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Soft tissue sarcomas

"Soft tissue sarcomas - 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 Soft tissue sarcomas Soft tissue sarcomas Soft tissue sarcomas are a group of rare cancers affecting the tissues that connect, support and surround other body structures and organs. Tissues that can be affected by soft tissue sarcomas include fat, muscle, blood vessels, deep skin tissues, tendons and ligaments. Soft tissue sarcomas can develop in almost any part of the body, including the legs, armsand the trunk (torso). There are many different types of soft tissue sarcoma, depending on where in the body they are located. For example: leiomyosarcomas which develop in muscle tissue liposarcomas which develop in fat tissue angiosarcomas which develop in the cells of the blood or lymph vessels gastrointestinal stromal tumours (GISTs) which can develop inthe connective tissues that support the organs of the digestive system Soft tissue sarcomas account for around 1 in every 100 cancers diagnosed in the UK. What causes soft tissue sarcomas? Cancer develops when cells multiply uncontrollably, forming tumours. In the vast majority of soft tissue sarcomas its unclear what causes this to happen but there are a number of factors known to increase the risk, including: age soft tissue sarcomas can occur at any age, including in children, but they are more common in middle-aged or elderly people and your risk increases as you get older certain genetic conditions some genetic conditions, such as neurofibromatosis type 1 and retinoblastoma, are associated with an increased risk of soft tissue sarcomas previous radiotherapy some people who have previously had radiotherapy for another type of cancer develop a soft tissue sarcoma, often many years after their previous treatment exposure to certain chemicals exposure to some chemicals, including vinyl chloride, dioxins and phenoxyacetic herbicides, has been associated with increased rates of soft tissue sarcomas One particular type of soft tissue sarcoma called Kaposis sarcoma which develops in skin cells is caused by a virus known as the human herpesvirus type 8 (HHV-8) infecting someone with a weakened immune system (such as people with HIV ). Signs and symptoms As soft tissue sarcomas can develop in most parts of the body, they can cause a wide range of symptoms. For example, a tumour near the stomach may cause abdominal (tummy) pain , a feeling of fullness and constipation , whereas a tumour near the lungs may cause a cough or breathlessness . There are often no obvious symptoms in the early stages of soft tissue sarcomas, although you may notice a soft, painless lump under your skin or deeper, that cant easily be moved around and gets bigger over time. You should speak to your GP if you have a worrying lump or any other troublesome symptoms. A lump the size of a golf ball or larger should be regarded as suspicious and needs to be investigated urgently. Although it is much more likely you have a benign (non-cancerous) condition, it is important to get your symptoms checked out. Diagnosing soft tissue sarcomas If your GP feels there is a possibility you do have cancer, they will refer you for a number of hospital tests to confirm whether you have a soft tissue sarcoma. In 2015, the National Institute for Health and Care Excellence ( NICE ) published guidelines to help GPs recognise the signs and symptoms ofsoft tissue sarcomaand refer people for the right tests faster. To find out if you should be referred for further tests for suspected soft tissue sarcoma, read the NICE 2015 guidelines on Suspected Cancer: Recognition and Referral . A diagnosis of a soft tissue sarcoma will usually be made by a hospital specialist and will be based on your symptoms, a physical examination, and the results of: a biopsy where a sample of suspected cancerous tissue is removed using a needle or during an operation so it can be tested and analysed in a laboratory imaging tests a magnetic resonance imaging (MRI) scan is the main type of scan carried out to assess soft tissue sarcomas, although other scans may also be carried out If a diagnosis of a soft tissue sarcoma is confirmed, these tests will also help determine how far the cancer has spread (known as the stage) and how aggressive the cancer is (known as the grade). Treating soft tissue sarcomas If youre diagnosed with a soft tissue sarcoma your care team of specialist doctors and nurses will help you decide on the most appropriate treatment. Treatment depends on factors such as the stage and grade of the cancer, the location of any tumours, and your age and general health. The main treatments used are: surgery to remove any tumours radiotherapy where high-energy radiation is used to kill cancer cells chemotherapy where medication is used to kill cancer cells Surgery Surgery is the main treatment for soft tissue sarcomas that are detected at an early stage. It involves removing the cancerous tumour along with a section of surrounding healthy tissue. This will help ensure no cancer cells are left behind. Every effort will be made to reduce the impact of surgery on the appearance and functionality of the affected body part. But there is a possibility youll have some difficulty using the part of the body that is operated on after surgery and sometimes reconstructive plastic surgery may be needed to repair significant damage. In a small number of cases, there may be no option but to amputate the part of the body where the cancer is located, such as part of the leg. Radiotherapy Radiotherapy is often used after surgery to destroy any remaining cancer cells. This is carried out using an external machine that directs beams of radiation at a defined treatment area. Radiotherapy may also sometimes be used before surgery to make a tumour easier to remove, or as part of your treatment to reduce your symptoms if surgery is not possible. Common side effects of radiotherapy include sore skin, tiredness andhair lossin the treatment area. These tend to get better within a few days or weeks of treatment finishing. Read more about the side effects of radiotherapy Chemotherapy Like radiotherapy, chemotherapy is sometimes used before surgery to shrink a tumour and make it easier to remove. This involves being given anti-cancer medication directly into a vein (intravenously). Chemotherapy may also be used alone or alongside radiotherapy for soft tissue sarcomas that cannot be surgically removed. Chemotherapy medications have a poisonous effect on the bodys cells, and can cause a number of temporary but unpleasant side effects, such as feeling tired and weak all the time, feeling and being sick, and hair loss from several parts of the body. Read more about the side effects of chemotherapy Outlook As with most types of cancer, the outlook for a soft tissues sarcoma depends largely on how far the cancer has advanced when it is diagnosed. If the cancer is detected at an early stage and can be removed during surgery, there is a possibility it can be cured. But youll need regular check-ups following treatment to check for any signs the cancer has come back. You may also need long-term physiotherapy and occupational therapy to help you manage any physical difficulties resulting from surgery. Acure is not usually possible if a soft tissue sarcoma is only detected at a late stage when it has already spread to other parts of the body, although treatment can help slow the spread of the cancer and control your symptoms. Read further information: Macmillan Cancer Support: soft tissue sarcomas Sarcoma UK: what is sarcoma? 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 Kaposi's sarcoma Radiotherapy Other health sites Sarcoma UK Cancer Research UK: Soft tissue sarcomas Macmillan Cancer Support: Soft tissue sarcomas GIST Support 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"

Soft tissue sarcomas: Teenagers and young adults

Soft tissue sarcomas | 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 Soft tissue sarcomas: Teenagers and young adults Soft tissue sarcomas: Teenagers and young adults Introduction The soft tissue Tests for soft tissue sarcomas Treating soft tissue sarcomas Living with a soft tissue sarcoma Introduction This section is for teenagers and young adults. Its about a type of cancer called soft tissue sarcoma. There are several different types of soft tissue sarcoma. The information in this section covers rhabdomyosarcomas, synovial sarcomas, soft tissue Ewings sarcoma and fibrosarcomas. These are the most common types in teenagers. If you have a different type and want to know more,contact Macmillan . If youre looking for information about soft tissue sarcomas in people of all ages, read our general soft tissue sarcoma section. Soft tissue sarcomas are cancers that develop from cells in the soft, supporting tissues of the body. There are many different types, but the ones that tend to affect teenagers are: rhabdomyosarcomas synovial sarcomas soft tissue Ewings sarcoma fibrosarcomas Sarcomas can also develop in the bones. This is called osteosarcoma. Signs and symptoms of soft tissue sarcomas The symptoms of a sarcoma will depend on where it is: if its in an arm or leg, symptoms include a lump or swelling in the limb this is usually painless, but not always if its in the tummy (abdomen), symptoms include a painful, swollen tummy, and problems going to the toilet to poo (called constipation) if its in your bladder, symptoms include pain in the lower tummy, finding it difficult to pee (pass urine), and having blood in your pee if its in the chest, symptoms can include breathlessness, a cough and pain in your chest if its in the head or neck, symptoms include a lump, a blockage and discharge from the nose or throat;occasionally an eye may become swollen and stick out a bit You may also have other symptoms, such as tiredness, loss of appetite or weight loss. Remember most people with these symptoms wont have a sarcoma. But if you have any of these symptoms, or are worried that you may have a sarcoma, the first thing to do is to speak to your GP. Theyll examine you and refer you to a hospital if they think you need to see a specialist doctor. Causes Its unknown what causes sarcomas in teenagers and young adults. People often think a knock or injury might have caused a sarcoma, but theres no evidence for this. Remember that nothing youve done has caused the cancer. Types of soft tissue sarcoma Rhabdomyosarcoma This type of sarcoma grows in the active muscles of the body. These are muscles that we have control over, like the muscles we use to move our arms or legs. Rhabdomyosarcomas are most likely to happen in the head, neck, bladder, vagina, arms, legs and trunk. There are different types or rhabdomyosarcoma. The most likely one to happen in teenagers and young adults is called an alveolar rhabdomyosarcoma and affects an arm or a leg. To find out more look atMacmillans rhabdomyosarcoma information that is written for all ages. Synovial Sarcoma This type of sarcoma is most likely to happen in the tissue around the joints, like your elbow, knee and ankle. It can also happen in other parts of your body, but that is less common. This type of sarcoma might not be obvious straight away because the lump grows slowly and is usually not sore. Soft tissue Ewings sarcoma If you have a type of soft tissue sarcoma called a soft tissue Ewings sarcoma, its treated in the same way as a Ewings sarcoma in a bone. You can read more about this in Macmillans bone cancer section. Fibrosarcoma This type of sarcoma happens in the fibrous tissue in your body. Fibrous tissue joins the structures inside your body together like your muscles to bones. Youre most likely to find a fibrosarcoma on your arms, legs or trunk, but they can happen deeper in your body. If youre looking for information about soft tissue sarcomas in people of all ages, read our general soft tissue sarcoma information. The soft tissue The soft tissues of the body connect, surround and support other body tissue and organs. Soft tissue includes muscle, cartilage, fat, fibrous tissue, nerves and blood vessels. Types of soft tissue sarcoma Soft tissue sarcomas are cancers that develop from cells in the soft, supporting tissues of the body. There are many different types, but the ones that tend to affect teenagers are: rhabdomyosarcomas synovial sarcomas fibrosarcomas There are also bone sarcomas. Doctors can tell the type of soft tissue sarcoma by closely examining the sample of tissue thats been removed (called a biopsy) under a microscope. Rhabdomyosarcomas These develop from muscle and the surrounding tissue. There are 2 main types that affect younger people: alveolar rhabdomyosarcomas these are more common in teenagers and young adults and are usually found in an arm or leg (limb), or in the muscles of the chest or tummy (abdomen) embryonal rhabdomyosarcomas these are more common in children and can start in a number of areas, for example, around the eye, where the throat joins with the nose, the bladder, the womb, or the vagina Synovial sarcomas These usually develop near to but not inside joints, such as the knee or elbow. But they can develop anywhere in the body. They usually appear as hard lumps. Fibrosarcomas These start in cells called fibrocytes, which form the tissue that helps join parts of our body together, such as joining the muscles to the bones. Fibrosarcomas are usually found in the arms, legs or torso, but can also start in areas deeper in the body. The information in this section covers the common types of soft tissue sarcoma, but if you have a different one and want to know more, please contact Macmillan . Causes Its unknownwhat causes sarcomas in teenagers and young adults. Remember that nothing youve done has caused the cancer. Some rare conditions that run in families (known as genetic conditions) can increase the chance (risk) of getting a soft tissue sarcoma. You would usually know if anyone in your family had one of these conditions. People who had radiotherapy for another type of cancer when they were a child may have an increased risk of developing a sarcoma in later life this would be from their teens onwards. People often think a knock or injury might have caused a sarcoma, but theres no evidence for this. If youre looking for information about soft tissue sarcomas in people of all ages, read our general soft tissue sarcoma information. Tests for soft tissue sarcomas There are some tests you might have at your GP surgery or at the hospital. These tests will help the doctors see whether you have a soft tissue sarcoma. Visiting your GP If you think you might have some of the symptoms of a soft tissue sarcoma, you should go to your GP. Theyll be able to talk to you about your symptoms, and they can arrange tests to find out more. Theyll examine you and usually arrange for some tests, such as X-rays. There may be a number of reasons why youre feeling unwell, so it can be difficult to diagnose the problem straight away. If your GP cant find the cause, youll be referred to a specialist at the hospital. At the hospital To begin with, you may see a specialist at a general hospital for more tests. If your GP suspects you have a soft tissue sarcoma, they may refer you directly to a sarcoma specialist. If youre diagnosed with a sarcoma and youre not already seeing a specialist, youll be referred to one. Youll probably see a lot of doctors, nurses and other staff. Your hospital doctor will examine you and arrange for some of thefollowing tests, which Macmillan have information on: X-rays bone scans ultrasound scans MRI , CT or PET scans biopsies bone marrow tests You wont necessarily need all of these tests. Further tests If the tests show that you have a sarcoma, you might need a few more tests to check how your body is working in general. Macmillan have information on these, including: blood tests tests to check your heart is healthy, including an echocardiogram or electrocardiogram (ECG), or a nuclear medicine scan (MUGA scan) tests to check your kidneys are healthy, which can involve blood tests or having your wee (urine) collected for a period of time or a nuclear medicine blood test (GFR) This may seem like a lot of tests, but theyll help the doctors plan the best treatment for you. Having tests and waiting for the results can be a scary time. Talking about how you feel and getting support from family, friends and your specialist nurse and doctor can make it a bit easier. If youre looking for information about soft tissue sarcomas in people of all ages, read our general soft tissue sarcoma information. Treating soft tissue sarcomas This section is for teenagers and young adults. Its about treatment for a type of cancer called a soft tissue sarcoma. There are different types of soft tissue sarcoma, and the information in this section covers rhabdomyosarcomas, synovial sarcomas and fibrosarcomas, which are the most common types in teenagers. If you have a different type and want to know more, please contact Macmillan . The 3 main types of treatment for soft tissue sarcomas are surgery, chemotherapy and radiotherapy. Most people have a combination of treatments. Your doctors will plan your treatment based on: thetype of sarcoma you have the stage of the cancer (how big it is and whether it has spread from where it started) the grade of the cancer (how fast-growing the cancer cells are). If you have any questions about your treatment, ask your doctor or nurse. Theyll be happy to help you understand whats involved. If you have a type of soft tissue sarcoma called a soft tissue Ewings sarcoma, its treated in the same way as a Ewings sarcoma in a bone. Chemotherapy This is when youre given anti-cancer drugs to destroy the cancer cells. For soft tissue sarcomas, chemotherapy can be given in a number of situations: before surgery to shrink the tumour after surgery to reduce the risk of the cancer coming back, and to treat cancer cells that have spread when it isnt possible to remove the sarcoma with an operation For soft tissue sarcomas, chemotherapyis given into a vein, usually through a central line, a port or a PICC line. You can find out more about chemotherapy and how its given. Youll have chemotherapyover a few days, then youll have a few weeks off so that your body can recover from any side effects. The days you have the chemotherapyand the rest period afterwards are called a cycle. Most people have several cycles of chemotherapy. Youll probably need to stay in hospital for some of the time during chemotherapy, but its often possible to have part of your treatment as an outpatient. Different chemotherapy drugs are used for soft tissue sarcomas, and youll usually have 2 or 3 drugs in combination. This is sometimes called a regimen or treatment plan. Your doctor will decide which regimen or treatment plan is best for you depending on the grade and stage of your sarcoma. You may have chemotherapy treatment as part of a clinical research trial. It will be your decision whether or not you take part in a trial. Your doctor will explain it fully before you make the choice if there is a trial that is right for you. Some of the main chemotherapy drugs for soft tissue sarcomas are: ifosfamide vincristine actinomycin D doxorubicin cyclophosphamide cisplatin If you have a rhabdomyosarcoma, you may be given ifosfamide, vincristine and actinomycin. Giving these drugs together is called IVA. You might also be given ifosfamide, vincristine actinomycin and doxorubicin. Giving these drugs together is called IVADO. Macmillan have more information about chemotherapy , including information about individual drugs and combinations of drugs , IVA and IVADO chemotherapy. This is written for anyone whos looking for information about chemotherapy, not just for young adults. Other types of soft tissue sarcoma can be treated with different combinations of drugs, such as ifosfamide and doxorubicin, or vinorelbine and cyclophosphamide. Your cancer doctor and specialist nurse will explain more about the type of chemotherapy youre going to have and how many cycles youll need. Side effects Different chemotherapydrugs cause different side effects. Some people have just a few side effects and others have more. Its hard to know how its going to be for you, as everyone is different. The most common are hair loss, tiredness, sickness and being more at risk of getting an infection. Side effects can often be controlled, so always let your doctor or nurse know about the side effects youre having. They can usually do something to improve them. Most side effects are short-term (temporary) and gradually disappear once treatment stops. If you want to know more about the type of chemotherapyyoure having and its side effects, theres lots more information inMacmillans chemotherapy section . Surgery Surgery to remove the cancer is one of the main treatments for soft tissue sarcomas. Your surgeon will aim to remove all of the cancer, and at the same time reduce any long-term effects as much as possible. The operation you have will depend on the size of the sarcoma and where it is in your body. You might meet other people with the same type of sarcoma who have had a different operation. Everyone is different. Your cancer doctor and specialist nurse will talk to you about your operation and make sure you understand why you need to have it and whats involved. Below are some of the different types of operation you might have for a soft tissue sarcoma. We also have more information about what will happen before and after the operation in our surgery section. Wide local excision You may have an operation called a wide local excision to remove the cancer and an area of tissue surrounding it (called the margin). This tissue is checked to make sure it doesnt contain any cancer cells. Sometimes the surgeon also removes some of the lymph nodes (glands) near the cancer to find out if there are any cancer cells there. If there are cancer cells in the margin or lymph nodes, some people may need to have more surgery. Skin graft or soft tissue graft If you need to have a large area of tissue removed, you may need to have a skin graft or soft tissue graft. This is when skin and sometimes muscle is taken from a different part of the body to place over the area where the sarcoma was removed from. This is called plastic surgery or reconstructive surgery. Its done to give you as natural an appearance as possible and to make sure you can still do the things you did before your operation. Both operation sites will gradually heal over a few weeks after the operation. Limb-sparing surgery If the sarcoma is in an arm or leg you may have limb-sparing surgery. This means the surgeon takes away the cancer without removing the arm or leg. Youll have all of the tumour taken away from your limb, as well as any bone and muscle affected by the tumour. The surgeon then replaces what theyve taken away. This may involve using plastic surgery or reconstructive surgery (see skin graft or soft tissue graft) to replace the tissue thats been removed, or it may involve surgery to replace any bone thats been removed. If you need to have bone removed, the surgeon replaces it with a specially designed metal implant called an endoprosthesis. If the cancer affects a bone in or near a joint, your joint can be replaced with an artificial one. Before the operation Your physiotherapist might give you exercises before your operation to strengthen your muscles. If youve had chemotherapy, youll need 2 or 3 weeks to recover from the treatment before you can have your operation. Doctors will check that your blood count has returned to normal. Theyll also make sure that youre well enough to have the operation. If youve lost weight or been off your food, you might need to build yourself up a bit. The hospital dietitian can help you do this. Youll probably also see a physiotherapist, wholl give you exercises to do to strengthen your muscles. If you want to have a look at the endoprosthesis that will be put in during your surgery, your nurse or surgeon can usually arrange this. After the operation Youll have a bandage or splint on your limb to keep it still and let it heal. Youll probably have a tube, called a drain, coming out of your wound. This stops fluid building up in your wound. A nurse will take it out after about 3 to 4 days or when there isnt very much fluid coming out of the wound. You wont feel like eating or drinking much for a few hours after your operation, so youll be given fluids into a vein. Youll probably feel a bit sore to begin with, but youll be given strong painkillers to help. Its important to tell the nurses if you need extra pain relief. The pain usually starts to get better within 2to 3 days. As time goes on youll need fewer painkillers and will start to feel a lot more comfortable. Be honest about how you are feeling to your doctors and nurses and they can make sure that you are comfortable and as pain-free as possible. Once youre home youll probably feel a bit better and stronger every day. But if you do have any problems its important to get them treated right away, as a delay could mean they get much more serious. If your new joint starts to stiffen up you may need some more physiotherapy, so tell your doctor so they can arrange this for you. If you notice any new redness, soreness or swelling in the limb thats been operated on, its really important to get in touch with your doctor right away. You might have an infection that needs treatment, so youll need to see the surgeon who did your operation without delay. Theres more information about the long-term effects of limb-sparing surgery in our section on living with and after a soft tissue sarcoma . Amputation Very occasionally the only way to get rid of the cancer is to remove the limb where the sarcoma is growing. This is called an amputation and its only ever done if there is no alternative. Before the operation Your doctor will talk things through with you so that you fully understand whats involved. Losing a limb can feel very scary and you might want to talk to a specialist nurse or a counsellor about your feelings. It might also help to talk to someone who has had an amputation your nurse or doctor can arrange this. Its really important to get support. After the operation Youll have bandages or a plaster cast on the area thats been operated on. Therell be a drain coming from the wound to remove any excess fluid that builds up. The drain is usually taken out by a nurse on the ward after 3 to 4 days or when there is no fluid coming from the wound. Youll also be given fluid into a vein in your arm until you feel like eating and drinking again. Youll probably feel a bit sore after your operation, especially for the first 2 to 4 days, but youll be given strong painkillers to help with this. Its important to tell the doctors and nurses if you need extra pain relief. You may have pain that feels as if its coming from the part of the limb thats been removed. This is known as phantom pain. Let your doctor or nurse know if you have this. There are medicines that can help ease it or take it away. It usually gets better and goes away in time. A physiotherapist will visit you a day or so after your operation. Theyll show you exercises to keep your muscles strong and flexible. If youve had an arm removed, youll be able to get up and move around once youve recovered from the anaesthetic and dont feel too sore. If youve had a leg removed, the physiotherapist will show you how to move around in bed and get from your bed to a chair. Youll probably be moving around with crutches or in a wheelchair within a few days. Once youre up and around youll go to the hospital gym for physiotherapy. This is a big part of your recovery. Your physiotherapist will give you more exercises to do as your wound heals and you get stronger. Itll take a few months for your limb to heal to its final shape after the operation, so you wont be fitted with your permanent prosthesis (artificial limb) until this happens. In the meantime, youll be given a temporary prosthesis and youll start learning how to use it in physiotherapy. A specialist team will help you recover from the operation and get you used to the artificial limb that youre fitted with. Youll be able to go home about two weeks after your operation. You can read more about recovering after the operation in our information about living with and after a soft tissue sarcoma . Remember that it may be possible to talk to someone who has been through the same as you. Your doctor or nurse can arrange this. Radiotherapy Radiotherapy treats cancer by using high-energy X-rays to destroy cancer cells while doing as little harm as possible to normal cells. Theres more information about it in the radiotherapy section. For soft tissue sarcomas radiotherapy can be given in a number of situations: after surgery to reduce the risk of the cancer coming back in the same area, or to get rid of any cancer cells that may be left behind; youll usually have it about 4 to 6 weeks after the operation, when your wound has healed before surgery to shrink the tumour and make it easier to remove with an operation when it isnt possible to remove the sarcoma with an operation Radiotherapy is generally given every weekday (Monday to Friday). Each treatment takes a few minutes. Side effects Radiotherapy isnt painful, but it can cause some side effects. After a few treatments you may begin to feel tired, and your skin may go red or get darker and feel sore or itchy around the area thats being treated. This gets better once your radiotherapy treatment is over. Other side effects depend on which part of your body is being treated. Having radiotherapy around a joint can make it feel stiff, but physiotherapy can help. If youre looking for information about soft tissue sarcomas in people of all ages, read our general soft tissue sarcoma information. Living with a soft tissue sarcoma This information is about life after having surgery for a soft tissue sarcoma. You may find it useful to read the information about surgery first. Life after limb-sparing surgery The long-term effects of limb-sparing surgery depend on which part of your body is affected and what kind of operation you have. The best person to ask about your operation is your surgeon. After limb-sparing surgery the limb might not work as well as it used to. Physiotherapy is an important part of your recovery. Youll be given exercises to do to help you get your limb working as well as possible. These can be hard work, but its important to keep going with them. Joint replacements If youve had a joint replacement, youll be able to walk and swim and do most of the things you could do before, but your doctor might advise you not to play high-impact sports like hockey, football, tennis or rugby. These activities could damage or loosen the new joint. Check with your surgeon about any special instructions they may have for what activities you can do. If youve had a shoulder replacement you might find it harder to lift your arm above your shoulder. After any kind of joint replacement, you will be given physiotherapy. Its very important to do the exercises your physiotherapist shows you so that you get as much movement back as possible. Life after amputation After amputation most people have an artificial limb, called a prosthesis. There are artificial limbs designed to let you do all types of physical activities, including walking, swimming, running, cycling and playing sports. Different types of prosthesis let you do different things. Some people have one for wearing day-to-day, and an extra one specially designed for something like swimming or doing athletics. How will I feel? You might feel lots of different emotions. You might be tearful, angry, fed up or depressed at times. You might think youve lost all your confidence and that youll never be able to live a normal life or be in a relationship. These feelings are normal, and its important that you get support to help you cope with them. You could talk to: family or friends a counsellor this can be arranged by your doctor or nurse other young people in a similar situation Things will be tough as you get used to living with an amputation, but help is available. Other peoples reactions can be hard to cope with, too. You might be worried about what your friends think or how theyre going to treat you. The thought of going back to school, college or work can be scary. Even people in your family who you are close to might not know what to say or do. Others might say things that sound stupid or seem hurtful. Try to choose a couple of really close relatives or friends you can call on when things get you down. You might also find it useful to talk to someone outside your close circle, like a counsellor. Most people find it helps to talk about how theyre feeling or whats on their mind. If youre looking for information about soft tissue sarcomas in people of all ages, read our general soft tissue sarcoma information. 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 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

Sore throat

Sore throat | 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 Sore throat Sore throat 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 Sore throats are very common and usually nothing to worry about. They normally get better within a week. Most are caused by minor illnesses such as cold or flu and can be treated at home. Treatments for a sore throat There are things you can do to help soothe a sore throat. Do take ibuprofen or paracetamol paracetamol is better for children and for people who cant take ibuprofen (children under 16 should never take aspirin) drink plenty of cool or warm fluids, and avoid very hot drinks eat cool, soft foods avoid smoking and smoky places suck lozenges, hard sweets, ice cubes or ice lollies but dont give young children anything small and hard to suck because of the risk of choking gargle with a homemade mouthwash of warm, salty water (children should not try this) How to gargle with salt water Dissolve half a teaspoon of salt in a glass of warm water (warm water helps salt dissolve). Gargle with the solution, then spit it out (do not swallow it). Repeat as often as you like. There are also products such as medicated lozenges and sprays sold in pharmacies that you may want to try. There isnt much scientific evidence to suggest they help, although some people find them worth using. Antibiotics arent usually prescribed for a sore throat, even if its caused by a bacterial infection. Theyre unlikely to make you feel better any quicker and they have unpleasant side effects . Sore throat self-help guide Complete our self-help guide to check your symptoms and find out what to do next. When to get professional advice Go to A&E or phone 999 if: You or your child have: symptoms that are severe or getting worse quickly difficulty breathing or swallowing severe pain started drooling a muffled voice a high-pitched sound as you breathe (stridor) If you have a sore throat, you can get advice and treatment directly from a pharmacy. Find your nearest pharmacy You dont usually need to get medical advice if you have a sore throat. Your pharmacist may advise you to see your GP if: your symptoms are severe for example with a high temperature or you feel shivery you have persistent symptoms that havent started to improve after a week you experience severe sore throats frequently you have a weak immune system for example, you have HIV , are having chemotherapy , or are taking medication that suppresses your immune system If your GP practice is closed, phone 111 . If you have a persistent sore throat (one that lasts 3 to 4 weeks), you should see your GP who may refer you for further tests. This is because your sore throat may be a symptom of a more serious condition. Causes of a sore throat The cause of a sore throat isnt always obvious. But in most cases its a symptom of a viral or bacterial infection. Common causes A sore throat is often a symptom of: colds or flu you may also have a blocked or runny nose, a cough , a high temperature (fever), a headache and general aches laryngitis (inflammation of the voice box) you may also have a hoarse voice, a dry cough and a constant need to clear your throat tonsillitis (inflammation of the tonsils) you may also have red or spotty tonsils, discomfort when swallowing and a fever strep throat (a bacterial throat infection) you may also have swollen glands in your neck, discomfort when swallowing and tonsillitis glandular fever you may also feel very tired, have a fever and swollen glands in your neck It may also be caused by something irritating your throat. For example, smoke, gastro-oesophagealreflux disease (where acid leaks up from the stomach) and allergies . Less common causes Less often, a sore throat can be a sign of: a painful collection of pus at the back of the throat (quinsy) the pain may be severe and you may also have difficulty opening your mouth or difficulty swallowing inflammation of the flap of tissue at the back of the throat (epiglottitis) the pain may be severe and you may have difficulty breathing and difficulty swallowing These conditions are more serious and should be seen by a doctor as soon as possible. Source: NHS 24 - Opens in new browser window Last updated: 26 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 Common cold Tonsillitis Glandular 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

