and work out your BMI. A BMI score of 25 or above has been shown to increase a persons chances of developing kidney cancer. Those with a BMI score of 30 or above are at particularly high risk. This may be because overweight or obese people, particularly women, have higher levels of a hormone called oestrogen in their body. Its thought that excess levels of oestrogen may stimulate the growth of cancerous cells. Cases of kidney cancer have been increasing over the last 40 years, which has been linked to rising obesity levels. Smoking Smoking is also asignificant risk factor for developing kidney cancer, and the more you smoke the greater the risk. For example, research has shown that if you regularly smoke 10 cigarettes a day, youre one-and-a-half timesmore likely to develop kidney cancer compared to a non-smoker. This increases to twice as likelyif you smoke 20 or more cigarettes a day. Its not clear why smoking increases your chances of developing kidney cancer. Family history and genetics If you have a close family member (parents, brothers, sisters or a child) whos been diagnosed with kidney cancer, youre about twice as likely to develop kidney cancer yourself. Examples of inherited genetic conditions and syndromes that increase your risk of developing kidney cancer include: tuberous sclerosis a rare genetic condition that causes multiple non-cancerous (benign) tumours to grow in the body; its autosomal dominant, which means you only have to inherit the faulty gene from one parent to get it; about 1 in every 100 people with tuberous sclerosis will develop kidney cancer hereditary papillary kidney cancer a rare form of cancer caused by faulty genes inherited from your parents; its autosomal dominant and causes small, slow-growing, cancerous tumours to develop in the kidneys, which can sometimes spread hereditary leiomyomatosis and renal cell carcinoma (HLRCC) a rare, autosomal dominant form of cancer, where cancerous tumours develop from smooth muscle tissue (leiomyomatas); people with HLRCC have a 10to 16% increased risk of developing kidney cancer Von Hippel-Lindau syndrome a rare genetic syndrome that causes small non-cancerous tumours to develop inside the nervous system; VHL is also autosomal dominant and about 4 out of 10 people who have it develop kidney cancer Birt-Hogg-Dub syndrome an inherited syndrome that causes non-cancerous tumours to develop in the hair follicles of the skin; they usually occur on the face, neck and torso Otherpossible risk factors There are also anumber of other possible risk factors for developing kidney cancer, including: mild painkillers some mild painkillers have been linked to an increased risk of developing kidney cancer; NSAIDs , such as ibuprofen , may slightly increase the risk, although occasional use or low doses are unlikely to be harmful kidney disease if you have kidney failure and need to have regular dialysis (treatment to replicate the functions of the kidneys), your risk of developing kidney cysts and kidney cancer is increased high blood pressure (hypertension) high blood pressure is a known risk factor for kidney disease, and youre up to twice as likely to develop kidney cancer if you have raised blood pressure Diagnosing kidney cancer In many cases, kidney cancer is diagnosed after routine scans and check-ups, as the condition doesnt always have obvious symptoms. You should speak to your GP if you have any symptoms of kidney cancer,such asblood in your urine or a constant pain below your ribs. Your GP will examine you and, if they think your symptoms need further assessment, refer you to a specialist urologist (a doctor whospecialises inconditions that affect the urinary tract). If you notice blood in your urine,your GP will usuallycarry out a blood test and take a urine sample. The results will help rule out otherpossible causes, such as infection or kidney stones . In 2015, the National Institute for Health and Care Excellence ( NICE ) published guidelines to help GPs recognise the signs and symptoms ofrenal (kidney) cancerand refer people for the right tests faster. To find out if you should be referred for further tests for suspectedkidney cancer, read the NICE 2015 guidelines on Suspected Cancer: Recognition and Referral . If you need to be referred urgently, youll usually be seen within 2 weeks. Further tests If your GP refers you to a hospital specialist,further tests will helpdetermine whether you have kidney cancer. Ultrasound scan An ultrasound scan uses high-frequency sound waves to create an image of an organ in the body. It can often detect changes in the shape of the kidney that might becaused bya cancerous tumour. An ultrasound scan may be needed if the cause of the blood in your urine cant be found. Computerised tomography scan You may also be referred for a computerised tomography (CT) scan . During a CT scan, a series of detailed images of the inside of your body are taken and put together by a computer. If you have a CT scan, you may be given a special dye to drink, or it may be injected. The dye makes the results of the CT scan clearer. Image-guided biopsy In some cases of kidney cancer, an image-guided biopsy is carried out. Its a minor surgical procedure performed under local anaesthetic .This means youll be awake during the procedure, but thearea surrounding the affected kidney will be numbed, so that you dont feel anything. During an image-guided biopsy, a radiologist or surgeon will use an ultrasound or CT scan to guide a needle through your skin and into your kidney. A small tissue sample will be removed from your kidney and examined under a microscope to check for cancerous cells. Magnetic resonance imaging (MRI) scan You may also need to have a magnetic resonance imaging (MRI) scan , which can be used toproduce detailed images of your kidneys. The images can help identify a tumour and determineits size. Cystoscopy Acystoscopy is a medical procedure that uses an instrument called a cystoscope to examine theinside of your bladder and urinary system. This proceduredoesnt look atthe kidneys, but it can rule out or confirm whether any bleeding is coming from problems in the bladder. Intravenous pyelogram (IVP) An intravenous pyelogram (IVP) test involves injecting a dye into your bloodstream. X-rays are taken after a short time, with the dye highlighting any growths present in the kidneys. Staging and grading If kidney cancer is confirmed, its usually possible to determine its grade and stage. The stage describes how far the cancer has spread, and the grade describes how aggressive the cancer is and how quickly its likely to spread. Both the stage and grade of your kidney cancer will help determine your recommended treatment and the likelihood of achieving a cure. Healthcare professionals use the TNM systemto stage kidney cancer: T indicates how large the tumour has grown (a tumour is a lump of cancerous tissue) N indicates whether nearby lymph nodes are affected (lymph nodes are small, oval-shaped glands found throughout the body, which help protect against infection) M indicates whether the cancer has spread to another part of the body (M stands for metastases, which is the medical term for cancer that has spread) The stages of tumour size are: T1a where the tumour is less than 4cm (about 1.6 inches)in diameter T1b where the tumour is 4to 7cm (about 1.6-2.8 inches) in diameter T2 where the tumour is larger than 7cm (2.8 inches)in diameter, but hasnt spread out of the kidney T3a where the tumour has spread into the adrenal gland or the layer of fat surrounding the kidney T3b where the tumour has spread into the renal vein (the vein that carries blood back from the kidney to the heart) or into the vena cava (the vein that carries blood back from the top half of the body) T3c where the tumour has spread past the diaphragm (the sheet of muscle that separates the top part of the abdomen from the bottom part) T4 where the tumour has spread beyond the tough layer of tissue that surrounds and protects the kidney There are 3 lymph node stages: N0 where no lymph nodes have been affected N1 where there are cancer cells in 1 lymph node N2 where there are cancer cells in 2 or more lymph nodes M0 means that the cancer hasnt spread to another part of the body. M1 means that the cancer has spread. Kidney cancer is graded using a scale of one to four. The higher the grade, the more aggressive the cancer. Coping with cancer Being diagnosed with cancer can be very distressing, particularly if its incurable. The news can often be difficult to take in and comprehend. After cancer has been diagnosed, you may find that talking to a counsellor or psychiatrist helps you deal withfeelings of depression and anxiety . Antidepressants may also be used to help you through this process. Read more about coping with a cancer diagnosis . More information can be found on our pages about living with cancer . Treating kidney cancer The treatment of kidney cancer depends on the size and spread of the cancer. Surgery is the most common first course of action, with the aim of removing the cancer cells. Unlike most other cancers, chemotherapy isnt very effective in treating kidney cancer. However, there are non-surgical treatments available, such as radiotherapy or targeted drug therapies. The main treatments for kidney cancer include: nephrectomy embolisation radiotherapy targeted therapies immunotherapy Your treatment plan You can expect to be cared for by a multidisciplinary team, often comprising a specialist cancer surgeon, an oncologist (who specialises in radiotherapy and chemotherapy ), a radiologist, a nephrologist (a kidney specialist) and a specialist nurse. Youll begiven a key worker, usuallythe specialist nurse, who will be responsible for coordinating your care. Your team will recommend what they think is the best treatment option, but the final decision will be yours. When deciding what treatment is best for you, your doctors will consider: the stage and grade of your cancer (how big it is and how far its spread) your age and general health If the cancer hasnt spread out of your kidney (T1 or T2 kidney cancer), it can usually be cured by removing some or all of the kidney. If the cancer has spread out of your kidney (T3 or T4 kidney cancer), a complete cure may not be possible. However, it should be possible to slow the cancers progression and treat any symptoms. Surgical treatments Nephrectomy A nephrectomy is an operation to remove a kidney. If the tumour is less than 4cm (1.5 inches) in diameter, it may only be necessary to remove some of your kidney. This is known as a partial nephrectomy. A partial nephrectomy may also be required if your remaining kidney is in poor health. If the tumour is more than 4cm in diameter, your entire kidney will need to be removed. Even if the cancer has spread beyond your kidney, you may still benefit from having your kidney removed. Removing the kidney can help resolve the pain, and make other types of non-surgical treatment more effective. Its possible to live a normal life with only 1 kidney, because the other kidney will be able to compensate. During a nephrectomy, the surgeon may also remove nearby lymph nodes to make sure the cancer hasnt spread beyond the kidney. There are 2 ways that both a partial and open nephrectomy can be performed They are an: open nephrectomy where the kidney is removed through a large incision in your abdomen (stomach) laparoscopic or keyhole nephrectomy wherea series of smaller incisions are made in your abdomen, and the kidney is removed using small surgical instruments Both techniques have advantages and disadvantages. A laparoscopic nephrectomy has a considerably quicker recovery time than an open nephrectomy. However, the procedure requires surgeons with specialised training, so you may have to wait longer to receive treatment than you would if youdecided to have an open nephrectomy. Some types of kidney cancer, where the tumour is located in the centre of the kidney, may not be suitable for a laparoscopic nephrectomy. One of the main disadvantages of an open nephrectomy is that its a major surgical procedure that can place a considerable strain on the body. This means it may not be suitable for people who are particularly frail or unwell. You should discuss the pros and cons of both procedures with your surgical team. Embolisation If youre unable to have a nephrectomy, you may benefit from an alternativeoperation known as embolisation. During embolisation, the surgeon will insert a small tube called a catheter into your groin, then use X-ray images to guide the catheter into the blood supply of your kidney. A substance will then be injected through the catheter to block the blood supply to your kidney. By blocking blood supply to the kidney, any tumours that are present will become starved of oxygen and nutrients, causing them to shrink. Non-surgical treatments for advanced kidney cancer Kidney cancer is one of the few types of cancer thats less responsive to chemotherapy (where powerful medication is used to kill cancerous cells). However, a number ofclinical trials are underway that are looking at new combinations of chemotherapy medications that appear to be benefiting some people. There are also a number of different non-surgical treatments that can slow the spread of the cancer and help control its symptoms. Radiotherapy Radiotherapy cant usually cure kidney cancer, but it canslow down its progress and help reduce pain. You should only need a few minutes of radiotherapy every day, for a number of days. When radiotherapy is used to control the symptoms of cancer rather than cure it, the side effects tend to be mild. Possible side effects may include fatigue (tiredness), nausea and vomiting. Cryotherapy Cryotherapy involves killing cancer cells by freezing them. It may beused if a person isnt fit enough for surgery, or if their tumour is small. Cryotherapy is usually classed as either percutaneous (where needles arepassed through the skin) or laparoscopic (where needles are placed directly into the kidney through a small incision). Side effects include bleeding around the kidney and injury to the tube that carries urine from the kidney to the bladder (the ureter). Radiofrequency ablation Radiofrequency ablation (RFA) uses heat generated by radio waves to kill cancer cells. This is a percutaneous treatment, meaning no incision is needed. This treatment is only available at specialist centres. Its mainly used if youre not strong enough for surgery or your kidney cancer is in the early stages. RFAcant be used if the cancer is too close to other organs, such as the bowel. Side effects include bleeding in the treatment area, a collection of blood (haematoma) near the kidney, and problems passing urine due to the narrowing of the tube that joins the kidney to the bladder (the ureter). Targeted therapies A number ofnew medicines have been developed for the treatment of kidney cancer. These are: sunitinib pazopanib axitinib sorafenib temsirolimus everolimus bevacizumab These medicines are sometimes referred to as targeted therapies because theyre designed to target and interrupt the functions needed by cancer to grow and spread. At present, only sunitinib, pazopanib and axitinibhave been recommended by the National Institute for Health and Care Excellence (NICE) . Theyre available on the NHS for people who are still relatively healthy and have advanced kidney cancer, or kidney cancer thats spread to other parts of their body. Sorafenib, temsirolimus, everolimus and bevacizumab arent currently recommended by NICE. Sunitinib Sunitinib is the most commonly prescribed treatment for kidney cancer. Its a type of medication known as a tyrosine kinase inhibitor. Tyrosine kinase is an enzyme (protein) that helps cancer cells to grow. Sunitinib works by blocking protein kinase, stopping cancer from growing. Sunitinib is taken as a capsule with or without food. You take it once a day for 4 weeks before having a 2-week break. This 6-week cycle is repeated for as long as the treatment is effective. Its very important that you take sunitinib in the exact dosage thats been prescribed for you. Never stop taking medication for cancer without first consulting your specialist. Common side effects of sunitinib include: nausea diarrhoea high blood pressure (hypertension) hair discolouration mouth soreness skin discolouration skin rashes or blisters The Cancer Research UK website has more information about sunitinib and its side effects . Pazopanib Like sunitinib, pazopanib is a tyrosine kinase inhibitor that can be used to slow down or stop the growth of cancer cells in the kidneys.It also prevents cancer cells from developing blood vessels, which they need to grow. Pazopanib is taken as a tablet once a day with a glass of water. You should take it about the same time each day, either at least an hour before eating or 2 hours afterwards. Its important that you take it in the exact dosage that your specialist has prescribed for you. Common side effects of pazopanib include: nausea diarrhoea high blood pressure hair discolouration abnormal liver function The Cancer Research UK website has more information about pazopanib . Axitinib Axitinib may be recommended for treating advanced kidney cancer if sunitinib and/or pazopanib have stopped working or havent been effective. Like sunitinib and pazopanib, axitinib is a tyrosine kinase inhibitor that blocks tyrosine kinase and stops cancer growing. Axitinib is taken as a tablet with a glass of water twice a day, about 12 hours apart. Your specialist may start you on a low dose which, depending on how you feel, may be increased after 2 weeks. Its very important that you take the exact dose thats been prescribed for you. Common side effects of axitinib include: diarrhoea nausea and vomiting loss of appetite tiredness a decrease in thyroid hormone level ( hypothyroidism ) headaches weight loss loss of fertility The Cancer Research UK website has more information about axitinib . Sorafenib Sorafenib is another tyrosine kinase inhibitor that blocks the protein, tyrosine kinase, which encourages cancer cells to grow. It also prevents cancer cells from developing blood vessels which they need to grow. Sorafenib is taken as a tablet twice a day (at the same time each day) with a glass of water. It can also be taken with a meal, but make sure the food is low-fat, because high-fat foods make it less effective. Again, its very important that you take sorafenib as instructed by your doctor at the exact dosage prescribed for you. Common side effects of sorafenib include: diarrhoea fatigue nausea and vomiting hair thinning (in around one in four people) increased risk of bleeding such as nosebleeds or bleeding gums loss of fertility flushed skin The Cancer Research UK website has more information about sorafenib. Temsirolimus Temsirolimus is sometimes used to treat advanced kidney cancer. Its a type of medication known as an mTOR inhibitor, which blocks a protein called mTOR, thats usually active in cancer cells, making them reproduce and multiply. Temsirolimus also prevents blood vessels from developing, which cancer cells need to grow. Temsirolimus is a liquid thats delivered directly into the bloodstream, either through a tube thats put into a vein in your arm (catheter), or a tube into a large vein in your chest (a central line). The treatment takes 30to 60 minutes and you have it once a week in hospital. Before each dose, an antihistamine is usually given to prevent an allergic reaction. Common side effects of temsirolimus include: red, dry, itchy skin nausea and vomiting lack of appetite diarrhoea a sore mouth or mouth ulcers sleeping problems loss of fertility Everolimus Everolimus is a medication for advanced kidney cancer thats returned during or following treatment. It stops some of the signals produced within cells that make them grow and divide. Everolimus prevents the mTOR protein from working properly, which plays an important role in the growth of cancer cells. Everolimus is taken as a tablet once a day at the same time each day. It should be swallowed whole with a glass of water, rather than being chewed or crushed. It can be taken with or without food. Its very important that everolimus is taken using the exact dosage and method prescribed. Common side effects of everolimus include: a sore mouth tiredness a rash or itchy, dry skin loss of appetite nausea and vomiting a lack ofperiods in women (this may be temporary) loss of fertility The Cancer Research UK website has more information about everolimus . Immunotherapy As well as medications that prevent, disrupt and slow down the growth and development of kidney cancer (kinase and mTOR inhibitors), there are also treatments that work by encouraging the immune system to attack cancer cells. This type of treatment is known as immunotherapy. Bevacizumab is a medication thats given intravenously (into a vein, through a drip). It blocks a protein called endothelial growth factor (VEGF), which helps cancer to grow. Bevacizumab is usually used in combination withan immunotherapy treatment called interferon. Interferon is taken as an injection just under the skin (subcutaneously), three times a week. It encourages your immune system to attack and destroy the cancer cells. Another medication called aldesleukin is sometimes used to treat kidney cancer thats spread. Its similar to a natural protein the body produces called interleukin-2 (IL-2), which is part of the immune system. IL-2 activates lymphocytes (a type of white blood cell), which fight illnesses and infections. Aldesleukin works in a number of ways. It interferes with how cancer cells grow and multiply, it stimulates the immune system into attacking cancer cells, and it makes cancer cells send out chemicals that attract immune system cells. Like interferon, aldesleukin is usually given as a subcutaneous injection. Immunotherapy treatments are now rarely used to treat advanced kidney cancer. This is because targeted therapies tend to be more effective in controlling the condition, and immunotherapy can sometimes cause serious side effects. The Cancer Research UK website has more information about treatments for advanced kidney cancer . Preventing kidney cancer As the causes of kidney cancer arent fully understood, its not possible to completely prevent it. However,leading a healthy lifestyle may help reduceyour chances of developing the condition. Read about the causes of kidney cancer . Combining a healthy diet and regular exercise will help you avoid becoming overweightor obese, which are both significant risk factors for kidney cancer. If youre overweight or obese, you can lose weight and maintain a healthy weight by combining regular physical activitywith a calorie-controlled diet. Read more about healthy weight loss and treating obesity . Diet A low-fat, high-fibre diet that includes whole grains and plenty of fresh fruit and vegetables (at least 5 portions a day) is recommended for a healthy heart. You should also limit the amount of salt in your diet to no more than 6g (0.2oz or 1 teaspoon) a day. Too much salt will increase your blood pressure. Avoid eating foods high in saturated fat because it will increase your cholesterol level. High-fat foods include: meat pies sausages and fatty cuts of meat butter ghee a type of clarified butter often used in Indian cooking lard cream hard cheese cakes and biscuits foods that contain coconut or palm oil Theres some evidence that eating a diet that has plenty ofoily fish (at least 1 portion a week) may help reduce the risk of kidney cancer. Examples of oily fish include: salmon mackerel sardines trout herring Oily fish also contains vitamin D , which can reduce the risk of some cancers. You can also getvitamin D from sunlight or by taking supplements. Exercise Its recommended that adults should do a minimum of 150 minutes (2 hours and 30 minutes) of moderate-intensity aerobic activity, such as cycling orbrisk walking , every week. The exercise should be strenuous enough to increase your heart rateand you should feel slightly out of breath afterwards. Examples of activities you could incorporate into your exercise programme include: brisk walking hill climbing running cycling swimming If you find it difficult to do 150 minutes of exercise a week, start at a level you feel comfortable with. However, you should visit your GP for a health check if youve never exercised before or youre returning to exercise after a long period of time. Read more about exerciseand its benefits . Giving upsmoking If you smoke, giving up is the most effective way of preventing kidney cancer, as well as a number of other serious health conditions, such as stroke , heart attack and lung cancer . Your GP can help if you want to stop smoking, by giving you information and advice, and prescribing medication. Our stopping smoking pages haveuseful information and advice about giving up smoking. Alternatively, you can call Quit Your Way Scotland on 0800 84 84 84. Read more about giving up smoking . Alcohol Theres evidence to suggest that drinking a moderate amount of alcohol, such as4to 5 glasses of wine a month, will help reduce your risk of developing kidney cancer. The reasons for this arent fully understood. However, you shouldnt exceed the recommendedlimits for alcohol, because excessive drinking will place you at risk of developing liver disease , liver cancer , and high blood pressure (hypertension) . Read more about drinking and alcohol and alcohol units . Source: NHS 24 - Opens in new browser window Last updated: 14 November 2023 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Dont include personal information e.g. name, location or any personal health conditions. Email Address e.g. [email protected] Message Maximum of 500 characters Send feedback Add this page to\n Info For Me Also on NHS inform Chronic kidney disease Radiotherapy Other health sites Macmillan Cancer Support: Kidney cancer Macmillan Cancer Support: Chemotherapy Kidney Research UK National Kidney Federation The Renal Association Kidney Cancer UK Search for cancer support services near you Enter a place or postcode NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats 2023 NHS 24 v1.1.1.17852