Spleen problems and spleen removal

Spleen problems and spleen removal | 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 Spleen problems and spleen removal Spleen problems and spleen removal Some people are born without a spleen or need to have it removed because of disease or injury. The spleen is a fist-sized organ foundin the upper left side of your abdomen, next to your stomach and behind your left ribs. Its animportant part of your immune system but you can survive without it. This is because the liver can take over many of the spleens functions. What does the spleen do? The spleen has a few important functions. It fights any invading germs in the blood (the spleen contains infection-fighting white blood cells). It controls the level of blood cells. The spleen controls the level of white blood cells, red blood cells and platelets (small cells that form blood clots). It screens the blood and removes any old or damaged red blood cells. If the spleen doesnt work properly, it may start to remove healthy blood cells. Thiscan lead to: anaemia , from a reduced number of red blood cells an increased risk of infection, from a reduced number of white blood cells bleeding or bruising, from a reduced number of platelets Spleen problems Spleen pain Spleen pain is usually felt as a pain behind your left ribs. It may be tender when you touch the area.This can be a sign of a damaged, ruptured or enlarged spleen. A damaged or ruptured spleen The spleen can become damaged or may rupture (burst) after a forceful blow to the abdomen,car accident, sporting accident or fractureto the ribs. Rupture can happen straight away or it may happen weeks after the injury. Signs of a ruptured spleen are: pain behind your left ribs and tenderness when you touch this area dizziness and a rapid heart rate (a sign of low blood pressure caused by blood loss) Sometimes, if you lie down and raise your legs, the pain can be felt at the tip of your left shoulder. A ruptured spleen is a medical emergency, as it can cause life-threatening bleeding. Go straight to A&E if: you think youve ruptured or damaged your spleen Enlarged spleen The spleen can become swollen after an infection or injury. It can also become enlarged as a result of a disease such as cirrhosis , leukaemia or rheumatoid arthritis . An enlarged spleen doesnt always cause symptoms. Otherwise, look out for: feeling full very quickly after eating (an enlarged spleen can press on the stomach) feeling discomfort or pain behind your left ribs anaemia and/or fatigue frequent infections easy bleeding Doctors can often tell if you have an enlarged spleen by feeling your abdomen. A blood test, CT scan or MRI scan would confirm the diagnosis. The spleen is not usually removed if its just enlarged. Instead, youll receive treatment for any underlying condition and your spleen will be monitored. Antibiotics may be prescribed if theres an infection. Youll need to avoid contact sports for a while, as youll be at greater risk of rupturing the spleen while it is enlarged. Surgery is only necessary if the enlarged spleen is causing serious complications or if the cause cant be found. Splenectomy (having the spleen removed) An operation to remove the spleen, known as a splenectomy, may be needed if the spleen is damaged, diseased or enlarged. It may sometimes be more appropriate to have just part of your spleen removed a partial splenectomy. If theres time, youll be advised to have a series of immunisations before the operation. Laparoscopy Most splenectomies are carried out using laparoscopy (keyhole surgery). A laparoscope is long, thin, flexible instrument withits own light source. It is attached to a camera andwill relay high definition, magnified pictures back to a TV screen to guide the surgeons instruments. Laparoscopic splenectomy allows a surgeon to access the inside of your abdomen without having to make large incisions (cuts) in your skin. However, you will still need a general anaesthetic. The procedure involves: making several incisions in your abdomen (tummy area) guiding a laparoscope into your body through one of the incisions, so doctors can see what theyre doing passing thin instruments into your abdomen through the other incisions, to remove your spleen gas will be pumped into your abdomento make this easier The incisions will then be stitched up or sometimes glued together.You may be able to go home the same day, or may need to stay in hospital overnight. If you go home the same day, someone will need to stay with you for the first 24 hours. Open surgery Open surgery, where one large incision is made, may be needed if the spleen is too large or too damaged to be removed via keyhole surgery.Often, in emergencies, this will be the preferred method to rapidly control bleeding. Youll need a general anaesthetic and may need to stay in hospital for a few days to recover. Afterwards Its normal to feel sore and be bruised after a splenectomy, but youll be given pain relief medication. You should be able to eat and drink as normal soon after the operation. Like any operation, a splenectomy carries a small risk of complications, including bleeding and infection. Your doctor will run through these risks with you. You should be given breathing and leg movement exercises to doat home, to reduce your risk of getting a blood clot or a chest infection. Another risk is the surgical wound becoming infected. If you spot any signs of infection, contact your GP or hospital immediately, as youmay need antibiotics. Recovery usually takes a few weeks. Your doctor or nurse will advise when you can go back to your usual activities, such as driving. Living without a spleen If your spleen needs to be removed, other organs such as the liver can take over many of the spleens functions. This meansyou will still be able to cope with most infections. However, there is a small risk that a serious infection may develop quickly.This risk will be present for the rest of your life. Risk of infection Young children have a higher risk of serious infection than adults, but the risk is still small. The risk is also increased if you have a medical condition such as sickle cell anaemia , coeliac disease or a condition that affects your immune system, such as HIV . This risk can be minimised by following simple precautions to prevent infection. Vaccinations Read about vaccinations for children and adults without a fully working spleen. Antibiotics Its recommended that you take low-dose antibiotics for the rest of your life to prevent bacterial infections. Antibiotics are particularly important: for children under the age of 16 for the first 2 years after your spleen is removed if your immune system doesnt work properly Be alert for signs of infection Watch out for signs of infection, such as: high temperature (fever) sore throat cough severe headache headache with drowsiness or a rash abdominal pain redness and swelling around the surgical wound Your GP can prescribe a course of antibiotics for you to use if you get an infection. You should start taking them at the first sign of an infection, so see your GP as soon as possible. If your infection becomes serious, you will be admitted to hospital. Animal and tick bites Bites from animals and ticks (small blood-sucking parasites) can cause infections. If you get bitten by an animal, particularly a dog, start your course of antibiotics and seek medical advice urgently. If you go trekking or camping regularly, you may be at risk of babesiosis, which is a rare disease transmitted by ticks. Try to avoid tick bites by wearing clothes that cover your skin, particularly long trousers. If you become ill, get medical advice straight away. Telling medical staff about your condition Healthcare professionals will mark your health records to show that you dont have a working spleen. However, always remember to tell any medical professionals that you see, including your dentist. Carry medical ID Its a good idea to carry or wear some medical ID. For example: if your spleen is removed, the hospital may give you a splenectomy card to take home with you you may want to buy your own medical ID, such as a MedicAlert or Medi-Tag bracelet or pendant If you need help or emergency treatment, your medical ID will alert the staff to your condition. Travel abroad Read advice about travelling abroad without a fully working spleen. Scars The scars from your operation will gradually fade. 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 Children and adults without a fully working spleen (Asplenia) 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

Stillbirth

Stillbirth | 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 Stillbirth Stillbirth A stillbirth is when a baby dies after the 24th week of a pregnancy or during birth. Its a devastating experience for parents and can affect you and your family in ways you dont expect. How you might be feeling Your emotions will likely be in turmoil and you might feel angry, guilty, sad and lonely but also love and pride. Theres no right or wrong way to feel. If you already have children, think about how they might be feeling too and what support theyll need. This is a very difficult time for you and everyone close to you so its important to support each other and ask for help if you need it. Causes of stillbirth The stillbirth or death of a newborn baby can happen for lots of reasons and doctors dont yet know all the causes. Some are linked to problems with the placenta or mums health and others to the babys health or development but in some cases the reason cant be explained. Although there are many reasons that a stillbirth can happen, you can decrease the risk by maintaining a health lifestyle before and during pregnancy. Read more about living a healthy lifestyle during pregnancy Death during pregnancy If your baby dies before birth, labour is usually induced. Going through labour and giving birth is the safest option for most women, even though it can be very distressing. Its natural to want to know why this happened. Its not always possible to know why your baby died and that can be hard to come to terms with. Your midwife and obstetrician will be there to support you through it. They will tell you what to expect and give you whatever help you need. Should I hold my baby? Your midwife or doctor will ask if youd like to see or hold your baby. You might want to involve other members of your family too. If youre worried about what your baby looks like, your midwife or doctor can describe them to help you decide. Many parents find it comforting to see, touch and hold their baby and, if you want to, you can bath and dress them. Cuddle cot Your midwife can talk to you about a Cuddle Cot, a special cooling mattress inside a cot which can let you spend more time with your baby in the hospital or at home. This gives you more time to say goodbye, with the support of family and friends. If the hospital doesnt have a Cuddle Cot then there are other organisations that can organise one for bereaved parents. Ask your midwife. After a stillbirth What you choose to do is very personal and individual, as is the way you grieve. Specialist help and support is available for parents and families who have lost a baby and your midwife, family nurse and health visitor can help you to find the right support locally. Registering a stillbirth Your babys stillbirth must be registered. Your midwife and the hospital staff can advise you how to do this. You cant officially register a baby lost before 24 weeks of pregnancy, but some hospitals will give you a certificate in memory of your baby if you ask. More about registering the death of a baby Funeral arrangements Youll need time to think what youd like for your babys funeral. This could be a burial or cremation with a service in the style of your choice. Take as much time as you need to decide on the right way to say goodbye. All hospitals in Scotland will offer a funeral service for your baby free of charge or you may choose to make your own private arrangements, which can give you more choice and control. More about funeral arrangements Coping with the loss of a baby Everyone reacts differently to the loss of a baby. Your emotions might be overwhelming and you might feel physically drained too. Take time to rest and look after yourself. Its important to know you are not alone and have done nothing wrong. More about coping with the loss of a baby Post-mortem If you lost your baby after 13 weeks, youll be offered a post-mortem (autopsy). This is a medical investigation to try to understand what happened and find out if there are issues that could affect a future pregnancy Whether or not to have a post-mortem can be a difficult decision and youll be given support and time to think it over. If you have questions or worries, ask the person who discusses the post-mortem with you. Recovering from a stillbirth You will need care from your midwife and doctor to make sure your body is recovering. Your midwife will assist you through all the decisions you need to make and help you to find the right support. You dont have to manage alone and it can sometimes help to talk with others who have been through baby loss. You, your babys father or your partner and your family are likely to need time to grieve. Remembering your baby Some parents find it helps to do something to remember their baby, like: creating a space in their garden saying a prayer writing a poem Others keep photographs, handprints or footprints, or locks of their babys hair in a memory box. No matter what stage of pregnancy your loss is, you can make a memory box ask your midwife about this. Some hospitals give special boxes to parents just for this. Some parents dont want to do any of these things, and thats okay too. Theres no right or wrong way. To request a different language or format please email: [email protected] Source: Public Health Scotland - Opens in new browser window Last updated: 06 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 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

Stomach ache and abdominal pain

Stomach ache and abdominal pain | 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 Stomach ache and abdominal pain Stomach ache and abdominal pain 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 A stomach ache is cramps or a dull ache in the tummy (abdomen). It usuallydoes not last longand is often not serious.Severe abdominal pain is a greater cause for concern. Abdominal pain self-help guide Complete our self-help guide to check your symptoms and find out what to do next. Stomach crampswith bloating Stomach crampswith bloating areoftencaused bytrapped wind. Your pharmacist can recommend treatments to help, such as: buscopan mebeverine Find your local pharmacy Sudden stomach cramps with diarrhoea If your stomach cramps have started recently and you also have diarrhoea , the cause may be a tummy bug (gastroenteritis) . This means you have a viral or bacterial infection of the stomach and bowel. It should get better without treatment after a few days. Gastroenteritis may be caused by: coming into close contact with someone whos infected eating contaminated food ( food poisoning ) If you have repeated bouts of stomach cramps and diarrhoea, you may have a long-term condition, such as irritable bowel syndrome (IBS) . Sudden severe abdominal pain Sudden agonising pain in a particular area of your abdomen may be a sign of a serious problem. Itcould rapidly get worse without treatment. If there is any possibility that you could be pregnant, take a pregnancy test. Go to A&E or phone 999 for an ambulance if: youre less than 16 weeks pregnant and have severe abdominal pain a stomach ache came on very suddenly or is severe it hurts when you touch your stomach youre vomiting blood or your vomit looks like ground coffee your poo is bloody or black and sticky and extremely smelly you cannot pee you cannot poo or fart you cannot breathe you have chest pain you have diabetes and youre vomiting someone has collapsed Speak to your GP if: a stomach ache gets much worse quickly stomach pain or bloating will not go away or keeps coming back you have stomach pain and problems with swallowing food youre losing weight without trying to you suddenly pee more often or less often peeing is suddenly painful you bleed from your bottom or vagina, or have abnormal discharge from your vagina you have diarrhoea that does not go away after a few days If your GP is closed, phone 111. Serious causes of sudden severe abdominal pain include: appendicitis the swelling of the appendix means your appendix will need to be removed a bleeding or perforated stomach ulcer acute cholecystitis inflammation of the gallbladder, which may need to be removed kidney stones small stones may be passed out in your urine, but larger stones may block the kidney tubes, and youll need to go to hospital to have them broken up diverticulitis inflammation of the small pouchesin the bowel that sometimes requires treatment with antibiotics in hospital ectopic pregnancy when a fertilised egg develops outside the womb ectopic pregnancy can be very serious if it isnt treated If your GP suspects you have one of these conditions, they may refer you to hospitalimmediately. Sudden and severe pain in your abdomen can also sometimes be caused by an infection of the stomach and bowel (gastroenteritis). It may also be caused by a pulled musclein your abdomen or by an injury. Long-term or recurring abdominal pain See your GP if you or your child havepersistent or repeated abdominal pain. The cause is often not serious and can be managed. Possible causes in adults include: irritable bowel syndrome (IBS) the pain is often relieved when you go to the toilet inflammatory bowel disease (IBD)for example Crohns disease , ulcerative colitis and endometriosis a urinary tract infection (UTI) that keeps returning youll usually alsohavea burning sensation when you urinate constipation period pain painful muscle cramps in women that are linked to the menstrual cycle stomach ulcer heartburn and acid reflux gastritis (inflammation of the stomach lining) Possiblecauses in children include: constipation aUTIthat keeps returning heartburn and acid reflux abdominal migraines recurrent episodes of abdominal pain with no identifiable cause 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: Diarrhoea Chest 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

Stomach cancer

Stomach 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 Stomach cancer Stomach cancer About stomach cancer Symptoms of stomach cancer Causes of stomach cancer Diagnosing stomach cancer Treating stomach cancer Living with stomach cancer About stomach cancer Stomach cancer, or gastric cancer, is a fairly uncommon type of cancer. The initial symptoms of stomach cancer are vague and easy to mistake for other less seriousconditions.They include: persistent indigestion and heartburn trapped wind and frequent burping feeling very full or bloated after meals persistent stomach pain Symptoms of advanced stomach cancer can include: blood in your stools, or black stools loss of appetite weight loss As the earlysymptoms of stomach cancer are similar to those of many otherconditions, the cancer is often advanced by the time its diagnosed. Its therefore important to get any possible symptoms of stomach cancer checked by your GP as soon as possible. Read more about diagnosing stomach cancer Whos affected The exact cause of stomach cancer is still unclear, although youre more likely to develop it if you: are male are 55 years of age or older smoke have a diet low in fibre and high in processed food or red meat have a diet that contains a lot of salted and pickled foods have a stomach infection caused by Helicobacter pylori (H. pylori) bacteria Read more about the causes of stomach cancer . Types of stomach cancer There are several different types of stomach cancer. More than 95% of stomach cancers develop in the cells of the stomach lining and are known as adenocarcinomas. Less common types of stomach cancer include lymphoma of the stomach, which develops in the lymphatic tissue (tissue that drains away fluid and helps fight infection), and gastrointestinal stromal tumours (GISTs), which develop in the muscle or connective tissue of the stomach wall. How stomach cancer is treated Many cases of stomach cancer cant be completely cured, but its still possible to relieve symptoms and improve quality of life using chemotherapy and in some cases radiotherapy and surgery. If operable, surgery can cure stomach cancer as long as all of the cancerous tissuecan be removed. Surgery to remove some or all of the stomach is known as agastrectomy. It will still be possible to eat normally after a gastrectomy, but youll probably have to adjust the size of your portions. Chemotherapy can also be used before surgery to help shrink the tumour and sometimes after surgery to help prevent the cancer returning. Read more about treating stomach cancer Living with stomach cancer Living with stomach cancer and the effects of surgery can be tough, but there are a range of services that can provide social, psychological and financial support. Read more about living with stomach cancer Symptoms of stomach cancer Many symptoms of stomach cancer are similar to less serious conditions, so it can be difficult to recognise in the early stages. Early stage symptoms include: persistent indigestion trapped wind and frequent burping heartburn feeling full very quickly when eating feeling bloated after eating feeling sick pain in your stomach or breastbone difficulty swallowing ( dysphagia ) vomiting (the vomit may be streaked with blood), although this is uncommon in the early stages Advanced stomach cancer Symptoms of more advanced stomach cancer include: blood in your stools, or black stools loss of appetite weight loss tiredness lumpiness and swelling in your stomach (caused by a build-up of fluid) anaemia (a reduced number of red blood cells that can cause you to feel tired and breathless) yellowing of the skin and whites of the eyes (jaundice) When to seek medical help Stomach cancer is usually easier to treat if its diagnosed early. Its thereforeimportant for your GP to refer you to a specialist as soon as possible if stomach cancer is suspected. Stomach cancer is much more common in older people, with 90 out of 100 cases occurring in people who are over 55 years of age. Indigestion is a very common symptom in the general population. However, its unlikely that someone with indigestion whos under the age of 55 will have stomach cancer. However,see your GP if you have indigestion and weight loss, anaemia or persistent vomiting. Theyshould refer you to a specialist for further testing. Also see your GP if you have difficulty swallowing. Thisisnt a common symptom among the general population and the cause should always be investigated. Read more about diagnosing stomach cancer Causes of stomach cancer Stomach cancer is caused by changes in the cells of the stomach, although its unclear exactly why these changes occur. Cancer begins with a change (mutation) in the structure of the DNA in cells, which can affect how they grow. This means cells grow and reproduceuncontrollably, producing a lump of tissue called a tumour. Left untreated, cancer can spread to other parts of the body, usually through the lymphatic system (a network of vessels and glands called lymph nodes located throughout the body). Once the cancer reaches your lymphatic system, its capable of spreading to other parts of your body, including your blood, bones and organs. Its not known what triggers thechanges in DNAthat lead to stomach cancer and why only a small number of people develop the condition. Increased risk However, evidence suggests that a number of different factors can affect yourchances of developing stomach cancer. Age and gender Your risk of developing stomach cancer increases with age. Most cases occur in people aged 55 or over. For reasons that are unclear, men are twice as likely as women to develop stomach cancer. Smoking People who smoke are about twice as likely to develop stomach cancer compared with non-smokers. This is because you swallow some cigarette smoke when you inhale and it ends up in your stomach. Cigarettes containharmful chemicals which can damage the cells in your stomach. The more you smoke and the longer youve been smoking, the bigger the risk.In the UK, around 1in every 5 cases of stomach cancer (20%) is thought to be caused by smoking. H. pylori infection Helicobacter pylori (H. pylori)is a common type of bacteria. In most people, these bacteria are harmless, butin some people an H. pylori infection can cause problems such as stomach ulcers , recurring bouts of indigestion orlong-term inflammation of the stomach lining (chronic atrophic gastritis). Research has foundpeople with severe chronicatrophic gastritis havean increasedrisk of developing stomach cancer, although this risk is still small. Diet A diet rich in pickled vegetables, such as pickled onions or piccalilli, salted fish, salt in general and smoked meats, such as pastrami or smoked beef, increases your risk of stomach cancer. Countries where this type of diet is popular, such as Japan, tend to have much higher rates of stomach cancer than the UK. A high fibre diet with 5 portions of fruit and vegetables a daywill help protect against stomach cancer, and a diet high in fats and processed food and red meat will increase your risk of getting stomach cancer. Family history Youre more likely to develop stomach cancer if you have a close relative with the condition, such as one of your parents or a sibling (brother or sister). In such cases, it may be appropriate for your doctor to arrange genetic counselling. Its not fully understood why stomach cancer seems to run in families. It may be because of shared risk factors, such as having similar diets or having an H. pylori infection, or because of certain genes you inherit from your parents. In around 1 in 50 cases of stomach cancer, testing has found that people share a mutation in a gene known as E-cadherin. You may be more at risk of getting the condition if you have the blood type A. Yourblood type is passed on from your parents, so this could be another way in which family history may increase your risk of developing stomach cancer. Theres also a condition that runs in families called familial adenomatous polyposis (FAP), which may increase your risk of developing stomach cancer. FAP causes small growths, called polyps, to form in your digestive system, and is known to increase your risk of developing bowel cancer . Having another type of cancer Your risk of developing stomach cancer is increased if youve had another type of cancer, such as cancer of the oesophagus or non-Hodgkin lymphoma (cancer that develops in your white blood cells). For men, the risk of getting stomach cancer is increased after having prostate cancer , bladder cancer , breast cancer or testicular cancer . For women, the risk of developing stomach cancer increases after having ovarian cancer , breast cancer or cervical cancer . Certain medical conditions Having certain medical conditions can also increase your risk of developing stomach cancer, such as pernicious anaemia (a vitamin B12 deficiency, which occurs when your body cant absorb it properly), and peptic stomach ulcers (an ulcer in your stomach lining, often caused by H. pylori infection). Stomach surgery If youve had stomach surgery, or surgery to a part of your body that affects your stomach, you may be more likely to develop stomach cancer. This can include surgery to remove part of your stomach (known as a partial gastrectomy), surgery to remove part of your vagus nerve (the nerve that carries information from your brain to organs such as your heart, lungs and digestive system), or surgery to repair a stomach ulcer. How stomach cancer spreads There are 3 ways stomach cancer can spread: directly the cancer can spread from the stomach into nearby tissues and organs, such as the pancreas, colon, small intestine and peritoneum (the lining of the inside of the abdominal cavity) throughthe lymphatic system the lymphatic system is a series of glands (nodes) located throughout your body, similar to the blood circulatory system; the glands produce specialised cells needed by your immune system to fight infection throughthe blood which can cause the cancer to spread from the stomach to other parts of the body, most commonly the liver Stomach cancer that spreads to another part of the body is known as metastatic stomach cancer. Diagnosing stomach cancer Speak to your GP as soon as possible if you have stomach cancer symptoms such as indigestion, unexpected weight loss, anaemia and persistent vomiting. Your GP will ask about your symptoms and examine your stomach for any lumpiness or tenderness. If they think that stomach cancer may be a possibility theyll refer you to a specialist for further investigation. In 2015, the National Institute for Health and Care Excellence (NICE) published guidelines to help GPs recognise the signs and symptoms of stomach cancer and refer people for the right tests faster.Find out who should be referred for further tests for suspected stomach cancer . Hospital tests If your GP thinks you may have stomach cancer, theyll refer you to a specialist for tests. These may include a blood test and chest X-ray , which will assess your overall health. A sample of your stools may also be tested for blood. Because ofthe potentially serious nature of stomach cancer, you should be referred to the specialist within 2 weeks. Read more about waiting times . Endoscopy and endoscopic ultrasound An endoscopy is a procedure where the inside of your body is examined using a piece of equipment called an endoscope (a long, thin flexible tube with a light and a video camera at the end). If you need to have an endoscopy, you wont be able to eat or drink for four to eight hours before the procedure. This is to ensure your stomach and duodenum (top of the small intestine) are empty. Youll be awake during the endoscopy, but may be given a sedative by injection to make you feel drowsy and relaxed. A local anaesthetic may also be sprayed onto the back of your throat, so the area is numbed. The endoscope will be passed down your gullet (food pipe) and into your stomach so the specialist can look for any stomach ulcers or signs of cancer. If tissue is found that may be cancerous, a sample will be taken for testing. This procedure is known as a biopsy . The sample will be examined under a microscope in a laboratory. The results will show whether the cells are cancerous (malignant) or non-cancerous (benign) and will usually take 7 to 10 days to come back. The endoscopy itself usually takes about 15 minutes, although you should allow about 2 hours in total for your visit. If your specialist thinks you may have cancer in the top part of your stomach, you may have an ultrasound scan at the same time as an endoscopy. This is known as an endoscopic ultrasound and uses high-frequency sound waves to produce an image of your stomach (this method is commonly used to view an unborn baby in the womb). If you have an endoscopic ultrasound, an ultrasound probe will be attached to the end of the endoscope before its passed down your throat. The scan will help determine the stage of any cancer in the top part of your stomach. After an endoscopy, or an endoscopic ultrasound, you wont be able to drive for several hours because of the sedative. You may also have a sore throat , although this should pass within a few days. Barium meal X-ray A barium meal X-ray or barium swallow involves drinking a chalky liquid containing a substance called barium, which makes your stomach show up on an X-ray. Nowadays, however, its less commonly used to diagnose stomach cancers. Organs such as your stomach dont usually show up on an X-ray because theyre made of soft tissue that isnt dense enough to stop the X-rays passing through. However, when these organs are filled with barium, it blocks the X-rays and shows up white on an X-ray screen. You wont able to eat or drink for at least 6 hours before the procedure because your stomach and duodenum need to be empty. You may be given an injection to relax the muscles in your digestive system. A barium swallow usually takes about 15 minutes. 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, and the barium may cause constipation . Your stools may be white for a few days afterwards as the barium passes through your system. Further testing If youre diagnosed with stomach cancer, further tests may be needed to help determine how far its spread and how quickly its likely to spread (known as the stage and grade). Your cancer specialist (oncologist) will discuss this with you. However, it may not always be possible to identify the exact stage of your condition until your treatment starts. Laparoscopy Your specialist may need to examine your stomach in more detail to see if the cancer has spread, particularly to the lining of the abdominal cavity (peritoneum). If it has, you may need to have a small operation called a laparoscopy. This procedure is carried out under a general anaesthetic , so youll be unconscious during it. During the procedure, a thin viewing tube with a camera at the end (a laparoscope) will be inserted into your stomach through a small incision in the lower part of your tummy. In some cases, your specialist may need to examine more than one area of your stomach and make more than one incision. Computerised tomography or positron emission tomography scans During CT scans or PET scans , a series of X-ray images of your body are taken. A computer is then used to put the images together and create a detailed picture of the inside of your body. These scans will help your doctor assess how advanced your cancer is. It allows them to see whether the cancerous cells have formed tumours anywhere else in the body. The scans can alsohelp your doctors work out which type of treatment will be most effective and appropriate for you. Liver ultrasound scan If your specialist thinks your stomach cancer may have spread to your liver, you may need to have a liver ultrasound . This type of scan uses high-frequency sound waves to produce an image of your liver. Staging and grading After all of the tests have been completed and your test results are known, it should be possible to tell what stage and grade of stomach cancer you have. Staging is a measurement of how far cancer has spread. There are a number of different ways stomach cancer can be staged.One method uses a numbering system from 1 to 4. The higher the number, the further the cancer has spread. The majority of stomach cancers are at stage 3 or 4 when diagnosed, which means a cure isntusually possible. Grading describes how quickly the cancer is likely to spread in the future. There are 3 grades of stomach cancer: low-grade the cancer tends to grow slowly medium-grade the cancer grows a bitfaster high-grade the cancer is aggressive and likely to grow quickly Cancer Research UK has more information about the staging and grading of stomach cancer. Treating stomach cancer The treatments recommended for stomach cancer will depend on your general health and how far the cancer has spread. Most hospitals use multidisciplinary teams made up of a number of different specialists (see below) who work together to plan and carry outthe best treatment, tailored to your circumstances. Feel free to discuss treatment with your care team at any time and ask questions. Your treatment plan The main treatments for stomach cancer are surgery, chemotherapy and radiotherapy . You may have 1 of these treatments or a combination. If surgery is recommended, you may have chemotherapy beforehand. If the tumour is in the upper part of your stomach, including the junction between the oesophagus and stomach, you may also have radiotherapy prior to surgery. Surgery is mainly used if stomach cancer is diagnosed at an early stage, whereas chemotherapy and radiotherapy tend to be used when the condition is diagnosed at a later stage. Where possible, the primary aim of treatment is to completelyremove the tumour and any other cancerous cells in your body.Its estimated that a cure is possible in 20 to 30% of stomach cancer cases. If its not possible to remove the tumour, your doctors will focus on trying to prevent it from getting any bigger and causing further harm to your body. This may be done using surgery or chemotherapy. In some cases, its not possible to eliminate the cancer or slow it down. In this case, your treatment will aim to relieve your symptoms and make you as comfortable as possible, usually with surgery or radiotherapy. A relatively new medication calledtrastuzumab (see below) can also be used to treat some types of advanced stomach cancer. Your healthcare team will talk to you about which treatments are most suitable. Surgery If youre diagnosed with stomach cancer at an early stage,it may be possible for the cancer to be completely removed during surgery. In some cases, it may be possible to pass a thin, flexible tube (endoscope) down your oesophagus (gullet),rather than making incisions in your tummy. This is known as endoscopic surgery, and can be used toremove a sample of the tumour for testing ( biopsy ). It can also be used to remove the tumour completely if stomach cancer is diagnosed at an early stage. However, if your cancer has spread beyond your stomach, it may not be possible to remove it completely. If this is the case, you may still have surgery to remove any cancer blocking your stomach, to ease your symptoms. This will depend on whether your symptoms can be controlled and the risks and side effects of undertaking major surgery. Any type of surgery for stomach cancer will involve a large operation and a long recovery time. If you have stomach cancer surgery, youll usually need to stay in hospital for around 2 weeks. Youll also need several weeks at home to recover. Surgery to remove your stomach You mayneed to have part or all of your stomach removed. Surgery to remove part of your stomach is known as a partial or sub-total gastrectomy, and surgery to remove all of your stomach is known as a total gastrectomy. In some cases, your surgeon may remove part of your oesophagus as well as all ofyour stomach, usinga procedure known as an oesophagogastrectomy. These operations may be carried outusing either a large incision in your tummy (open surgery), or a number of smaller incisions through which surgical tools can be passed (laparoscopic or keyhole surgery). Both of these techniques are carried out under general anaesthetic , which means youll be unconscious throughout the procedure. During these operations, your surgeon will also remove the lymph nodes (small glands that help fight infection) nearest to the cancer. Its possible that your stomach cancer may have spread to these lymph nodes, and removing them helps prevent the cancer returning. Partial gastrectomy If your cancer is in the lower part of your stomach, you may have a partial gastrectomytoremove it. After surgery, your stomach will be smaller than it was before the operation. However, the top part of your stomach, where your oesophagus feeds into it, wont be affected. Total gastrectomy or oesophagogastrectomy If your cancer is in the middle or at the top of your stomach, you may need to have a total gastrectomy. If the cancer is close to the end of your oesophagus, where it meets your stomach, you mayneed to have an oesophagogastrectomy. If you have a total gastrectomy, the end of your gullet will be joined to the top of your jejunum (the top part of your small intestine). If you have an oesophagogastrectomy, the remaining part of your gullet will be joined to your jejunum. Surgery to ease your symptoms If your stomach cancer has spread beyond your stomach, it may not be possible to remove it using surgery. However, if your stomach has been significantly affected by cancer it can cause a blockage, which prevents food from being properly digested. A blocked stomach can cause symptoms such as stomach pain, vomiting and feeling very full after eating. If your stomach is blocked, there are a few options: stenting a stent is a plastic or wire mesh tube inserted through the oesophagus using an endoscope under local anaesthetic ; after being inserted, the stent will be expanded and open up the stomach partial or total gastrectomy to remove the blockage and improve your symptoms bypass surgery an operation where part of your stomach above the blockage is joined to yoursmall intestine, leaving the blocked part of your stomach out of your digestive system Chemotherapy Chemotherapy is a specialist treatment for cancer that uses medicines, called cytotoxic medicines,to stop cancer cells dividing and multiplying. As it circulates through your body, the medicine can target cancer cells in your stomach and any that may have spread to other parts of your body. You may have chemotherapy for stomach cancer before surgery to reduce the amount of cancer that has to be removed during the operation. Chemotherapy can also be used after surgery to destroy any remaining cancer cells and prevent the cancer from coming back. Chemotherapy can also help to slow the progression of cancer and ease the symptoms of more advanced stomach cancer, which may not be suitable for surgery. If may be given orally (as tablets) or intravenously (by injection or a drip through a vein directly into your bloodstream), or a combination of both. Intravenous chemotherapy is usually given in hospital, while oral chemotherapy is taken at home. Chemotherapy is often given in cycles, each usually lasting about three weeks. Alternatively, chemotherapy may be administered through a small pump, which gives you a constant low dose over a few weeks or months. The pumps are portable and can be worn at home, which means fewer trips to hospital. Side effects of chemotherapy Chemotherapy works by preventing cancerous cells from growing rapidly. However, it also destroys non-cancerous cells such ashair follicles and red and white blood cells. Side effects may include: tiredness nausea and vomiting nerve damage ( peripheral neuropathy ) hair loss diarrhoea anaemia (a lack of red blood cells) weight loss skin changes such as redness, swelling and a tingling sensation in the palms of the hands and/or soles of the feet The side effects you experience after having chemotherapy will depend on the type of chemotherapy and the number of treatment sessions you need. Youll be told who to contact if youre experiencing serious side effects from chemotherapy, and its very important that this contact information is recorded carefully. If you experience nausea and vomiting as a result of chemotherapy, you may be able to take anti-sickness medication to counter it. This may be given intravenously (by injection directly into your bloodstream) at the same time as your chemotherapy. The side effects of chemotherapy will only last for as long as your course of treatment lasts. Once your treatment is over, thehair folliclesand blood cellswill repair themselves. This means your hair will grow back, although it might look or feel different from how it did before chemotherapy (for example, it may be a slightly different colour, or be softer or curlier than before). Radiotherapy Radiotherapy uses beams of high energy radiation to destroy cancer cells. Its not often used to treat stomach cancer because theres a risk that other organs close to your stomach might be damaged by the treatment. However, if you have advanced stomach cancer thats causing pain or bleeding,you may need to have radiotherapy. In some cases, following surgery, you may have chemotherapy and/or radiotherapy to help prevent the stomach cancer from recurring. If a cancer is bleeding slowly and causing anaemia , a single fraction of radiotherapy can be used to try to prevent further bleeding. If you need radiotherapy, your treatment will usually begin 2 or 3 months after surgery or chemotherapy, to give your body a chance to recover. This is a painless procedure where you lie under a radiotherapy machine while it directs radiation at your stomach. Youll be positioned by a radiographer (a specialist in radiotherapy) so that the machine targets the cancer cells and avoids as much healthy tissue as possible. Radiotherapy often involves having treatment sessions 5 days a week. Each session will only last a few minutes. The radiation doesnt stay in your system afterwards, and its perfectly safe to be around others between your treatments. How long youll need to have radiotherapy for will depend on how its used. Radiotherapy used after surgery to help prevent stomach cancer coming back usually lasts 5 weeks. If its being used to control symptoms of advanced stomach cancer, it may only last 1 or 2 weeks. Side effects of radiotherapy You may experience the following side effects after having radiotherapy: tiredness nausea diarrhoea irritation and darkening of your skin where the treatment takes place These side effects will usually improve within a few weeks of treatment finishing. Trastuzumab Trastuzumab(sold under the brand name Herceptin) is a medicationused to treat breast cancer and some cases of advanced stomach cancer. Some stomach cancers are stimulated by a type of protein called human epidermal growth factor receptor 2 (HER2). Trastuzumab works by blocking the effects of this protein. This doesnt cure stomach cancer, butit can slow its growth and increase survival time. If youre diagnosed with advanced stomach cancer and tests show high levels of the HER2 protein in the cancerous cells, your doctors may recommend treatment with a combination of chemotherapy and trastuzumab. Trastuzumab is given intravenously, through a drip, and youll have the treatment in hospital. Each treatment session takes up to 1 hour and youll usually need a session once every 3 weeks. Trastuzumab can cause side effects, including heart problems. Therefore, it may not be suitable if you have a heart problem such as angina , uncontrolled high blood pressure ( hypertension ) or heart valve disease. If you need to take trastuzumab, youll also need regular tests on your heart to check for any problems. Other side effects of trastuzumab may include: an initial allergic reaction to the medication, which can cause nausea, wheezing, chills and fever diarrhoea tiredness aches and pains Living with stomach cancer Being diagnosed with cancer is a tough challenge for most people, but support is available to help you cope. You may find the followingadvice helpful: keep talking to your friends and family they can be a powerful support system talk to others in the same situation research your condition set reasonable goals take time out for yourself Cancer charities, such as Macmillan Cancer Support , are a good source of information and support. Recovery Getting back to normal after surgery can take time. Its important to take things slowly and give yourself time to recover. During your recovery,avoid lifting heavy things such as children or shopping bags, and strenuous tasks such as housework. You may also be advised not to drive. Some other treatments, particularly chemotherapy and radiotherapy , can make you very tired. You may need to take a break from some of your normal activities for a while. Dont be afraid to ask for practical help from family and friends. Follow-up After your treatment has finished, youll be invited for regular check-ups, usually every three months for the first year. During the check-up, your doctor will examine you and may arrange blood tests or scans to see how youre responding to treatment. Diet after surgery If youve had an operation to remove part of your stomach (partial gastrectomy), youll only be able to eat small amounts of food for a while after your operation. This is because your stomach wont be able to hold as much food as it could before the surgery, and your body will need to adjust to its new stomach capacity. You should gradually be able to increase the amount you eat as your stomach begins to expand. If youve had surgery to remove all of your stomach (total gastrectomy), it may be some time before you can eat normally again. As with a partial gastrectomy, youll only be able to eat small amounts of food until your body adjusts. You may have to eat little and often, and make changes to the types of food you eat. Your care team will be able to advise you about what and when you should eat. Having surgery to remove your stomach also means youll need to have regular injections of vitamin B12. Vitamin B12 is usually absorbed through your stomach from the food you eat and is needed to help preventa condition called anaemia and nerve problems. Looking after yourself Eat regularly and healthily. You may not have time to sit down for every meal, but you should make time to do so at least once a day. Its understandable if there are times when you feel resentful, and then guilty for feeling so. You may also feel exhausted, isolated and worry about the person you care for.Remember: youre human, and those feelings are natural. Dealing with dying If your stomach cancer cant be cured, your GP will give you support and any necessary pain relief (often alongside chemotherapy or radiotherapy, which can be used to reduce your symptoms).This is called palliative care .Support is also available for your family and friends. 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 Other health sites Cancer Research UK: Stomach cancer Macmillan Cancer Support: Stomach 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