Kidney infection

Kidney infection - Illnesses & conditions | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotlands Service Directory 0 Home Illnesses and conditions Kidneys, bladder and prostate Kidney infection Kidney infection About kidney infections Symptoms of kidney infections Causes of kidney infections Diagnosing kidney infections Treating kidney infections Complications of kidney infections Preventing kidney infections About kidney infections A kidney infection(pyelonephritis) is a painful and unpleasant illnesscaused by bacteria travelling from your bladder into one or both ofyour kidneys. Its more serious than cystitis , a common infection of the bladder that makes urinating painful. If treated promptly, a kidney infection doesnt cause serious harm, but will make you feel very unwell. If a kidney infection isnt treated, it can get worse and cause permanent kidney damage. Symptoms of a kidney infection often come on within a few hours. You can feel feverish, shivery, sick and have a pain in your back or side. Read more about the symptoms of a kidney infection When to see your GP See your GPif you have a fever and persistenttummy, lower backor genital pain,or if you notice a changeto your usual pattern of urination. Most kidney infections needprompt treatment with antibiotics to stop the infection from damaging the kidneys or spreading to the bloodstream. You may also need painkillers. If youre especially vulnerable to the effects of an infection, for example, if youhave a pre-existing health condition or arepregnant, you may be admitted to hospitaland treated with antibiotics through an intravenous drip. After taking antibiotics, you should feel completely better after about 2 weeks. In rare cases, a kidney infection can cause further problems. These include blood poisoning ( sepsis ) and a build-up of pus in the kidney called an abscess. Read more about treating a kidney infection and the complications of a kidney infection What causes a kidney infection? A kidney infection usually happens when bacteriaoften a type calledE. coligets into theurethra (the tube which carries urine out of the body)and travels up through the bladderandinto the kidneys. Read more about the causes of a kidney infection Whos at risk? Kidney infections are relatively rare. Its estimated that one in every 830 people develops a kidney infection each year in the UK. They can happen at any age, but are much more common in women. In fact, women are 6 times more likely to get a kidney infection than men. This is because a womans urethra is shorter, making it easier for bacteria to reach the kidneys. Younger women are most at risk because they tend to be more sexually active, and having frequent sex increases the chances of getting a kidney infection. Younger children are also vulnerable to developing kidney infections because they may be born with an abnormality of the urinary tract or have a condition called vesico-ureteric reflux, where there is a backflow of urine from the bladder up to the kidneys. Can kidney infections be prevented? You can reduce your chances of developing a kidney infection by keeping your bladder and urethra free from bacteria. This can include drinking plenty of fluids, keeping your genitals clean and treating any constipation. Read more about preventing akidney infection Symptoms of kidney infections The symptoms of a kidney infection usually develop quite quickly over a few hours or days. Common symptomsinclude: pain and discomfort in your side, lower backor around your genitals high temperature (it may reach 39.5C or 103.1F) shivering or chills feeling very weak or tired loss of appetite feeling sick or being sick diarrhoea You may have other symptomsif you also have cystitis or urethritis(an infection of the urethra). These additional symptoms may include: pain or a burning sensation during urination need to urinate frequently or urgently feeling that youre unable to urinate fully blood in yoururine cloudy or foul smelling urine pain in your lower abdomen Children Children with a kidney infection may also have additional symptoms, such as: a lack of energy irritability poor feeding and/or vomiting not growing at the expected rate abdominal pain jaundice(yellowing of the skin and whites of the eyes) blood in the urine unpleasant smelling urine bedwetting When to seek medical advice Contact your GP if you have a high temperature, persistent pain, or if you notice a change to your usual pattern of urination. Contact your GP immediately if you think your child may have a kidney infection. If you have blood in your urine, you should always see your GP so the cause can be investigated. Kidney infections require prompt treatment with antibiotics to help relieve symptoms and prevent complications developing . Your GP can carry out some simple tests to help diagnose a kidney infection. See diagnosing kidney infections for more information Causes of kidney infections A kidney infection happens when bacteria infects your kidneys. The bacteria are usually a type called E. coli, which live in your bowel. The bacteriaget inthrough the opening of the urethraand move upwards through your urinary tract, first infecting your bladder and then your kidneys. Its thought the bacteria can get into your urinary tract byaccidentally spreading from your anus to your urethra. This can happen if you wipe your bottom after going to the toilet and the soiled toilet paper comes into contact with your genitals. It can also happen during sex. In rare cases, a kidney infection can develop if bacteria or fungi infect the skin and the infection spreads through your bloodstream into your kidney. However, this type of infection usually only occurs in people with weakened immune systems. Whos most likely to get a kidney infection? Women and children are most at risk of developing a kidney infection, as well as other urinary tract infections (UTIs) such as cystitis . In women, the urethra is closer to the anus than in men, making it easier for bacteria from the anus toenter the urethra accidentally. The female urethra is also much shorter than the male urethra (which runs through the penis). This makes it easier for bacteria to reach the bladder and move into the kidneys. Otherfactors can also put you more at risk of developing a kidney infection, including: having a condition that blocks, or obstructs, your urinary tract, such as kidney stones or an enlarged prostate children with constipation can also be at an increased risk being born with an abnormality in your urinary tract having a condition that prevents you emptying your bladder fully, such as an injury to your spinal cord this can allow bacteria in your bladder to multiply and spread having a weakened immune system for example, due to type 2 diabetes or as a side effect of chemotherapy having an infection of the prostate gland called prostatitisthe infection can spread from the prostate gland into the kidneys having aurinary catheter (a thin, flexible tube inserted into your bladder to drain away urine) being female and sexually active sexual intercourse can irritate the urethra and allow bacteria to travel into your bladder being a man who has anal sex bacteria can travel up the urethra into the bladder being pregnant this can cause physical changes that slow the flow of urine out of your body and make it easier for bacteria to spread to the kidneys having undergonefemale genital mutilation (FGM) an illegal practice where awomans genitalsare deliberately cut or changed for cultural, religious and social reasons Diagnosing kidney infections To work out if you have a kidney infection, your GP will ask you about your symptoms and your recent medical history. They will usually also assess your general health by taking your temperature and measuring your blood pressure. Urine test A urine test can help to establishwhether you have a urinary tract infection (UTI) . The test involves taking a small sample of urine and checking it to see ifthere areany bacteria in it. Youll be given a container and told how to collect the urine, which you can do in the surgery or at home. If you do it at home, youll need to label the container, seal it in a plastic bag and store it in the fridge. Ideally, hand it in tothe surgery within four hours. Aurine test canttellwhether the infection ifyou have one is in your kidneys or another part of your urinary system, such as your bladder. For your GP to be confident you have a kidney infection, you need to have a positive urine test pluscertain symptoms, such as a fever or a pain in your side. Hospital scans You may be referred to hospital for further testing if: your symptoms fail to respond to treatment with antibiotics your symptoms suddenly get worse you have additional symptoms that arent usually associated with a kidney infection youreat risk of complications of a kidney infection Children with recurrent UTIs will also be referred to hospital for further testing. In these circumstances,scans can check your urinary tract for signs of problems. This may include: a computer tomography (CT) scan wherea scanner takes a series of X-rays and a computer is used to assemble them into a detailed image ofyour urinary tract an ultrasound scan which uses sound waves to buildan image of the inside of your body an isotope scan wherea dye is injected into the bloodstream and a series of X-rays are taken Read more about treating a kidney infection Treating kidney infections Most people with a kidney infection can be treated at home with a course of antibiotics, and possibly painkillers as well. See your GP if you have a fever and persistent tummy, lower back or genital pain, or if you notice a change to your usual pattern of urination. All children with symptoms of a urinary tract infection (UTI) or kidney infection, including cystitis , should see their GP or out-of-hours emergency service. Medication Antibiotics If youre being treated at home, youll usually be prescribed a course of antibiotic tablets or capsules that lasts between 7 and 14 days. For most peopleapart from pregnant women antibiotics called ciprofloxacinorCo-amoxiclavare recommended. However, other antibiotics may also be used. Common side effects of ciprofloxacin include feeling sick and diarrhoea . Co-amoxiclavcan make the contraceptive pill and contraceptive patches less effective, so you may need to use another form of contraception during the course of treatment. A 14-day course of an antibiotic called cefalexin is recommended for pregnant women. Usually, youll start to feel betterquite soon aftertreatment starts and you should feel completely better after about2 weeks. If your symptoms show no sign of improvement24 hours after treatment starts, contact your GP for advice. Painkillers Takinga painkiller such as paracetamol should help relieve symptoms of pain and a high temperature. However, non-steroidal anti-inflammatories (NSAIDs) such as ibuprofen arent usually recommended to relieve pain during a kidney infection. This is because theymay increase the risk of further kidney problems. Self-help tips If you havea kidney infection, try not to hover over the toilet seat when you go to the loo, because it can result inyour bladder not being fully emptied. Its alsoimportant to drink plenty of fluids, because this will help prevent dehydration and will help to flush out the bacteria from your kidneys. Aim to drink enough so that youre frequently passing pale-coloured urine. Make sure that you get plenty of rest. A kidney infection can be physically draining, evenif youre normally healthy and strong. It may take up to two weeks before youre fit enough to return to work. Treatment at hospital Your GP may refer you to hospital if you have an underlying problem with your urinary tract, which makes you vulnerable to kidney infections. Its standard practice to further investigate all men with a kidney infection simply because the condition is much rarer in men. Only women who have had 2 or more kidney infections tend to be referred.Most children with a kidney infection will be treated in hospital. Hospital treatment may also be neededif: youre severely dehydrated youre unable to swallow or keep down any fluids or medications you have additional symptoms that suggest you may have blood poisoning , such as a rapid heartbeat and losing consciousness youre pregnant and you also have a high temperature youre particularly frail andyour general health is poor your symptoms fail to improve within 24 hours of starting treatment with antibiotics you have a weakened immune system you have a foreign body inside your urinary tract, such as a kidney stone or a urinary catheter you have diabetes youre over the age of 65 you have an underlying condition that affects theway yourkidneys work, such aspolycystic kidney disease or chronic kidney disease If youre admitted to hospital with a kidney infection, youll probably be attached to a drip soyou can be given fluids to help keep you hydrated. Antibiotics can also begiven through the drip. Youll have regular blood and urine tests to monitor your health and how effectively the antibioticsare fighting off the infection. Most people respond well to treatment. As long as there areno complications, theyre usually well enough to leave hospital within three to seven days.Treatment will usually switch to tablets or capsules after you stop receivingantibiotics through a drip. Complications of kidney infections Most kidney infections are treated successfully without complications, although some people may develop further problems. Complications of a kidney infection are rare, but youre more likely todevelop them if you: are a child areover 65 are pregnant have diabetes , chronic kidney disease or sickle cell anaemia have had a kidney transplant (particularly in the first three months after the transplant) havea weakened immune system developed the kidney infection while in hospital Kidney abscess A kidneyabscess isa rare, but serious, complication of a kidney infection, where pus develops inside the tissue of the kidney. Yourethought to be most at risk of developing a kidney abscess if you have diabetes . The symptoms of a kidney abscess are similar to those of a kidney infection. The most common are: a high temperature of 38C (100.4F) or above chills abdominal pain loss of appetite pain when passing urine Kidney abscesses are potentially serious because the bacteria inside the abscess can spread to other parts ofyour body, such asyour bloodstream or lungs, and can be fatal. Smaller abscesses can usually be treated with antibiotics through a drip. Surgery is usually required for larger abscesses. This involves drainingthe pus out of the abscess using a needle thats inserted into the kidney. Blood poisoning Blood poisoning (also called sepsis) is another rare, but potentially fatal, complication of a kidney infection.It happens when bacteria spreads from the kidneys into the bloodstream. Once bacteria arein your blood, the infection can spread to any part of your body, including all of the major organs. Insomeone with a kidney infection, thesymptoms of blood poisoning include: low blood pressure , which makes you feel dizzy when you stand up confusion or disorientation excessive sweating uncontrollable shaking or shivering high temperature or lower body temperature than usual (under 36C, or 96.8F) pale skin rapid heartbeat breathlessness Blood poisoningis a medical emergency that usually requires admission to a hospitalintensive care unit (ICU) while antibiotics are used to fight the infection. If youre taking certain medications for diabetes, such as metformin or angiotensin-converting enzyme (ACE) inhibitors, they may be temporarily withdrawn until you recover. This is because they can cause kidney damage during an episode of blood poisoning. Severe infection Another rare, but potentially fatal, complication of a kidney infection is a condition called emphysematous pyelonephritis (EPN). EPN is a severe infection, where the tissues of the kidneys are rapidly destroyed and the bacteria causingthe infection begin to release a toxic gas, which builds up inside the kidneys. The exact cause of EPN is unclear, but almost all casesare in people with diabetes. The usual treatment is emergency surgery to remove some, or all, of the affected kidney. Its possible to livea full and active lifewith only one kidney. Kidney failure In very rare cases, a kidney infection can cause severe kidney damage that results in kidney failure. This is when the kidneys stop working properly. Kidney failure is potentially fatal, but it can be treated with dialysis or a kidney transplant. Other problems A kidney infection can also cause other complications, including high blood pressure (hypertension) or premature labour or birth. Preventing kidney infections The best way to prevent a kidney infection is to keep your bladder and urethra free from bacteria. These self-help tips explain howyou can do this. Drink plenty of liquids Drinking plenty of liquids, particularly water, will help to wash bacteria from your bladder and urinary tract. Drinking cranberry juice or taking cranberry extracts may also help prevent urinary tract infections (UTIs) .However, you shouldavoid cranberry juice or extracts if youre taking warfarin , a medicine used to prevent blood clots.Cranberry juice can make the effects of warfarin more potent, so theres a risk of excessive bleeding. Toilet tips To help keep yoururinary tractfree from bacteria: go to the toilet as soon as you feel the need to urinate, rather than holding it in wipe from front to back after going to the toilet practice good hygiene by washing your genitals every day and before having sex empty your bladder after having sex if youre a woman,avoid hovering over a toilet seat as this position can often leave urine behind in the bladder Treat constipation Constipation can increase your chances of developing a urinary tract infection(UTI), sotry totreatany constipationpromptly. Recommended treatments for constipationinclude: increasing the amount of fibre in your diet to 20g to 30g of fibre a day using a mild laxative on a short-term basis drinking plenty of fluids Seeyour GP if your symptoms dont improve after 14 days (or 7 days for children with constipation). Read moreabout treatingconstipation Be careful with contraceptives If youkeep gettingUTIs (more than 3 a yearis considered high), avoid using spermicide-coated condoms or diaphragms . This is because spermicide can stimulate the production of bacteria. Stick tolubricated condoms without spermicide,because unlubricated ones can irritate the urethra and make it more vulnerable to infection. Source: NHS 24 - Opens in new browser window Last updated: 01 December 2023 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Dont include personal information e.g. name, location or any personal health conditions. Email Address e.g. [email protected] Message Maximum of 500 characters Send feedback Add this page to\n Info For Me Also on NHS inform Kidney stones Cystitis Urinary tract infection (UTI) in children NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats 2023 NHS 24 v1.1.1.17852

Kidney stones

Kidney stones - Illnesses & conditions | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotlands Service Directory 0 Home Illnesses and conditions Kidneys, bladder and prostate Kidney stones Kidney stones About kidney stones Symptoms of kidney stones Causes of kidney stones Diagnosing kidney stones Treating kidney stones Preventing kidney stones About kidney stones Kidney stones can develop in one or both kidneys and most often affect people aged 30 to 60. Theyrequite common, with around 3 in 20 men and up to 2 in 20 women developing them at some stage of their lives. The medicalterm for kidney stones is nephrolithiasis, and ifthey cause severe pain its known as renal colic. Symptoms of kidney stones Small kidney stones maygo undetected and be passed out painlessly in the urine.But its fairly common for a stone to block part of the urinary system, such as the: ureter the tube connecting the kidney to the bladder urethra the tube urine passes through on its way out of the body A blockage can cause severe pain in the abdomen or groin and sometimes causes a urinary tract infection(UTI) . Read more about the symptoms of kidney stones . What causes kidney stones? The waste products in the blood can occasionally form crystals that collect inside the kidneys. Over time, the crystals may build up to form a hard stone-like lump. This is more likely to happen if you dont drink enough fluids, if youre takingsome types ofmedication,or if you havea medical conditionthat raises the levels of certain substances in your urine. Read more about the causes of kidney stones . After a kidney stone has formed,your bodywill try to pass itout when you go to the toilet (in the urine). This meansit will often travel through the urinary system (the kidneys, kidney tubes and bladder). Treating and preventing kidney stones Most kidney stonesare small enough to be passed in your urine, and it may be possible to treat the symptoms at home with medication. Larger stones may need to be broken up using ultrasound orlaser energy. Occasionally, keyhole surgery may be needed to remove very large kidney stones directly. Read more about treating kidney stones . Its estimated thatup tohalf of all people who have had kidney stones will experience them again within the following 5 years. To avoid getting kidney stones, make sure you drink plenty of water every dayso you dont become dehydrated . Its very important to keep your urine diluted (clear) to prevent waste products forming into kidney stones. Read more about preventing kidney stones . Symptoms of kidney stones Very small kidney stones are unlikely to cause many symptoms. It may even go undetected and pass out painlessly when you urinate. Symptoms usually occur if the kidney stone: gets stuck in your kidney starts to travel down the ureter (the tube that attaches each kidney to the bladder) the ureter is narrow and kidney stones cancause pain as they try to pass through causes an infection In these cases, the symptoms of kidney stones can include: a persistent ache in the lower back,which is sometimes also felt in the groin men may have pain in theirtesticles and scrotum periods of intense pain in the back or side of your abdomen, or occasionally in your groin, whichmay last for minutes or hours feeling restless and unable to lie still nausea (feeling sick) needing to urinate more often than normal pain when you urinate (dysuria) blood in your urine (haematuria) thismay be caused by the stone scratching the kidney or ureter Blocked ureter and kidney infection A kidney stone that blocks the ureter can lead to a kidney infection. This is because waste products are unable to pass the blockage, which may cause a build-up of bacteria. The symptoms of a kidney infection are similar to symptoms ofkidney stones, but may also include: a high temperature (fever) of 38C (100.4F) or over chills and shivering feeling very weak or tired diarrhoea cloudy and bad-smelling urine Read more about kidney infections . Causes of kidney stones Kidney stones are usually formed following a build-up of certain chemicals in the body. This build-upmay be any of the following: calcium ammonia uric acid a waste product produced when the body breaks down food to use as energy cysteine an amino acid that helps to build protein Certain medical conditions can lead to an unusually high level of these substances in your urine. Youre alsomore likely to develop kidney stones if you dont drink enough fluids. Recurrent kidney stones Some people are particularly likely to keepon developing kidney stones, including people who: eat a high-protein, low-fibre diet areinactive or bed-bound have a family history of kidney stones have had several kidney or urinary infections have had a kidney stone before, particularly if it was before you were 25 have only one fully working kidney have had an intestinal bypass (surgery on your digestive system), or a condition affecting the small intestine, such as Crohns disease Medication Theres evidence to suggest that certain medications may increase your risk of developing recurrent kidney stones. These include: aspirin antacids diuretics (used to reduce fluid build-up) certain antibiotics certain antiretroviral medication(used to treat HIV ) certain anti-epileptic medication Types of kidney stones Kidney stones can develop for a number of reasons. Calcium stones Calcium stones are the most common type of kidney stone and form if theres too much calcium in the urine, which can be due to: an inheritedcondition called hypercalcuria, which leads tolarge amounts of calcium in urine an overactive parathyroid gland (the parathyroid glands help to regulate the amount of calcium in your body) kidney disease a rare condition called sarcoidosis some cancers Calcium stones are usually either large and smooth or spiky and rough. Struvite stones Struvite stones are often caused by infections, and they most commonly occur after a urinary tract infection thats lasted a long time. Struvite stones are more common in women than men. Uric acid stones Uric acid stones can form if theres a large amount of acid in your urine. They may be caused by: eating a high-protein diet that includes lots of meat a conditionsuch as gout that prevents the body breaking down certain chemicals an inherited condition that causes higher than normal levels of acid in the body chemotherapy Cystine stones Cystine stones are the rarest type of kidney stone. Theyre caused by an inherited condition called cystinuria, which affects the amount of acid that is passed in your urine. Diagnosing kidney stones Your GP will usually be able to diagnose kidney stones from your symptoms and medical history. It will be particularly easy if youve had kidney stones before. You may be given tests, including: urine tests to check for infections and pieces of stones an examination of any stones that you pass in your urine blood tests to check that your kidneys are working properly, and to also check the levels of substances that could cause kidney stones, such as calcium You can collecta kidney stone by urinating through some gauze or a stocking. Having a kidney stone to analyse will make a diagnosis easier, and may help your GP determine which treatment method will be of most benefit to you. If you have severe pain that isnt controlled by painkillers, or if you have a high temperature as well as pain, you may be referred to a urologist (a specialist in treating urinary problems). Imaging tests If yourereferred to hospital for an imaging test,a number of different techniques may be used. Imaging tests can help confirm the diagnosis, or identify precisely where a kidney stone is. These testsinclude: a computerised tomography (CT) scan where a series of X-rays at slightly different angles are taken and a computer is used to put the images together X-ray an imaging technique that uses high-energyradiation to highlight abnormalities in body tissue an ultrasound scan uses high-frequency sound waves to create an image of the inside of your body an intravenous urogram (IVU) or intravenous pyelogram (IVP) a dye that shows up on X-ray is injected into a vein in your arm; the X-ray image highlights any blockages as the kidneys filter the dye out of your blood and into yoururine CT scans are now often used because theyre thought to be more accurate. IVUs were previously the preferred imaging method. The imaging technique you have may depend on whats availableat your local hospital. Treating kidney stones Most kidney stones are small enough (less than 4mm in diameter) to be passed out in your urine and can probably be treated at home. But even small kidney stones can be painful, although thisusually only lasts a couple of days and disappears when the stone has been passed. Medication If you are in severe pain, your GP can give you pain relief by injection. A second dose can be given after half an hour if youre still experiencing pain. Medication can also be injected to treat the symptoms of nausea (feeling sick) and vomiting. This is called an anti-emetic (anti-sickness) medication. You may also be given a prescription for painkillers, anti-emetics, or both, to take at home. Self care You may be advised to wait until you pass your kidney stone when you go to the toilet, and to try to collect it from your urine. You can do this by filtering your urine through gauze or a stocking. Give the stone to your GP so that they can have it analysed to help determine any further treatment you may need. You should drink enough water to make your urine colourless. If your urine is yellow or brown, youre not drinking enough. Admission to hospital If your kidney stone has moved into your ureter (the tube that carries waste products from the kidneys to the bladder), and its causing severe pain, your GP may admit you to hospital for treatment. This may be necessary if: youre at an increased risk of your kidneys failing(for example, because you only have one kidney) your symptoms dont improve within an hour of being given painkillers or anti-sickness medication youredehydrated and vomiting too much to keep fluids down youre pregnant youre over 60 years of age Treating large kidney stones If a kidney stone is too big to be passed naturally 6mm to 7mm(about 0.23in to 0.27in)in diameter or larger you may need treatment to remove it another way. This could include: extracorporeal shock wave lithotripsy (ESWL) ureteroscopy percutaneous nephrolithotomy (PCNL) open surgery The type of treatment you have will depend on the size and location of your stones. Extracorporealshock wave lithotripsy (ESWL) ESWL is the most common way of treating kidney stones that cant be passed in the urine. It involves using ultrasound (high-frequency sound waves) to pinpoint where a kidney stone is. Ultrasound shock waves are then sent to the stone from a machine to break it into smaller pieces, so it can be passed in your urine. ESWL can be an uncomfortable form of treatment, so its usually carried out after giving painkilling medication. You may need more than one session of ESWL to successfully treat your kidney stones. ESWL is up to 99% effective for stones up to 20mm (0.8in) in diameter. Ureteroscopy If a kidney stone is stuck in the ureter, you may need to have a ureteroscopy, which is also sometimes known as retrograde intrarenal surgery (RIRS). Itinvolves passing a long, thin telescope called a ureteroscope through your urethra (the tubeurine passes through on its way out of the body) andinto your bladder. Its then passed up into your ureter to where the stone is stuck. The surgeon may either try togently remove the stone using another instrument, or they may use laser energy to break it up into small pieces so that it can be passed naturally in your urine. Ureteroscopy is carried out under general anaesthetic (where youre unconscious), so you shouldnt drive or operate machinery for up to 48 hours after the procedure. For stones up to 15mm (0.6in), a ureteroscopy is effective in 50% to 80% of cases. Aplastic tube called a stent may need to betemporarily inserted inside you to allow the stone fragments to drain into the bladder. Percutaneous nephrolithotomy (PCNL) PCNL is an alternative procedure that may be used for larger stones. It may also be usedif ESWL isnt suitable for example, because the person being treated is obese. PCNL involves using a thin telescopic instrument called a nephroscope. A small incision is made in your back and the nephroscope is passed through it and into your kidney. The stone is either pulled out or broken into smaller pieces using a laser or pneumatic energy. PCNL is always carried out under general anaesthetic,so you shouldnt drive or operate machinery for up to 48 hours after the procedure. PCNL is 86% effective for stones that are 21mm to 30mm (0.8in to 1.2in) in diameter. Open surgery Nowadays, open surgery for kidney stones is rare. Less than 1% of cases require this type of surgery. Its only usually used if theres a very large stone or abnormal anatomy. During open surgery, an incision will be made in your back so that your surgeon is able to access your ureter and kidney. The kidney stone can then be removed. Treating uric acid stones If you have a uric acid stone, you may be advised to drink around 3 litres (just over 5 pints) of water each day to try to dissolve it. Uric acid stones are much softer than other types of kidney stone, and they can be made smaller if theyre exposed to alkaline fluids. Youmay need to take some medication to make your urine more alkaline before the uric acid stone starts to dissolve. Complications of treatment Complications can occur following the treatment of large kidney stones. Your surgeon should explain these to you before you have the procedure. Possible complications will depend on the type of treatment you have and the size and position of your stones.Complications could include: sepsis an infection that spreads through the blood, causing symptoms throughout the whole body a blocked ureter caused by stonefragments; the ureter is the tube that attaches the kidney to the bladder an injury to the ureter a urinary tract infection bleeding during surgery pain Its estimated that 5% to 9% of people may experience complications after having a ureteroscopy. Preventing kidney stones The best way of preventing kidney stones is to make sure you drink plenty of water each day to avoid becoming dehydrated. Keeping your urine diluted helps to stop waste products getting too concentrated and forming stones. You can tell how diluted your urine is by looking at its colour. The darker your urine is, the more concentrated it is. Your urine is usually a dark yellow colour in the morning because it contains a build-up of waste products that your body has produced overnight. Drinks such as tea, coffee and fruit juice can count towards your fluid intake, but water is the healthiest option and is best for preventing kidney stones developing. You should also make sure you drink more when its hot or when youre exercising, to replenish fluids lost through sweating. Read more about preventing dehydration . Diet If your kidney stone is caused by too much calcium, you may be advised to reduce the amount of oxalates in your diet. Oxalates prevent calcium being absorbed by your body, and can accumulate in your kidney to form a stone. Foods that contain oxalates include: beetroot asparagus rhubarb chocolate berries leeks parsley celery almonds, peanuts and cashew nuts soy products grains, such as oatmeal, wheat germ and wholewheat Dont reduce the amount of calcium in your diet unless your GP advises you to. This is because calcium is very important for maintaining healthy bones and teeth. To avoid developing a uric acid stone, you should reduce the amount of meat, poultry and fish in your diet. You may also be prescribed medication to change the levels of acid or alkaline in your urine. Medication If you have a kidney stone, medication will usually be prescribed for pain relief or to prevent infections developing. However, some medication may need to be reviewed by your GP if its thought to be causing your kidney stone. The type of medication your GP prescribes will depend on the type of kidney stone you have. For example, if you have: calcium stones you may be prescribed adiuretic medication if they are caused by hypercalcuria (an inherited condition) struvite stones you may be prescribed antibiotics to help prevent a urinary tract infection or kidney infection , which are the main causes of struvite stones uric acid stones you may be prescribed allopurinol (a medication used to lower uric acid levels) and medication to help alkalise your urine cystine stones you may be prescribed medication to lower levels of cystine inyour urine Source: NHS 24 - Opens in new browser window Last updated: 01 December 2023 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Dont include personal information e.g. name, location or any personal health conditions. Email Address e.g. [email protected] Message Maximum of 500 characters Send feedback Add this page to\n Info For Me Also on NHS inform Kidney infection Chronic kidney disease Other health sites Lab Tests Online UK: PTH National Kidney Federation Kidney Research UK UK Kidney Association NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats 2023 NHS 24 v1.1.1.17852

Labyrinthitis

Labyrinthitis | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotlands Service Directory 0 Home Illnesses and conditions Ears, nose and throat Labyrinthitis Labyrinthitis Labyrinthitis is an inner ear infection. It causes the labyrinth inside your ear to become inflamed, affecting your hearing and balance. Labyrinthitis usually starts suddenly and can be worrying. You should seek medical advice straight away. What is the labyrinth? The labyrinth is the innermost part of the ear. It contains 2 parts: the cochlea this sends sounds to the brain so you can hear the vestibular system a complex set of fluid-filled tubes that affect your balance The labyrinth usually becomes inflamed either because of: a viral infection, such as a cold or flu (viral labyrinthitis) a bacterial infection, which is much less common (bacterial labyrinthitis) Symptoms of labyrinthitis The most common symptoms of labyrinthitis are: vertigo (dizziness) the sensation that you, or the environment around you, is moving hearing loss (from mild to total loss of hearing) a feeling of pressure inside your ear(s) ringing or humming in your ear(s) ( tinnitus ) feeling sick (nausea) or being sick mild headaches Certain things can make the dizziness worse, including: colds or illness, or anything that makes you feel generally unwell the dark tiredness or jetlag being on your period Avoid driving, using tools and machinery, or working at heights if youre feeling dizzy. When to get medical advice Speak to your GP practice if: you have symptoms of labyrinthitis your symptoms are getting worse Diagnosing labyrinthitis Your GP may: ask about your symptoms check your medical history carry out a physical examination you may be asked to move your head or body and they can check your ears for signs of inflammation and infection test your hearing labyrinthitis is more likely if you have hearing loss check your eyes if theyre flickering uncontrollably your balancing system may not be working properly Treating labyrinthitis Youll usually have already seen your GP about labyrinthitis symptoms and may have started some treatment. There are things you can also do during this time to help manage your symptoms at home. Things you can do to help your symptoms Do drink plenty of water to avoid becoming dehydrated its best to drink little and often lie still in a dark room if you feel very dizzy lie in a comfortable position (on your side is often best) try to get enough sleep tiredness can make symptoms worse try to reduce noise and anything that causes stress from your surroundings avoid alcohol avoid bright lights Treatments from your doctor If your symptoms are particularly severe, your GP may prescribe: prochlorperazine can help with dizziness and sickness antiemetic can help if youre feeling sick and vomiting corticosteroids can help by reducing inflammation Vestibular rehabilitation therapy (VRT) A small number of people experience dizziness and vertigo for months or years. This is known as chronic labyrinthitis. Chronic labyrinthitis requires a treatment called vestibular rehabilitation therapy (VRT) . VRT is usually supervised by a physiotherapist. You can ask your GP to refer you or you can pay for private treatment. If you see a private physiotherapist, make sure they are fully qualified and a member of a recognised body. For example, the Chartered Society of Physiotherapy (CSP) . Not all physiotherapists have training in VRT. You should tell them that you need this type of treatment before making an appointment. Who can get labyrinthitis? Most cases of viral labyrinthitis occur in adults aged 30 to 60 years old. Viral labyrinthitis is quite common in adults. Other types of ear infections are usually more common in children. Bacterial labyrinthitis is much less common. Younger children under 2 years old are more vulnerable to developing bacterial labyrinthitis. Vestibular neuronitis Many people diagnosed with labyrinthitis only experience the balance symptoms without hearing loss. This is known as vestibular neuronitis rather than labyrinthitis. Both names are often used to describe the same diagnosis. Source: ENT Scotland - Opens in new browser window Last updated: 28 March 2024 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Dont include personal information e.g. name, location or any personal health conditions. Email Address e.g. [email protected] Message Maximum of 500 characters Send feedback Add this page to\n Info For Me Also on NHS inform Meningitis Hearing loss Vertigo NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats 2023 NHS 24 v1.1.1.17852