Stomach ulcer

Stomach ulcer (gastric ulcer) | 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 Stomach ulcer Stomach ulcer About stomach ulcers Stomach ulcer symptoms Stomach ulcer causes Stomach ulcer diagnosis Stomach ulcer treatment Stomach ulcer complications About stomach ulcers Stomach ulcers (gastric ulcers)are open sores that develop on the lining of the stomach. Ulcers can also occur in part of the intestine just beyond the stomach. These are called duodenal ulcers. Stomach and duodenal ulcers are sometimes called peptic ulcers. This information applies to both. Symptoms of stomach ulcers Although the most common symptom of a stomach ulcer is a burning or gnawing pain in the centre of the abdomen (tummy). Not all stomach ulcers are painful. Some people experience: indigestion heartburn nausea (feeling sick) You should speak to your GP if you think you have a stomach ulcer. More about the symptoms of a stomach ulcer Get urgent medical advice Speak to your GP immediately (or phone 111) if: your symptoms persist youre vomiting blood the blood can appear bright red or have a dark brown, grainy appearance like coffee grounds youre passing dark, sticky, tar-like stools you feel a sudden, sharp pain in your tummy that gets steadily worse These could be a sign of a serious complication. What causes stomach ulcers? Stomach ulcers occur when the layer protecting the stomach lining from stomach acid breaks down. This allows the stomach lining to become damaged. This is usually caused by: an infection with Helicobacter pylori (H. pylori) bacteria taking non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen or aspirin particularly if theyre taken for a long time or at high doses Theres little evidence that stress or certain foods causes stomach ulcers. More about the causes of stomach ulcers Treating stomach ulcers Youll be treated using antibiotics if your ulcer was caused by a H. pylori infection. This kills the bacteria and should prevent the ulcer coming back. Youll be treated using a proton pump inhibitor (PPI) if your ulcer was caused by NSAIDs. Your doctor will prescribe these and discuss whether you should keep using NSAIDs. Alternative medication to NSAIDs, such as paracetamol , may be recommended. Most stomach ulcers take a few months to heal after treatment. However, stomach ulcers can come back after treatment, although this is less likely to happen if the underlying cause is addressed. More about treating stomach ulcers Complications Complications are rare but can be very serious and potentially life-threatening. The main complications include: bleeding at the site of the ulcer the stomach lining at the site of the ulcer splits open known as perforation the ulcer blocks the movement of food through the digestive system known as gastric obstruction More about the complications of stomach ulcers Stomach ulcer symptoms The most common symptom of a stomach ulcer is a burning or gnawing pain that develops in your abdomen (tummy). However, some stomach ulcers arent painful and are only noticed when a complication develops, such as bleeding from the ulcer. Tummy pain The pain caused by a stomach ulcer can either travel: out from the middle of your tummy up to your neck down to your belly button through to your back And: can last from a few minutes to a few hours often starts within a few hours of eating can cause you to wake up during the night Taking antacids (indigestion medication) may temporarily relieve the pain, but it will keep coming back if the ulcer isnt treated. Less common symptoms Less common symptoms of a stomach ulcer include: indigestion heartburn loss of appetite feeling and being sick weight loss Some people also find they burp or become bloated after eating fatty foods. Stomach ulcer causes Stomach ulcers are usually caused by Helicobacter pylori (H. pylori) bacteria or non-steroidal anti-inflammatory drugs (NSAIDs). These can break down the stomachs defence against the acid it produces to digest food. The stomach lining then becomes damaged causing an ulcer to form. H. pylori bacteria H. pylori bacteria live in the stomach lining. The bacteria can irritate the stomach lining and make it more vulnerable to damage from stomach acid. Infections are common. Its possible to be infected without realising it because the infection doesnt usually cause symptoms. People of all ages can be infected. Its not clear exactly why some people are more vulnerable to the effects of H. pylori bacteria than others. Non-steroidal anti-inflammatory drugs ( NSAIDs) NSAIDs are medicines widely used to treat pain, a high temperature (fever) and inflammation (swelling). Commonly used NSAIDs include: ibuprofen aspirin naproxen diclofenac Many people take NSAIDs without having any side effects. But theres always a risk the medication could cause problems, such as stomach ulcers, particularly if taken for a long time or at high doses. You may be advised not to use NSAIDs if you currently have a stomach ulcer or if youve had one in the past. Paracetamol is a safer painkiller to use. More about NSAIDs Lifestyle factors Theres little evidence that stomach ulcers are caused by: spicy foods stress alcohol But these can make the symptoms worse. However, smoking can: increase your risk of developing stomach ulcers make treatment less effective Stomach ulcer diagnosis If your GP thinks you have an ulcer, they will want to know if youre taking non-steroidal anti-inflammatory drugs (NSAIDs) might test you for an Helicobacter pylori (H. pylori) infection In some cases, you may be referred for a gastroscopy to look for an ulcer inside your stomach. Testing for H. pylori infection If your GP thinks your symptoms might be caused by an H. pylori infection, youll be offered a: urea breath test stool antigen test a small stool sample is tested for the bacteria blood test Urea breath test Youll be given a special drink containing a chemical thats broken down by H. pylori. Your breath is then analysed to see whether or not you have an H. pylori infection. Blood test A sample of your bloods tested for antibodies to the H. pylori bacteria. Antibodies are proteins produced naturally in your blood to help fight infection. This tests now largely been replaced by the stool antigen test More about blood tests Gastroscopy A gastroscopy is a procedure that involves passing a thin, flexible tube (an endoscope) with a camera at one end into your mouth and down into your stomach and first section of the small intestine (duodenum). You may: be given a mild sedative injection before the procedure have your throat sprayed with a local anaesthetic to make it more comfortable to pass the endoscope The images taken by the camera will usually confirm or rule out an ulcer. A small tissue sample may also be taken from your stomach or duodenum to test for the H. pylori bacteria. Youll have this procedure as an outpatient in hospital. This means you wont have to spend the night. You may have a repeat gastroscopy after 4 to 6 weeks to check that the ulcers healed. Stomach ulcer treatment If you have a stomach ulcer, your treatment will depend on what caused it. With treatment, most ulcers heal in a month or two. Treating Helicobacter pylori (H. pylori) infection If your stomach ulcers caused by a Helicobacter pylori (H. pylori) bacterial infection, youll be given: a course of antibiotics a medication called a proton pump inhibitor (PPI) This is also recommended if its thought your stomach ulcers caused by a combination of an H. pylori infection and non-steroidal anti-inflammatory drugs (NSAIDs). Antibiotics If you have an H. pylori infection, youll usually be prescribed a course of 2 or 3 antibiotics. The most commonly used antibiotics are: amoxicillin clarithromycin metronidazole You should take these twice a day for a week. Side effects The side effects of these are usually mild, but can include: feeling and being sick diarrhoea a metallic taste in your mouth Further testing Youll be re-tested at least 4 weeks after finishing your antibiotic course to see if there are any H. pylori bacteria left in your stomach. If there are, a further course of eradication therapy using different antibiotics may be given. Ulcers caused by NSAIDs If your stomach ulcers caused by taking NSAIDs: youll be given a course of PPI medication your use of NSAIDs will be reviewed, and you may be advised to use an alternative painkiller Alternative painkillers You may be advised to use an alternative painkiller not associated with stomach ulcers, such as paracetamol . COX-2 inhibitorsare sometimes recommended. These are an alternative type of NSAID thats less likely to cause stomach ulcers. Low-dose aspirin If youre taking low-dose aspirin to reduce your risk of blood clots, your GP will tell you whether you need to keep taking it. If you do, you may also be prescribed long-term treatment with a PPI or H2-receptor antagonist to prevent further ulcers. Complications Its important to understand the potential risks associated with continued NSAID use. Youre more likely to develop another stomach ulcer and could experience a serious complication, such as internal bleeding. Read more about the complications of stomach ulcers Proton pump inhibitors (PPIs) PPIs work by reducing the amount of acid your stomach produces. This prevents further damage to the ulcer as it heals naturally. The most commonly used PPIs are: omeprazole pantoprazole lansoprazole Theyre usually prescribed for 4 to 8 weeks. Side effects Side effects of these are usually mild, but can include: headaches diarrhoea or constipation feeling sick abdominal (tummy) pain dizziness rashes These should pass once treatment has been completed. H2-receptor antagonists Sometimes a type of medication called H2-receptor antagonists are used instead of PPIs. These also reduce the amount of acid your stomach produces. Ranitidine is the most widely used H2-receptor antagonist for treating stomach ulcers. Side effects Side effects are uncommon, but can include: diarrhoea headaches dizziness rashes tiredness Antacids and alginates As these treatments can take several hours before they start to work, your GP may recommend taking additional antacid medication. Antacids: neutralise your stomach acid provide immediate, but short-term, symptom relief should be taken when you experience symptoms or when you expect them, such as after meals or at bedtime Some antacids also contain a medicine called an alginate, which produces a protective coating on the lining of your stomach. Antacids containing alginates are best taken after meals. You can buy these medications at pharmacies. Your pharmacist can tell you which is most suitable for you. Side effects Side effects of both medications are usually mild, but can include: diarrhoea or constipation farting stomach cramps feeling and being sick Lifestyle changes There arent any special lifestyle measures you need to take during treatment. However, avoiding stress, alcohol, spicy foods and smoking may reduce your symptoms while your ulcer heals. Stomach ulcer complications Complications of stomach ulcers are rare, but can be very serious. The main complications are: internal bleeding perforation the lining of the stomach splits open gastric outlet obstruction the stomach ulcer obstructs the normal passage of food through your digestive system Internal bleeding Internal bleedings the most common complication of stomach ulcers. It can occur when an ulcer develops at the site of a blood vessel. The bleeding can either be slow and long-term, or rapid and severe. Slow, long-term bleeding Slow, long-term bleeding can lead to anaemia. Symptoms of anaemia include: fatigue breathlessness pale skin heart palpitations (noticeable heartbeats) You should visit your GP if you have persistent symptoms of anaemia. If they think you have a stomach ulcer, they may refer you to a gastroenterologist for an examination and treatment. More about anaemia Severe bleeding Contact your GP or the NHS 24 111 service immediately if you have symptoms of more severe bleeding, including: youre vomiting blood the blood can appear bright red or have a dark brown, grainy appearance like coffee grounds youre passing dark, sticky, tar-like stools Stopping severe bleeding An endoscopy will be used to identify the cause of the bleeding. Treatment can be given during the endoscopy to stop the bleeding. Sometimes: specialised procedures carried out under X-ray guidance are used to stop bleeding ulcers surgery is needed to repair the affected blood vessel Blood transfusions may also be needed to replace the blood youve lost. Perforation Perforations are a rarer complication of stomach ulcers. This is when the lining of the stomach splits open. This can be very serious because it lets the bacteria that live in your stomach escape and infect the lining of your abdomen (peritoneum). This is known as peritonitis. Peritonitis In peritonitis, an infection can rapidly spread into the blood ( sepsis ) before spreading to other organs. This carries the risk of multiple organ failureand can be fatal if left untreated. The most common symptom of peritonitis is sudden abdominal pain, which gets steadily worse. If you have this type of pain, contact your GP or the NHS 24 111 service immediately. Peritonitis is a medical emergency that requires hospital admission. In some cases, surgery may be needed. Gastric outlet obstruction In some cases, an inflamed (swollen) or scarred stomach ulcer can obstruct the normal passage of food through your digestive system. This is called a gastric outlet obstruction. Symptoms include: vomiting large amounts of undigested food a constant feeling of bloating or fullness feeling more full than usual after eating less food unexplained weight loss Treating a gastric outlet obstruction An endoscopy can be used to confirm the obstruction. If the obstructions caused by inflammation, proton pump inhibitors (PPIs) or H2-receptor antagonists can be used to reduce stomach acid levels until the swelling goes down. If the obstructions caused by scar tissue, surgery may be needed. This can involve passing a small balloon through an endoscope and inflating it to widen the site of the obstruction. 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 NSAIDs Stomach ache and abdominal pain Other health sites Lab Tests Online UK: H. pylori test 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

Streptococcus A (strep A)

Streptococcus A (Strep 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 Infections and poisoning Streptococcus A (strep A) Streptococcus A (strep A) Group A Streptococcus (GAS), also known as Strep A, are bacteria commonly found on the skin or in the throat. Under some circumstances these bacteria can cause disease. GAS infection commonly presents as a mild sore throat (strep throat) and skin/soft tissue infections such as impetigo and cellulitis. Phone 999 or go to A&E if: you or your child is having difficulty breathing (you may notice grunting noises or their tummy sucking under their ribs) there are pauses when you or your child breathes you or your childs skin, tongue or lips are blue you or your child is floppy and will not wake up or stay awake Contact your GP if you or your child: is getting worse is feeding or eating much less than normal is showing signs of dehydration, like sunken eyes, drowsiness has not passed urine for 12 hours is under 3 months and has a temperature of 38C is older than 3 months and has a temperature of 39C or higher feels hotter than usual when you touch their back or chest, or feels sweaty is very tired or irritable If your GP is closed, phone the 111 service. If you feel that you or your child is seriously unwell, trust your own judgement and seek medical assistance. Strep A tests are not available through the NHS in Scotland for self-testing at home. Should you or your child need to be tested for Strep A, your GP or other healthcare professional will advise you. GAS infections GAS bacteria can cause a wide variety of skin, soft tissue and respiratory tract infections ranging in severity from mild to life-threatening. These include: tonsillitis sore throat scarlet fever impetigo erysipelas (a type of cellulitis) cellulitis pneumonia In rare cases, patients may go on to develop post-streptococcal complications, such as: rheumatic fever glomerulonephritis (heart and kidney diseases caused by an immune reaction to the bacteria)\u200b iGAS infections GAS can very rarely cause more serious conditions, known as invasive group A Streptococcus (iGAS) infections. These can include: bacteraemia (an infection of the bloodstream) septic arthritis meningitis necrotising fasciitis (a severe infection involving death of areas of soft tissue below the skin) Streptococcal toxic shock syndrome (rapidly progressive symptoms with low blood pressure and multi-organ failure) iGAS infections tend to happen in the elderly, the very young, or people with an underlying risk factor such as injecting drug use, alcoholism, immunosuppression or cancer. Treating GAS infections Most GAS infections are relatively mild illnesses that clear up on their own without the need for antibiotics. Often symptoms that look like GAS infections, like sore throats , are more commonly caused by viruses than GAS bacteria. If you or your child has a runny nose with their sore throat, its likely to be a virus infection. Sore throats caused by viruses do not need to be treated with antibiotics unless there are concerns about complications. More about sore throat symptoms, self-care at home, and what to do if your condition worsens Your healthcare professional will consider antibiotics if they think: you or your child need medication to get better or to ease symptoms you or your child are at risk of serious complications from a GAS infection you or your child has scarlet fever If you or your child is prescribed antibiotics, they could be in liquid or pill form. Its not uncommon for someone to have GAS bacteria on their skin or in their throat without being unwell. These people often dont know they have the bacteria and wont need antibiotics. Preventing GAS infection GAS are spread by close contact between individuals, through respiratory droplets (moisture in your breath) and direct skin contact. To help reduce the risk of picking up or spreading infections: Do wash your hands properly with soap for 20 seconds use a disposable tissue to catch coughs and sneezes and wash your hands afterwards keep away from others if you feel unwell Dont do not share contaminated food, utensils, cups and glasses, baths, bed linen or towels GAS can be a secondary infection, developing in people who are already unwell with illnesses like the flu. You can help protect your child from this risk by making sure they get their free flu vaccine this winter. New evidence also shows that the nasal spray flu vaccine offered to children may also protect them from GAS infection. 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: Sore throat Self-help guide: Fever in adults Self-help guide: Fever in babies Fever in adults Fever in children Other health sites Group A strep in Scotland 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

Stress, anxiety and low mood

"Mental wellbeing | 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 Mental wellbeing Mental wellbeing Advice on dealing with low mood, anxiety, phobias, stress and where you can get help. Five steps to mental wellbeing Steps you can take to help you feel happier and more positive. Mind to Mind Other people share the small changes that have made a big difference to their mental wellbeing Get help with your mental health Use our tool to find the right SilverCloud, Daylight or Sleepio course to help improve your mental health and wellbeing Anger management How to control your anger Anger can become a problem if you find it difficult to keep it under control. Find out how to recognise signs of anger and how to manage it. Why am I so angry? Reasons why anger problems occur and where to get help for anger issues Fears and phobias 10 ways to fight your fears Whatever it is that makes you feel afraid, here are 10 ways to help you cope with your day-to-day fears and anxieties. Coping with fears and phobias Find out more about how to cope with phobias Coping with a fear of the dentist Tips on coping with your fear of the dentist, including advances in dentistry and sedation clinics Help for phobias Many people with phobias resign themselves to living in fear, but this doesn't have to be the case as help is available Anxiety and panic How to deal with panic and anxiety Find out ways to manage anxiety or panic. Low mood and depression Do you have the winter blues? Lots of people get depressed in winter, the medical term is seasonal affective disorder (SAD). Exercise for depression Regular exercise can boost your mood if you have depression How to feel happier Try these 6 tips to help you be happier, more in control, and able to cope better with life's ups and downs. Low mood and depression Learn what you can do if you are experiencing low mood, depression or anxiety Tips for coping with depression If you're feeling depressed, try these coping strategies What to do if youre worried someone is depressed Often it's a partner, family member or friend who first realises that someone needs help Stress 10 stress busters Try these 10 tips to help you deal with stress Beat stress at work Some pressure at work can be motivating, but when it becomes excessive it can lead to work-related stress Breathing and relaxation exercises for stress \u200bThese exercises are designed to help you relieve stress and relax. Coping with exam stress Tests and exams can be a challenging part of school life for both children and parents. Find tips and advice to help relieve exam stress. Coping with money worries Find sources of advice and support to help you cope with money worries. Easy time-management tips Tips and advice to help you manage your time and achieve the lifestyle balance you want. What to do if you are struggling with stress Learn what to do if you are struggling to deal with stress Dealing with traumatic events Support for people who have experienced a traumatic event There are many organisations that can provide advice and support after traumatic events Therapy and counselling Benefits of talking therapy Talking therapies can help all sorts of people in lots of different situations Depression support groups Information on the support groups available if you have depression Find the right therapist What to look out for when finding the right therapist for you Self-help therapies Learn more about self-help therapies and what they can be used for Talking therapies explained Information on common types of talking therapies and how they can help certain conditions Pregnancy Your mental health and wellbeing after birth How to look after your mental wellbeing after the birth and when to get help Your mental health and wellbeing in pregnancy How to look after your mental wellbeing during pregnancy and when to get help Mental health self-help guides Anxiety self-help guide Work through a self-help guide for anxiety that uses cognitive behavioural therapy (CBT). Bereavement and grief self-help guide Work through a self-help guide for coping with bereavement and grief that uses cognitive behavioural therapy (CBT). Chronic pain self-help guide Work through a self-help guide that uses cognitive behavioural therapy (CBT) to help you live with chronic pain. Depression self-help guide Work through a self-help guide for depression that uses cognitive behavioural therapy (CBT). Panic self-help guide Work through a self-help guide for panic that uses cognitive behavioural therapy (CBT). Phobias self-help guide Work through a self-help guide for phobias that uses cognitive behavioural therapy (CBT). Problems with anger self-help guide Work through a self-help guide for managing problems with anger based on Cognitive Behavioural Therapy (CBT). Problem solving self-help guide Work through a self-help guide for problem solving based on Cognitive Behavioural Therapy (CBT). PTSD and CPTSD self-help guide Work through a self-help guide for PTSD and CPTSD based on Trauma-Focused Cognitive Therapy (TF-CT). Self-esteem self-help guide Work through a self-help guide that uses cognitive behavioural therapy (CBT) to improve self-esteem. Sleep problems and insomnia self-help guide Work through a self-help guide that uses cognitive behavioural therapy (CBT) and expert advice to manage sleep problems. Social anxiety self-help guide Work through a self-help guide for social anxiety that uses cognitive behavioural therapy (CBT). Obsessive compulsive disorder (OCD) self-help guide Work through a self-help guide for mild-to-moderate obsessive compulsive disorder (OCD) that uses cognitive behavioural therapy (CBT). Addictions Problem gambling Learn about the signs of problem gambling and how to get help and support. Women's health Self-help tool: Menopause and mental wellbeing Self-help tool: Periods and mental wellbeing 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"

Sudden infant death syndrome (SIDS)

Sleeping safely | 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 Early parenthood Going home Sleeping safely For the first 6 months of your babys life the safest place for them to sleep is in a cot in the same room as the person looking after them, for all sleeps. Sadly, every year a small number of babies die suddenly and unexpectedly in their sleep. Sometimes a cause is found, such as an underlying health condition, but often theres no obvious reason. You may hear the term sudden infant death syndrome (SIDS) which used to be called cot death. Sudden infant death syndrome SIDS happens most often during sleep at any time, day or night. Doctors dont yet know what causes it but its most likely to happen in the first 6 months. Babies born early and underweight, and twins or multiple babies are more at risk. What increases the risk of SIDS? SIDS is at increased risk of happening if you: sleep with your baby in an armchair or on the sofa share a bed with your baby and you or your partner smoke share a bed with your baby and you or your partner have been drinking alcohol or have been taking drugs smoke or smoked when you were pregnant or lived with someone who did SIDS is at increased risk of happening if your baby: is put on their tummy or side gets too warm sleeps on a soft mattress sleeps in another room during the day or night, where you cant see them sleeps sitting up or not completely flat, such as in a car seat, as their head can roll forwards and affect how theyre breathing was born before 37 weeks and/or born weighing less than 2.5 kg Breastfeeding your baby reduces the risks of SIDS Helping your baby sleep safely Always tuck your baby in with blankets across their chest and under their arms Public Health Scotland Since the Back to Sleep campaign began in 1991, the rate of SIDS has dropped by 80%. For the first 6 months the safest place for your baby to sleep is in a cot, crib or moses basket in your room beside your bed and in the same room as you, for all sleeps. Youll also be close by if they need a feed or cuddle. You can help your baby get a good sleep and stay as safe as possible by: always putting them to sleep flat on their back on a firm flat mattress, and putting them on their back again if they roll over tucking them in with blankets across their chest and under their arms always putting them feet first at the bottom of the cot so they cant wriggle down and get caught under the blankets removing any bumpers, pillows or soft toys from the cot as these can cause your baby to overheat or affect your babys breathing if theyre too close to their face making sure they dont get too hot or cold check their temperature by feeling their stomach or the back of their neck, and dont go by hands and feet as theyll often feel cold keeping their head uncovered when theyre sleeping and taking off any swaddling or sleeping bag if theyre in bed with you taking your baby out of their car seat when theyre not travelling, and out from a bouncy seat, swing or nest if theyre asleep as their head can roll forward if theyre not sleeping flat, which can affect their breathing making your home smoke-free, and keeping your baby away from cigarette smoke If your baby uses a dummy, use it for every sleep. If youre breastfeeding, wait at least 4 weeks before giving your baby a dummy. Make sure that any other family or friends who may look after your baby know how to put your baby down for a sleep safely. Do not sleep on a sofa or chair Never put yourself in a position that you can fall asleep with your baby in an armchair or on the sofa as this increases the risk of SIDS by 50% (Source: Baby Sleep Info Source and the Lullaby Trust). Sharing a bed with your baby Adult beds arent designed for babies. Before you bed-share, consider whether you think its a safe place for your baby to sleep. Check that: your baby cannot fall out of the bed your baby cannot get trapped between the mattress and the wall your adult bedding can be kept away from your baby other children and pets will not be in the bed at the same time as your baby Mothers do sometimes bed-share when breastfeeding, however, without some planning and thought it can be very dangerous. If you are breastfeeding while lying down, make sure your baby cannot roll onto their front. Try and keep your baby on their back, or move them onto their back once they have been fed. If youre thinking about bed-sharing, talk to your midwife, health visitor or family nurse about how to reduce the risks for your baby. Baby Sleep Info Source has more information about bed-sharing When your baby should always sleep separately Its never safe to share a bed with your baby if: you or your partner have had alcohol or taken drugs (legal or illegal) you smoked when you were pregnant you or your partner is a smoker your babys small or was born early you or your partner are overly tired less than 4 hours sleep in previous 24 hours Your baby should sleep separately in their cot in these situations. How much sleeps normal? Theres no normal amount of sleep and some babies sleep more than others. New babies sleep a lot sometimes as much as 18 hours a day for the first month or so. But your baby probably wont sleep for more than a few hours at a time to begin with. Unusually sleepy baby If your baby seems unusually sleepy they might be unwell. Always trust your instincts and get medical advice if youre worried. Dont expect your baby to sleep several times a day and wake only for feeds and to smile, there will be some crying and grumbling. Crying When your baby cries and you go to them and comfort them, youre teaching them the worlds a safe place. This helps them to develop the skills to sleep through the night. How to soothe a crying baby Plagiocephaly Sometimes babies develop a flatter area either at the back of or on one side of their head. This is called plagiocephaly. Plagiocephaly usually gets better on its own if your babys spending less time lying down. More about plagiocephaly 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 Ready Steady Baby leaflet in English (Easy Read) Source: Public Health Scotland - Opens in new browser window 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 Other health sites Lullaby Trust: How to reduce the risk of SIDS Scottish Cot Death Trust Twins Trust: Sleeping advice for twins and more 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