Lactose intolerance

"Lactose intolerance - Illnesses & conditions | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotlands Service Directory 0 Home Illnesses and conditions Nutritional Lactose intolerance Lactose intolerance About lactose intolerance Causes of lactose intolerance Diagnosing lactose intolerance Treating lactose intolerance Complications of lactose intolerance About lactose intolerance Lactose intolerance is a common digestive problem where the body is unable to digest lactose, a type of sugar mainly found in milk and dairy products. Symptoms of lactose intoleranceusually develop within a few hours of consuming foodor drink that contains lactose. They may include: flatulence (wind) diarrhoea bloated stomach stomach cramps and pains stomach rumbling feeling sick The severity of your symptoms and when they appear depends on the amount of lactose youve consumed. Some people may still be able to drink a small glass of milk without triggering any symptoms, while others may not even be able to have milk in their tea or coffee. When to seek medical advice The symptoms of lactose intolerance can be similar to several other conditions, so its important to see your GP for a diagnosis before removing milk and dairy products from your diet. For example, the symptoms above can also be caused by: irritable bowel syndrome (IBS) a long-term disorder that affects the digestive system milk protein intolerance an adverse reaction to the protein in milk from cows (not the same as a milk allergy ) If your GP thinksyouhave lactose intolerance,they may suggest avoiding foods and drinks containing lactose for two weeks to see if your symptoms improve. Read more about diagnosing lactose intolerance What causes lactose intolerance? The body digests lactose using a substance called lactase. This breaks down lactose into two sugars called glucose and galactose, which can be easily absorbed into the bloodstream. People withlactose intolerancedont produce enough lactase, so lactose stays in the digestive system where its fermented by bacteria. This leads to the production of various gases, which cause the symptoms associated with lactose intolerance. Depending on the underlying reason why the body isnt producing enough lactase, lactose intolerance may be temporary or permanent. Most cases that develop in adults are inherited and tend to be lifelong, but cases in young children are often caused by an infection in the digestive system and may only last for a few weeks. Read more about the causes of lactose intolerance Whos affected? In the UK, lactose intolerance is more common in people of Asian or African-Caribbean descent. Lactose intolerance can develop at any age. Many cases first develop in people aged 20 to 40, although babies and young children can also be affected. Is it an allergy? Lactoseintolerance isnt the same as a milk or dairy allergy. Food allergies are caused by your immune system reacting to a certain type of food. Thiscauses symptoms such asa rash, wheezing and itching. If youre allergic to something, even a tiny particle can be enough to trigger a reaction, while most people with lactose intolerance can still consume small amounts of lactose without experiencing any problems (although this varies from person to person). Treating lactose intolerance Theres no cure for lactose intolerance, but limiting your intake of food and drink containing lactose usually helps tocontrol the symptoms. Depending on what dairy products youre able to eat, you may also require additionalcalciumandvitamin Dsupplements to keepyour bones strong and healthy. In some cases, your GP may refer you to a dietitian for further advice. In addition to dietary changes, lactase substitutesmayalso be helpful. These aredrops or tablets you can take with your meals or drinks to improve your digestionof lactose. Read more about treating lactose intolerance Complications of lactose intolerance Milk and other dairy products contain calcium, protein andvitamins such as A, B12 and D. Lactose also helps your body absorb a number of other minerals, such as magnesium and zinc. These vitamins and minerals are important for the development of strong, healthy bones. If youre lactose intolerant, getting the right amount of important vitamins and minerals can prove difficult. This may lead to unhealthy weight loss andput you at increased risk of developing the following conditions: Osteopenia where you have a very low bone-mineral density. If osteopenia is not treated, it can develop into osteoporosis. Osteoporosis where your bones become thin and weak. If you have osteoporosis, your risk of getting fractures and broken bones is increased. Malnutrition when the food you eat doesnt give you the nutrients essential for a healthy functioning body. If youre malnourished, wounds can take longer to heal and you may start to feel tired or depressed. If youre concerned that dietary restrictions are putting you at risk of complications, you may find it helpful to consult a dietitian. They can advise you on your diet and whether you require food supplements. Your GP should be able to refer you to an NHS dietitian free of charge. Alternatively, you can contact a private dietician. The British Dietetic Association has information on how to find a private dietitian. Causes of lactose intolerance Lactose intolerance is usually the result of your body not producing enough lactase. Lactase is an enzyme (a protein that causes a chemical reaction to occur) normally produced in your small intestine thats used to digest lactose. If you have a lactase deficiency, it means your body doesnt produce enough lactase. Digesting lactose After eating or drinking something containing lactose, it passes down your oesophagus (gullet) into your stomach, where its digested. The digested food then passes into your small intestine. The lactase in your small intestine should break lactose down into glucose and galactose (other types of sugar), which are then absorbed into your bloodstream. If there isnt enough lactase, the unabsorbed lactose moves through your digestive system to your colon (large intestine). Bacteria in the colon ferment (break down) the lactose, producing fatty acids and gases such as carbon dioxide, hydrogen and methane. The breakdown of the lactose in the colon, and the resulting acids and gases that are produced, cause the symptoms of lactose intolerance such as flatulence and bloating. Types of lactase deficiency The main types of lactase deficiency are outlined below. Primary lactase deficiency Primary lactase deficiency is the most common cause of lactose intolerance worldwide. This type of lactase deficiency is caused by an inherited genetic fault that runs in families. Primary lactase deficiency develops when your lactase production decreases as your diet becomes less reliant on milk and dairy products. This is usually after the age of two, when breastfeeding or bottle-feeding has stopped, although the symptoms may not be noticeable until adulthood. Secondary lactase deficiency Secondary lactase deficiency is a shortage of lactase caused by a problem in your small intestine. It can occur at any age, and may be the result of another condition, surgery to your small intestine, or taking certain medication. Secondary lactase deficiency is the most common cause of lactose intolerance in the UK, particularly in babies and young children. Possible causes of secondary lactase deficiency include: gastroenteritis an infection of the stomach and intestines coeliac disease a bowel condition caused by an adverse reaction to a protein called gluten Crohns disease a long-term condition that causes inflammation of the lining of the digestive system ulcerative colitis a long-term condition that affects the large intestine chemotherapy a cancer treatment long courses of antibiotics The decrease in the production of lactase in secondary lactase deficiency is sometimes only temporary, but it may be permanent if its caused by a long-term condition. Its also possible to develop secondary lactase deficiency later in life, even without another condition to trigger it. This is because your bodys production of lactase naturally reduces as you get older. Congenital lactase deficiency Congenital lactase deficiency is a rare condition that runs in families and is found in newborn babies. Its caused by an inheritedgenetic fault that means affected babies produce very little or no lactase. The genetic mutation responsible forcongenital lactase deficiency is passed on in an autosomal recessive inheritance pattern. This meansboth parents must have a copy of the faulty gene to pass onthe condition. Developmentallactase deficiency Some babies born prematurely (before the 37th week of pregnancy) have a temporary lactose intolerance because their small intestine wasnt fully developedby the time they were born. This is known as developmental lactase deficiency and it usually improves asaffected babies get older. Diagnosing lactose intolerance Its important to visit your GP if you think you or your child may have lactose intolerance, as the symptoms can be similar to other conditions. Before seeing your GP, keep a diary of what you eat and drink, and what symptoms you experience. Tell your GP if you notice any patterns, or if there are any foods you seem particularly sensitive to. Your GP may suggest trying toremove lactose from your diet for two weeks to see if it helps to relieve your symptoms. This will provide further evidenceof whetheryoure lactose intolerant. Further testing Other tests arent usually needed, but your GP may sometimes suggest further tests to: help confirm the diagnosis find out how much lactase (the enzyme used to digest lactose) your body is producing try to determine what might be causing your lactose intolerance Some of the main tests that may beusedare described below. Hydrogen breath test A hydrogen breath test is a simple way of determining if you may be lactose intolerant. Youll be asked to avoid eating or drinking during the night before the test. When you arrive for the test, youll be asked to blow up a balloon-like bag.This sample of your breath will be tested to find out how much hydrogen is present, measured in parts per million (ppm). Youll then be given a drink of lactose solutionand your breath will be tested every 15 minutes over the next few hours to see if the level of hydrogen changes. If your breath contains a large amount of hydrogen (more than 20ppm above your baseline) after consuming the lactose solution, its likely that youre lactose intolerant. This isbecauselactose intolerance can cause the bacteria in the colon (large intestine) to produce more hydrogen than normal. Lactose tolerance test In a lactose tolerance test, youll be given a drink of lactose solution and a blood sample will be taken from your arm using a needle. The blood will be tested to see how much glucose (blood sugar) it contains. If youre lactose intolerant, your blood sugar levels will either rise slowly, or not at all. This is because your body is unable to break down the lactose into glucose. Milk tolerance test In a milk tolerance test, youll be given a glass of milk (about 500ml) and your blood sugar levels will be tested. If your blood sugar levels dont rise after drinking the milk, you may be lactose intolerant. Small bowel biopsy Asmall bowel biopsy is rarely used to diagnose lactose intolerance. However, it may be carried out to see if your symptoms are being caused by another condition, such as coeliac disease . In a small bowel biopsy, a sample of your small intestinal lining is taken using anendoscope (a thin, flexible tube with a light and a tiny cutting tool at the end) thats passed down your throat. This will be carried out under local anaesthetic , so it wont hurt. The sample of intestinal lining will be tested to see how much lactase it contains. If it only contains a small amount of lactase,its likely youre lactose intolerant. The sample can also be examined to look for signs of possible underlying conditions such as coeliac disease. Treating lactose intolerance Theres no cure for lactose intolerance, but most people are able to control their symptoms by making changes to their diet. Some cases of lactose intolerance, such as those caused by gastroenteritis , are only temporary and will improve within a few days or weeks. Other cases, such asthose caused by an inherited genetic fault or a long-term underlying condition, are likely to be lifelong. Changing your diet In most cases, cutting down on or avoiding sources of lactose and replacing them with lactose-free alternatives is enough to control the symptoms of lactose intolerance. The exact changes you need to make to your diet depend on how sensitive you are to lactose. Some people are able to tolerate some lactose in their diet without any problems, whereas others experience symptoms after consuming food containing only a tiny amount of lactose. If you decide to experiment with what you can and cant eat, make sureto introduce new foods gradually, rather than all at once. This will help you to get used to any foods you might be sensitive to and identify any that cause problems. Eating fewer products containing lactose, or avoiding them completely, can mean you miss out on certain vitamins and minerals in your diet and increase your risk of complications. Youll also need to make sure youre getting enoughnutrition from either lacto-free foods or dietary supplements. If you or your child are extremely sensitive to lactose, talk to your GP about your diet. Milk products are rich in calcium needed for healthy bones so you may need to have regular bone density checks. You may be referred to a dietitian (an expert in diet and nutrition) whocan advise about what foods should be included in your, or your childs, diet. Sources of lactose Some of the main sources of lactose you may need to cut down on or avoid if youre lactose intolerant are described below. Milk A major source of lactose is milk, including cows milk, goats milk and sheeps milk. Depending on how mild or severe your lactose intolerance is, you may need to change the amount of milk in your diet. For example: you may be able to have milk in your tea or coffee, but not on your cereal some products containing milk, such as milk chocolate, may still be acceptable in small quantities you may find that drinking milk as part of a meal, rather than on its own, improves how the lactose is absorbed If even a small amount of milk triggers your symptoms, there are some alternatives you can try, such as soya or rice milk (see below). Dairy products Other dairy products made from milk, such as butter, ice cream and cheese, can also contain high levels of lactose and may need to be avoided if youre lactose intolerant. Some dairy products however, such as hard cheese and yoghurt, contain lower levels of lactose than milk and other products, so you may still be able to have them. Its worth experimenting with different foods to find out if there are any dairy products you can eat because theyre a good source ofessential nutrients such ascalcium. Other foods and drinks As well as milk and dairy products, there are other foods and drinks that can sometimes contain lactose. These include: salad cream, salad dressing and mayonnaise biscuits chocolate boiled sweets cakes some types of bread and other baked goods some breakfast cereals packets of mixes to make pancakes and biscuits packets of instant potatoes and instant soup some processed meats, such as sliced ham Check the ingredients of all food and drink products carefully, because milk or lactose are often hidden ingredients. The lactose found in some foodswont necessarily be listed separately on the food label, so you need to check the ingredients list for milk, whey, curds and milkproducts such as cheese, butter and cream. Some ingredients may sound like they contain lactose when they dont, such aslactic acid, sodium lactate and cocoa butter. These ingredients dont need to be avoided if youre lactose intolerant. Medication Some prescription medicines, over-the-counter medicines and complementary medicines may contain a small amount of lactose. While this isnt usually enough to trigger the symptoms of lactose intolerance in most people, it may cause problems if your intolerance is severe or youre taking several different medicines. If you need to start taking a new medication, check with your GP or pharmacist in case it contains lactose. Lactose-free foods and drinks There are a number of alternative foods and drinks available in supermarkets to replace the milk and dairy products you need to avoid. Food and drinks that dont usually contain lactose include: soya milks, yoghurts and some cheeses milks made from rice, oats, almonds, hazelnuts, coconut, quinoa, and potato foods which carry the dairy-free or suitable for vegans signs carob bars You can also buy cows milk containing additional lactase (the enzyme used to digest lactose). This means you still get the nutritional benefits of the milk, but youre less likely to experience any symptoms after consuming it. Getting enough calcium If youre unable to eat most dairy products, you may not be getting enough calcium in your daily diet.Calcium has several important functions, including: helping build strong bones and teeth regulating muscle contractions (including heartbeat) ensuring blood clots normally Therefore, its a good ideato choose lactose-free products with added calcium and ensure your diet contains alternative sources of calcium, such as: green leafy vegetables, such as spinach, kale, broccoli, cabbage and okra soya beans tofu nuts bread and anything made with fortified flour fish containing edible bones (for example, sardines, salmon, and pilchards) You can also buy combined calcium and vitamin D supplements from most pharmacists to help maintain good bone health. Its important to check with your GP or dietitian whether you should be taking supplements, however, as taking excessively high levels of calcium can cause side effects. Lactase substitutes In addition to dietary changes, you may also find it useful to takeliquid drops, tablets or capsules that containlactase substitutes. These are available from most health foods shops. Lactase substitutes replace the lactase your small intestine isnt producing, whichcan reduce your symptoms by helping your body break down any lactose in your diet more easily. Lactase substitutescan either be added to milkor taken justbefore eating a meal containing lactose. Lactose intolerance in children If your child is lactose intolerant, they may be able to consume small amounts of lactose without experiencing symptoms. This is quite safe, but you may need to experiment to find out how much they can comfortably eat or drink. If your child is unable to tolerate any lactose, your doctormay refer you to a dietitian for nutritional advice because its importantfor young children to have certain nutrients in their diet to ensure healthy growth and development. In general, the same rules about foods to try or to avoid are similar for children and adults (see above). For babies with lactose intolerance, lactose-free formula milk is available to buy from pharmacies and supermarkets. However, soya formula isnt recommended for children under six months because it contains hormones that may interfere with your babys future physical and sexual development. Breastfed babies may benefit from lactase substitute drops to help their bodies digest the lactose in breast milk. For many children, lactose intolerance is only temporary and will improve after a few weeks. After this point its safe to gradually reintroduce milk and dairy products into their diet. Complications of lactose intolerance Milk and other dairy products are an important part of a healthy diet. They contain calcium, protein and vitamins such as vitamins A, B12 and D. Lactose is also important because it helps your body absorb a number of other minerals, including magnesium and zinc. These vitamins and minerals are important for the development of strong, healthy bones. If you are lactose intolerant, getting the right amount of important vitamins and minerals can prove difficult. This may lead to unhealthy weight loss andput you at increased risk of developing the following conditions. Osteopenia where you have a very low bone-mineral density. If osteopenia is not treated, it can develop into osteoporosis. Osteoporosis where your bones become thin and weak. If you have osteoporosis, your risk of getting fractures and broken bones is increased. Malnutrition when the food you eat does not give you the nutrients essential for a healthy functioning body. If you are malnourished, wounds can take longer to heal and you may start to feel tired or depressed. If you are concerned that dietary restrictions are putting you at risk of complications, you may find it helpful to consult a dietitian. They can advise you on your diet and whether you require food supplements. Your GP should be able to refer you to an NHS dietitian free of charge. Alternatively, you can contact a private dietician. The British Dietetic Association has information on how to find a private dietitian. Source: NHS 24 - Opens in new browser window Last updated: 21 November 2023 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Dont include personal information e.g. name, location or any personal health conditions. Email Address e.g. [email protected] Message Maximum of 500 characters Send feedback Add this page to\n Info For Me Other health sites Allergy UK: Cow's milk allergy Allergy UK: Cow's milk allergy in adults British Dietetic Association NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats 2023 NHS 24 v1.1.1.17852"