Suicide

Getting help with your suicidal thoughts | Suicide | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotlands Service Directory 0 Home Surviving suicidal thoughts Getting Help with your Suicidal Thoughts Suicide If youre experiencing suicidal thoughts or thinking about killing yourself, its important to know that youre not alone. There is practical support and advice available. Suicidal thoughts can happen to any of us, at any time. Often people start noticing thesethoughts after a traumatic or stressful event in their life but sometimes theres no obvious trigger. Who you are, what you feel and what has happened or is happening in your life does not change the fact that theres help available. Whether youve just started to notice or have had similarthoughts for a long time you canchange things for the better,today. Call 999 or go to your nearest A&E now if: someones life is at immediate risk, for example by serious injury or overdose. Find your nearest A&E Coping right now focus on getting through today get yourself to a safe place, like a friends house be around other people stay away from drugs and alcohol If youre feeling overwhelmed or out of control you can try these practical tools from Mind. Find out what you can do to help yourself cope and how you can distract yourself . You can also read advice on how to cope with suicidalthoughts from Rethink Mental Illness . Phone a helpline NHS 24 For everyone open 24 hours. Phone: 111 and choose the mental health option Samaritans For everyone open 24 hours. Phone: 116 123 Childline For children and young people under 19 open24 hours. Phone: 0800 1111 Breathing Space For everyone openMonday to Thursday 6pm to 2am andFriday 6pm to Monday 6am at weekends. Phone: 0800 83 85 87 Campaign Against Living Miserably (CALM) For men open 5pm to midnight every day Phone: 0800 58 58 58 Switchboard LGBT+ For anyone who identifies as LGBT+ open 10am to 10pm every day Phone: 0300 330 0630 Message a webchat Samaritans For everyone open 24 hours Webchat: samaritans.org/how-we-can-help/contact-samaritan/chat-online/ Childline For children and young people under 19 open 24 hours Webchat: childline.org.uk/get-support/1-2-1-counsellor-chat/ Campaign Against Living Miserably (CALM) For men open 5pm to midnight every day Webchat: href=https://www.thecalmzone.net/help/webchat/>thecalmzone.net/help/webchat/ Switchboard LGBT+ For anyone who identifies as LGBT+ open 10am to 10pm every day Webchat: switchboard.lgbt Coping with suicidal thoughts Making a safety plan If you struggle with suicidal thoughts or are supporting someone else, it may help to make a safety plan to use if you need it. The Staying Safe website provides information on how to make a safety plan, including video tutorials and online templates to guide you through the process. You can also get information on planning for a mental health crisis from Mind Other languages and accessible formats Easy Read Get help with your suicidal thoughts Easy Read British Sign Language (BSL) Get help with your suicidal thoughts BSL Bengali Get help with your suicidal thoughts Bengali Chinese (simplified) Get help with your suicidal thoughts Chinese (simplified) Polish Get help with your suicidal thoughts Polish 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

Sunburn

Sunburn | 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 Injuries Skin injuries Sunburn Sunburn Sunburn is skin damage caused by ultraviolet (UV) rays. It usually causes the skin to become red, sore, warm, tender and occasionally itchy for about a week. The skin will normally start to flake and peel after a few days and will usually fully heal within 7 days. While sunburn is often short-lived and mild, its important totryto avoid it, because it can increase your chances of developing serious health problems, such as skin cancer, in later life. Its easy to underestimate your exposure to the sun when outside, as the redness doesnt usually develop for several hours. Breezes and getting wet (such as going in and out of the sea) may cool your skin, so you dont realise youre getting burnt. You should always be aware of the risk of sunburn if youre outside in strong sun, and look out for your skin getting hot. What to do if youre sunburnt If you or your child has sunburn, you should get out of the sun as soon as possible head indoors or into a shady area. You can usually treat mild sunburn at home, although there are some circumstances where you should seek medical advice. The following advice may help to relieve your symptoms until your skin heals. Do cool the skin by sponging it with cold water or by having a cold bath or shower applying a cold compress such as a cold flannel to the affected area may also help drink plenty of fluids to cool you down and prevent dehydration take pain relief such as ibuprofen or paracetamol to relieve any pain aspirin should not be given to children under 16 try to avoid all sunlight, including through windows, by covering up the affected areas of skin until your skin has fully healed Get treatment advice from your local pharmacy Your nearest pharmacist can advise you on the best treatment if you have sunburn. Find your nearest pharmacy When to seek medical advice Contact your GP practice if: You have sunburn and feel unwell or have any concerns about your sunburn, particularly if youre burnt over a large area or have any of the more severe symptomssuch as: blistering or swelling of the skin (oedema) chills a high temperature (fever) of 38C (100.4F) or above,or 37.5C (99.5F) or above in children under five dizziness, headaches and feeling sick (symptoms of heat exhaustion) You should also see your GP if a young child or baby has sunburn, as their skin is particularly fragile. If your GP practice is closed, phone 111. Your GP may recommend using hydrocortisone cream for a few days (this is also available over the counter at pharmacies) to reduce the inflammation of your skin. Severe sunburn may require special burn cream and burn dressings from your GP or a nurse at your GP practice. Very occasionally, hospital treatment may be needed. Whos at risk of sunburn? Everyone who is exposed to UV light is at risk of getting sunburn, although some people are more vulnerable than others. You should take extra care when out in the sun if you: have pale, white or light brown skin have freckles or red or fair hair tend to burn rather than tan have many moles have skin problems relating to a medical condition are only exposed to intense sun occasionally for example, while on holiday are in a hot country where the sun is particularly intense have a family history of skin cancer People who spend a lot of time in the sun, whether its for work or play, are at increased risk of skin cancer if they dont take the right precautions. Snow, sand, concrete and water can reflect the suns rays onto your skin, and the sun is more intense at high altitudes. Dangers of UV rays The short-term risks of sun exposure are sunburn and sun allergy . The longer-term risks (over decades) include: actinic (solar) keratoses rough and scaly pre-cancerous spots on the skin skin cancer including both melanoma and non-melanoma skin cancer eye problems such as photokeratitis (snow blindness) andcataracts premature ageing of the skin and wrinkling Preventing sunburn Skin should be protected from strong sunlight by covering up with suitable clothing, seeking shade and applying sunscreen. In the UK, the risk of getting sunburnt is highest from March to October, particularly from 11am to 3pm, when the suns rays are strongest. There is also a risk of getting sunburn in other weather conditions. For example, light reflecting off snow can also cause sunburn. You can also burn in cloudy and cool conditions. Suitable clothing Suitable clothing includes: a wide-brimmed hat that shades the face, neck and ears a long-sleeved top trousers or long skirts in close-weave fabrics that do not allow sunlight through sunglasses with wraparound lenses or wide arms with the CE Mark and European Standard EN 1836:2005. Sunscreen When buying sunscreen, make sure its suitable for your skinand blocks both ultraviolet A (UVA) and ultraviolet B (UVB) radiation. The sunscreen label should have: the letters UVA in a circle logo and at least 4-star UVA protection at least SPF30 sunscreen to protect against UVB Most people do not apply enough sunscreen. The amount of sunscreen needed for the body of an average adult to achieve the stated sun protection factor (SPF) is around 35ml or 6 to 8 teaspoons of lotion. If sunscreen is applied too thinly, it provides less protection. If youre worried you might not be applying enough SPF30, you could use a stronger SPF50 sunscreen. If you plan to be out in the sun long enough to risk burning, sunscreen needs to be applied twice: 30 minutes before going out just before you go out Sunscreen should be applied to all exposed skin, including the face, neck and ears (and head if you have thinning or no hair), but a wide-brimmed hat is better. How long it takes for your skin to go red or burn varies from person to person. The Cancer Research UK website has a handy tool where you can find out your skin type , to see when you might be at risk of burning. Water-resistant sunscreen is needed if sweating or contact with water is likely. Sunscreen needs to be reapplied liberally, frequently and according to the manufacturers instructions. This includes straight after youve been in water (even if it is water-resistant) and after towel drying, sweating or when it may have rubbed off. Advice for babies and children Children aged under 6 months should be kept out of direct strong sunlight. From March to October in the UK, children should: cover up with suitable clothing spend time in the shade (particularly from 11am to 3pm) wear at least SPF30 sunscreen To ensure they get enough vitamin D, children aged under 5 are advised to take vitamin D supplements even if they do get out in the sun. Source: NHS 24 - Opens in new browser window Last updated: 14 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

Supraventricular tachycardia

Supraventricular tachycardia - 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 Supraventricular tachycardia Supraventricular tachycardia Supraventricular tachycardia is a condition where the heartbeat is abnormally fast. It can happen to anyone at any age and often occurs for the first time in children or young adults. In most cases, supraventricular tachycardia is harmless. It doesnt usually last long and can settle without treatment. Why it happens Some people are born with an abnormality of the hearts natural wiring or conduction system. This allows a short circuit to develop. Under certain circumstances, this allows the heart to race very fast. One example of this is Wolff-Parkinson-White syndrome . This is where theres an abnormal electrical connection between the: atria (upper heart chambers), and the ventricles (lower heart chambers) Some people with this condition can develop supraventricular tachycardias. This is because of this short circuit. Symptoms of supraventricular tachycardia If you have supraventricular tachycardia, youll usually feel your heart racing in your chest or throat. The heart rate is usually between 140 to 180 beats per minute but can be as high as 250. A normal heartbeat should be 60 to 100 beats per minute at rest. During a supraventricular tachycardia, the heart muscle contracts very fast. This means that it cannot relax properly between contractions to fill with blood. This reduces the amount of blood being pumped around the body. Therefore, you may also feel: chest pain dizziness light-headedness fatigue (tiredness) breathlessness On rare occasions, you may faint because of a drop in blood pressure. These symptoms vary in length and frequency. Diagnosing supraventricular tachycardia If your doctor thinks that you might have supraventricular tachycardia, youll be referred for tests. These can include an: electrocardiogram (ECG) ambulatory heart monitor echocardiogram Causes of supraventricular tachycardia Common causes of supraventricular tachycardia in people at risk of the condition include: stress anxiety a change in posture some medications alcohol caffeine smoking recreational drugs Treating supraventricular tachycardia The treatment for supraventricular tachycardia varies from person to person. It depends on: the type of supraventricular tachycardia you have your symptoms treatment of any underlying cause your age your overall health Types of treatment Supraventricular tachycardia treatments focus on controlling the rate and rhythm of the heart. They include: medication, like beta blockers and other anti-arrhythmic drugs electric shock treatment (DC cardioversion) in an urgent case radiofrequency ablation Source: Scottish Government - 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 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

Swollen glands

Swollen glands | 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 Glands Swollen glands Swollen glands Swollen lymph glands are usually a sign of infection. Swollen lymph glands that are caused by an infection usually get better by themselves in 1 to 2 weeks. Sometimes swollen lymph glands can have a more serious cause and may need to be seen by a doctor. Phone 111 or ask for an urgent GP appointment if: You have swollen glands and you: are finding it very difficult to swallow have difficulty breathing Speak to your GP practice if: You have swollen glands and: theyre getting bigger theyve not gone down within 1 week they feel hard or do not move when you press them youre having night sweats or have a very high temperature (you feel hot and shivery) you have no other signs of illness or infection you have swollen lymph glands just above or below your collar bone (the bone that runs from your breastbone to each of your shoulders) What are the lymph glands? The lymph glands (or lymph nodes) are small lumps of tissue that contain white blood cells. These help to fight bacteria, viruses and anything else that causes infection. Theyre an important part of the immune system and are found throughout the body. What swollen lymph glands feel like The lymph glands can swell to more than a few centimetres in response to infection or disease. Swollen glands feel like tender, painful lumps. You may feel them: on each side of the neck under the chin in the armpits around the groin Common causes of swollen glands Swollen glands are usually caused by a viral or bacterial infection like: a cold tonsillitis glandular fever a throat infection an ear infection a dental abscess cellulitis (a skin infection) The glands in the affected area will often become suddenly tender or painful. You may also have other symptoms like a sore throat, cough, or fever. These infections usually clear up on their own and the swollen glands will soon go down. Swollen lymph glands are rarely caused by anything more serious. Managing swollen glands at home When an infection causes swollen glands you can help to ease symptoms at home. Do drink plenty of fluids rest use over-the-counter medicines like paracetamol or ibuprofen 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 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

Syphilis

Syphilis | 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 Syphilis Syphilis British Sign Language (BSL) | | Polski | Romn | slovenina Syphilis is a bacterial infection. Its hard to detect and is one of the most easily caught sexually transmitted infections (STIs). Symptoms of syphilis Most people with syphilis dont notice any symptoms and dont know they have it. Symptoms change over time and may come and go. Syphilis usually has 3 stages. The first stage (primary syphilis) Ten days to 3 months after infection, you may notice a small, painless sore or ulcer. This is typically on either the: penis vagina anus rectum tongue lips You might only have 1 sore, but can have more. Swelling in your lymph glands (such as in the neck, groin or armpit) often happens with the ulcers. The sore will then disappear within 2 to 6 weeks. If left untreated, syphilis will move into its second stage. The second stage (secondary syphilis) Symptoms of secondary syphilis begin a few weeks after the original sore disappears. Common symptoms of secondary syphilis include: a non-itchy skin rash appearing anywhere on the body, but commonly on the palms of the hands or soles of the feet tiredness headaches swollen lymph glands Less common symptoms include: fever weight loss patchy hair loss joint pains These symptoms may disappear within a few weeks, or come and go for a few months. Syphilis will then move into a stage where you will experience no symptoms. Youre still infected during this stage. This is called latent syphilis. You can still pass it on during the first year of this stage. After a couple of years, you cant pass the infection to others, even though you remain infected. However, during this stage, the infection can be passed on from a mother to an unborn child during pregnancy. The latent stage can continue for many years (even decades) after you first become infected. Without treatment, there is a risk that latent syphilis will move on to the more serious stage tertiary syphilis. The third stage (tertiary syphilis) The symptoms of tertiary syphilis can begin years or even decades after the initial infection. 1 in 3 people who are not treated for syphilis develop serious symptoms eventually. The symptoms of tertiary syphilis will depend on what part of the body the infection spreads to. For example, it may affect the brain, nerves, eyes, heart, bones, skin or blood vessels, potentially causing any of the following symptoms: stroke dementia loss of co-ordination numbness paralysis blindness deafness heart disease skin rashes At this stage, syphilis can be dangerous enough to cause death. Testing for syphilis If you think you might have syphilis, get tested for free by: booking an appointment at your local sexual health service contacting your GP practice for an appointment What does a syphilis test involve? The only reliable way to tell if you have syphilis or not is to have a blood test. This is usually sent to the lab for analysis. However, in some sexual health services, a same day test can be done if you have symptoms. Treatment for syphilis Antibiotics will treat the syphilis infection, even during pregnancy. These are given by injection, tablets or capsules. Treatment may be started before your test result is known. You may be given one or more doses, depending on the stage of infection. Youll need to go back to your GP practice or sexual health clinic 6 and 12 weeks after starting treatment to be retested. You should avoid having sex until you and your partner (s) have finished treatment and your tests have shown treatment has worked. This includes oral sex and sex using a condom. Your partner should also get tested for syphilis. It can be hard to spot in its early stages and they might not realise they have it. They will generally be offered treatment regardless. Syphilis and pregnancy In Scotland, pregnant women are tested for syphilis as part of their antenatal checks . If youre pregnant and have syphilis, you can pass it on to your baby before theyre born. This is known as congenital syphilis. Having syphilis during pregnancy can increase the risk of: miscarriage premature birth stillbirth How syphilis is passed on You can get syphilis by having unprotected vaginal, anal or oral sex (sex without a condom). Around one third of all people who get syphilis do so through having unprotected oral sex with no other vaginal or anal sex involved. It can also be passed by coming into contact with an ulcer on your partners penis, vagina, anus or inside their mouth. Syphilis can be passed on: to an unborn baby during pregnancy (congenital syphilis) by injecting drugs with a needle thats been used by someone who has syphilis during a blood or organ transplant (this is extremely rare as all blood and organ donations in the UK are checked for syphilis) Syphilis also makes HIV easier to pass on and catch. The number of people getting syphilis in Scotland has greatly increased over the last 5 years. You could be at higher risk if you: are a man who has sex with men have had sex overseas have had multiple sexual partners How to prevent syphilis 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. Other STIs If you have been diagnosed with syphilis you should get tested for all STIs including: HIV chlamydia gonorrhoea 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 (BSL) | | Polski | Romn | slovenina British Sign Language (BSL) | | Polski | Romn | slovenina Add this page to\n Info For Me Also on NHS inform Book a sexual health appointment online Syphilis (BSL) Syphilis (Chinese) Syphilis (Polish) Syphilis (Romanian) Syphilis (Slovak) Other health sites BASHH: sexual health 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