Laryngeal (larynx) cancer

Laryngeal (larynx) cancer - Illnesses & conditions | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotlands Service Directory 0 Home Illnesses and conditions Cancer Cancer types in adults Laryngeal (larynx) cancer Laryngeal (larynx) cancer About laryngeal cancer Causes of laryngeal cancer Diagnosing laryngeal cancer Treating laryngeal cancer Recovering from laryngeal cancer Preventing laryngeal cancer About laryngeal cancer Laryngeal cancer is a type of cancer that affects the larynx (voice box). The larynx is part of the throat found at the entrance of the windpipe (trachea). It plays an importantrole in helping you breathe and speak. The condition is more common in people over the age of 60. Its about 4 times more common in men than women. Symptoms of laryngeal cancer The main symptoms of laryngeal cancer include: a change in your voice, such as sounding hoarse pain when swallowingor difficulty swallowing a lump or swelling in your neck along-lasting cough a persistent sore throat or earache in severe cases, difficulty breathing Some people may also experiencebad breath, breathlessness , a high-pitched wheezing noisewhenbreathing, unexplained weight loss, or fatigue (extreme tiredness). When to speak to your GP You should speak to your GP if you have hadany of the main symptoms for more than 3 weeks. These symptoms are often caused by less serious conditions, such as laryngitis , but its a good idea to get them checked out. If necessary, your GP can refer you to a hospital specialist for further tests to confirm or rule out cancer. Read more about diagnosing laryngeal cancer . What causes laryngeal cancer? Its not clear exactly what causes laryngeal cancer, but your risk of getting the condition is increased by: smoking tobacco regularly drinking large amounts of alcohol having a family history of head and neck cancer having an unhealthy diet exposure to certain chemicals and substances, such as asbestos and coal dust By adopting a healthy lifestyle, including avoiding alcohol and tobacco, you can significantly reduce your chances of developing laryngeal cancer. Read more about the causes of laryngeal cancer and preventing laryngeal cancer . How laryngeal cancer is treated The main treatments for laryngeal cancerare radiotherapy , surgery and chemotherapy . Radiotherapy or surgery to remove the cancerous cells from the larynx can often cure laryngeal cancer if its diagnosed early. If the cancer is advanced, a combination of surgery to remove part or all of the larynx, radiotherapy and chemotherapy can be used. If you have surgery to remove your larynx, youll no longerbe able to speak or breathe in the usual way. Instead, you will breathe through a permanent hole in your neck (stoma) and you will need additional treatment to help restore your voice. This may include an implant in your throat, or an electrical deviceyou hold against your throat to produce sound. Read more about treating laryngeal cancer and recovering from laryngeal cancer surgery . Causes of laryngeal cancer Laryngeal cancer is caused by changes in the cells of the larynx, although its not clear exactly why this happens. All cancers begin with a change ina cellsDNA.DNA provides our cells with a basic set of instructions, such as when to grow and reproduce. A change inDNA can alter the instructions that control cell growth, which means cells continue to grow instead of stopping when they should. This causes the cells to reproduce in an uncontrollable manner, producing a growth of tissue called a tumour. Its not known why the DNA inside the cells of the larynx is affected in cases of laryngeal cancer. But it appears that exposure tothings that can damage the cells and tissue of the larynx increases the risk of cancer developing. What can increase your risk? Anumber of things can increase your chances of developing laryngeal cancer. Alcohol and tobacco Alcohol and tobacco are the 2 main things that can increase your risk of developing laryngeal cancer. Theyrethought to contain chemicals that can damage the cells of the larynx. Themore you drink or smoke, the higher your risk of developing laryngeal cancer. People who smoke more than 25 cigarettes a day, or people who have smoked for more than 40 years, have been found to be about 40 times more likely to develop laryngeal cancer thanpeople who dont smoke. Compared to people who dont drink, people who regularly drink large amounts of alcohol are about 3 times more likely to develop laryngeal cancer. If you drink and smoke, your risk of laryngeal cancer increases even further. By stopping both drinking and smoking, you can significantly reduce your risk of developing the condition. Read more about preventing laryngeal cancer . Family history People who have a first-degree relative (parent, sibling or child) diagnosed with head or neckcancer are thought to be twice as likely to develop laryngeal cancer as someone without a family history. Diet Theres evidence to suggest that a diet high in red meat, processed food and fried foodmight increase your risk of developing laryngeal cancer. Havinga Mediterranean diet or a diet containing plenty of fruit and vegetables may reduce your risk.Read more about preventing laryngeal cancer . Human papilloma virus (HPV) Human papilloma virus (HPV)is the name given to a group of viruses that affect the skin and moist membranes that line the body, such as those in the cervix (neck of the womb), anus, mouth and throat. HPV is known to cause changes in the cells of the cervix, which can lead to cervical cancer . Its thought the virus may have a similar effect on the cells of the throat. HPV is often spread during sex, including oral sex. Exposure to harmfulsubstances Having a job where youre exposed to high levels of certain substances may also increase your risk of developing laryngeal cancer. These include: asbestos coal or wood dust paint or diesel fumes nickel sulphuric acid fumes formaldehyde (a chemicalused in a wide range of industrial processes, such as paint manufacturing and cosmetics) isopropyl alcohol (often used as a cleaning solvent) Diagnosing laryngeal cancer If you have symptoms of laryngeal cancer, such as a hoarse voice and pain when swallowing, your GP will ask about your symptoms and recent medical history. They may also examine the inside and outside of your throat for abnormalities, such as lumps and swellings. If laryngeal cancer is suspected, youll probably be referred to the ear, nose and throat (ENT) department of your local hospital for further testing. The National Institute for Health and Care Excellence (NICE) recommends thatanyone aged 45or over with persistent unexplained hoarseness or an unexplained lump in their neck should have an appointment with a specialist within 2 weeks. Nasendoscopy A nasendoscopy is a procedure used to get a clear view of your larynx. During the procedure, a small, flexible tube with a light and video camera at one end (endoscope) isinserted into your nostril and passed down the back of your throat. The images from the endoscope are displayed on a monitor. Youll usually be awake while this is carried out and it may feel uncomfortable.A local anaesthetic spray issometimes used to numb your nose and throat beforehand, so you dont feel any pain. Laryngoscopy If it wasnt possible to get a good view of your larynx during a nasendoscopy, or a possible problem is spotted, you may have a further test called a laryngoscopy. Like a nasendoscopy, this procedure involves using an endoscope to examine your larynx. However, the endoscope used during a laryngoscopy is longer and inserted through the mouth. This allows the larynx to be seen in greater detail. A laryngoscopycan be very uncomfortable, so its usually carried out under general anaesthetic (where youre asleep). You should be able to leave hospital as soon as youve recovered from the effects of anaesthetic, which is usually the same day or the day after. Biopsy During anasendoscopy orlaryngoscopy, your doctor may use small instruments to remove a sample of cells from your larynx so it can be examined for signs of cancer. This is known as a biopsy . Alternatively, if you have a lump in your neck, a needle and syringe can be used toremove a tissue sample. This is known as fine needle aspiration. Further testing If the results of the biopsy show you have cancer and theres a risk it may have spread, youll probably be referred for further testing to assess how widespread the cancer is. The tests may include: a computerised tomography (CT) scan a series of X-rays are taken to build up a more detailed three-dimensional picture of your larynx and the surrounding tissue a magnetic resonance imaging (MRI) scan a strong magnetic field and radio waves are used to produce a more detailed image of your larynx and the surrounding tissue a PET-CT scan a CT scan is used to take pictures of the inside of your body after youve been injected witha mildly radioactive substance that helps to show cancerous areas more clearly an ultrasound scan high-frequency sound waves are used to check for signs of cancer in the lymph nodes (glands found throughout the body) near the larynx Staging and grading After these tests have been completed, your doctor should be able to tell you the extent of the cancer. This is known as the stage and grade of the cancer. Healthcare professionals use a system called the TNM system to stage laryngeal cancer. T describes the size of the tumour, N describes whether cancer has spread to the lymph nodes and M gives an indication of whether the cancer has spread to other parts of the body. the T stage is given as a number from 1to 4 small tumours confined to 1 part of the larynx are described as T1 tumours and large tumours that have grown into tissues outside the larynx are described as T4 the N stage is given as a number from 0to 3 N0 means the lymph nodes are not affected, whereas stages N2 to N3 mean that 1 or more lymph nodes are affected the M stage is given as either M0 or M1 M0 means the cancer has not spread to other parts of the body and M1 means that it has There are also 3 different grades(1to 3) used to describelaryngeal cancer. Lower-grade cancers, such as grade 1, tend to grow more slowly and are less likely to spread.Higher-grade cancers, such as grade 3,grow quickly andare more likely to spread. You can read more about the stages and grades of laryngeal cancer on the Cancer Research UK website. Treating laryngeal cancer The treatment for laryngeal cancer largely depends on the size of the cancer. The main treatments are radiotherapy, surgery and chemotherapy. Most hospitals use multidisciplinary teams (MDTs) of specialists that work together to decidethe best way to proceed with your treatment. Members of your MDT will probably include a surgeon, a clinical oncologist (a specialist in the non-surgical treatment of cancer), and a specialist cancer nurse who will be responsible for co-ordinating your care. Your cancer team will recommend what they think is the best treatment option, but the final decision will be yours. Before visiting hospital to discuss your treatment options, you may find it useful to write a list of questions youd like to askyour care team. For example, you may want to find out the advantages and disadvantages of particular treatments. Your treatment plan Your recommended treatment plan will depend on the stage of thecancer (see diagnosing laryngeal cancer for more information on staging). If you have early-stage laryngeal cancer, it may be possible to remove the cancer using surgery (endoscopic resection) or radiotherapy alone. This may also be the case with slightly larger cancers, although a combination of surgery and radiotherapy is sometimes required. In later-stage laryngeal cancer, more extensive surgery may be needed. Radiotherapy and chemotherapy will probably be used in combination. In some cases, the entire larynx may have to be removed. A medication called cetuximab may be used in cases where chemotherapy is not suitable. Radiotherapy Radiotherapy uses controlled doses of high-energy radiation to destroy cancerous cells. It can be used as a treatment on its own for early-stage laryngeal cancer, or it can be usedafter surgery to stop cancerous cells returning. Its sometimes combined with chemotherapy. The energy beams used during radiotherapy have to be precisely targeted to your larynx.To ensurethe beams are directed at the exact area, a special plastic mask will be made to hold your head in the right position. A mould of your face will be taken so that the mask can be made before treatment starts. Radiotherapy is usually given in short daily sessions from Monday to Friday, with a break from treatment at the weekend. The course of treatment usually lasts for 3 to 7 weeks. As well as killing cancerous cells, radiotherapy can affect healthy tissue and has a number of side effects, including: sore, red skin (similar to sunburn ) mouth ulcers dry mouth loss of taste loss of appetite tiredness feeling sick Your MDT will monitor any side effects and treat them when possible. For example, protective gels can be used to treat mouth ulcers, and medicines are available for a dry mouth. Radiotherapy can sometimes cause your throat tissue to become inflamed. Severe inflammation can cause breathing difficulties. Contact your key worker or visit your local accident and emergency (A&E) department as soon as possible if you have difficulty breathing. Most side effects should pass within a few weeks of treatment finishing. Read more about radiotherapy . Surgery There are 3 types of surgery thatcan be used to treat laryngeal cancer. They are: endoscopic resection partial laryngectomy total laryngectomy Endoscopic resection Endoscopic resection can be usedinearly-stage laryngeal cancer. During the procedure, a surgeon uses a special microscope to get a magnified view of the larynx. This allows them to remove the cancer either with a laser or small surgical instruments. An endoscopic resection is carried out under general anaesthetic , so you willbe unconscious during the procedure and wont feel any pain. Yourmouth and throatmay feel sore for a few weeks after the operation and theres a risk of your voice changing as a result of the procedure, which can be permanent. Partial laryngectomy A partial laryngectomy can be used to treat some laryngeal cancers. The operation involves surgically removing the affected part of your larynx. Some of your vocal cords will be left in place, so you will still be able to talk, but your voice may be quite hoarse or weak. While your larynx is healing, you may find breathing difficult. Your surgeonmay need tocreate a temporary hole in your neck, which will be attached to a tube you can breathe through. This is known as a temporary tracheostomy. Once your larynx has healed, the tube can be removed and the hole will heal, leaving a small scar. This operation isuncommon nowadays,as endoscopic resection is preferred whenever possible. Total laryngectomy A total laryngectomy is usually used to treat advanced laryngeal cancer. The operation involves removing your entire larynx. Nearby lymph nodes (small glands that form part of the immune system) may also need to be removed if the cancer has spread to them. As your vocal cords will be removed, you wont be able to speak in the usual way after the operation. However, there are several ways to help restore your speech. If you have a total laryngectomy, your surgeon will also need to create a permanent hole in your neck (called a stoma) to help you breathe after the operation. You will be given training on how to keep your stoma clean. Having a stoma can seem daunting and frightening at first, but most people get used to it after a few months. See recovering from laryngeal cancer for more information about speaking after surgery and looking after a stoma. Chemotherapy Chemotherapy uses powerful cancer-killing medicines to damage the DNA of the cancerous cells and stop them reproducing. It may be used toshrink a tumour before surgery or radiotherapy, or in combination with radiotherapy to make the radiotherapy more effective. It can also be used totreat laryngeal cancer thats advanced or has come back after treatment. In this situation, it can relieve symptoms and may slow the cancers growth. Chemotherapy medication is usually given as an injection into a vein (intravenously) once every3or 4 weeks, for up to 6 months. You may need to stay in hospital for a few daysduring each treatment or you may just come in for a short visit each time. Chemotherapy can sometimes damage healthy tissue as well as the cancerous tissue. This, unfortunately, means side effects are common, such as: feeling and being sick hair loss loss of appetite diarrhoea sore mouth and mouth ulcers tiredness Chemotherapy can also weaken your immune system, making you more vulnerable to infection and illness. Its therefore important to report any symptoms of potential infection to yourMDT, such as a high temperature, chills or a persistent cough. You should also avoid close contact with peopleknown to have an infection. Theside effects of chemotherapy should improve after your treatment has finished. Read more about chemotherapy . Cetuximab Cetuximab is a type of medication called biological therapy. These medications target and disrupt the processes that cancerous cells use to grow and reproduce. Cetuximab can be used in combination with radiotherapy to treat more advanced laryngeal cancer, when its not possible to use chemotherapy. For example, people with kidney or heart disease, or people with an ongoing infection, may not be able to have chemotherapy, because it could make them very ill. Cetuximab is given slowlythrough a drip into your vein (intravenously) for up to an hour or more. Its usually given weekly forup to 7 weeks. Side effects of cetuximab are usually mild and include: rashes feeling sick diarrhoea breathlessness Cetuximab can also trigger allergic reactions in some people, which can cause problems such as a swollen tongue or throat. In a few cases,the reaction can be severe and potentially life-threatening. Most serious reactions occur within a day of treatment starting, so youll be closely monitored once your treatment begins. If you have symptoms of a severereaction, such as a rapid heartbeat or breathing problems, medication can be used to relieve them (such as corticosteroids ). Recovering from laryngeal cancer If youve had some or all of your larynx removed (laryngectomy), its likely that youll need to spend 1 or 2 days in an intensive care unit until youve recovered. You wont be able to eat until your throat has healed, which for most peopletakes at leasta week or two. While your throat heals, youll need to be fed through a tube thats passedthrough your nose and into your stomach. If youve had all of your larynx removed(total laryngectomy), you wont be able to speak normally, because you will no longer have vocal cords.A number of techniques can be used to replicate the functions of your vocal cords although they can takeweeks or months to learn. Therefore, its likely that youll need to use alternative methods of communicating, such as using a pen or paper,during the first few weeks or months after surgery. This can be a frustrating experience the loss of something youve previously taken for granted can be difficult to cope with. Try to prepare yourself for strangers reacting in unpredictable and possibly upsetting ways.Some people who have had a laryngectomy have reported that other people sometimes assume theyre deaf or have a learning difficulty because of their inability to speak. Your emotions The emotional impact of living with a laryngectomy can be significant. Many people report experiencing a rollercoaster effect. For example, you may feel down when laryngeal cancer is diagnosed, then feel up after the cancer has been removed, then feel down again as you try to come to terms with the practicalities of living with a laryngectomy. These emotional changes can sometimes trigger feelings of depression . You may be depressed if you have felt very down during the past month and you no longer take pleasure in doingthings you enjoy. Contact your GP or care team for advice if you thinkyou may be depressed. There are a range of effective treatments available. The National Association of Laryngectomee Clubs (NALC) is also a useful resource for people trying to come to terms with living with a laryngectomy. NALC is a patient support group that provides advice on all aspects of living with a laryngectomy. Looking after your stoma If youve had all of your larynx removed, the surgeon will need to create a permanent hole in your throat through which you will breathe (a stoma). During the first few months after surgery, its likely that your stoma will produce a lot of mucus, particularly if youve had radiotherapy . Excessive mucus can cause breathing difficulties, so a tube may be attached to your stoma to help you breathe more easily. Once the production of mucus has settled down, the tube can be removed. Its important to clean your stoma at least once a day, otherwise it can become crusty and may become vulnerable to infection.A specialist nurse can teach you how to keep your stoma clean. Youll be given special filters to place over your stoma that can help keep your stoma moist and free of germs. Its important to remember that youll need to cover your stoma with a tissue when you cough or sneeze, rather than covering your mouth or nose. This is because mucus or saliva will come out of your stoma. Speaking after surgery If your larynx has been completely removed as part of your treatment for laryngeal cancer, youll need additional treatment to help restore your voice. Before your laryngectomy, you may meet a speech and language therapist (SLT) to discuss possible treatment options for restoring your voice. An SLT is a healthcare professional who specialises in helping people who have difficulties speaking and using language. There are several different treatment options. Voice prosthesis A voice prosthesis is an artificial valve implanted into your neck. When you want to speak, you cover the stoma and breathe out through the valve. The valve produces a noise, which you can use to make words by moving your lips and mouth in the usual way. The voice thats produced by the valve sounds natural, although it may be lower-pitched than your previous voice. If you choose to have a voice prosthesis, it can be fitted during the surgery to remove your larynx. Oesophageal speech Oesophageal speech is a technique for speaking that your SLT can teach you. It involves learning to push airthrough your oesophagus (gullet). As the air moves through your oesophagus, it vibrates and makes a noise. You can produce words by moving your lips and mouth. Some people find it quite easy to learn oesophageal speech, whereas others find it difficult. Regular practice by yourself and with your SLT can help youimprove. Electrolarynx An electrolarynx is a small, battery-operated electrical device that vibrates and produces sound. You hold the device under your chin, and as you move your mouth and lips the vibrations translate into spoken words. Your SLT can train you to use it correctly. Preventing laryngeal cancer Its thought that most laryngeal cancers can be prevented by adopting a healthy lifestyle. Avoidingtobacco products, cutting down on how much alcohol you drink andhaving a healthy diet are particularly important in reducing your chances of developing the condition. Avoiding tobacco products Using tobacco products increases your chances of developing several different types of cancer, including laryngeal cancer. Tobacco comes in many forms, including: cigarettes pipe tobacco cigars cigarillos snuff (powdered tobaccosnorted through the nose) chewing tobacco If you smoke or use other tobacco products, stopping will have both short- and long-term health benefits, including significantly reducing your risk of developing laryngeal cancer. If you decide to stop smoking your free NHSstop smoking service can help you give up. You can also call Quit Your Way Scotland on0800 84 84 84 forfree expert advice and support. If you want to stopsmoking, but dont want to be referred to a stop smoking service, your GP should be able to prescribe medical treatment to help with any withdrawal symptoms you may have. Read more about stopping smoking . Cutting down on alcohol Staying within the recommended guidelines for alcohol consumption will also reduce your risk of developing laryngealand liver cancers. Studies have found that your risk of developing laryngeal cancer reduces significantly within 5to 10 years of not drinking, and after 20to 30 years your risk is about the same as someone who has never drunk alcohol. Contact your GP if youre finding it difficult to reduce the amount of alcohol you drink. You may need additional treatment, which could include counselling, group work or medication. Read more about treatments for alcohol misuse and tips on cutting down how much you drink . Healthy diet Research shows a diet that contains plenty of fresh fruits and vegetables, particularly tomatoes, citrus fruit (such as oranges, grapefruits and lemons), olive oil and fish oil,may reduce your risk of getting laryngeal cancer. This type of diet is sometimes known as a Mediterranean diet. Eating plenty of fruitand vegetables each day may help to reduce your chances of developing many types of cancer, including laryngeal cancer. Read about food and diet and healthy eating for more information and advice. Source: NHS 24 - Opens in new browser window Last updated: 14 November 2023 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Dont include personal information e.g. name, location or any personal health conditions. Email Address e.g. [email protected] Message Maximum of 500 characters Send feedback Add this page to\n Info For Me Also on NHS inform Radiotherapy Chemotherapy Other health sites Cancer Research UK: Laryngeal cancer Macmillan Cancer Support: Laryngeal cancer National Association of Laryngectomee Clubs Search for cancer support services near you Enter a place or postcode NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats 2023 NHS 24 v1.1.1.17852