Testicular cancer

Testicular 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 Testicular cancer Testicular cancer About testicular cancer Symptoms of testicular cancer Diagnosing testicular cancer Treating testicular cancer Causes of testicular cancer About testicular cancer Cancer of the testicle is one of the less common cancers. It tends to mostly affect men and anyone with testicles between 15 and 49 years of age. The most common symptom is a painless lump or swelling in one of the testicles . It can be the size of a pea or it may be much larger. Other symptoms can include: a dull ache in the scrotum a feeling of heaviness in the scrotum Its important to be aware of what feelsnormal for you. Get to know your body and speak to your GP if you notice any changes. Read more aboutthe symptoms of testicular cancer and diagnosing testicular cancer . The testicles The testicles are the 2 oval-shaped male sex organs that sit inside the scrotum on either side of the penis. The testicles are an important part of the male reproductive system because they produce sperm and the hormone testosterone, which plays a major role in male sexual development. Types of testicular cancer The different types of testicular cancer are classified by the type of cells the cancer begins in. The most common type of testicular cancer is germ cell testicular cancer, which accounts for around 95% of all cases. Germ cells are a type of cell that the body uses to create sperm. There are 2 main subtypes of germ cell testicular cancer. They are: seminomas which have become more common in the last 20 years and now account for 50 to 55% of testicular cancers non-seminomaswhich account for most of the rest and include teratomas, embryonal carcinomas, choriocarcinomas and yolk sac tumours Both typestend to respond well to chemotherapy . Less common types of testicular cancer include: Leydig cell tumours which account for around 1 to 3% of cases Sertoli cell tumours which account for around 1% of cases lymphoma which accounts for around 4% of cases This topic focuses on germ cell testicular cancer. You can contact the cancer support specialists at Macmillan for more information about Leydig cell tumour and Sertoli cell tumours. Their helpline number is 0808 808 00 00 and its open Monday to Friday, 9am to 8pm. Read more about Hodgkin lymphoma and non-Hodgkin lymphoma . How common is testicular cancer? Testicular cancer is a relatively rare type of cancer. Testicular cancer is unusual compared to other cancers because it tends to affect younger men and anyone with testicles. Although its relatively uncommon overall, testicular cancer is the most common type of cancer to affect men and anyone with testicles between the ages of 15 and 49. For reasons that are unclear,white men and anyone with testicles have a higher risk of developing testicular cancer compared with other ethnic groups. The number of cases of testicular cancer that are diagnosed each year in the UK has roughly doubled since the mid-1970s. Again, the reasons for this are unclear. Causes of testicular cancer The exact cause or causes of testicular cancer are unknown, but a number of factors have been identified that increase a mans risk of developing it. The 3 main risk factors are described below. Undescended testicles Undescended testicles(cryptorchidism) is the most significant risk factor for testicular cancer. About 3to 5% of boys are born with their testicles inside their abdomen. They usually descend into the scrotum during the first year of life, but in some boys the testicles dont descend. In most cases, testiclesthat dont descend by the time a boy is 1 year old descendat a later stage. If the testicles dont descend naturally,an operation known as anorchidopexy can be carried out to move the testicles into the correct position inside the scrotum. Its important that undescended testicles move down into the scrotum during early childhood because boys with undescended testicles have a higher risk of developing testicular cancer than boyswhose testicles descend normally. Its also much easier to observe the testicles when theyre in the scrotum. People with undescended testicles are about 3 times more likely to develop testicular cancer than those whose testicles descend at birth or shortly after. Family history Having a close relative with a history of testicular cancer or an undescended testicle increases your risk of also developing it. For example, if your father had testicular cancer, youre around 4 times more likely to developit than someone with no family history of the condition. If your brother had testicular cancer, youre about 8 times more likely to develop it. A number of genes may be involvedin the development of testicular cancerin families where more than 1 person has had the condition. This is an ongoing area of researchin which patients and their families may be asked to take part. Previous testicular cancer People whove previously been diagnosed with testicular cancer are between 4 to 12 times more likely to develop it in the other testicle. For this reason,if youve previously been diagnosed with testicular cancer, its very important that you keep a close eye on the other testicle. If youve been diagnosed with testicular cancer, you also need to be observed for signs of recurrence for between 5 and 10 years, so its very important that you attend your follow-up appointments. Cancer Research UK has more information about testicular cancer risks and causes . Outlook Testicular cancer is one of the most treatable types of cancer, and the outlook is one of the best for cancers. Almost all men and anyone with testicles who are treated for testicular germ cell tumours are cured, and its rare for the condition to return more than 5 years later. Treatment almost always includes the surgical removal of the affected testicle called orchidectomy or orchiectomy which doesnt usually affect fertility or the ability to have sex. In some cases, chemotherapy or, less commonly, radiotherapy may be used for seminomas (but not non-seminomas). Read more about treating testicular cancer . Symptoms of testicular cancer The most common symptom of testicular cancer is a lump or swelling in 1 of your testicles. The lump or swelling can be about the size of a pea, but may be larger. Most lumps or swellings in the scrotum arent in the testicle and arent a sign of cancer. But they should never be ignored. Visit your GP as soon as you notice a lump or swelling in your scrotum. Associated symptoms Testicular cancer can also cause other symptoms, including a: dull ache or sharp pain in your testicles or scrotum, which may come and go feeling of heaviness in your scrotum change in the texture or increase in firmness of a testicle difference between one testicle and the other When to speak to your GP Speak to your GP as soon as you notice any lump or swelling on your testicle. Theyll examine your testicles to help determine whether or not the lump is cancerous. Lumps within the scrotum can have many different causes and testicular cancer is rare. If your GP thinks the lump is in your testicle they may consider cancer as a possible cause. Research has shown that less than 4% of scrotal lumps or swellings are cancerous. For example,varicoceles (swollen blood vessels) and epididymal cysts (cysts in the tubes around the testicle) are common causes of testicular lumps. If you do have testicular cancer, the sooner treatment begins, the greater the likelihood that youll be completely cured. If you dont feel comfortable visiting your GP, you can go to your local sexual health clinic , where a healthcare professional will be able to examine you. Metastatic cancer If testicular cancer has spread to other parts of your body, you may also experience other symptoms. Cancer that has spread to other parts of the body is known as metastatic cancer. Around 5% of people with testicular cancer will experience symptoms of metastatic cancer. The most common place for testicular cancer to spread to is nearby lymph nodes in your abdomen or lungs. Lymph nodes are glands that make up your immune system. Less commonly, the cancer can spread to your liver, brain or bones. Symptoms of metastatic testicular cancer can include: a persistent cough coughing or spitting up blood shortness of breath swelling and enlargement of male breasts alump or swelling in your neck lowerback pain Diagnosing testicular cancer Speak to your GP as soon as possible if you notice a lump or other abnormality in your scrotum that you think may be on one of your testicles. Most scrotal lumps arent cancerous, but if you have a lump that you think may be in one of your testicles its important you have it checked as soon as possible. Treatment for testicular cancer is much more effective when startedearly. Physical examination As well as asking you about your symptoms and looking at your medical history, your GP will usually need to examine your testicles. They may hold a small light or torch against your scrotum to see whether light passes through it. Testicular lumps tend to be solid, which means light is unable to pass through them. A collection of fluid in the scrotum will allow light to pass through it. Tests for testicular cancer If you have a non-painful lump, or a change in shape or texture of oneof your testicles, and yourGP thinks it may be cancerous, youll be referred for further testing within 2 weeks. Scrotal ultrasound A scrotal ultrasound s can is a painless procedure that uses high-frequency sound waves to produce an image of the inside of your testicle. Its one of the main ways of finding out whether or not a lump is cancerous (malignant) or non-cancerous (benign). During a scrotal ultrasound, your specialist will be able to determine the position and size of the abnormality in your testicle. It will also give a clear indication of whether the lump is in the testicle or separate within the scrotum, and whether its solid or filled with fluid. A fluid-filled lump or collection around the testisis usually harmless. A more solid lump may be a sign the swelling is cancerous. Blood tests To help confirm a diagnosis, you may need a series of blood tests to detect certain hormones in your blood, known as markers. Testicular cancer often produces these markers, so if theyre in your blood itmay indicate you have the condition. Markers in your blood that will be tested for include: AFP (alpha feta protein) HCG (human chorionic gonadotrophin) A third blood test is also often carried out as it may indicate how active a cancer is. Its calledLDH (lactate dehydrogenate), but it isnt a specific marker fortesticular cancer. Not all people with testicular cancer produce markers. There may still be a chance you have testicular cancer even if your blood test results come back normal. Histology The only way to definitively confirm testicular cancer is to examine part of the lump under a microscope. These tests and reports are called histology. Unlike many cancers where a small piece of the cancer can be removed (a biopsy ), in most cases the only way to examine a testicular lump is by removing theaffected testicle completely. This is because the combination of the ultrasound and blood marker tests is usually sufficient to makea firm diagnosis. Also, a biopsy may injure the testicle and spread cancer into the scrotum which isnt usually affected. Your specialist will only recommend removing your testicle if theyre relatively certain the lump is cancerous. Losing a testicle wont affect your sex life or ability to have children. The removal of a testicle is called an orchidectomy. Its the main type of treatment for testicular cancer, so if you have testicular cancer its likely youll need to have an orchidectomy. Other tests In almost all cases, youll need further tests to check whether testicular cancer has spread. When cancer of the testicle spreads, it most commonly affects the lymph nodes in the back of the abdomen or the lungs. Therefore, you may require a chest X-ray to check forsigns of a tumour. Youll also need a scan of your entire body. This is usually a CT scan (computerised X-ray) to check for signs of the cancer spreading. In some cases, a different type of scan, known as a magnetic resonance imaging (MRI) scan may be used. Stages of testicular cancer After all tests have been completed, its usually possible to determine the stage ofyour cancer. There are 2 ways that testicular cancer can be staged. The first is known as the TNM staging system: T indicates the size of the tumour N indicates whether the cancer has spread to nearby lymph nodes M indicates whether the cancer has spread to other parts of the body (metastasis) Testicular cancer is also staged numerically. The 4 main stages are: stage 1 the cancer is contained within your testicle and epididymis (the tube at the back of the testicle) stage 2 the cancer has spread from the testicles into the lymph nodes (small glands that help fight infection) at the back of the abdomen stage 3 the cancer has spread to the lymph nodes in the middle of the chest or in the neck stage 4 the cancer has spread to the lungs or, rarely, to other tissues ororgans, such as the liver, bones or brain Cancer Research UK has more information about testicular cancer stages . Treating testicular cancer Chemotherapy, radiotherapy and surgery are the 3 main treatments for testicular cancer. Your recommended treatment plan will depend on: the type of testicular canceryou have whether its aseminoma or a non-seminoma the stageof your testicular cancer The first treatment option for all cases of testicular cancer, whatever the stage, is to surgically remove the affected testicle (an orchidectomy). For stage 1 seminomas, after the testicle has been removed, a single dose of chemotherapy may be given to help prevent the cancer returning. A short course of radiotherapy is also sometimes recommended. However, in many cases, the chance of recurrence is low and your doctors may recommend that youre very carefully monitored over the next few years. Further treatment is usually only needed for the small number of people who have a recurrence. Forstage 1 non-seminomas, close follow-up (called surveillance) may also be recommended, or a short course of chemotherapy using a combination of different medications. For stage 2, 3 and 4 testicular cancers, 3 to 4 cycles of chemotherapy are given using a combination of different medications. Further surgery is sometimes needed after chemotherapy to remove any affected lymph nodes or deposits in the lungs or, rarely, in the liver. Some people with stage 2 seminomas may be suitable for less intense treatment with radiotherapy, sometimes with the addition of a simpler form ofchemotherapy. In non-seminoma germ cell tumours, additional surgery may also be required after chemotherapy to remove tumours from other parts of the body, depending on the extent of the spread of the tumour. Deciding what treatment is best for you can be difficult. Your cancer team will make recommendations, but the final decision will be yours. Before discussing your treatment options with yourspecialist,you may find it useful to write a list of questions to ask them. For example, you may want to find out the advantages and disadvantages of particular treatments. Orchidectomy An orchidectomy is a surgical procedure to remove a testicle. If you have testicular cancer, the whole of the affected testicle will need to be removed because only removing the tumour may lead to the cancer spreading. By removing the entire testicle, your chances of making a full recovery are greatly improved.Your sex life andability to father children wont be affected. About1 in 50 people will get a second new testicular cancer in their remaining testicle. In such circumstances, itssometimes possible to only remove the part of the testicle containing the tumour. You should ask your surgeon about this if youre in this position. If testicular cancer is detected in its very early stages, an orchidectomy may be the only treatment you require. An orchidectomy isnt carried out through the scrotum. Its done by making an incision in your groin through which the testicle isremoved with all of the tubes and blood vessels attached to the testicle that pass through the groin into the abdomen. The operation is carried out under general anaesthetic . You can have an artificial (prosthetic) testicle inserted into your scrotum so that the appearance of your testicles isnt greatly affected. The artificial testicle is usually made of silicone (a soft type of plastic).It probably wont be exactly like your old testicle or the one you still have. It may be slightly different in size or texture. Afteran orchidectomy, its often possible to be discharged quickly, although you may need to stay in hospital for a few days. If only 1 testicle is removed, there shouldnt be any lasting side effects. If both testicles are removed (a bi-lateral orchidectomy), youll be infertile. However, removing both testicles at the same time is very rarely required, and only 1 in every 50 cases require the other testicle to be removed at a later date. You may be able to bank your sperm before having a bi-lateral orchidectomy to allow you to father children if you decide to. Sperm banking Most people are still fertile after having 1 testicle removed. However, some treatments for testicular cancer can cause infertility. Some people with testicular cancer may have low sperm counts because of changes that occur in the testicles before the cancer develops. For some treatments, such as chemotherapy, infertility may occur, but standard chemotherapies have a less than 50% chance of causing infertility if the remaining testicle is normal. In people who need to have post-chemotherapy removal of lumps at the back of the abdomen, known as retroperitoneal lymph node dissection (RPLND), the ability to ejaculate (eject sperm from the penis) may be affected, even though the remaining testicle can still produce sperm. Before your treatment begins, you may want to consider sperm banking. This is where a sample of your sperm is frozen so that it can be used at a later date to impregnate your partner during artificial insemination. Before sperm banking, you may be asked to have tests for HIV , hepatitis B and hepatitis C . If youre having complex chemotherapy for stage 2 to 4 testicular cancer, you should always be offered sperm banking. Ask if youre concerned about your fertility. Not all men are suitable for sperm banking. For the technique to work, the sperm has to be of a reasonably high quality. There may also be situations where its considered too dangerous to delay treatment for sperm banking to take place. MostNHS cancer treatment centres offer a free sperm banking service. However, its up to each area of the country to decide whether they store sperm for free or whether you have to pay. Cancer Research UK has more information about sperm banking , including the cost of sperm storage. Testosterone replacement therapy If you still have a remaining testicle, in most cases (90%)your body will make enough testosterone so you wont notice any difference. If there are any problems with your remaining testicle, you may experience symptoms due to a lack of testosterone. These symptoms can be caused for other reasons but can include: tiredness weight gain loss of libido (sex drive) reduced beard growth reduced ability to achieve or maintain an erection ( erectile dysfunction ) Having both testicles removed will definitely stop you producing testosterone and youll develop the above symptoms. Testosterone replacement therapy is where youre given testosterone in the form of an injection, skin patch or gel to rub into your skin. If you have injections, youll usually need to have them every 2 to 3 months. After having testosterone replacement therapy, youll be able to maintain an erection and your sex drive will improve. Side effects associated with this type of treatment are uncommon, and any side effects that you do experience will usually be mild. They may include: oily skin, which can sometimes trigger the onset of acne breast enlargement and swelling a change innormal urinary patterns, such as needing to urinate more frequently or having problems passing urine (caused by an enlarged prostate gland that puts pressure on your bladder) There are also concerns that testosterone replacement may increase the risk of prostate cancer and you should discuss this with your doctor. However, the risks from having testosterone replacement are usually much lower than the benefits of receiving it. Lymph node and lung surgery More advanced cases of testicular cancer may spread to your lymph nodes. Lymph nodes are part of your bodys immune system, which helps protect against illness and infection. Lymph node surgery is carried out under general anaesthetic. The lymph nodes in your abdomen are the nodes most likely to need removing. In some cases, the nerves near the lymph nodes can become damaged, which means that rather than ejaculating semen out of your penis during sex or masturbation, the semen instead travels back into your bladder. This is known as retrograde ejaculation. If you have retrograde ejaculation, youll still experience the sensation of having an orgasm during ejaculation, but you wont be able to father a child. There are a number of ways of treating retrograde ejaculation, including the use of medicines that strengthen the muscles around the neck of the bladder to prevent the flow of semen into the bladder. Men and anyone with testicles who wants to have children can have sperm taken from their urine for use inartificial insemination or in-vitro fertilisation (IVF). There are also a number ofnewer surgical techniques that carry a lower risk of retrograde ejaculation and infertility. Some people with testicular cancer have deposits of cancer in their lungs and these may also need to be removed after chemotherapy if they havent disappeared or reduced sufficiently in size. This type of surgery is also carried out under general anaesthetic and doesnt usually significantly affect breathing in the long-term. Nerve-sparing retroperitoneal lymph node dissection A newer type of lymph node surgery, called nerve sparing retroperitoneal lymph node dissection (RPLND), is increasingly being used because it carries a lower risk of causing retrograde ejaculation and infertility. In nerve-sparing RPLND, the site of the operation is limited to a much smaller area. This means theres less chance of nerve damage occurring. The disadvantage is that the surgery is more technically demanding. Therefore, nerve-sparing RPLND is currently only available at specialist centres that employ surgeons with the required training. Laparoscopic retroperitoneal lymph node dissection Laparoscopic retroperitoneal lymph node dissection (LRPLND) is a type of keyhole surgery that can be used to remove the lymph nodes. During LRPLND, the surgeon will make a number of small incisions in your abdomen. An instrument called an endoscope is inserted into one of the incisions. An endoscope is a thin, long, flexible tube with a light and a camera at one end, enabling images of the inside of your body to be relayed to an external television monitor. Small, surgical instruments are passed down the endoscope and can be used to remove the affected lymph nodes. The advantage of LRPLND is that theres less post-operative pain and a quicker recovery time. Also, as with nerve-sparing RPLND, in LRPLND theres a smaller chance that nerve damage will lead to retrograde ejaculation. However, as LRPLND is a new technique, theres little available evidence regarding the procedures long-term safety and effectiveness. If youre consideringLRPLND, you should understand there are still uncertainties about the safety and effectiveness ofthe procedure. Radiotherapy Radiotherapy uses high-energy beams of radiation to help destroy cancer cells. Sometimes, seminomas may require radiotherapy after surgery to help prevent the cancer returning. It may also be needed in advanced cases where someone is unable to tolerate the complex chemotherapies that are usually used to treat stage 2, 3 and 4 testicular cancer. If testicular cancer has spread to your lymph nodes, you may require radiotherapy after a course of chemotherapy. Side effects of radiotherapy can include: reddening and soreness of the skin, which is similar to sunburn nausea diarrhoea fatigue These side effects are usually only temporary and should improve when your treatment is completed. Chemotherapy Chemotherapy uses powerful medicines to kill the malignant (cancerous) cells in your body or stop them multiplying. You may require chemotherapy ifyou have advanced testicular cancer or its spread within your body. Its also used to help prevent the cancer returning. Chemotherapy is commonly used to treat seminomas and non-seminoma tumours. Chemotherapy medicines for testicular cancer are usually injected into a vein. In some cases, a special tube called a central line is used, which stays in a vein throughout your treatment so that you dont have to keep having blood tests or needles placed in a new vein. Sometimes, chemotherapy medicines can attack your bodys normal, healthy cells. This is why chemotherapy can have many different side effects. The most commoninclude: vomiting hair loss nausea sore mouth and mouth ulcers loss of appetite fatigue breathlessness and lung damage infertility ringing in your ears ( tinnitus ) skin that bleeds or bruises easily low blood counts increased vulnerability to infection numbness and tingling (pins and needles) in your hands and feet kidney damage These side effects are usually only temporary and should improve after youve completed your treatment. Side effects, such as infections that occur when you have a low blood count, can be life-threatening, and its essential that you always call your cancer care team if youre worried between chemotherapy treatments. Bleomycin One of the medicines commonly used, called bleomycin, can cause long-term lung damage and you should discuss this with your doctors if damage to your lungs would have specific issues for your career or lifestyle. However, the advice may still be that you should receive it for the best chance of a cure. Having children You shouldnt father children while having chemotherapy and for a year after your treatment has finished. This is because chemotherapy medications can temporarily damage your sperm, increasing your risk of fathering a baby with serious birth defects. Therefore, youll need to use a reliable method of contraception , such as a condom , during this time. Condoms should also be used during the first 48 hours after having a course of chemotherapy. This is to protect your partner from any potentially harmful effects of the chemotherapy medication in your sperm. Read more about the side effects of chemotherapy . Follow-up Even if your cancer has been completely cured, theres a risk it will return.The risk of your cancer returning will depend on what stage it was atwhen you were diagnosed and what treatment youve had since. Most recurrences of non-seminoma testicular cancer occur within 2 years of surgery or completion of chemotherapy. In seminomas, recurrences still occur until 3 years. Recurrences after 3 years are rare, occurring in less than 5% of people. Because of the risk of recurrence, youll need regular tests to check if the cancer has returned. These include: a physical examination blood tests to check for tumour markers a chest X-ray a computerised tomography (CT) scan Follow-up and testing is usually recommended dependingon the extent of the cancer and the treatment offered. This is usually more frequent in the first year or two but follow-up appointments may last for up to 5 years. In certain cases, it may be necessary to continue follow-up appointments for 10 years or longer. If the cancer returns following treatment for stage 1 testicular cancer, and its diagnosed at an early stage, it will usually be possible to cure it using chemotherapy and possibly also radiotherapy. Some types of recurring testicular cancer have a cure rate of over 95%. Recurrences that occur after previous combination chemotherapy can also be cured, but the chances of this will vary between individuals and youll need to ask your doctors to discuss this with you. Cancer Research UK hasmore information about follow-up for testicular cancer. Causes of testicular cancer The causes of testicular cancer are not fully understood. However, several things that increase yourrisk of developing the condition. Undescended testicles Undescended testicles is the most significant risk factor. When male babies grow in the womb, their testicles develop inside their abdomen. The testicles then normally move down into the scrotum when the baby is born or during their first year of life. However, for some children, the testicles fail to descend. The medical name forundescended testicles is cryptorchidism. Surgery is usually required to move the testicles down. If you have had surgery to move your testicles down into your scrotum, your risk of developing testicular cancer may be increased. Of surgery is performed before the child is 13 years of age, their risk of later developing testicular cancer is approximately double that of the rest of the population. However, if the operation is carried out after the boy is 13 years of age, the risk of developing testicular cancer is 5 times greaterthan that ofthe rest of the population. Previous testicular cancer Men and anyone with testicles who has previously been diagnosed with testicular cancer are 12 times more likely to develop testicular cancer in the other testicle. For this reason, its important to attend follow-up appointments if you have previously been diagnosed with testicular cancer. Age and race Unlike most other types of cancer, testicular cancer is more common in young and middle-aged men and anyone with testicles. Men and anyone with testicles aged 30to 34 are most likely to be diagnosed with testicular cancer. Testicular cancer is more common in white men and anyone with testicles than other ethnic groups. Its also more common in Northern and Western Europe compared with other parts of the world. Family history Having a close relative with a history of testicular cancer increases your risk of developing it. If your father had testicular cancer, you are 4 to 6 times more likely to developit thana person with no family history of the condition. If your brother had testicular cancer, you are 8 to 10 times more likely to develop it (having an identical twin with testicular cancer means that you are 75 times more likely to develop it). The fact that testicular cancer appears to run in families has led researchers to speculate that there may be one or more genetic mutations (abnormal changes to the instructions that control cell activity) that make a person more likely to develop testicular cancer. Mutations in 2 genes (known as the KITLG and SPRY4 genes) mayincrease the risk of a person developing testicular cancer. Endocrine disruptors Examples of endocrine disruptors include: some types of pesticide polychlorinated biphenyls (PCBs), chemical compounds used as a coolant dibutyl phthalate, a chemical used to manufacture cosmetics, such as nail polish In most countries, including the UK, many endocrine disruptors, such as PCBs, have been withdrawn as a result of their link to health problems. However, there is a concern that exposure to endocrine disruptors may still occur due to contamination of the food chain. However, there is not yet enough evidence to prove a definite link between indirect exposure to low levels of endocrine disruptors and health problems. Indirect exposure is the type of exposure that would occur if the food chain was contaminated. Infertility Men and anyone with testicles who are infertileare 3 times more likely to develop testicular cancer. The reasons for this are not clear. Smoking Research has found that long-term smokers (people who have been smoking a pack of 20 cigarettes a day for 12 years or 10 cigarettes a day for 24 years) are twice as likely to develop testicular cancerthan non-smokers. HIV and AIDS Studies show that men and anyone with testicles with HIV or AIDS have an increased risk of testicular cancer. Source: NHS 24 - Opens in new browser window Last updated: 14 November 2023 How can we improve this page? Help us improve NHS in

Testicular cancer: Teenagers and young adults

Testicular 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 teenagers and young adults Testicular cancer: Teenagers and young adults Testicular cancer: Teenagers and young adults The testicles Having tests for testicular cancer Treating testicular cancer Life after treatment for testicular cancer The testicles It can be embarrassing to talk about your testicles and any changes to them that youve noticed. Understanding more about what they do might help. Facts about testicles Testicles are small and oval-shaped. They hang below your penis in a sac called the scrotum. From puberty, your testicles produce a hormone called testosterone. This gives you a lower voice, hair on your face and body, and makes your muscles get bigger. You also need it for your sex drive and for getting an erection. The testicles make sperm from puberty (around 13to 14 years old) onwards. When sperm meets with a female egg during sex, this can cause pregnancy. The testicles make millions of sperm a day, but if sperm are not ejaculated they are reabsorbed back into your body. Sperm wait in the epididymis next to the testicle until they are ejaculated. At ejaculation, they travel up through the spermatic cord and mix with fluid from the prostate to make semen. They go out of the body through the urethra (this is the same tube you pass urine (pee) through). Lymph nodes (glands) Lymph nodes are small and round, and connect to each other by tiny tubes that carry fluid called lymph. We have lymph nodes throughout our bodies. They are part of the lymphatic system, which protects us from infections. Sometimes cancer cells from the testicle can spread to lymph nodes at the back of the abdomen (tummy). Youll have a scan to check your lymph nodes. If youre looking for information for all ages about testicular cancer,readour general testicular cancer section . Having tests for testicular cancer You may have tests done by your GP or at the hospital. They will help your doctors see whether you have testicular cancer. Visiting your GP If you think you might have some of the symptoms of testicular cancer, you should go to your GP. Theyll be able to talk to you about your symptoms. If they think the symptoms could be because of cancer they can do tests to find out more. If your doctor thinks there is a chance you might have cancer, theyll examine your testicles. They might also arrange for you to have an ultrasound test. This uses sound waves to take a picture of the testicles. At the hospital If you need more tests youll be referred to a hospital. This could be a general hospital or a specialist cancer hospital. Youll be seen by a specialist doctor (urologist), who will examine you and do the following tests: blood tests to check for chemicals in the blood called tumour markers some testicular cancers (but not all) produce high levels of these an ultrasound scan of the scrotum and testicles (if you havent already had one) this can usually tell the difference between a cancer and a cyst (a harmless lump filled with fluid) Removing a testicle If your ultrasound shows the lump is almost certainly cancer, an operation to remove a testicle (orchidectomy) is done. Youll only have this operation if its necessary. Your specialist will explain this to you. After the operation a doctor will use a microscope to look for cancer cells in the removed testicle. This may be the only operation you need. It will not stop you having sex or becoming a dad in the future. Further tests If testicular cancer is diagnosed you will need some other tests: more blood tests to check how well your liver and kidneys are working, and to check your tumour markers again chest X-rays to check your lungs are healthy this is sometimes done before the operation CT , MRI , or PET scans to find out if the cancer has spread to the lymph nodes at the back of your abdomen (tummy), or to anywhere else in your body Youll be seen by a cancer specialist and usually a specialist nurse at a cancer treatment centre to get your test results. The results will help your specialist plan the best treatment for you. Having tests and waiting for the results can be a scary time. Talking about how you feel and getting support from your family, friends, specialist nurse and doctor can make it a bit easier. If you need any further treatment you will have it at the cancer treatment centre. If youre looking for information for all ages about testicular cancer, read our general testicular cancer section . Treating testicular cancer Treatment for testicular cancer can be very successful. Surgery and chemotherapy are the 2 main types of treatment. Often people have both treatments. To make sure you have the right treatment, your specialist needs to know what stage the cancer is. The stage of a cancer describes the tumour and whether it has spread outside the testicle. You may need some more tests to confirm what stage you are at. Waiting to hear about the stage of the cancer can be worrying. But this information is important because it helps your doctors plan the right treatment. Treatment for testicular cancer can be really successful. Most young men with testicular cancer are cured, even if the cancer has spread. If you have any questions about your treatment, dont be afraid to ask your doctor or nurse. Surgery Surgery to remove the testicle is one of the main treatments for testicular cancer. The operation is called an orchidectomy. It can be done as a day patient or during a short stay in hospital. You may feel shocked and scared at the thought of having this done. Your doctor and nurse will tell you more about it so that you know what to expect. The surgeon makes a small cut (incision) through your lower abdomen (tummy) in the groin on the affected side. The testicle is pushed up from the scrotum and removed through the cut. During the operation the surgeon can put a false testicle into your scrotum so that youll look the same as before. Your surgeon will explain this to you before the operation, or you can ask them about it. If this wasnt done at the time of the operation, but now you think you would like this, talk to your doctor or nurse. It is a small operation to put this in later on. After the operation Youll have a small dressing where the cut was made. This can usually be removed a day or so after the operation. The stitches in the wound will dissolve by themselves over the next few months. Youll probably feel a bit sore and youll be given painkillers to take regularly. Let your nurse or doctor know if theyre not controlling the pain. Wearing fitted briefs or shorts that support you and loose trousers like jogging bottoms can feel more comfortable after your operation. Youll probably feel tired and need to take things easy for about a week. You can expect to make a quick recovery after this operation. If one of your testicles is removed, you will still be able to have sex and make someone pregnant. Your other testicle should produce enough of the hormone testosterone and sperm. It isnt common to have both testicles removed. If youve had this done then youll be prescribed testosterone so youll still be able to have sex. But you wont be making sperm now, so you wont be able to make someone pregnant through sex. Your doctor will talk to you about sperm banking before your surgery. Storing your sperm before the operation can help you to become a dad in the future. Our sections on sex and relationships and fertility have more information as well as ways of coping. Surveillance If after surgery the chance of the cancer coming back is very low, your doctor might suggest you have surveillance. This means having regular checks to look for signs of the cancer coming back. If it does come back and its picked up very early, then its easy to cure. If the cancer doesnt come back then youve avoided having unnecessary treatment. At each clinic appointment, your doctor will examine you and you may have blood tests and chest X-rays. Going to all your surveillance appointments is really important. You could put a reminder in your phone. Chemotherapy Chemotherapy is when youre given anti-cancer drugs to destroy the cancer cells. You might be given chemotherapy: after the operation to remove your testicle, to reduce the chance of the cancer coming back to destroy cancer cells that have already spread outside the testicle if the cancer comes back occasionally before surgery, if the cancer has spread Chemotherapy can affect your fertility. Before your chemotherapy starts, your doctor will talk to you about storing some of your sperm. This is called sperm banking. We have more information about fertility issues. Chemotherapy is given into a vein as injections or drips. You have your chemotherapy through one of the following: a fine tube called a cannula a line into a vein in the chest (called a central line) a line into the arm (PICC line) that leads into a vein in the chest Find out more about how chemotherapy is given . The amount of chemotherapy you have depends on the stage of the cancer. If the stage is low then you will have 1to 2 cycles (sessions) of chemotherapy. If the stage is higher, or if the cancer comes back during surveillance, youll usually have 3to 4 cycles of chemotherapy. The drugs most often used to treat testicular cancer are cisplatin, etoposide and bleomycin. Giving these drugs together is called BEP. Chemotherapy is given in cycles of treatment. A cycle usually takes 3 weeks. If you have BEP, youll usually spend 3 to 5 days of the first week having your chemotherapy as a day patient, or you might need to stay in hospital overnight. After this youll come back to the clinic for another injection of chemotherapy a week later, and again the following week. If the cancer has spread to other parts of the body, or if it isnt going away completely with BEP, then different chemotherapy drugs can be given. Side effects Different chemotherapy drugs cause different side effects. You will probably have a few side effects, but its hard to know exactly how its going to be you. Your doctor will do everything they can to treat any side effects you have. Most side effects are short-term and gradually disappear once treatment stops. The most common temporary side effects are: hair loss tiredness feeling sick or being sick (which can be controlled with medicines) being more at risk of getting an infection Theres more information in the chemotherapy section . Sometimes side effects can be long-term. For example, although chemotherapy usually only affects fertility for a year or so, sometimes its permanent. Read Macmillans fertility section for more information. There may be other late effects of treatment and your specialist can talk to you about this. Further surgery If the lymph nodes at the back of your tummy area are still swollen after chemotherapy, theyre usually removed with an operation.Lymph nodes are part of the bodys immune system and help fight infection. The lymph nodes in the tummy are called the retroperitoneal lymph nodes, so the operation is called a retroperitoneal lymph node dissection. The operation will be done by experienced surgeons in specialist centres. The lymph nodes might contain cells that could become cancerous in the future, so having them removed is the only certain way to find this out. You might be in hospital for up to 10 days. The surgeon usually makes a cut from the top of your tummy (near your breastbone) to below your belly button. This leaves you with a scar but itll gradually fade until it ends up looking like a fine line. Sometimes you have surgery to remove any abnormal cells in areas like the lung or the lymph nodes in the chest. After the operation Youll have a drip in your arm to give you fluids until youre able to eat and drink normally. Youll also have drainage tubes from the wound to stop any extra fluid collecting. The nurses will keep a check on the dressing over your wound and change it when needed. Youll be given painkillers to take regularly. Your staples (like metal stitches) are removed 7 to 10 days after the operation. It might take a few months to get back to the level of fitness you had before. This operation can affect your fertility, because the nerves that control the release of sperm (ejaculation) may be damaged by surgery. Surgeons use nerve-sparing techniques to try to stop this happening. The operation doesnt usually stop you getting an erection or having an orgasm. If youre looking for information for all ages about testicular cancer, read our general testicular cancer section . Life after treatment for testicular cancer Being diagnosed with cancer can have a big impact on your life, even after youve finished treatment . After treatment Once you finish your treatment, youll have regular follow-up appointments at the hospital. Youll have blood tests for tumour markers and sometimes other scans or X-rays. If the tumour markers go up, this can be a sign that the cancer has come back. This means you need more treatment, which can still cure the cancer. How will I feel? You might find it embarrassing to talk about your private parts and how the cancer or cancer treatment has affected them. It can feel awkward talking to doctors or your family about this. Try not to let this put you off talking about things. It can be really helpful to let someone know how youre feeling, so that you dont bottle things up. Sex and fertility Fertility is the ability to have children. Some cancers and cancer treatments can affect a young mans fertility, but your doctors will always think about this when planning your treatment. Your doctor will talk to you about sperm banking prior to treatment if this might happen. If only1of your testicles has been removed, the one left should continue to make sperm and produce enough testosterone so that your fertility is not affected. You can still have sex. If you have chemotherapy, your ability to produce sperm might be affected. After chemotherapy you can have a sample checked to see if this has happened. You can still have sex, but when you are on chemotherapy (and for a few months afterwards) you should always wear a condom to protect your partner from the chemotherapy. If you had an operation to remove both of your testicles or the lymph nodes at the back of your tummy (abdomen), your fertility and your ability to have sex may be affected. This is a really tough thing to cope with on top of everything else that youre going through. Your specialist nurse will provide support and help you find more advice and support if you feel you need it. There are things which can be done to help so that you can still have sex. If youre looking for information for all ages about testicular cancer, read our general testicular cancer 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 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

Testicular lumps and swellings

Testicular lumps and swellings | 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 Testicular lumps and swellings Testicular lumps and swellings Lumps and swellings in the testicles (balls) are relatively common in boys, men and anyone with testicles. Its important to know whats normal for you so you can notice any changes in your testicles. When to get medical advice Speak to your GP practice if you have: a lump in your testicles swollen testicles a change in the shape of your testicles a change in the way your testicles feel 1 testicle that has become bigger than the other aching or discomfort in your testicles that does not go away Diagnosing testicular lumps and swellings There is not a singular test for testicular lumps and swellings. The doctor will discuss your situation and carry out a physical examination. Your doctor may: look at and feel your testicles shine a torch through the bag of skin containing your testicles (scrotum) to check for a build-up of fluid refer you for an ultrasound scan take a urine (pee) sample if they suspect your lump or swelling may be caused by an infection If the lump or swelling is painful or very big, your doctor may refer you to a specialist for an operation to drain, shrink or remove it. What causes testicular lumps and swellings? Lumps and swellings in the testicles can have lots of different causes. The vast majority of testicular lumps and swellings are caused by non-cancerous (benign) conditions. Most of these may not need treatment. If you experience testicular lumps and swellings, they may be caused by: varicoceles soft lumps that develop gradually above the testicle and on the left side of the scrotum hydroceles swellings in the scrotum caused by a build-up of fluid epididymal cysts a small, smooth fluid-filled swelling that slowly develops in the epididymis (a coil-like structure behind the testicles that helps to store and transport sperm) epididymo-orchitis inflammation in the epididymis and the testicle caused by bacterial infections such as urinary tract infections (UTIs) , sexually transmitted infections (STIs) and mumps inguinal hernias when fatty tissue or part of the bowel pokes through into the groin at the top of the inner thigh testicular torsion a benign but serious condition caused by the spermatic cord (the cord that supplies blood to the testicles) becoming severely twisted testicular cancer a more serious health condition Treatment for testicular lumps and swellings Treatment for testicular lumps and swellings will vary depending on whats causing it. Painkillers such as paracetamol can be taken to ease discomfort or pain. In some cases, surgery may be used to treat some testicular lumps and swellings. The surgery is carried out under either local anaesthetic or general anaesthetic depending on the procedure. Antibiotics may be prescribed if the cause is a bacterial infection. If you have been diagnosed with testicular cancer , you will be cared for by a team of clinicians who will help decide the best treatment for you. Surgery to remove the affected testicle will be recommended in most cases and this may sometimes be followed by a course of chemotherapy or radiotherapy . 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 Other health sites Cancer Research UK: Testicular cancer British Association of Urological Surgeons: Testicular lumps 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

Thirst

Thirst - 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 Thirst Thirst About thirst About thirst Feeling thirsty all the time and for no good reason isnt normal and should be investigated by your GP. Thirst is normally justthe brains way of warning that youre dehydrated because youre not drinking enough fluid. Butexcessive and persistent thirst (known aspolydipsia) could be a sign ofan underlying problem such as diabetes . Common causes of thirst Dehydration You will usually feel thirsty because youre notdrinking the amount of fluid your body needs. This may be because youve been sweating heavily or youve lost fluid because you have diarrhoea and are vomiting . You can soon quench your thirst and restore the fluid balance in your body by having a drink and ensuring you remain well hydrated. Itsparticularly important to stay well hydratedduring hot weather, while exercising and while youre unwell with vomiting and diarrhoea. Food In some cases, thirst may be caused by something as simple as a recent meal or snack. Eatingsalty or spicy foods can cause you to suddenly feel thirsty. Diabetes If you feel thirsty all the time, it could be a sign of diabetes particularly if you also have other symptoms such as needing to urinate frequently, extreme tiredness (fatigue) andunexplained weight loss. Diabetes is a lifelong condition that makes it difficult to control the level of sugar (glucose) in your blood. The high levels of glucose can mean your kidneys need to produce more urine to help pass the glucose out of your body. This can make you feel thirsty because your brain is telling you to drink more to make up for the fluids youve lost. If you feel thirsty all the time and have other symptoms, your GP will probably carry out a blood glucose test to see whether you have diabetes. Pregnancy Feeling thirsty, as well as urinating more often than usual, is a common symptom in pregnancy and usually nothing to worry about. Very occasionally, these problems can be a sign of gestational diabetes (a type of diabetes that affects women during pregnancy). You should be screened for this as part of your antenatal care if youre at risk. Medication Excessive thirst cansometimes be a side effect of certain types of medication, including lithium, certain antipsychotics and diuretics (water tablets). If you think a particular medicine is causing your thirst, it may be possible to change to a different medicine or reduce your dose. Speak to your GP about this. Other causes of thirst There are also many other potential causes of severe thirst. These include: diabetes insipidus a condition caused by problems with a hormone that regulates the amount of fluid in the body diabetic ketoacidosis a dangerous complication of diabetes caused by a lack of the hormone insulin in the body sickle cell aneamia an inherited blood disorder psychogenic polydipsia where a person with a mental health condition, such as schizophrenia , drinks excessive amounts of water that cant be excreted (got rid of) by the kidneys excessive bleeding Source: NHS 24 - Opens in new browser window Last updated: 10 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 Dehydration Other health sites Diabetes UK Diabetes.co.uk: excessive thirst 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

Threadworms

Threadworms | 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 Threadworms Threadworms About threadworms Symptoms of threadworms Causes of threadworms Treating threadworms About threadworms Threadworms, also known as pinworms, are tiny parasitic worms that infect the large intestine of humans. Threadwormsare a common type ofworminfection in the UK, particularly in children under the age of10. The wormsare white and look like small pieces of thread. You may notice them around your childsbottom or intheir poo. They dont always cause symptoms, but peopleoften experience itchiness around their bottomor vagina. It can beworse at night and disturb sleep. Read more about the symptoms of threadworms . When to seek professional advice Pharmacy First Scotland: Threadworm treatment from your pharmacy If you have threadworms you can get advice and treatment directly from a pharmacy. Find your local pharmacy on Scotlands Service Directory. Search for a pharmacy near you If you think you or your child may have threadworms, you can usually treat the infection yourself with medication available at pharmacies without a prescription. You only need to see your GP if youthink you have threadworms and youre pregnant or breastfeeding, or if you think your child has threadworms and theyre under 2years old. In these circumstances, the recommendedtreatment isusually different. Severe or persistent threadworm infections can cause: loss of appetite weight loss skin infection around the anus if bacteria enterany scratches caused by itching wearing cotton gloves while sleeping may help prevent this difficulty getting to sleep or staying asleep (insomnia) bedwetting In such cases, you should seek further advice from your GP. In very rare cases, threadworms can spread outside the intestinetothe urinary tract orliver, or the vagina or womb in girls or women. How threadworms are spread Threadworms lay their eggs around an infected persons anus (bottom), usually at night. Along with the eggs, the worm also secretes a mucus that causes itching. If the eggs get stuck on the persons fingertips when they scratch, they can be transferred to their mouth or on to surfaces and clothes. If other people touch an infected surface, they can thentransfer the eggs to their mouth. Threadworm eggs can survive for up to 2weeks before hatching. If the eggs hatch around the anus, the newborn worms can re-enter the bowel. Eggs that have been swallowed will hatch inside the intestine. After 2weeks, the worms reach adult size and begin to reproduce, starting the cycle again. Read more about what causes threadworms . Treating threadworms If you or your child has threadworms, everyone in your household will need to be treatedas theres a highrisk of the infection spreading. This includes those who dont have any symptoms of an infection. For most people, treatment will involve taking a single dose of a medication calledmebendazole to kill the worms. If necessary, another dose can be taken after 2weeks. During treatment and for a few weeks afterwards, its also important to follow strict hygiene measures to avoid spreading the threadworm eggs. This includes regularly vacuuming your house and thoroughly washing your bathroom and kitchen. If youre pregnant or breastfeeding, hygiene measures are usually recommended without medication. This is alsooften the case for young children. Read more about treating threadworm infections . Preventing threadworms Its not always possible to prevent a threadworm infection, but you can significantly reduce your riskby always maintaining good hygiene and encouraging children to do the same. Children should wash their hands regularly, particularly after going to the toilet and before mealtimes. Kitchen and bathroom surfaces should be kept clean. If your child is infected, encouraging them not to scratch the affected area around their anus or vagina will help prevent reinfection and reduce the risk of the infection spreading to others. Symptoms of threadworms Threadworms often go unnoticed by people who have them. However, they can cause intense itching around the anus (and the vagina in girls), particularly at night when the female worms are laying eggs. This can disturb sleep. In some cases, you may spot threadworms on your bed clothes or sheets at night, or you may notice them in your stools. The worms look like threads of white cotton and are about 1cm long. Causes of threadworms A threadworm infection is passed from person to person by swallowing threadworm eggs. A female threadworm can lay thousands of tiny eggs around the anus or vagina.The female threadworm also releases mucus, whichcan cause an itchy bottom . Scratching the anus or vagina, or wiping them after going to the toilet, can cause the eggs to stick to your fingertips or under your fingernails. If you dont wash your hands, the eggs can be transferred to your mouth or on to food or objects, such as toys and kitchen utensils. If someone else touches a contaminated object, or eats contaminated food and thentouches their mouth, theyll become infected. After the eggs have been swallowed they pass into a persons intestine, where they hatch. After about 2 weeks the threadworms will have grown into adults, at which point theyll reproduce and the cycle of infection will start again. Transferring eggs Threadworm eggs can be transferred from your anus (or vagina) to anything you touch, including: bedsheets andbed clothes flannels and towels childrens toys kitchen utensils toothbrushes furniture kitchen or bathroom surfaces Threadworm eggs can survive on surfaces for up to two weeks. As well as being swallowed by a person who touches a contaminated object or surface, threadworm eggs can also be swallowed after being breathed in. This can happen if the eggs become airborne for example, after shaking a contaminated towel or bed sheet. Animals and pets Threadworms only infect humans and arent spread in animal faeces. However, theres a small risk that threadworms can be caught from pets if the animals fur becomes contaminated with eggs after an infected person strokes it. If another person then touches the animals fur, the eggs could be passed on to them. Whos at risk? Threadworm infections most commonly affect young children because they often forget to wash their hands and they share toys with other children. People who are in close contact with someone with a threadworm infection also have a high risk of infection. This is why all members of a householdneed tobe treated when someone has a threadworm infection. Read more about treating threadworms . Treating threadworms To treat threadworms successfully, all household members must be treated, even if they dont have any symptoms. This is because the risk of the infection spreading is very high. The aim of treatment is to get rid of the threadworms and prevent reinfection. This will usually involve a combination of medication to kill the worms and strict hygiene measures to stop the spread of the eggs. The main medication used to treat threadworms is available from your local pharmacy without a prescription. However, its important to follow the manufacturers instructionsas it isnt suitable for everyone. Medication Mebendazoleis the main medication used to treat threadworm infections. It can be bought over the counter from your local pharmacy orprescribed by your GP. Its available as a chewable tablet or a liquid. Mebendazole works by preventing the threadworms absorbing sugar, which means they should die within a few days. This medication is 90 to 100% effective at killing the threadworms, but it doesnt kill the eggs. This is why the hygiene measures outlined below should also be followed for 6weeks. Visit your pharmacist if the infection continues two weeks after treatment. They may recommend a second dose of medication. In rare cases, mebendazole can cause abdominal pain or diarrhoea , particularly if the threadworm infection is severe. Hygiene measures Strict hygiene measures can help clear up a threadworm infection and reduce the likelihood of reinfection. The lifespan of threadworms is approximately 6weeks, so its important that hygiene measures are followed for at least this length of time. Everyone in the household must follow the advice outlined below. wash all night clothes, bed linen, towels and soft toys when youre first diagnosed this can be done at normal temperatures, but make sure the washing is well rinsed thoroughly vacuum and dust the whole house, paying particular attention to the bedrooms this should be repeated regularly carefully clean the bathroom and kitchen by damp-dusting surfaces and washing the cloth frequently in hot water this should be repeated regularly avoid shaking any material that may be contaminated with eggs, such as clothing or bed sheets this will prevent eggs being transferred to other surfaces dont eat food in the bedroom you may end up swallowing eggs that have been shaken off the bedclothes keep your fingernails short encourage other members of your household to do the same discourage nail-biting and sucking fingers in particular, make sure children dont suck their thumb wash your hands frequently and scrub under your fingernails its particularly important to do this before eating, after going to the toilet, and before and after changing your babys nappy wear close-fitting underwear at night and change your underwear every morning bathe or shower regularly its particularly important to bathe or shower first thing in the morning: make sure you clean around your anus and vagina to remove any eggs ensure everyone in your household has their own face flannel and towel dont share towels keep toothbrushes in a closed cupboard and rinse them thoroughly before use Children can easily pick up another threadworm infection from friends or at school, so maintaining good hygiene may help prevent reinfection. Pregnant or breastfeeding women Medication isnt usually recommended for pregnant or breastfeeding women. Instead, you should follow the hygiene measures above. See your GP if youre more than 3months pregnant, or if youre breastfeeding and you continue to experience problemsafter only taking hygiene measures. In certain circumstances, your GP may consider prescribing medication. Children under 2years old Make sure you wash your babys bottom gently but thoroughly every time you change their nappy. Also wash your hands thoroughly before and after changing their nappy. Mebendazole isnt licensed for use in children under 2years of age, but GPs may decide to prescribe itoff-label for children over 6months. If medication isnt used, the hygiene measures outlined above are recommended instead. 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 Impetigo Search for 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

Thrush

Thrush | 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 Thrush Thrush British Sign Language (BSL) | | Polski | Romn | slovenina Thrush is a very common yeast infection. Its not a sexually transmitted infection (STI). Its usually harmless but it can be uncomfortable and keep coming back. Symptoms of thrush Some people wont have any signs or symptoms of thrush at all. Sometimes there can be too much yeast and it can cause symptoms. Thrush symptoms in women Symptoms of thrush in women include: white vaginal discharge (often like cottage cheese), which does not usually smell itching and irritation around the vagina soreness and stinging during sex or when you pee Thrush symptoms in men Symptoms of thrush in men include: irritation, burning and redness around the head of the penis and under the foreskin a white discharge (like cottage cheese) an unpleasant smell difficulty pulling back the foreskin Thrush in other areas Thrush can affect other areas of skin, including the armpits, groin and between your fingers. Symptoms of thrush in other areas include: a red itchy or painful rash (the rash might not be easy to see on darker skin) white or yellow discharge When to get medical advice Speak to your GP practice or local sexual health clinic if: you have symptoms of thrush for the first time you have thrush and are under 16 or over 60 thrush keeps coming back (more than 4 times in 12 months) treatment for thrush has not worked you have thrush and are pregnant or breastfeeding you have thrush and a weakened immune system for example, because of diabetes , HIV or chemotherapy Testing for thrush If you think you might have thrush, get tested for free by: contacting your GP practice for an appointment booking an appointment at your local sexual health service Testing is also available in some pharmacies . What does a thrush test involve? The test for thrush only takes a few seconds and isnt usually painful, though it may be uncomfortable for a moment. Its not always necessary to have a test for thrush. If you do have a test, a doctor or nurse may: look at the genital area use a swab (cotton bud) to collect a sample from the parts of the body that could be affected such as the vagina Thrush may have similar symptoms to some STIs, so its important you seek advice if you think you may be at risk of an STI. Treatment for thrush Treatment is simple and only necessary if you have signs and symptoms of thrush. You may be given: antifungal cream to apply to the genital area vaginal pessaries (tablets that you put into your vagina) oral pills a combination of treatments Your doctor or nurse will tell you how to use the treatment. Its very important to take the treatment as instructed and finish any course of treatment even if the symptoms go away earlier. You can buy antifungal treatments from most pharmacies if youve been diagnosed with thrush in the past and you know the symptoms. Some antifungal products can weaken latex condoms , diaphragms and caps . You should avoid sex while undergoing treatment if this is your method of contraception. You should tell your doctor, nurse or pharmacist if youre pregnant, might be pregnant, or if youre breastfeeding. This may affect the type of treatment youre given. If thrush isnt treated it eventually goes away on its own. Theres no need for your partner(s) to have treatment unless they have signs and symptoms of thrush. What causes thrush? Your chances of developing thrush increase if: your skin is irritated or damaged youre taking antibiotics you have poorly controlled diabetes you have a weakened immune system for example youre having chemotherapy or living with HIV youre having hormone replacement therapy (HRT) youre pregnant you use products that irritate the skin such as perfumed products, bubble baths or vaginal washing products How to prevent thrush Some people find that different triggers cause thrush. If you notice a pattern, you may be able to help control it. There are things you can do to relieve symptoms and stop thrush from coming back. Do use a soap substitute (emollient) to add moisture instead of soap these are available in some pharmacies use non-soap bath additives such as unfragranced bath oil instead of bubble bath dry properly after washing wear cotton underwear avoid sex until thrush has cleared up if sex is uncomfortable if you do have sex, make sure your vagina is well-lubricated Dont do not use soaps on or near your genital area, it can be drying do not let products like shampoo or conditioner run onto your genital area do not use bubble baths, essential oils or soap or shower gels in the bath as theyll run onto the genital skin and 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 wear tight underwear, tights, tight trousers or jeans do not use fabric softeners If youre prescribed an antibiotic for another condition, remind your doctor that you tend to get thrush and ask for some preventive treatment for thrush at the same time. Regular thrush Some people may only get thrush once. Others may get it multiple times. You may need to take treatment for longer if you keep getting thrush (you get it more than 4 times in 12 months). If you get recurrent thrush the doctor or nurse will want to check that other conditions, such as diabetes, arent the cause of the thrush. Theyll recommend how often you should use treatment. 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 (BSL) | | Polski | Romn | slovenina British Sign Language (BSL) | | Polski | Romn | slovenina Add this page to\n Info For Me Also on NHS inform Thrush (BSL) Thrush (Chinese) Thrush (Polish) Thrush (Romanian) Thrush (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

Thyroid cancer

Thyroid 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 Thyroid cancer Thyroid cancer About thyroid cancer Symptoms of thyroid cancer Causes of thyroid cancer Diagnosing thyroid cancer Treating thyroid cancer Complications of thyroid cancer About thyroid cancer Thyroid cancer is a rare type of cancer that affects the thyroid gland, a small gland at the base of the neck. The most common symptom ofcancer of the thyroid is a painless lump or swelling that develops in the neck. Other symptoms only tend to occur afterthe condition has reached an advanced stage, and may include: unexplained hoarseness that lasts for more than a few weeks a sore throat or difficulty swallowing that doesnt get better a lump elsewherein yourneck If you have a lump in your thyroid gland, it doesnt necessarily mean you have thyroid cancer.About 1 in 20 thyroid lumps are cancerous. Read more about the symptoms of thyroid cancer The thyroid gland The thyroid gland consists of 2lobes located oneither side of the windpipe. Its main purpose is to release hormones (chemicals that have powerful effects on many different functions of the body). The thyroid gland releases 3separate hormones: triiodothyronine known as T3 thyroxine known as T4 calcitonin The T3 and T4 hormones help regulate the bodys metabolic rate (the rate at which the various processes in the body work, such as how quickly calories are burnt). An excess ofT3 and T4 will make you feel overactive and youmay lose weight. If you dont have enough of these hormones, youll feel sluggish and youmay gain weight. Calcitonin helps control blood calcium levels. Calcium is a mineral that performs a number of important functions, such as building strong bones. Calcitonin isnt essential for maintaining good health because your body also has other ways of controlling calcium. Types of thyroid cancer There are 4main types of thyroid cancer. They are: papillary carcinoma this is the most common type, accounting for about 6 out of 10(60%) cases; it usually affects people under the age of 40, particularly women follicular carcinoma accounts for around3 out of 20 (15%) cases of thyroid cancer and tends to affect older adults medullary thyroid carcinoma accounts for between 5 and 8 out of every 100 diagnosed cases (5% to 8%); unlike the other types of thyroid cancer, medullary thyroid carcinomacan run in families anaplastic thyroid carcinoma this is the rarest and most aggressive type of thyroid cancer, accounting for less than 1in 20 thyroid cancers; it usually affects older people over the age of 60 Papillary and follicular carcinomas are sometimes known as differentiated thyroid cancers, and theyre often treated in the same way. How common is thyroid cancer? Thyroid cancer is a rare form of cancer, accounting for less than 1% of all cancer cases in the UK. Its most common in people aged 35 to 39 years and in those aged 70 years or over. Women are 2to 3times more likely to develop thyroid cancer than men. Its unclear why this is, but it may bea result ofthe hormonal changes associated with the female reproductive system. What causes thyroid cancer? In most cases, the cause of thyroid cancer is unknown. However, certain things can increase your chances of developing the condition. Risk factors for thyroid cancer include: having a benign (non-cancerous) thyroid condition having a family history of thyroid cancer (in the case of medullary thyroid cancer) having a bowel condition known as familial adenomatous polyposis acromegaly a rare condition where the body produces too much growth hormone having a previous benign (non-cancerous) breast condition weight and height radiation exposure Read more about the causes of thyroid cancer Diagnosing thyroid cancer Atype of blood test known as a thyroid function testwill measure the hormone levels in your blood and rule out or confirm other thyroid problems. If nothing else seems to be causing the lump in your thyroid, fine-needle aspiration cytology (FNAC) is used. Further testing may be required if the FNAC results are inconclusive, or if more information is needed to make your treatment more effective. Read more about how thyroid cancer is diagnosed . Treating thyroid cancer Yourrecommended treatment plan will depend on the type and grade of your cancer, and whether a complete cure is realistically achievable. Differentiated thyroid cancers (DTCs)are treated using a combination of surgery to remove the thyroid gland (thyroidectomy) and a type of radiotherapy that destroys any remaining cancer cells and prevents the thyroid cancer returning. Medullary thyroid carcinomas tend to spread faster than DTCs, so it may be necessary to remove any nearby lymph nodes, as well as your thyroid gland. Read more about treating thyroid cancer Recurrence Cancerous cells will returnin an estimated 5% to 20% of people with a history of thyroid cancer. In approximately 10% to 15% of people, the cancerous cells will come back in other parts of their body, such as their bones. Cancerous cells can sometimesreturn many years after surgery and radioactive iodine treatment has been completed. Youll be asked to attend regular check-ups so any cancerous cells that return can be treated quickly. Read more about the complications of thyroid cancer Preventing thyroid cancer From the available evidence, eating a healthy, balanced diet is the best way to avoid getting thyroid cancer and all other types of cancer. A low-fat, high-fibre diet is recommended that includes plenty of fresh fruit and vegetables (at least 5 portions a day) and whole grains. Symptoms of thyroid cancer In its early stages, thyroid cancer tends to cause no or very few symptoms. The main symptom of thyroid cancer is a lump or swelling at the front of the neckjust below your Adams apple, which is usually painless. Women also have Adams apples, but theyremuch smaller and less prominentthan a mans. The lymph nodes in your neck can also be affected and become swollen. Lymph nodes are small glands that are part of the lymphatic system, which helps fight infection. Other symptoms of thyroid cancer only tend to occur after the condition has reached an advanced stage, and may include: unexplained hoarseness that doesnt get better after a few weeks a sore throat or difficulty swallowing that doesnt get better pain in your neck When to seek medical advice You should always speak to your GP if you develop a swelling or lumpat the front of your neck. Although its unlikely to be thyroid cancer, its important thatit isinvestigated. About 1 in 20 swellings or lumps in the neck are caused by thyroid cancer. Most cases are caused by non-cancerous swellings calledgoitres. Goitres Agoitre is an enlarged thyroid gland. Non-cancerous goitresare usually caused by other less serious problems with your thyroid gland, such as: too much triiodothyronine (T3) and thyroxine (T4) hormones this is known as having an overactive thyroid gland , or hyperthyroidism not enough T3 and T4 hormones this is known as having an underactive thyroid gland , or hypothyroidism Thyroid cancer support The Butterfly Thyroid Cancer Trust provides information, advice and support for people with thyroid cancer. As well as the website, they also have a helpline number that can be contacted on01207 545469, Monday to Friday, 10am to 4pm. Causes of thyroid cancer In most cases, the exact cause of thyroid cancer is unknown. However, there are certain things that can increase your chances of developing the condition, including having another thyroid condition and being exposed toradiation. What is cancer? Cancer begins with a change (mutation) in the structure of the DNA in cells, which can affect how they grow. This means cells grow andreproduce uncontrollably, producing a lump of tissue called a tumour. Left untreated, cancer can spread to other parts of the body, usually through the lymphatic system. The lymphatic system is made up of a network of vessels and glands (lymph nodes) located throughout the body. Lymph nodesproduce many of the cells needed by your immune system (the bodys natural defence system against infection and illness). Once the cancer reaches your lymphatic system, its capable of spreading to other parts of your body, including your blood, bones and organs. The most common types of thyroid cancer are papillary carcinomas and follicular carcinomas, which are known as differentiated thyroid cancers (DTCs). They spread much more slowly than other types of cancer. When DTCs are diagnosed, theyre usually limited to the thyroid gland itself or nearby lymph nodes. The rarer types of thyroid cancer are more aggressive and spread faster. By the time medullary thyroid carcinoma is diagnosed, it may have spread to the lymph nodes. In advanced cases, it may have also spread to the bones and lungs. Anaplastic thyroid cancer often spreads to the windpipe and, in some cases, the lungs. Risk factors for thyroid cancer The main risk factors for developing thyroid cancer are: having a thyroid condition having a family history of thyroid cancer (in the case of medullary thyroid cancer) having a bowel condition known as familial adenomatous polyposis (FAP) acromegaly (a rare condition where the body produces too much growth hormone) having previous benign (non-cancerous) breast conditions weight and height radiation exposure Thyroid conditions Your risk of developingthyroid cancer isslightly increased if you have certain non-cancerous (benign) thyroid conditions, such as an inflamed thyroid gland(thyroiditis) or anenlarged thyroid gland (goitre). Having an overactive thyroid gland (hyperthyroidism) or an underactive thyroid gland (hypothyroidism) doesnt increase your chances of developing thyroid cancer. Around 1in 5cases ofthyroid cancer occur in people whove had a previous benign thyroid condition. Family history Inherited genetic mutations are responsible for a small number of medullary thyroid carcinomas. If the instructions carried in genes are altered, some of the bodys processes wont work normally. This inherited mutation occurs in: familial medullary thyroid cancer multiple endocrine neoplasia (MEN) syndrome, types 2A and 2B In cases of MEN2A or MEN2B thyroid cancer, the mutations usually develop during childhood or the teenage years. In familial medullary thyroid cancer, the mutations usually develop in adulthood. If one of your parents has a history of medullary thyroid carcinoma or MEN syndrome, you should consider having a blood test to find out whether you have the mutated genes. If your test results are positive, its recommended you have surgery to remove your thyroid gland as a precaution. Familial adenomatous polyposis If you have a bowel condition calledfamilial adenomatous polyposis (FAP), your risk of developing thyroid cancer is increased. FAP runs in families and is caused by inheriting a faulty gene. Macmillan Cancer Support have more information about familial adenomatous polyposis . Acromegaly Thyroid cancer risk is increased in people who have acromegaly.Thisis a rare condition where the body produces too much growth hormone. Previous breast conditions If youve hada benign (non-cancerous) breast condition in the past, such as abreast cyst or fibroadenoma (non-cancerous tumour), yourrisk of developing thyroid cancerincreases by around half (50%) comparedwith women who havent had this type of condition. Weight and height If youre overweight, youre more at risk of developing thyroid cancer than someone who isnt overweight. Research hasalso shown thattaller adultshavean increased risk. However, the reasons for this are unclear. Radiation exposure Exposure to radiation during childhood is another risk factor for thyroid cancer. Radiation from nuclear fallout and radiation used for medical treatments have bothbeen associated with thyroid cancer. Many recently reported cases of thyroid cancer are thought to have been caused by radiation exposure during medical procedures carried out between 1910 and 1960. During this time, not much was known about the risks of radiation treatment. Today there are much stricter regulations regarding the use of radiation for medical procedures. Other risk factors Diet If your diet contains low levels of the trace element iodine, youre at anincreased risk of developing thyroid cancer. Peopleexposed to radiation, or those witha history of benign thyroid conditions,are more likely to have low levels of iodine. Eating a lot of butter, cheese and meat may also increase your risk of developing thyroid cancer. To help reduce your risk, you should include plenty of fresh fruit and vegetables in your diet. People with a high body mass index (BMI) also have an increased risk of developing thyroid cancer. Gender Women are about 2to 3times more likely to develop thyroid cancer than men. Its thought this may bebecause of thehormones released during a womans monthly period or during pregnancy. However, theres little scientific evidence to support this theory. Diagnosing thyroid cancer For many people, the first stage of diagnosing thyroid cancer is a consultation with a GP. Your GP will examine your neck and ask about any associated symptoms you may be experiencing, such as unexplained hoarseness. Thyroid function test A blood test known as a thyroid function test is used to check whether the swelling in your neck is caused by other problems with your thyroid gland. It will rule out conditions such as an overactive thyroid gland (hyperthyroidism) or an underactive thyroid gland (hypothyroidism), which are the most common thyroid problems. A thyroid function test measures the amount of certain types of hormones in your blood. Further tests will be needed if the thyroid function test reveals your thyroid gland is working normally. Fine-needle aspiration cytology Fine-needle aspiration cytology (FNAC)is the next stage in diagnosing thyroid cancer. Its an outpatient procedure, which means you wont have to spend the night in hospital. Asmall needleis inserted into the lump in your neck to allow a tiny sample of cells to be removed. The sampleis thenstudied under a microscope. This testcan usually reveal whether cancerous cells are present in your thyroid gland and, if they are, what type of thyroid cancer you have. Further testing Further testing may be recommended if the FNAC results are inconclusive or if further information is needed to make your treatment more effective. These tests may include: repeat FNAC combined with an ultrasound scan other types of scan, such as a computerised tomography (CT) scan or magnetic resonance imaging (MRI) scan In most cases, surgery will be recommended to remove the part of the thyroid gland that contains the lump or swellingwhen it hasnt been possible to rule out thyroid cancer. Treating thyroid cancer If youre diagnosed with thyroid cancer, youll be assigned a care team, who will devise a treatment plan for you. Your recommendedtreatment plan will depend on the type and grade of your cancer, and whether your care team thinks that a complete cure is realistically achievable. Cancer treatment team All NHS hospitals have multidisciplinary teams (MDTs)that treat thyroid cancer. An MDT is made up of a number of different specialists, and may include: a surgeon an endocrinologist (a specialist in treating hormonal conditions) an oncologist (a cancer treatment specialist) a pathologist (a specialist in diseased tissue) a radiotherapist or clinical oncologist (a specialist in non-surgical methods of treating cancer, such aschemotherapy and radiotherapy) a specialist cancer nurse, who will usually be yourfirst point of contact with the rest of the team Deciding on the best course of treatment can be difficult. Your cancer team will make recommendations after reviewing your case, but the final decision will be yours. Before you go to hospital to discuss your treatment options, you may want to write a list ofquestions to askthe specialist. For example, you may want to find out what the advantages and disadvantages of particular treatments are. Your treatment plan Your recommended treatment will depend on a number of things, including: the type of thyroid cancer you have the grade of your cancer whether your care team thinksa complete cure is realistically achievable Most differentiated thyroid cancers papillary carcinomas and follicular carcinomas and some medullary thyroid carcinomas have a good prospect of achieving a cure. Differentiated thyroid cancersare treated using a combination of: surgery to remove your thyroid gland (thyroidectomy) a type of radiotherapy calledradioactive iodine treatment, which isdesigned to destroy any remaining cancer cells and prevent the thyroid cancer returning Medullary thyroid carcinomas tend to spread faster than differentiated thyroid cancers, so it may be necessary to removeyour thyroid gland and any nearby lymph nodes. Radiotherapy iodine treatment is not effectiveat treating this type of thyroid cancer. Stage 4 medullary thyroid carcinomas arent usually curable, but it should be possible to slow their progression and control any associated symptoms. In most cases of anaplastic thyroid carcinoma, a cure isnt usually achievable. This is because its usually spread to other parts of thebody by the time its been diagnosed. Radiotherapyandchemotherapy can be used to slow the progression of anaplastic thyroid carcinoma and help control any symptoms. Some cases of differentiated thyroid cancer, medullary thyroid carcinoma and anaplastic thyroid carcinoma may benefit from a new type of treatment known as targeted therapies. This is where medication is used to directly target the cancerous cells. However, thesetypes of treatments are currently undergoingclinical trials and arent offered routinely on the NHS. Thyroidectomy In almost all cases of thyroid cancer its necessary to either remove some of your thyroid gland in a procedure called a hemithyroidectomy, or all of your thyroid gland(total thyroidectomy). This decisionwill be influenced by: the type of thyroid cancer you have the size of the tumour whether or not the cancer has spread beyond your thyroid gland Your surgeon should discuss with you the type of surgery required and why soyou can make an informed decision. A thyroidectomyis carried out under a general anaesthetic and usually takes around 2hours. The operation will leave a small scar on your neck, whichshouldnt be very noticeable. In a small number of cases, it may cause permanent hoarseness. Most people are well enough to leave hospital 3to 5days after having thyroid surgery. However, youll need to rest at home for 2to 3weeks and avoid any activities that could put a strain on your neck, such as heavy lifting. A member of your care team will be able to advise you about when youll be fit enough to resume normal activities and return to work. Replacement hormone therapy If some or all of your thyroid gland is removed, it will no longer be able to produce the hormones that regulate your metabolic system. This means youll experience symptoms of an underactive thyroid (hypothyroidism), such as fatigue (extreme tiredness), weight gain and dry skin. To compensate, youll need to take replacement hormone tablets for the rest of your life. If your surgery is to be followed by radioactive iodine treatment, its likely youll be given a hormone tablet called triiodothyronine. After radioactive iodine treatment is completed, youll be prescribed an alternative hormone tablet called thyroxine, which most people only need to take once a day. Youll need to have regular blood tests to check youre receiving the right amount of hormones and to determine whether your dose needs to be adjusted. It may take some time to achieve the optimum dose. Until this time, you may experience symptoms of tiredness or weight gain if your hormone levels are too low. Alternatively, if your hormone levels are too high, you may experience symptoms such as weight loss, hyperactivity or diarrhoea. You shouldnt experience any more side effects once theright dose has been achieved. Calcium levels Occasionally, the parathyroid glands can be affected during surgery. The parathyroid glands are located close to the thyroid gland and help regulate the levels of calcium in your blood. If your parathyroid glands are affected, your calcium levels may decrease, which can cause a tingling sensation in your hands, fingers, lips and around your nose. These symptoms should be reported to your MDT or GP as you may need to take calcium supplements. Most people only need to take a short course of calcium tabletsas the parathyroid glands will soon start to function normally again. Radioactive iodine treatment After having thyroid surgery, a course of radioactive iodine treatment may be recommended. This willhelp destroy any remaining cancer cells in your body and prevent the cancer returning. If youre taking thyroid hormone replacement tablets, youll need to stop taking them for 2 to 4 weeks before having radioactive iodine treatment. This is because they can interfere with the effectiveness of the iodine treatment. If withdrawing your hormone replacement treatment is problematic, you may be given a medicine called recombinant human thyroid stimulating hormone (rhTSH). This is given as an injection on 2 consecutive days. Your MDT will be able to advise you about whether or not rhTSH is suitable for you. The procedure Radioactive iodine treatment involves swallowing radioactive iodine in either liquid or capsule form. Theradiation in the iodine travels up into your neck through your blood supply and destroys any cancerous cells. Side effects of radioactive iodine treatment are uncommon, but a small number of people may experience tightness, pain or swelling in their neck and may feel flushed (warm). These side effects usually pass within 24 hours. After treatment, you may have a dry mouth and notice a change in your taste. These symptoms usually disappear after a few weeks or months, although they can be permanent in some people. Youll need to stay in hospital for3 to 5 days after the procedure because the iodine will make your body slightly radioactive. As a precaution, youll need to stay in a single room protected by lead sheets so that hospital staff arent exposed to radiation. You wont be able to have visitors during this time and hospital staff will keep their contact with you to a minimum. Your bodily fluids, such as urine, will alsobe slightly radioactive for3 to 5 days after your treatment, so its important that you flush the toilet every time you use it. Your sweat willbe radioactive, too, so you shouldbathe or shower every day. Youll be allowed home after the radioactive levels in your body have subsided. Dietary recommendations While having radioactive iodine treatment, youll need to eat a dietlow in iodine. An iodine-richdiet may reduce the effectiveness of your treatment. Its recommended that you: avoid all seafood limit the amount of dairy products you eat dont take cough medicines or use sea saltas they both contain iodine You should eat plenty of fresh meat, fresh fruit and vegetables ,and pasta and rice. These areall low in iodine. Pregnancy and breastfeeding You shouldnt have radioactive iodine treatment if youre pregnant or if theres a good chance that you may be. The treatment could damage your baby. Tell a member of your care team if youre unsure whether youre pregnant. Any treatment will need to be delayed until after your pregnancy. You must stop breastfeeding before you can be treated with radioactive iodine. If possible, you should stop breastfeeding6 weeks prior to treatment. You should not resume breastfeeding after treatment for your current child, but you may safely breastfeed any babies you may have in the future. Breastfeeding also isnt recommended while receiving iodine treatment. If youre breastfeeding, you should stop at least 4 weeks (but preferably 8) before starting iodine treatment. You should also notresume breastfeeding your baby. However, its safe for you to breastfeed if you have another child in the future. You shoulduse a reliable method of contraception for at least 6 months after having iodine treatment. This is because theres a small risk that any child conceived during this time could develop birth defects. This applies to both men and women. Fertility Radioactive iodine treatment doesnt affect fertility in women. However,theres a small risk that it could affect fertility in men who need to have multiple treatment sessions. Yourcare team will be able to advise you about the level of risk in your individual circumstances. If theres asignificant risk youll become infertile after having radioactive iodine treatment, you may wish to consider having your sperm or eggs harvested and frozen so they can be used for fertility treatment at a later date. External radiotherapy External radiotherapy , where radioactive waves are targeted at affected parts of the body, is usually only used to treat advanced or anaplastic thyroid carcinomas. The length of time youll need to have radiotherapy for will depend on the particular type of thyroid cancer you have and its progression. Side effects of radiotherapy include: nausea vomiting tiredness pain when swallowing dry mouth These side effects should pass 2 to 3 weeks after your course of radiotherapy has finished. Chemotherapy Chemotherapy is usually only used to treat anaplastic thyroid carcinomas that have spread to other parts of your body. Itinvolves taking powerful medicines that kill cancerous cells. Its rarely successfulin curing anaplastic cancer, but can slow its progression and help relieve symptoms. Possible side effects of chemotherapy include: nausea vomiting tiredness loss of appetite hair loss mouth ulcers If youre receiving chemotherapy, youll also be more vulnerable to infection. See your GP if you suddenly feel ill or your temperature rises above 38C (100.4F). Targeted therapies A number of targeted therapies are being tested inclinical trials to treat advanced cases of: medullary thyroid cancers differentiated thyroid cancers that dont respond to radioactive iodine anaplastic thyroid carcinomas In targeted therapies, medication specifically targets the biological functions that cancers need to grow and spread. As research is ongoing, some medications used in this type of treatment are unlicensed. In exceptional circumstances, your specialist may suggest using an unlicensed medication. Theyll do this if: they think its likely to be effective there are no better alternatives the benefits of treatment outweigh any associated risks If your specialist is considering prescribing an unlicensed medication, theyll tell you that its unlicensed and will discuss the possible risks and benefits with you. The decision about whether to fund treatment with medications used in targeted therapies is often made by individualclinical commissioning groups (CCGs). Complications of thyroid cancer Cancerous cells can return many years after surgery and radioactive iodine treatment has been completed. Itsestimated that 5% to 20% of people with a history of thyroid cancer will experience a return of cancerous cells in their neck. An estimated 10% to 15% of people willsee a return of cancerous cells in other parts of their body, such as their bones. Because ofthe risk of cancer cells returning, youll be asked to attend regular check-ups so any cancerous cells that do return can be treated quickly. Thyroglobulin testing Thyroglobulin testing is a special type of blood test thats used to monitor some types of thyroid cancer and to check for the return of cancerous cells. Thyroglobulin is a protein released by a healthy thyroid gland, but it can also be released by cancerous cells. If youve had your thyroid gland removed, there should be no thyroglobulin present in your blood, unless cancerous cells have returned. Regularly testing your blood for thyroglobulin can be an effective way of checking whether or not any cancerous cells have returned. For the first few years after having surgery youll probably need to have thyroglobulin testing every 6 months. After this period, youll need to be tested once a year. Ultrasound scan An ultrasound scanner uses high-frequency sound waves to create an image of part of the inside of the body. An ultrasound scan can detect changes inside your neck that could indicate the recurrence of cancer. Radioactive iodine scan Aftersurgery to remove part or all of your thyroid gland, you may be asked to attend a radioactive iodine scanning test. You swallow a small amount of radioactive iodine before undergoing a scan. The radioactive iodine will highlight any cancerous thyroid cells in the body. Before the scan, youll need to go on a low-iodine diet and stop taking your thyroid hormone medication. Asonly a smalldose of radioactive iodineis used, its not necessary tokeep your distance from others. However, if you think you may be pregnant or youre breastfeeding, let the doctors know before your test. A radioactive iodine scan willusually be carried out6 to 8 months after surgery. 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 Overactive thyroid Underactive thyroid Other health sites British Thyroid Foundation Butterfly Thyroid Cancer Trust Cancer Research UK: Thyroid cancer Lab Tests Online UK: thyroglobulin test 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