Laryngitis

Laryngitis | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotlands Service Directory 0 Home Illnesses and conditions Ears, nose and throat Laryngitis Laryngitis Laryngitis is inflammation of the larynx (voice box). In most cases, it gets better without treatment in about a week. Symptoms of laryngitis Symptoms of laryngitis can begin suddenly and usually get worse over a period of 2 to 3 days. Common symptoms of laryngitis include: hoarseness difficulty speaking sore throat mild fever irritating cough a constant need to clear your throat The hoarse voice and speaking difficulties usually get worse each day youre ill. They may last for up to a week after the other symptoms have gone. In a few cases, the larynx can swell and cause breathing difficulties. This isnt common in adults but can happen in young children who have smaller, narrower windpipes. Laryngitis is often linked to another illness. For example, a cold , flu , throat infection or tonsillitis . So you might also have other symptoms such as: a headache swollen glands runny nose pain when swallowing feeling tired and achy When to get medical advice Speak to your GP practice if: You or your child: have symptoms that are particularly severe or they last longer than 2 weeks experience breathing difficulties Things you can do to help your symptoms Do drink plenty of water try to rest your voice as much as possible Dont do not smoke do not spend time in smoky or dusty places Treating the underlying cause If you see your GP, theyll discuss the possible causes with you and may refer you for tests or to a specialist in hospital. In some cases, it may be possible to treat the underlying cause of laryngitis. For example, if the symptoms are caused by an allergic reaction, you may be able to: avoid the thing youre allergic to take medication to help control your allergy What causes laryngitis In most cases, laryngitis is caused by either: a viral infection such as a cold or flu irritation to your larynx for example by straining your voice or reflux In these cases, most of the symptoms usually pass within a week. This is known as acute laryngitis. Laryngitis can occasionally last much longer. This is known as chronic laryngitis. Chronic laryngitis can be caused by: smoking alcohol misuse reflux How to prevent laryngitis As laryngitis is often caused by a common viral infection, such as a cold or flu, its not always possible to prevent it. There are things you can reduce your risk of developing the condition. Do avoid smoking make sure you have the flu vaccine every year if youre eligible wash your hands often, especially before handling food and after using the toilet avoid close contact with people who have respiratory infections, such as a cold or flu particularly if youre prone to laryngitis avoid irritants, such as smoke or dust particularly if you have a cold or other respiratory infection raise your head with pillows when youre sleeping to protect your larynx from any acid reflux from your stomach during sleep avoid regularly clearing your throat as this can irritate the larynx try small sips of water instead follow the low-risk drinking guidelines when drinking alcohol avoid shouting or singing loudly or for long periods of time Source: ENT Scotland - Opens in new browser window Last updated: 28 March 2024 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Dont include personal information e.g. name, location or any personal health conditions. Email Address e.g. [email protected] Message Maximum of 500 characters Send feedback Add this page to\n Info For Me Also on NHS inform Common cold Flu Tonsillitis NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats 2023 NHS 24 v1.1.1.17852

Leg cramps

Leg cramps | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotlands Service Directory 0 Home Illnesses and conditions Muscle, bone and joints Conditions Leg cramps Leg cramps Leg cramps are a common and usually harmless condition. They cause the muscles in your leg to suddenly become tight and painful. Symptoms of leg cramps A leg cramp is an episode of sudden pain in the muscles of the leg. Its caused by an involuntary contracting (shortening) of the leg muscle. Cramps usually occur in the calf muscles, although they can affect any part of your leg. This includes your feet and thighs. Cramps can last from a few seconds up to 10 minutes. Thigh muscle cramps tend to last the longest. During a cramping episode, the affected muscles will become tight and painful and the feet and toes will be stiff. After the cramping has passed, you may have pain and tenderness in your leg for several hours. Cramps often happen during the night when youre sleeping. When to get help Leg cramps might be a sign of a more serious health condition. Speak to your GP urgently if: leg cramps last longer than 10 minutes and dont get better when you start to move leg cramps develop after youve come into contact with a substance like mercury, lead or dirt that gets in a cut If your GP is closed, phone 111. Speak to your GP if: your leg cramps are affecting your quality of life youre having frequent leg cramps your leg cramps are interfering with your sleep you also have numbness or swelling in your legs your leg muscles are shrinking or becoming weaker Your GP will ask about your symptoms and examine your legs and feet. They may also ask if you have other symptoms, like numbness or swelling. This may be a sign that you have secondary leg cramps caused by an underlying condition. In this case, you may need further tests, like blood tests and urine tests, to rule out other conditions. Causes of leg cramps The cause of leg cramps is sometimes unknown (idiopathic). In other cases, there may be an underlying condition or identifiable cause (secondary leg cramps). Idiopathic leg cramps Idiopathic leg cramps may be caused by: abnormal nerve activity during sleep excessive strain placed on leg muscles, for example during exercise a sudden restriction in the blood supply to the affected muscles Also, tendons naturally shorten over time as a person gets older. This may explain why older people are particularly affected by leg cramps. Tendons are tough bands of tissue that connect muscles to bone. If your tendons become too short, they may cause the muscles connected to them to cramp. Secondary leg cramps Secondary leg cramps are caused by an underlying condition or another identifiable cause like: pregnancy the extra weight of pregnancy can place strain on the leg muscles, making them more vulnerable to cramping exercise leg cramps are often experienced when resting after exercise neurological conditions for example, motor neurone disease or peripheral neuropathy liver disease if your liver stops working properly, toxins will build up in your blood, which can make your muscles spasm infection some types of bacterial infection, like tetanus, can cause muscle cramps and spasm toxins in some people, high levels of toxic (poisonous) substances in the blood, like lead or mercury, can cause leg cramps dehydration in some people, low levels of water in the body can lead to a drop in your salt levels, which can trigger muscle cramps Treating leg cramps Medication is usually only needed in persistent cases where cramping does not respond to exercise. If you have secondary leg cramps, treating the underlying cause may help relieve your symptoms. Leg cramps that occur during pregnancy should pass after the baby is born. Treating cramps that occur as a result of serious liver disease can be more difficult. Your treatment plan may include using medications like muscle relaxants. Medication Certain medications have been known to cause leg cramps in a small number of people. If you develop leg cramps after starting a new medication, speak to your pharmacist. Never stop taking a prescribed medication unless your GP or healthcare professional advises you to do so. Stretches for leg cramps Most cases of leg cramps can be relieved by exercising the affected muscles. Exercising your legs during the day will often help reduce how often you get cramping episodes. To stretch your calf muscles: Stand with the front half of your feet on a step, with your heels hanging off the edge. Slowly lower your heels so that they are below the level of the step. Hold for a few seconds before lifting your heels back up to the starting position. Repeat a number of times. Preventing leg cramps If you often get leg cramps, regularly stretching the muscles in your lower legs may help prevent the cramps or reduce their frequency. You might find it useful to stretch your calves before you go to bed each night. If you lie on your back, make sure that your toes point upwards. Placing a pillow on its side at the end of your bed, with the soles of your feet propped up against it may help keep your feet in the right position. If you lie on your front, hang your feet over the end of the bed. This will keep your feet in a relaxed position. Itll help stop the muscles in your calves from contracting and tensing. Keep your sheets and blankets loose. Source: NHS 24 - Opens in new browser window Last updated: 23 October 2023 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Dont include personal information e.g. name, location or any personal health conditions. Email Address e.g. [email protected] Message Maximum of 500 characters Send feedback Add this page to\n Info For Me NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats 2023 NHS 24 v1.1.1.17852