Thyroid cancer: Teenagers and young adults

Thyroid 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 teenagers and young adults Thyroid cancer: Teenagers and young adults Thyroid cancer: Teenagers and young adults Introduction The thyroid and types of thyroid cancer Having tests for thyroid cancer Treating thyroid cancer Introduction This section is for teens and young adults. Its about a type of cancer called thyroid cancer. If youre looking for information about thyroid cancer in people of all ages, read our thyroid cancer section. Papillary and follicular thyroid cancers are the most common types of thyroid cancer in young adults. If youd like to find out about a different type of thyroid cancer you could talk to MacmillanCancer Support . Its important to remember that thyroid cancer in young people can be successfully treated. Most young people are completely cured. Symptoms The first sign of thyroid cancer is usually a painless lump or swelling in the front of the neck that gradually gets bigger. Less common symptoms are: a hoarse voice that doesnt get better difficulty swallowing or breathing If you have any of these symptoms, its important to speak to a doctor. Remember these symptoms can happen for lots of reasons other than cancer. What are the causes of thyroid cancer? Its unknown exactly what causes thyroid cancer. But research into possible causes is going on all the time. Some things called risk factors increase your chance of developing cancer. But having these doesnt mean youll get cancer. Genes Genes are the biological information in each cell that we inherit from our parents. Genes affect the way we look (for example, our eye colour) and how our bodies grow and work. Some rare genetic conditions that run in families can increase the risk of thyroid cancer. But fewer than 1 in 10 cases of cancer are caused by an inherited faulty gene. Radiotherapy If you were exposed to radiation or had radiotherapy treatment to the neck area when you were younger, you may be at a higher risk of developing thyroid cancer many years later. If youre worried about thyroid cancer If you think you might have some of these symptoms you should go straight to your GP. Theyll be able to talk to you about your symptoms. If they think the symptoms could be because of cancer, they can do tests to find out more. The thyroid and types of thyroid cancer The thyroid is a small gland in the front of the neck just below the voice box (larynx). It is made up of 2 parts, or lobes, 1 on each side of the neck. Its part of a network of glands throughout the body that make up the endocrine system. This system is responsible for producing the bodys hormones that help to control and influence various body functions. The thyroid produces 2 hormones: thyroid hormone that controls your metabolism calcitonin that helps to control the calcium levels in your body Types of thyroid cancer There are 4 main types of thyroid cancer: papillary is the most common type of thyroid cancer its usually slow-growing follicular is the second most common type its also usually slow-growing medullary is a rare type of thyroid cancer which sometimes runs in families anaplastic is another rare type of thyroid cancer, which is more common in older people Young people are mostly affected by the papillary and follicular types. Rarely other types of cancer occur in the thyroid gland such as lymphoma, or other cancers that have spread from another part of the body. This section is for teens and young adults. Its about a type of cancer called thyroid cancer. If youre looking for information about thyroid cancer in people of all ages, read our thyroid cancer section. Having tests for thyroid cancer This information is for teenagers and young adults who may be having tests to find out if they have thyroid cancer. If you think you might have some of the symptoms of thyroid cancer , you should talk to your GP. If they think the symptoms could be because of cancer, they can do tests to find out more. Visiting your GP When you go to your GP they will usually examine you and arrange some blood tests. There may be a number of reasons why you have these symptoms. If your GP is concerned that you may have thyroid cancer they will make an appointment for you with a specialist at the hospital. At the hospital Youll probably be seen by lots of people at the hospital during and after the tests they do to find out what is happening to you. They work as a team and all have an important part in your care, even though you may only meet some of them. They may include: a doctor who specialises in thyroid problems (endocrinologist) a surgeon who specialises in thyroid surgery a pathologist who looks at blood and tissue samples to diagnose diseases a cancer specialist (oncologist) an X-ray specialist (radiologist) a clinical nurse specialist Your doctor will examine you and arrange for more detailed tests, which may include an ultrasound, a fine needle aspiration (FNA) or a biopsy. An FNA involves having a very small needle placed into your thyroid gland to remove a few cells for the pathologist to look at under the microscope. A biopsy involves removing a small piece of the thyroid to be analysed. You might have a general anaesthetic and so will be asleep when it is done. You may only need a local anaesthetic, which numbs the area. There is more information about having an anaesthetic in the surgery section. If the biopsy shows that it is thyroid cancer you will have some other tests to check the size of the tumour and whether it has spread. Macmillan Cancer Support has information on these tests. These tests may include: a chest X-ray to check your lungs a CT , MRI or PET scan a radioisotope scan You wont necessarily need all of these tests. It will depend on the results of the first ones. Having tests and waiting for the results can be an anxious time. Talking about how you feel and getting support from your family, friends, specialist nurse or doctor can help. If youre looking for information about thyroid cancer in people of all ages, read our general thyroid cancer information. Treating thyroid cancer Its important to remember that thyroid cancer in young people can be successfully treated. Most young people are completely cured. If thetestsyouve had show you have thyroid cancer, your team of specialists will discuss treatment with you. Surgery Surgery to remove the thyroid gland is the main treatment for thyroid cancer. You might hear the doctors talk about a thyroidectomy, which is the medical name for the operation. Sometimes the surgeon will only need to remove part of your thyroid. Lymph nodes In the neck, close to the thyroid,there are lymph nodes. These are part of the bodys immune system and help fight infection. Sometimes cancer cells settle in these lymph nodes, so the surgeon might remove some or all of the nodes as well. They may also remove some tissue from the area around the thyroid if they suspect that there are any cancer cells there. After the operation You will probably need to spend a few days in hospital after the operation. There will be a scar on your neck usually just above the collarbone. Sometimes you can have a low calcium level in your blood or a hoarse voice after the operation. You may need to take tablets to replace the thyroid hormone. The tissue removed will be carefully looked at under the microscope. Sometimes another operation is needed after this. The results will help your doctors decide if you need radioactive iodine treatment and other treatments. Your team will talk through the results of the operation with you. You may feel really shocked and scared by the thought of having this operation. But it does give a really good chance of a cure. Your specialist will talk things over with you in detail and make sure that you fully understand whats involved. If you want to know more about what happens when you go in for an operation, theres lots more information in the generalsurgery section. Radioactive iodine If youve been told that you need to have treatment with radioactive iodine, you may be worried about whats going to happen. Knowing what to expect can help. Your doctors and nurses will also explain things to you and give you support. How does it work? Theresa mineral called iodine in the bloodstream. Normal thyroid tissue takes iodine from the bloodstream and uses it to make thyroid hormones. Some thyroid cancers can take iodine from the bloodstream too. Radioactive iodine is often used after surgery when the whole thyroid gland has been removed. Any thyroid cancer cells left behind soak up the iodine which contains high doses of radiation. This helps to destroy them. Radioactive iodine doesnt usually affect other parts of the body because other cells dont take up iodine the way thyroid cells do. How is it given? You may have radioactive iodine as a capsule, as a drink or as an injection into a vein in your arm through a cannula. Preparing for treatment There are 2 ways to prepare your body for the radioiodine treatment, either youll: be given an injection of a drug called thyrotropin alfa (Thyrogen ) need to stop taking your thyroid hormone tablets 2 to 4 weeks before the treatment Some people wont be started on thyroid hormones until after surgery and radioactive iodine treatment. Youll probably feel very tired during this time. But, if you are not having the injections, its important that you stop taking thyroid hormones or the radioactive iodine treatment wont work. For 2 weeks before treatment, youll be asked to eat a low-iodine diet and avoid certain foods. This encourages the body to use up its stores of iodine. Then when the radioactive iodine is given, the cancer cells will soak it up because the amount of iodine in the body is so low. Youll be given information about what foods you should eat and what to avoid. You cant have this treatment if you are pregnant. If there is any chance of this tell your team and they can test you. What happens during treatment? This treatment makes you slightly radioactive for several weeks. Your body will gradually get rid of the radioactivity through your wee, sweat and saliva. You will be kept in hospital when the radioactivity is highest, which is usually between 1to 5 days. You will be looked after in a side room on the ward, either on your own or with someone else having the same treatment. During this treatment, the amount of contact you can have with your friends, family and the nurses will be limited, to protect them from exposure to the radiation. Anyone pregnant or younger than 18 usually isnt allowed to visit. This can make you feel lonely. You will be able to keep in touch with your friends and family by phone and internet. There should be plenty of books, magazines, DVDs, computer games and a TV in the room. You can take in a few of your own things in to help pass the time. Ask your team whether you can take a computer or an MP3 player into the room with you. Anything that comes back out of your room will be checked for radiation levels. Sometimes your things may have to be kept on the ward for a while if the radiation levels are high. But theyll be returned to you when theyre safe again. What happens after treatment? Once your radiation levels are safe, youll be allowed home. Youll also be able to start eating your usual foods again. Check with the staff about what you can and cant do when you get home. There are likely to be some precautions to take for up to a few weeks. You might need a scan shortly after your treatment. This shows if you need more radioiodine treatment. If you need more treatment it is usually given every 3to 6 months. Your fertility wont be affected by the treatment. But its safer not to become pregnant or get someone else pregnant during treatment, and for a year after. You should avoid all sex and open-mouthed kissing for a few days after treatment. Travelling on public transport can be restricted just after treatment, so you may not be able to go on holiday just after treatment. For a few months after treatment you might set off the alarms at the security gates. If you are planning a holiday, discuss it with your team. External beam radiotherapy You may also have external beam radiotherapy. For this treatment you come to hospital and lie on a bed in the radiotherapy department for about 10 to 20 minutes every day. You will have treatment every weekday for several weeks. It is like having an X-ray, so it doesnt hurt and you cannot feel it. Hormone therapy after treatment for thyroid cancer If youve had all your thyroid gland removed, your body cant produce thyroid hormones anymore. Without these hormones, your metabolism slows down. This can cause dry skin and hair, tiredness, poor concentration and lack of energy. What can help? These hormones can be replaced by taking tablets. Youll need to take them for the rest of your life. The usual long-term hormone treatment is thyroxine (levothyroxine) and you normally start taking it once your radioactive iodine treatment is finished. As well as replacing the hormones youre missing, thyroxine can also help stop papillary or follicular thyroid cancer coming back. So if you have only had part of your thyroid gland removed you may still need to take thyroid hormone tablets. Blood tests Youll need to have your blood checked regularly to monitor the hormone levels. It can sometimes take months to find the right dose of thyroxine for you. But once the right dose is found, there shouldnt be any side effects, because they are simply replacing normal thyroid hormones. Its important to remember to take your tablets every day. It can help to take them at the same time every day so you get into a routine. Macmillan Cancer Supporthas more general information about radiotherapy , surgery and radioactive iodine treatment . This information is written for people of all ages, not just young adults with thyroid cancer. This information is for teenagers and young adults and is about having treatment for thyroid cancer. If youre looking for information about thyroid cancer in people of all ages,read our thyroid cancer information. 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 Butterfly Thyroid Cancer Trust British Thyroid Foundation 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

Tinnitus

Tinnitus | 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 Tinnitus Tinnitus Tinnitus is the name for hearing sounds that come from inside your body rather than an outside source. Its not usually a sign of anything serious and may get better by itself. Symptoms of tinnitus Tinnitus is often called ringing in the ears but its not just ringing. You might hear: buzzing humming grinding hissing whistling music or singing noises that beat in time with your pulse You may also notice hearing loss or that youre more sensitive to everyday sounds. For some people, tinnitus may come and go. But sometimes it can impact your daily life and be very distressing. It can affect concentration and cause difficulty sleeping (insomnia) and depression . Tinnitus will sometimes get better over time, either by disappearing or by the body getting used to it. When to get medical advice Speak to your GP practice if: you continually or regularly hear sounds such as buzzing, ringing or humming in your ears your tinnitus is getting worse your tinnitus is bothering you for example, its affecting your sleep or concentration, or is making you feel anxious and depressed you have tinnitus that beats in time with your pulse Diagnosing tinnitus Your doctor can examine your ears to see if the problem might be caused by a condition they could easily treat, such as an ear infection or earwax build-up . They can also check if you have any hearing loss . If needed, your GP can refer you to a specialist for further tests and treatment. What causes tinnitus? Tinnitus can develop slowly over time or happen suddenly. Its not known exactly why it happens but its often linked to: hearing loss inner ear damage caused by repeated exposure to loud noises or some medicines an earwax build-up a middle ear infection Mnires disease a condition that also causes hearing loss and vertigo (a spinning sensation) otosclerosis an inherited condition where an abnormal bone growth in the middle ear causes hearing loss Who is affected? Most people have tinnitus for a short time after being exposed to loud noises, such as after a music concert. Around 1 in 10 people have persistent tinnitus. Around 1 in 100 having severe tinnitus that affects their daily life. Tinnitus can affect people of all ages, including children. Its more common in people aged over 65. How is tinnitus treated Theres currently no treatment for tinnitus that works for everyone. If your tinnitus is caused by an underlying condition, then treating that condition may help your tinnitus. If a cause cant be found, treatment will focus on helping you manage the condition on a daily basis. This may involve: sound therapy listening to neutral sounds to distract you from the sound of tinnitus counselling to teach you about tinnitus and help you learn to cope with it better cognitive behavioural therapy (CBT) to help change the way you think about your tinnitus so it becomes less noticeable tinnitus retraining therapy (TRT) to help you start to tune tinnitus out and become less aware of it Things you can do to help your symptoms Do try to relax deep breathing or yoga may help try to find ways to improve your sleep, such as sticking to a bedtime routine or cutting down on caffeine try to avoid things that can make tinnitus worse, such as stress or loud background noises join a support group talking to other people with tinnitus may help you cope Dont do not have total silence listening to soft music or sounds (sound therapy) may distract you from the tinnitus do not focus on it, as this can make it worse hobbies and activities may take your mind off it Source: ENT Scotland - Opens in new browser window Last updated: 05 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 Hearing loss Other health sites British Tinnitus 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

Tonsillitis

Tonsillitis | 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 Tonsillitis Tonsillitis 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 Tonsillitis is an infection that causes inflammation (redness and swelling) of the tonsils. Tonsillitis is a common condition in children, teenagers and young adults. What are the tonsils? The tonsils are 2 small glands that sit on either side of the throat. In young children, they help to fight germs and act as a barrier against infection. When the tonsils become infected, they stop it spreading further into the body. As a childs immune system gets stronger, the tonsils become less important and usually get smaller. In most people, the body is able to fight infection without the tonsils. Sore throat self-help guide Complete our self-help guide to check your symptoms and find out what to do next. Symptoms of tonsillitis The symptoms of tonsillitis include: a sore throat pain when swallowing earache high temperature (fever) over 38C (100.4F) coughing headache feeling sick feeling tired swollen, painful lymph glands in your neck white pus-filled spots on the tonsils bad breath loss of voice or changes to your voice Symptoms usually get better within 3 to 4 days. When to get medical advice Speak to your GP practice if: symptoms last longer than 4 days and dont show any signs of getting better symptoms are severe for example, if youre unable to eat or drink due to the pain, or you have difficulty breathing you keep getting throat infections If your GP practice is closed, phone 111. Diagnosing tonsillitis If needed, your GP will examine your throat and ask you some questions about your symptoms. They may take a swab of your throat to check if its caused by a viral or bacterial infection. Itll usually take a few days to get your results. If you develop severe tonsillitis as a teenager or adult, your GP may recommend a blood test for glandular fever. Treating tonsillitis Theres no specific treatment for tonsillitis. It usually gets better on its own within a week. Things you can do to help your symptoms Do take paracetamol or ibuprofen to help relieve pain drink plenty of fluids get plenty of rest Always read the leaflet that comes with your medicine before taking it. Follow the recommended dosage instructions. If youre not sure which treatments are suitable for you or your child, speak to a pharmacist for advice. Treatments from your doctor If test results show that your tonsillitis is caused by a bacterial infection, a short course of oral antibiotics may be prescribed. If oral antibiotics do not help and your symptoms are getting worse, your GP may refer you to hospital for antibiotics to be given into a vein (IV antibiotics). Surgery to remove the tonsils (tonsillectomy) A small number of children and adults have tonsillitis for longer, or it keeps returning. This is called chronic tonsillitis and surgery may be needed. Surgery to remove the tonsils (a tonsillectomy) is usually only recommended if: youve had several severe episodes of tonsillitis over a long period of time repeated episodes are disrupting normal activities What causes tonsillitis? Most cases of tonsillitis are caused by a viral infection, such as cold or flu . Some cases can also be caused by a bacterial infection, typically a strain of bacteria called group A streptococcus bacteria. Tonsillitis itself isnt contagious, but the infections that cause it are. How to prevent infections spreading Do wash your hands often, especially after touching your nose or mouth and before handling food always sneeze and cough into tissues throw used tissues away and wash your hands Complications of tonsillitis Complications of tonsillitis are rare and usually only occur if its caused by a bacterial infection. Theyre usually the result of the infection spreading to another part of the body. Possible complications of tonsillitis include: quinsy (peritonsillar abscess) an abscess (collection of pus) that develops between one of the tonsils and the wall of the throat obstructive sleep apnoea (OSA) where the walls of the throat relax during sleep, which causes breathing difficulties and poor sleep Other complications of tonsillitis are very rare. They usually only occur if an underlying bacterial infection is left untreated. Source: ENT Scotland - Opens in new browser window Last updated: 05 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 Earache Glandular fever Middle ear infection (otitis media) Other health sites GOSH: what happens when your childs tonsils are removed 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

Tooth decay

Tooth decay | 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 Tooth decay Tooth decay 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 . Tooth decay can occur when acid is produced from plaque, which builds up on your teeth. If plaque is allowed to build up, it can lead to further problems, such as dental caries(holes in the teeth), gum disease or dental abscesses , which are collections of pus at the end of the teeth or in the gums. Symptoms of tooth decay Tooth decay may not cause any pain. However, if you have dental caries you might have: toothache either continuous pain keeping you awake or occasional sharp pain without an obvious cause tooth sensitivity you may feel tenderness or pain when eating or drinking something hot, cold or sweet grey, brown or black spotsappearing on your teeth bad breath an unpleasant taste in your mouth Seeing a dentist Visit your dentist regularly, so early tooth decay can be treated as soon as possible and the prevention of decay can begin.Tooth decay is much easier and cheaperto treat in its early stages.Dentists can usually identify tooth decay andfurther problems with a simple examinationor X-ray . Find your nearest dentist Itsalso important to have regular dental check-ups . Adults should have a check-up at least once every 2 years andchildren under the age of 18 should have a check-up at least once a year. Read more on getting over a fear of the dentist Treatments for tooth decay Treatmentof tooth decay depends on how advanced it is. For early stage tooth decay your dentist will talk to you about the amount of sugar in your diet and the times you eat. They may apply a fluoride gel, varnish or pasteto the area. Fluoridehelps to protect teeth by strengthening the enamel, making teeth more resistant to the acids from plaque that can cause tooth decay. Your dentist may discussa filling or crown with you. This involves removing the dental decay, offering local anaesthetic to numb the tooth and filling the hole. If tooth decay has spread to the pulp (in the centre of the tooth, containing blood and nerves) this may be removed in a process known asroot canal treatment. If the tooth is so badly damaged that it cant be restored it may need to be removed. Your dentist maybe able toreplace the tooth with a partial denture , bridge or implant. Cost of NHS treatment NHS charges are set by the government and are standard for all NHS patients. Charges are assessed each year and usually change every April. Some people dont have to pay for dental treatment, including children, pregnant womenand new mothers.Financial help may also be available to those on a low income. The cost of private dental treatment varies between practices, as there is no set charge. If you choose to see a private dentist, make sure to agree the cost before having treatment. Preventing tooth decay Although tooth decay is acommon problem, its often entirely preventable. The best way to avoid tooth decay is to keep your teeth and gums as healthy as possible. For example, you should: visit your dentist regularly your dentist will decide how often they need to see you based on the condition of your mouth, teeth and gums cut down on sugary and starchy food and drinks, particularly between meals or within an hour of going to bed some medications can also contain sugar, so its best to look for sugar-free alternatives where possible look after your teeth and gums brushing your teeth properly with a fluoride toothpaste twice a day, using floss and an interdental brush at least once a day avoid smoking or drinking alcohol excessively tobacco can interfere with saliva production, which helps to keep your teeth clean,and alcohol can contribute to the erosion of tooth enamel see your dentist or GPif you have a persistently dry mouth this may be caused by certain medicines, treatment or medical conditions Read: how to keep your teeth clean reading food labels Protecting your childs teeth Establishing good eating habits by limiting sugary snacks and drinkscan help your child avoid tooth decay. Regular visits to the dentist at an early age should also be encouraged. Its important to teach your child how to clean their teeth properly and regularly. Your dentistcanshowyou how to do this. Younger children should use a childrens toothpaste, but make sure to read the label about how to use it. Children should still brush their teeth twice a day, especially before bedtime. How plaque causes tooth decay Your mouth is full of bacteria that form a film over the teeth called dental plaque. When you consume food and drink high in carbohydrates particularly sugary foods and drinks the bacteria in plaque turn the carbohydrates into energy they need, producing acid at the same time. If the plaque is allowed to build up, the acid can begin to break down (dissolve) the surface of your tooth, causing holes known as cavities. Once cavities have formed in the enamel, the plaque and bacteria can reach the dentine (the softer, bone-like material underneath the enamel). As the dentine is softer than the enamel, the process of tooth decay speeds up. Without treatment, bacteria will enter the pulp (the soft centre of the tooth that contains nerves and blood vessels). At this stage, your nerves will be exposed to bacteria, usually making your tooth painful. The bacteria can cause a dental abscess in the pulp and the infection could spread into the bone, causing another type of abscess . 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

Toothache

Toothache | 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 Toothache Toothache 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 then your nearest dental practice will still be able to help. Toothache refers to pain in and around the teeth and jaws thats usually caused by tooth decay. You may feel toothache in many ways. It can come and go or be constant. Eating or drinking can make the pain worse, particularly if the food or drink is hot or cold. The pain can also be mild or severe. It may feel sharp and start suddenly. It can be worse at night, particularly when youre lying down. A lost filling or broken tooth can sometimes start the pain. It can also sometimes be difficult to decide whether the pain is in your upper or lower teeth. When a lower molar tooth is affected, the pain can often feel like its coming from the ear. Toothache in other upper teeth may feel like its coming from the sinuses, the small, air-filled cavities behind your cheekbones and forehead. The area of your jaw close to the infected tooth may also be sore and tender to touch. Its also possible for periodontal disease to give rise to a dull pain. Periodontal disease is a bacterial infection that affects the soft and hard structures that support the teeth. When to see your dentist If you have toothache for more than one or two days, visit your dentist as soon as possible to have it treated. The longer you leave it, the worse it will get. If your toothache isnt treated, the pulp inside your tooth will eventually become infected. This can usually lead to a dental abscess , with severe and continuous throbbing pain. Painkillers, such as paracetamol and ibuprofen , may reduce the pain and discomfort while youre waiting for an appointment.Children under 16 years of age shouldnt be given aspirin. Find a dentist near you What causes toothache? Toothache occurs when the innermost layer of the tooth (dental pulp) becomes inflamed. The pulp is made up ofsensitive nerves and blood vessels. Dental pulp can become inflamed as a result of: tooth decay this leads to holes (cavities) forming in the hard surface of the tooth a cracked tooth the crackis often so small that it cant be seen with the naked eye loose or broken fillings receding gums where the gums shrink(contract) to expose softer, more sensitive parts of the tooth root periapical abscessa collection of pus at the end of the tooth caused by a bacterial infection There are a number of other conditions that can cause pain similar to toothache, even though the pulp isnt affected. These include: periodontal abscessa collection of pus in the gums caused by a bacterial infection ulcers on your gums sore or swollen gums around a tooth thats breaking through for example, when yourwisdom teeth start to come through sinusitis which sometimes causes pain around the upper jaw an injury to the joint that attaches the jaw to the skull (temporomandibular joint) Babies can also experience discomfort when their teeth start to develop. This is known as teething. Treating toothache The type of treatment you have for toothache will depend on the cause of the pain, so your dentist will examine your mouth and may carry out an X-ray to try to identify the problem. If your toothache is caused by tooth decay, your dentist will remove the decayed area and replace it with a filling. If your toothache is caused by a loose or broken filling, the filling will be taken out, any decay will be removed, and a new filling put in place. Ifthe pulp inside your tooth is infected, you may need root canal treatment. This procedure involves removing the infected pulp and then inserting a special type of filling to seal the tooth and prevent reinfection. Your tooth may need to be removed if the toothache cant be treated using these methods orthe tooth is wedged between another tooth and your jaw (impacted). Preventing toothache The best way toavoid getting toothache and other dental problems is to keep your teeth and gums as healthy as possible. To do this, you should: limit your intake of sugary foods and drinksyou should have theseas an occasional treat and only at mealtimes; read more about cutting down on sugar brush your teeth twice a day using a toothpaste that contains fluoride gently brush your gums and tongue as well clean between your teeth using dental floss and, if necessary, use a mouthwash stop smokingsmoking can make some dental problems worse Make sure you have regular dental check-ups ,preferably with the same dentist. The time between check-ups can vary, depending on how healthy your teeth and gums are and your risk of developing future problems. Your dentist will suggest when you should have your next check-up based on your overall oral health. Children should have a dental check-up every six months so tooth decay can be spotted and treated early. Read more about taking care of your teeth and keeping your teeth clean . 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 Gum disease Tooth decay 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

Transient ischaemic attack (TIA)