Lichen planus

Lichen planus | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotlands Service Directory 0 Home Illnesses and conditions Skin, hair and nails Lichen planus Lichen planus About lichen planus Symptoms of lichen planus Causes of lichen planus Diagnosing lichen planus Treating lichen planus Complications of lichen planus About lichen planus Lichen planus is a non-infectious, itchy rash that can affect many areas of the body. Affected areas caninclude the: arms, legs and trunk mouth (oral lichen planus) nails and scalp vulva, vagina and penis The exact cause of lichen planus is unknown. However, the condition isnt infectious and doesnt usually run in families. It cant be passed on to other people, including sexual partners. AGP can usuallydiagnose lichen planus by examining the rash and asking about your symptoms. Oral lichen planus is often diagnosed by a dentist during routine dental check-ups. Lichen planus is an itchy rash that can occur anywhere on the body. Source: https://dermnetnz.org/ Whos affected by lichen planus Lichen planus is thought to affect 1-2% of the worldwide population. Its more common in adults over the age of 40. Lichen planus of the skin affects men and women equally. However, oral lichen planus is more common in women. The mouth is affected in around 50% of all cases of lichen planus (oral lichen planus). Treating lichen planus Theres no single treatment that can cure lichen planus completely. However, treatments are availableto help manage the symptoms and make living with it easier. For example, steroid creams or ointments are often used to help relieve the itch and control the rash. Most cases of lichen planus of the skin clear up on their own within 6to 9months. The rash rarely lasts longer than 18 months.However, oral lichen planus and lichen planus that affects the genital area may be more persistent. Readmoreabout how lichen planus is treated . Erosive lichen planus Erosive lichen planus is a rare form of lichen planus that can last a long time. It causes painful ulcers to develop in the mouth and in the genital areas of bothmales and females. In some cases, long-term erosive lichen planus can increase the chance ofsome types of cancer developing. Read our page on complications of lichen planus for more information about erosive lichen planus. Symptoms of lichen planus The symptoms of lichen planus vary, depending on which area of the body is affected. Areas of the body most commonly affected by the condition include the: skin mouth penis vulva (external female sex organs) and vagina Lichen planus causes symptoms like itchy skin and red, slightly raised, bumps. Source: https://dermnetnz.org/ Lichen planus of the skin The symptoms of lichen planus of the skin are: purple-red coloured bumps (papules) that are slightly raised, shiny and have a flat top. The papules usually measure 3-5mm in diameter and may also have irregular white streaks (Wickhams striae) thicker scaly patches can appear, usually around the ankles this is known as hypertrophic lichen planus itchy skin Lichen planus of the skin often affects the wrists, ankles and lower back, although other parts of the body can also be affected. Thickened (hypertrophic) lichen planus affects the shins, and ring-shaped lichen planus affects creases in the skin, such as the armpits. After thepapules have cleared, the affected area of skin can sometimes become discoloured. Lichen planus of the mouth (oral lichen planus) The symptoms of oral lichen planus are: a white pattern on the tongue and inner cheeks red and white patches in the mouth burning and discomfort in the mouth while eating or drinking painful red gums Mild cases of oral lichen planus dont usually cause any pain or discomfort. Lichen planus of the penis The symptoms of lichen planus of the penis are: purple or white ring-shaped patches on the tip of the penis (glans) bumps (papules) that are flat-topped and shiny a non-itchy rash Lichen planus of the vulva and vagina The symptoms of lichen planus of the vulva and vagina include: soreness, burning and rawness around the vulva the vulva may be covered in white streaks and be a red, pink or pale white colour if the vagina is affected, sexual intercourse can be painful if the outer layers of skin break down, moist, red patches can form scar tissue can form, which distorts the shape of the vagina a sticky yellow or green discharge,which may be bloodstained the opening of the vagina can become narrowed Other areas Lichen planus can sometimes affect other areas, including: the nails which can become thinner, ridged and grooved, or they may become darker, thicker or raised; they may sometimes shed or stop growing the scalp red patches can appear around clusters of hair; in some cases, permanenthair loss can occur Causes of lichen planus The cause of lichen planus is unknown. Its thoughtto be related to the immune system, or an abnormal response of the immune system to certain medicines. Lichen planus isnt infectious, doesnt usually run in families and cant be passed on to others. Autoimmune reaction The immune system protects your body against illness and infectionby producing antibodies (proteins)that attack bacteria and viruses. In people with lichen planus, its thought that the immune system becomes overactive, causing an excess amount of proteins to be produced, which inflame the skin. This is known as an autoimmune reaction and causes the symptoms of lichen planus . Reaction to medication A reaction to certain medications is another possible cause of lichen planus. For example: gold injections these are disease-modifying anti-rheumatic drugs (DMARDs) that are sometimes injected into the muscles of people with arthritis to help reduce inflammation and painful joints antimalarial tablets these help treat and prevent malaria (a serious tropical disease spread by mosquitoes) Diagnosing lichen planus Lichen planus is often diagnosed by a GP or dentist examining the affected area. Lichen planus of the skin Your GP may be able to make a diagnosis based on the characteristic rash.However, lichen planus can be mistaken for other skin conditions, such as eczema ,which also causes the skin to become red, flaky and itchy. If your doctoris unable to make a confident diagnosis by examining your skin, they may want to take a small skin sample ( biopsy ), which will be examined under a microscope. If a skin biopsy is required, youll be given a local anaesthetic to numb the affected area so you dont feel any pain or discomfort during the procedure. Lichen planus of the mouth (oral lichen planus) A dentist or doctor can diagnose oral lichen planus by looking at the inside of your mouth. A biopsy may be recommended to confirm the diagnosis. A sampleofmouth tissue will be removed so that it can be examined under a microscope.As with lichen planus of the skin, youll be given a local anaesthetic to numb the pain. Treating lichen planus Theres no cure for lichen planus, so treatments aim to ease the symptoms and clear the rash. Mild lichen planus doesnt require treatment. Self-help Below is some general self-help advice that can help ease your symptoms and prevent them getting worse. Lichen planus of the skin avoid washing with soap or bubble bath use plain warm water instead wash your hair over a basin to stop affected areas of skin coming into contact with shampoo use anemollient to moisturise your skin Lichen planus of the mouth (oral lichen planus) avoid eating spicy foods and anything acidic, such as fruit juice, because they can irritate oral lichen planus avoid eating sharp food, such as crusty bread avoid drinking alcohol,particularly spirits if areas of your mouth are painful, stick to soft, bland foods, such as mashed potatoes and porridge if possible, continue to use your usual toothpaste avoid using mouthwashes that contain alcohol because they may be too strong, and keep your mouth as clean as possible visit your dentist regularly to help keep your teeth and gums healthy Lichen planus of the genitals avoid washing with soap or bubble bath use plain warm water or a soap substitute instead, such as aqueous cream use an emollient, such as petroleum jelly, before and after urinating applying ice packs to the affected areas may soothe itchingand swelling (never apply an ice pack directly to your skin wrapit in a clean tea towel before placingit on your body) women should avoid wearing tights Lichen planus of the skin, hair and nails There are a number ofmedicationsand treatments that may be recommended for lichen planus of the skin, hair and nails. These are outlined below. Corticosteroid creams and ointments Corticosteroid creams and ointmentscontain corticosteroids (artificial hormones) and are used to treat inflammatory skin conditions. They are oftenreferred toas topical corticosteroids . Topical corticosteroids help treat theswelling (inflammation) and redness caused by lichen planus. Strong topical corticosteroids, such as clobetasol propionate, are also effective in reducing any itchiness you may have. Treatment is applied to the red or purple itchy spots, but should be stopped when the colour of the rash changes to brown or grey. This pigment change occurs when the inflammation has settled. Continuing to apply the corticosteroid cream to the brown areas of skin willgradually cause the skin to thin. The side effects of corticosteroids can vary, depending on the: type and severity of treatment being used how long the treatment is used for nature of the condition being treated Potential side effects of topical corticosteroids can include: redness or burning and stinging of the skin skin rash thinning of the skin (atrophy) stretch marks (striae) contact dermatitis a condition that causes skin inflammation excessive hair growth (hypertrichosis) lightening of the skin Always check the patient information leaflet that comes with your medicine. Corticosteroid tablets Corticosteroid tablets are sometimes used to treat severe cases of lichen planus, when the symptoms arent being effectively controlled with creams or ointments. Possible side effects of corticosteroid tablets used on a short-term basis can include: increased appetite weight gain insomnia fluid retention (inability to pass urine) mood changes, such as feeling irritable or anxious Other treatments Other treatmentsrecommended for lichen planus of the skin are outlined below. Antihistamines these are often used to treat symptoms of allergies , such as itchy skin. If you have lichen planus of the skin thats causing itchiness, antihistamines may be prescribed to help reduce this. Light treatment there are 2types of light treatment: ultraviolet B (UVB) and psoralen plus ultraviolet A (PUVA). UVB is the most commonly used light treatment, but PUVA may be recommended in severe or widespread cases of lichen planus that dont respond to other types of treatment. Acitretin this medication is only prescribed by a specialist and is used to treat severe cases of lichen planus. The tablets have some associated side effects and may not mix well with other medicines. Your specialist can offer advice. Lichen planus of the mouth (oral lichen planus) Mild cases of oral lichen planus wont need any treatment. In more severe cases, treatment includes: a mouthwash that contains an anaesthetic to temporarily numb the mouth, which makes eating easier corticosteroid sprays, mouthwashes, pastes and dissolvable lozenges a mouthwash or gel that contains an antiseptic to help prevent the build-up of plaque in your mouth In more severe cases of oral lichen planus, corticosteroid tablets may also be used on a short-term basis. It can be difficult to prevent oral lichen planus, but to keep the lining of your mouth healthy its recommended that you: stopsmoking (if you smoke) avoid drinking large amounts of alcohol have a healthy, balanced diet , including plenty of fresh fruit and vegetables You should also maintain good oral hygiene by cleaning your teeth at leasttwice a day, and having regular dental check-ups ,so that any problems with your teeth or mouthcan be identified and treated early. Other treatments If corticosteroids are not effective in treating your symptoms, you may be prescribed a medication that suppresses your immune system to try to limit the autoimmune reaction thats thought to cause lichen planus. These types of treatments are known as immunomodulating agents. Depending on which area of your body is affected by lichen planus, treatments that may be recommended for you can include: treatments such as tacrolimus topical immunomodulating agents(used to treat lichen planus of the skin) treatments such as tacrolimusointment andpimecrolimus cream are rubbed directly onto the skin immunomodulating agents(used to treat lichen planus of the mouth) these are usually available in the form of tablets or capsules, and can be used to treat severe cases of oral lichen planus These treatments can causea number of different side effects, which your specialist can discuss with you. Youll also need to have regular blood tests while taking immunomodulating agents, particularly inthe early stages of treatment. Further information and support You can find support and information from organisations like: Changing Faces a charity for people who have a visible difference or facial disfigurement, who can be contacted on 0300 012 0275 for counselling and advice Complications of lichen planus Complications of lichen planus may include discoloured skin and, in some cases, erosive lichen planus may develop into certain types of cancer. Skin pigmentation After the lichen planus rash has cleared up, the affected area of skin may be a different colour to what it was originally. There may be a brown or grey mark, which can sometimes last for months. This is known as post-inflammatory hyperpigmentation, and tends to be more noticeable in people with darker skin. Erosive lichen planus Erosive lichen planus is a long-lasting (chronic) form of lichen planus that causes painful ulcers to develop, as well as burning and discomfort in the genital areas of bothmale and females. Occasionally, in around 2% of cases, long-term cases of erosive lichen planus can develop into certain types of cancer , such as: mouth cancer vulval cancer penile cancer Regularly examining yourself and being aware of any changes that occur will help you to identify any problems at an early stage. Pay close attention to ulcerated areas in your mouth or genitals that dont heal and persist for a long time. Visit your GP immediately if you notice any changes that youre concerned about. You should also visit your dentist regularly to ensure that your teeth and gums remain healthy, and that any ulcers or patches that form in your mouth are examined and treated promptly. Depending on individual circumstances, dentalcheck-ups for adultsare recommended anywhere between every 3 to 24 months. Read more about treating lichen planus , including self-help tips for managing all types of the condition. Source: NHS 24 - Opens in new browser window Last updated: 31 January 2023 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Dont include personal information e.g. name, location or any personal health conditions. Email Address e.g. [email protected] Message Maximum of 500 characters Send feedback Add this page to\n Info For Me Also on NHS inform Mouth ulcer Other health sites Changing Faces NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats 2023 NHS 24 v1.1.1.17852

Lipoedema

"Lipoedema | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotlands Service Directory 0 Home Healthy living Women's health Middle years (around 25 to 50 years) Long term conditions Lipoedema Lipoedema Lipoedema is a long term (chronic) condition of fat and connective tissue which builds up in your legs, hips, bottom and sometimes arms. It affects both sides of the body equally. Its more common in women and only very rarely affects men. Its not the same as obesity. For some people, it can have a big impact on daily routine, physical health and emotional wellbeing. Symptoms People with lipoedema usually have a small waist, but large hips and thighs. Their upper body and lower body can be completely different sizes. This makes it difficult to shop for clothes that fit right. Symptoms can include: enlargement of your legs, and in some cases arms, but usually not your feet or hands pain, discomfort, heaviness or tenderness affected areas affected areas of your body can bruise easily, sometimes for no obvious reason dimpled legs with a lumpy texture, fat may bulge at the knees swelling that gets worse in the afternoon, evening, after activity or in hot weather spider veins or varicose veins on your legs difficulty walking due to changes in your leg shape, heavy legs, or flat-feet Lipoedema can be linked to mental health problems, for example depression , anxiety and disordered eating. Speak to your doctor if you are experiencing any of these symptoms. Theyll be able to give you help and advice on how to manage your symptoms. Other conditions Other health conditions, like lymphoedema , can cause large or swollen legs. Sometimes people with lipoedema can also develop this condition. Causes The exact cause of lipoedema isnt known but it may be caused by changes in your hormones: during puberty when youre pregnant when youre going through the menopause when youre taking the contraceptive pill Its not caused by being overweight you can be a healthy weight and still have lipoedema. Lipoedema can run in families so let your doctor know if you think this is the case for you. Treatment and self-management Treatment will depend on your symptoms and how theyre affecting you. If your doctor thinks you have lipoedema they may refer you to a specialist for treatment. Although theres no cure, there are things which may help. Do maintain a healthy weight by eating a balanced diet this can also reduce your chances of developing other health conditions such as type 2 diabetes and high cholesterol drink plenty of water take part in activities you enjoy to keep active like swimming, dancing, yoga or walking wear compression garments tight forms of clothing that help to reduce pain and discomfort, as well as making it easier for you to walk look after your skin using moisturising cream (emollients) regularly will help to stop your skin drying out manual lymphatic drainage a specialist type of massage, which may help to reduce discomfort counselling or cognitive behavioural therapy (CBT) if youre finding it difficult to cope or if its affecting your mental health Compression therapy Compression therapy uses special compression garments to help manage symptoms. This can help to reduce pain, inflammation, and fluid build up (oedema). Compression garments are often available on prescription. This can include stockings, socks, leggings, arm sleeves, adjustable wraps and sometimes bandaging. Your doctor, practice nurse or specialist will recommend the most suitable type of compression garment for you. Theyll also advise you on how to use it. Further support Lipoedema can affect your quality of life and your mental wellbeing . Talking to someone and getting some extra support can really help. Youre not alone. Talk Lipoedema have lots of help and advice about living well with lipoedema. They can also put you in touch with other people with lipoedema, so you can share your experiences of the condition. Source:\r\n Scottish Government Last updated: 23 March 2023 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Dont include personal information e.g. name, location or any personal health conditions. Email Address e.g. [email protected] Message Maximum of 500 characters Send feedback Add this page to\n Info For Me Also on NHS inform Keeping active guidelines Health benefits of eating well Other health sites Talk Lipoedema: Liposuction Legs Matter: Lipoedema NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats 2023 NHS 24 v1.1.1.17852"