Transient ischaemic attack (TIA) | 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 Transient ischaemic attack (TIA) Transient ischaemic attack (TIA) A transient ischaemic attack (TIA), or mini stroke, happens when there is a temporary disruption in the blood supply to part of the brain. The disruption in blood supply results in a lack of oxygen to the brain. This can cause sudden symptoms like those of a stroke . However, a TIA does not last as long as a stroke. The effects only last for a few minutes or hours and fully resolve within 24 hours. Phone 999 immediately if: you suspect you or someone else is having a TIA or stroke Do not drive if you suspect you have had a stroke or TIA (transient ischaemic attack). Symptoms of a TIA Like a stroke, the signs and symptoms of a TIA usually begin suddenly. The main symptoms of stroke can be remembered with the word FAST. FAST stands for: Face the face might drop on one side, the person may not be able to smile or their mouth may have dropped, and their eyelid may droop Arms the person may not be able to lift both arms and keep them there because of arm weakness or numbness in one arm Speech they might slur their speech or it might be garbled, or the person may not be able to talk at all despite appearing to be awake Time its time tophone 999 immediately if you see any of these signs or symptoms Its important to be aware of the symptoms of a stroke or TIA, especially if you live with or care for somebody in a high-risk group, such as an elderly person or someone with diabetes or high blood pressure . Symptoms in the FAST test identify most strokes and TIAs. TIAs sometimes cause different symptoms that appear suddenly (usually over a few seconds). Other signs and symptoms may include: complete paralysis of one side of the body sudden loss or blurring of vision dizziness confusion difficulty understanding what others are saying problems with balance and co-ordination However, there may be other causes for these symptoms. During a TIA, its not possible to tell whether youre having a TIA or a full stroke, so its important to phone 999 immediately. Even if the symptoms disappear, you should still have an assessment at hospital. A TIA is a warning that youre at risk of having a full stroke. An assessment can help doctors decide the best way to reduce the chances of this happening. Causes of a TIA TIAs happen when there is a temporary disruption in the blood supply to part of the brain. In TIAs, the blockage resolves before any significant damage. A full stroke disrupts the blood flow to your brain for much longer. This leads to more severe damage to the brain and longer-term problems. The blockage responsible for most TIAs is usually caused by a blood clot that has travelled to the blood vessels supplying the brain. A type of irregular heartbeat called atrial fibrillation can also cause TIAs. It can create blood clots that escape from the heart and become stuck in the blood vessels that supply the brain. There are some things that can make you more likely to have a stroke or TIA: poor diet lack of exercise obesity smoking an excessive alcohol intake high cholesterol high blood pressure (hypertension) diabetes atrial fibrillation Lifestyle changes can help control some of these risk factors. You may also need to take regular medication. Taking anticoagulant medication if you have an irregular heartbeat due to atrial fibrillation will help reduce the risk of stroke. If youve had a stroke or TIA, these measures are particularly important because youre more likely to have another stroke in future. There are some risk factors you cant change like: age people over 65 are most at risk of having strokes, although they can happen at any age including in children family history if a close relative (parent, grandparent, brother or sister) has had a stroke, your risk is likely to be higher ethnicity if youre south Asian, African or Caribbean, your risk of stroke is higher, partly because rates of diabetes and high blood pressure are higher in these groups your medical history if youve had a stroke , transient ischaemic attack (TIA) or heart attack , your risk of stroke is higher Diagnosing TIAs You should have an assessment in hospital as soon as possible if you think youve had a TIA. Initial assessment TIAs are often over very quickly, so you may not have any symptoms by the time you see a doctor. You should tell the person assessing you about the symptoms you experienced and how long they lasted. This will help to rule out other conditions that may have caused your symptoms. Even if you no longer have symptoms, you might still need a neurological examination. This involves simple tasks designed to check your strength, sensation and co-ordination skills. Referral to a specialist If a TIA is suspected, youll see a specialist for further tests as soon as possible. Youll normally take aspirin while youre waiting for specialist assessment. This can help to reduce your risk of having a stroke or another TIA in the meantime. Its likely youll see a doctor who specialises in strokes. Tests You might have some tests to rule out other causes of your symptoms and to help identify the underlying cause of your TIA. Blood tests You might need blood tests to determine whether you have high cholesterol , and to check if you have diabetes . Electrocardiogram (ECG) An electrocardiogram (ECG) measures your hearts electrical activity using electrodes (small, sticky patches) on your skin. An ECG can detect abnormal heart rhythms, which may be a sign of conditions like atrial fibrillation (where your heart beats irregularly) . Carotid ultrasound A carotid ultrasound scan can show if theres narrowing or blockages in the neck arteries leading to your brain. A small probe (transducer) sends high-frequency sound waves into your body. When these sound waves bounce back, they create an image of the inside of your body. Brain scans Brain scans are not always necessary if youve had a TIA. You might have a magnetic resonance imaging (MRI) scan . This scan uses a strong magnetic field and radio waves to create an image of your brain. You might have a computerised tomography (CT) scan if an MRI scan is not suitable for you. This type of scan uses a series of X-rays to produce an image of the inside of brain. Treating TIAs Although the symptoms of a TIA stop on their own, youll need treatment to help reduce the risk of another TIA or a full stroke . Appropriate treatment following a TIA can help to reduce your risk of having one. Your doctor will tell you about lifestyle changes you can make to reduce your stroke risk. Your doctor will prescribe medication to treat the underlying cause of your TIA. You might need surgery as part of your treatment. Lifestyle changes There are lifestyle changes you can make that may help reduce your chances of having a stroke after a TIA like: eating a healthy diet a low-fat, low-salt, high-fibre diet is usually recommended, with plenty of fresh fruit, vegetables and whole grains exercising regularly this can help lower your cholesterol level and keep your blood pressure at a healthy level stopping smoking if you smoke cutting down on the amount of alcohol you drink Medication Most people whove had a TIA will take medication to reduce their chances of having a stroke or another TIA. After a TIA, the aim is to reduce the risk of a stroke especially in the first few days. To do this a combination of treatments is usually recommended. Some of the treatments might include: antiplatelets like aspirin and clopidogrel anticoagulants like apixaban, edoxaban, rivaroxaban, dabigatran or warfarin medication to lower your blood pressure (antihypertensives) statins to lower your cholesterol The antiplatelet medications need to be taken immediately. Others may only be started later and usually need to be taken long term. Carotid endarterectomy A carotid endarterectomy is an operation to remove part of the lining of the carotid artery and any blockage in the artery. By unblocking the carotid arteries, a carotid endarterectomy can reduce the risk of having a stroke or another TIA. Source: Scottish Government - Opens in new browser window Last updated: 16 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 Also on NHS inform Stroke Low-risk drinking guidelines Quit Your Way Scotland Keeping active Eatwell Guide: How to eat a healthy balanced diet How to lose weight safely Other health sites The Stroke Association Chest Heart & Stroke Scotland BIRT: Brain rehabilitation Headway: stroke Different Strokes 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

Trigeminal neuralgia

Trigeminal neuralgia - 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 Trigeminal neuralgia Trigeminal neuralgia About trigeminal neuralgia Symptoms of trigeminal neuralgia Causes of trigeminal neuralgia Diagnosing trigeminal neuralgia Treating trigeminal neuralgia About trigeminal neuralgia Trigeminal neuralgia is a sudden, severe facial pain, described as sharp, shooting or like an electric shock. It usually occurs in sudden short attacks lasting from a few seconds to about two minutes, which stop just as abruptly. In the vast majority of cases it affects part or all of one side of the face,with the pain most commonly felt in the lower part of the face. Very occasionally it affects both sides of the face, but not normally at the same time. People with the condition may experience attacks of pain regularly for days, weeks or months at a time. In severe cases, attacks may occur hundreds of times a day. Its possible for the pain to improve or even disappear altogether for several months or years at a time (known as a period of remission), although these periods of remission tend to get shorter with time. Some people may then go on to develop a more continuous aching, throbbing and burning sensation, sometimes accompanied by the sharp attacks. Typically, the attacks of pain are brought on by activities that involve lightly touching the face, such as washing, eating and brushing the teeth, but they can also be triggered by wind (even a slight breeze or air conditioning) or movement of the face or head. Sometimes, the pain can occur without any trigger whatsoever. Living with trigeminal neuralgia can be very difficult and it can have a significant impact on a persons quality of life, resulting in problems such as weight loss, isolation and depression. Read more about the symptoms of trigeminal neuralgia When to seek medical advice You should see your GP if you experience frequent or persistent facial pain, particularly if standard painkillers such as paracetamol and ibuprofen do not help and a dentist has ruled out any dental causes. Your GP will try to identify the problem by asking about your symptoms and ruling out conditions that could be responsible for your pain. However, diagnosing trigeminal neuralgia can be difficult, and it can take a few years for a diagnosis to be confirmed. Read more about diagnosing trigeminal neuralgia What causes trigeminal neuralgia? In the vast majority of cases, trigeminal neuralgia is caused by compression of the trigeminal nerve. This is the largest nerve inside the skull, which transmits sensations of pain and touch from your face, teeth and mouth to your brain. This compression is usually caused by a nearby blood vessel pressing on part of the nerve inside the skull. In rare cases, trigeminal neuralgia can occur as a result of damage to the trigeminal nerve, caused by an underlying condition such as multiple sclerosis (MS) or a tumour. Read more about the causes of trigeminal neuralgia Who is affected Its not clear exactly how many people are affected by trigeminal neuralgia, but the condition is thought to be rare. Some studies have suggested that around 27 in every 100,000 people are diagnosed with the condition in the UK each year, although this figure is probably too high as the condition tends to be over-diagnosed by doctors. Other estimates have suggested that there are about 6,500 new cases diagnosed each year in the UK. The condition affects women more often than men and is rare in people under the age of 40, although it can occur in younger people. Most cases are first seen in people between the ages of 50 and 60. How trigeminal neuralgia is treated Trigeminal neuralgia is usually a long-term condition, and the periods of remission often get shorter over time. However, most cases can be controlled to at least some degree with treatment. The first treatment offered will usually be with an anticonvulsant medication (usually used to treat epilepsy ) called carbamazepine. To be effective, this medication needs to be taken several times a day, with the dose gradually increased over the course of a few days or weeks so that high enough levels of the medication can build up in your bloodstream. Unless your pain starts to diminish or disappears altogether, the medication is usually continued for as long as is necessary, sometimes for many years. If you are entering a period of remission and your pain goes away, stopping the medication should always be done slowly over days or weeks, unless you are advised otherwise by a doctor. Carbamazepine was not originally designed to treat pain, but it can help relieve nerve pain by slowing down electrical impulses in the nerves and reducing their ability to transmit pain messages. If this medication is ineffective, unsuitable or causes too many side effects, you may be referred to a specialist to discuss alternative medications or surgical procedures that may help. There are a number of minor surgical procedures that can be used to treat trigeminal neuralgia usually by damaging the nerve to stop it sending pain signals but these are generally only effective for a few years. Alternatively, your specialist may recommend having surgery to open up your skull and move away any blood vessels compressing the trigeminal nerve. Research suggests this operation offers the best results in terms of long-term pain relief, but it is a major operation and carries a risk of potentially serious complications, such as hearing loss ,facial numbness or, very rarely, a stroke . Read more about treating trigeminal neuralgia Symptoms of trigeminal neuralgia The main symptom of trigeminal neuralgia is sudden attacks of severe, sharp and shooting facial pain that last from a few seconds to about two minutes. The pain is often described as an excruciating sensation, similar to an electric shock. The attacks can be so severe that you are unable to do anything during them, and the pain can sometimes bring you to your knees. Trigeminal neuralgia usually only affects one side of your face. In rare cases it can affect both sides, although not at the same time. The pain can be in the teeth, the lower jaw, upper jaw, cheek and, less commonly, in the forehead or the eye. You may feel aware of an impending attack of pain, though these usually come unexpectedly. After the main, severe pain has subsided, you may experience a slight ache or burning feeling. There may also be a constant throbbing, aching or burning sensation between attacks. You may have episodes of pain lasting regularly for days, weeks or months at a time. It is possible for the pain to then disappear completely and not recur for several months or years (a period known as remission). However, in severe cases, attacks may occur hundreds of times a day, and there may be no periods of remission. Symptom triggers Attacks of trigeminal neuralgia can be triggered by certain actions or movements, such as: talking smiling chewing brushing your teeth washing your face a light touch shaving or putting on make-up swallowing kissing a cool breeze or air conditioning head movements vibrations, such as walking or a car journey However, pain can occur spontaneously with no triggers whatsoever. Further problems Living with trigeminal neuralgia can be extremely difficult, and your quality of life can be significantly affected. You may feel like avoiding activities such as washing, shaving or eating to avoid triggering pain, and the fear of pain may mean you avoid social activities. However, its important to try to live a normal life, and be aware that becoming undernourished or dehydrated can make the pain far worse. The emotional strain of living with repeated episodes of pain can lead to psychological problems, such as depression . During periods of extreme pain, some people may even consider suicide . Even when pain-free, you may live in fear of the pain returning. When to see your GP You should see your GP if you experience frequent or persistent facial pain, particularly if standard painkillers such as paracetamol and ibuprofen do not help and a dentist has ruled out any dental causes. Your GP will try to identify the problem by asking about your symptoms and ruling out conditions that could be responsible for your pain. Trigeminal neuralgia can be a difficult condition to diagnose, so its important to try to describe your symptoms as accurately and in as much detail as possible. Read more about diagnosing trigeminal neuralgia Causes of trigeminal neuralgia Although the exact cause is not known, trigeminal neuralgia is often thought to be caused by compression of the trigeminal nerve or an underlying condition affecting this nerve. The trigeminal nerve The trigeminal nerve (also called the fifth cranial nerve) is the largest nerve inside the skull. You have two trigeminal nerves, one in each side of your face. Small branches from different parts of the face join into three major nerve branches. These are: the upper branch (ophthalmic) which carries sensory information from the skin above the eye, forehead and front of the head the middle branch (maxillary) which carries sensory information from the skin through the cheek, side of the nose, upper jaw, teeth and gums the lower branch (mandibular) which carries sensory information from the skin through the lower jaw, teeth and gums These branches enter the skull through three different routes and then join together in what is called the Gasserian ganglion, before connecting to the brainstem in the part of the skull called the posterior fossa. Trigeminal neuralgia can involve one or more branches of the trigeminal nerve. The maxillary and mandibular branches are affected most often, and the ophthalmic branch is the least commonly affected. Pressure on the trigeminal nerve Evidence suggests that in up to 95% of cases, the cause of trigeminal neuralgia is pressure on the trigeminal nerve close to where it enters the brain stem (the lowest part of the brain that merges with the spinal cord), past the Gasserian ganglion. In most cases, this pressure seems to be caused by an artery or vein compressing the trigeminal nerve, although its not known why this happens. Its also not clear exactly why this pressure can cause painful attacks, as not everyone with a compressed trigeminal nerve will experience pain. It may be that, in some people, the pressure on the nerve wears away its protective outer layer called the myelin sheath, which may cause uncontrollable pain signals to travel along the nerve. However, this does not fully explain why periods of remission (periods without symptoms) can occur and why pain relief is immediate after a successful operation to move the blood vessels away from the nerve. Other underlying causes Other reasons why the trigeminal nerve can become compressed or damaged include: a tumour (a growth or lump) a cyst (fluid-filled sac) arteriovenous malformation (an abnormal tangle of arteries and veins) multiple sclerosis (MS) a long-term condition that affects the central nervous system (the brain and spinal cord) Diagnosing trigeminal neuralgia As the pain caused by trigeminal neuralgia is often felt in the jaw, teeth or gums, it is common for people to visit their dentist initially, rather than their GP. If you visit your dentist, they will ask you questions about your symptoms and investigate your facial pain using a dental X-ray and other means to look for other more common causes, such as a dental infection or cracked tooth. If the dentist cannot find a cause, it is important not to undergo unnecessary treatment such as a root canal filling or an extraction, even though you may be convinced that it is a tooth problem. If your dentist cant find anything wrong, do not try to persuade them to remove a particular tooth, as this will not solve the problem. Often, the diagnosis of trigeminal neuralgia is made by a dentist, but if you have already seen your dentist and they have not been able to find an obvious cause of your pain, visit your GP. Seeing your GP There is no specific test for trigeminal neuralgia, so a diagnosis is largely based on your symptoms and your description of the pain. If you have experienced facial pain, your GP will ask you questions about your symptoms, such as how often they occur, how long the pain attacks last and which areas of your face are affected. The more details about your pain you can provide, the better. Your GP will consider other possible causes of your pain and may also examine your head and jaw to identify which parts are painful. Ruling out other conditions An important part of the process of diagnosing trigeminal neuralgia involves ruling out other conditions that can also cause facial pain. By asking about your symptoms and carrying out an examination, your GP may be able to rule out other conditions, such as: migraine joint pain in the lower jaw giant cell arteritis (temporal arteritis) a condition in which medium and large arteries in the head and neck become inflamed and cause pain in the jaw and temples a possible injury to one of the facial nerves Your medical, personal and family history will also need to be taken into consideration when determining possible causes of your pain. For example, trigeminal neuralgia is less likely if you are under 40 years old, and multiple sclerosis (MS) may be more likely if you have a family history of the condition or if you have some other form of this condition. However, trigeminal neuralgia is very unlikely to be the first symptom of MS. MRI scans If your GP is not sure about your diagnosis, or if you have unusual symptoms, they may refer you for a magnetic resonance imaging (MRI) scan of your head. An MRI scan uses strong magnetic fields and radio waves to create detailed images of the inside of your head. It can help identify potential causes of your facial pain, such as sinusitis (inflammation of the lining of the sinuses), tumours on one of the facial nerves, or nerve damage caused by MS. An MRI can also sometimes detect whether a blood vessel in your head is compressing one of the trigeminal nerves, which is one of the main causes of trigeminal neuralgia . However, highly sophisticated MRI scans may be needed to show this accurately, although this may not necessarily be helpful, because not everyone with a compressed trigeminal nerve has trigeminal neuralgia. Treating trigeminal neuralgia There are a number of treatments available that can offer some relief from the pain caused by trigeminal neuralgia. Identifying triggers and avoiding them can also help. Most people with trigeminal neuralgia will be prescribed medication to help control their pain, although surgery may be considered for the longer term in those cases where medication is ineffective or causes too many side effects. Avoid triggers The painful attacks associated with trigeminal neuralgia can sometimes be triggered or made worse by a number of different things. Therefore, in addition to your medical treatment, it may help to try to avoid these triggers, if possible. For example, if your pain is triggered by wind or even a draught in a room, it may help to avoid sitting near open windows or the source of air conditioning, and wearing a scarf wrapped around your face in windy weather. A transparent dome-shaped umbrella can also protect your face from the weather. Hot, spicy or cold food or drink may also trigger your pain, so avoiding these can help. Using a straw to drink warm or cold drinks may also help prevent the liquid coming into contact with the painful areas of your mouth. It is important to eat nourishing meals, however, so if you are having difficulty chewing, consider eating mushy foods or liquidising your meals. Certain foods seem to trigger attacks in some people, so you may want to consider avoiding things such as caffeine, citrus fruits and bananas. Medication As normal painkillers such as paracetamol are not effective in treating trigeminal neuralgia, you will normally be prescribed an alternative medication, such as an anticonvulsant medication (usually used to treat epilepsy ) to help control your pain. These medications were not originally designed to treat pain, but they can help relieve nerve pain by slowing down electrical impulses in the nerves and reducing their ability to transmit pain. They need to be taken regularly, not just when the pain attacks occur, but can be stopped when the episodes of pain cease and you are in remission. Unless otherwise instructed by your GP or specialist, it is important to build up the dosage slowly and reduce it again gradually over a few weeks. Taking too much too soon and stopping the medication too quickly can cause serious problems. Initially, your GP will probably prescribe a type of anticonvulsant called carbamazepine, although a number of alternatives are available if this is ineffective or unsuitable. Carbamazepine The anticonvulsantcarbamazepine is currently the only medication licensed for the treatment of trigeminal neuralgia in the UK. It can be very effective initially, but may become less effective over time. You will usually need to take this medicine at a low dose once or twice a day, with the dose slowly increasing up to four times a day until it provides satisfactory pain relief. Carbamazepine often causes side effects, which may make it difficult for some people to take. These include: tiredness and sleepiness dizziness (lightheadedness) difficulty concentrating and memory problems confusion feeling unsteady on your feet feeling sick and vomiting double vision a reduced number of infection-fighting white blood cells (leukopenia) allergic skin reactions, such asurticaria (hives) You should speak to your GP if you experience any persistent or troublesome side effects while you are taking carbamazepine, especially allergic skin reactions, as these could be dangerous. Carbamazepine has also been linked to a number of less common but more serious side effects, including thoughts of self-harm or suicide . You should immediately report any suicidal feelings to your GP. If this is not possible, call the NHS 24 111 service. Other medications Carbamazepine may stop working over time. If this occurs, or if you experience significant side effects while taking it, you should be referred to a specialist to consider alternative medications or procedures. There are a number of specialists you may be referred to for further treatment, including neurologists specialising in headaches, neurosurgeons and pain medicine specialists (for example, at a pain clinic). In addition to carbamazepine, there are a number of other medications that have been used to treat trigeminal neuralgia, including: oxcarbazepine lamotrigine gabapentin pregabalin baclofen None of these medications are specifically licensed for the treatment of trigeminal neuralgia, which means they have not undergone rigorousclinical trials to determine whether they are effective and safe to treat the condition. However, this is largely only because trigeminal neuralgia is a rare condition, and clinical trials are difficult to carry out on such a painful condition because giving some people an inactive, dummy medication (placebo) to compare these medications to would be unethical and impractical. However, many specialists will prescribe an unlicensed medication if they think it is likely to be effective and the benefits of treatment outweigh any associated risks. If your specialist is considering prescribing an unlicensed medication to treat trigeminal neuralgia, they should inform you that it is unlicensed and discuss possible risks and benefits with you. With most of these medications, the side effects can be quite difficult to cope with initially. Not everyone experiences side effects, but if you do, try to persevere because they do tend to diminish with time or at least until the next dosage increase, when you may find a further period of adjustment is necessary. Talk to your GP if you are finding the side effects unbearable. Surgery and procedures If medication does not adequately control your symptoms or is causing persistently troublesome side effects, you may be referred to a specialist to discuss the different surgical and non-surgical options available to relieve your pain. There a number of procedures that have been used to treat trigeminal neuralgia, so you will need to discuss the potential benefits and risks of each treatment with your specialist before making a decision. It is wise to be as informed as possible and to make the choice that it right for you as an individual. There is no guarantee that one or any of these procedures will work for you but, once you have had a successful procedure, you wont need to take your pain medications unless the pain returns. If one procedure does not work, you can always try another or remain on your medication temporarily or permanently. Some of the procedures that can be used to treat people with trigeminal neuralgia are outlined below. Percutaneous procedures There are a number of procedures that can offer some relief from trigeminal neuralgia pain, at least temporarily, by inserting a needle or thin tube through the cheek and into the trigeminal nerve inside the skull. These are known can percutaneous (through the skin) procedures, and they are carried out using X-rays to guide the needle or tube into the correct place while you are heavily sedated with medication or under a general anaesthetic (where you are asleep). Percutaneous procedures that can be carried out to treat people with trigeminal neuralgia include: glycerol injections where a medication called glycerol in injected around the Gasserian ganglion (where the three main branches of the trigeminal nerve join together) radiofrequency lesioning where a needle is used to apply heat directly to the the Gasserian ganglion balloon compression where a tiny balloon is passed along a thin tube inserted through the cheek and is inflated around the Gasserian ganglion to squeeze it; the balloon is then removed These procedures work by deliberately injuring or damaging the trigeminal nerve, which is thought to disrupt the pain signals travelling along it. You are usually able to go home the same day, following your treatment. Overall, all of these procedures are similarly effective in relieving trigeminal neuralgia pain, although there can be complications with each, and these vary with the procedure and the individual. The pain relief will usually only last a few years, and sometimes only a few months. Sometimes these procedures do not work at all. The major side effect of these procedures is numbness of part or all the side of the face, and this can vary in severity from being very numb or just pins and needles. The sensation, which can be permanent, is often similar to that following an injection at the dentist. Very rarely, you can get a combination of numbness and continuous pain called anesthesia dolorosa, which is virtually untreatable. The procedures also carry a risk of other short- and long-term side effects and complications, including bleeding, facial bruising, eye problems and problems moving the facial muscles. Stereotactic radiosurgery An alternative way to relieve pain by damaging the trigeminal nerve that doesnt involve inserting anything through the skin is stereotactic radiosurgery. This is a fairly new treatment that uses a concentrated beam of radiation to deliberately damage the trigeminal nerve where it enters the brainstem. Stereotactic radiosurgery does not require ageneral anaesthetic and no cuts (incisions) are made in your cheek. A metal frame is attached to your head with four pins inserted around your scalp (a local anaesthetic is used to numb the areas where these are inserted) and your head, complete with the frame attached, is held in a large machine for an hour or two (which may make you feel claustrophobic) while the radiation is given. The frame and pins are then removed, and you are able to go home after a short rest. It can take a few weeks or sometimes many months for this procedure to take effect, but it can offer pain relief for some people for several months or years. Studies into this treatment have shown similar results to the other procedures mentioned above. The most common complications associated with stereotactic radiosurgery include facial numbness andpins and needles (paraesthesia) in the face. This can be permanent and, in some cases, very troublesome. Microvascular decompression Microvascular decompression (MVD) is an operation that can help relieve trigeminal neuralgia pain without intentionally damaging the trigeminal nerve. Instead, the procedure involves relieving the pressure placed on the nerve by blood vessels that are touching the nerve or wrapped around it. This is a major procedure that involves opening up the skull, and is carried out under general anaesthetic by a neurosurgeon. During MVD, the surgeon will make an incision in your scalp, behind your ear, and remove a small circular piece of skull bone. They will then either remove or relocate the blood vessel(s), separating them from the trigeminal nerve using an artificial pad or a sling constructed from adjoining tissue. For many people, this type of surgery is effective in easing or completely stopping the pain of trigeminal neuralgia. It provides the longest lasting relief, with some studies suggesting that pain only recurs in about 30% of cases within 10-20 years of surgery. Currently, this is the closest possible cure for trigeminal neuralgia. However, its an invasive procedure and carries a risk of potentially serious complications, such as facial numbness, hearing loss, stroke and even death (in around 1 in every 200 cases). More information and support Living with a long-term and painful condition such as trigeminal neuralgia can be very difficult. You may find it useful to contact local or national support groups, such as the Trigeminal Neuralgia Association UK , for more information and advice about living with the condition, and to get in touch with other people who have the condition to talk to them about their experiences. Research has shown that groups that have support from health care professionals provide high-quality help, which can significantly improve your ability to manage this rare condition. Learning from others how to cope can help remove the fear of more pain and reduce the risk of depression. However, you need to be wary of potentially unreliable information you may find elsewhere, especially if offering cures for the condition. There is a great deal of misinformation on the internet, so do your research only on reliable websites, not on open forums or on social media. There are a number of research projects running both in the UK and abroad to determine the cause of this condition and to find new treatments, including new medications, so there is always hope on the horizon. Source: NHS 24 - Opens in new browser window Last updated: 16 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 Other health sites Trigeminal Neuralgia Assocation UK Brain and Spine Foundation: Trigeminal neuralgia NICE: Trigeminal neuralgia Community content from Health Unlocked - This will open in a new window. 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

Tuberculosis (TB)

Tuberculosis (TB) | 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 Tuberculosis (TB) Tuberculosis (TB) Audio | British Sign Language (BSL) About tuberculosis Symptoms of tuberculosis Causes of tuberculosis Diagnosing tuberculosis Treating tuberculosis About tuberculosis Tuberculosis (TB) is a bacterial infection spread through inhaling tiny droplets from the coughs or sneezes of an infected person. It is a seriouscondition, but can be cured with proper treatment. TB mainly affects the lungs. However, it can affect any part of the body, including the glands, bones and nervous system. Symptoms of TB Typical symptoms of TB include: a persistent cough that lasts more than three weeks and usually brings up phlegm, which may be bloody weight loss night sweats high temperature (fever) tiredness and fatigue loss of appetite new swellings that havent gone away after a few weeks You should see a GP if you have a cough that lastsmore than three weeks or if you cough up blood. Read more about the symptoms of TB and diagnosing TB What causes TB? TB is caused by a bacterium called Mycobacterium tuberculosis. TB that affects the lungs is the most contagious type, but itusually only spreads afterprolonged exposure to someone with the illness. For example,it often spreads within a family who live in the same house. In most healthy people, the immune system (the bodys natural defence against infection and illness) kills the bacteria, and you have no symptoms. Sometimesthe immune system cannot kill the bacteria, but manages to prevent it spreading in the body. This means you will not have any symptoms, but the bacteria will remain in your body. This is known as latent TB. Ifthe immune system fails to kill or contain the infection, it can spread within the lungs or other parts of the body and symptoms will develop within a few weeks or months. This is known as active TB. Latent TB could develop into an active TB infection at a later date, particularly if your immune system becomes weakened. Read more about the causes of TB Who is affected? Before antibiotics were introduced, TB was a major health problem in the UK. Nowadays, the condition is much less common. However, in the last 20 years, TB cases have gradually increased, particularly among ethnic minority communities who are originally from countries where TB is more common. Its estimated that around one-third of the worlds population is infected with latent TB. Of these, up to 10% will become active at some point. How TB is treated With treatment, TB can usually be cured. Most people will need a course of antibiotics, usually for 6 months. Several different antibiotics are used. This is because some forms of TB are resistant to certain antibiotics. If you are infected with a drug-resistant form of TB, treatment with 6 or more different medications may be needed. If you are in close contact with someone who has TB, tests may be carried out to see if you are also infected. These can include a chest X-ray , blood tests , and a skin test called the Mantoux test. Read more about treating TB Tuberculosis vaccination The BCGvaccine canprovide effective protection against TB in up to8 out of 10peoplewho are given it. Currently, BCG vaccinations are only recommended for groups of people who are at a higher risk of developing TB. This includes children living in areas with high rates of TB, or those who have close family members from countries with high TB rates, andpeople under the age of 16who are going to live and work with local people in an area with high rates of TBfor more than three months. Its also recommended that some people, such as healthcare workers, are vaccinatedbecause ofthe increased risk of contracting TB while working. Symptoms of tuberculosis The symptoms of tuberculosis (TB) depend on where the infection occurs. TB usually develops slowly. Your symptoms might not begin until months or even years after you were initially infected. In some cases the infection doesnt cause any symptoms, which is known as latent TB. Its called active TB if you have symptoms.You should contact your GP if you or your child have symptoms of TB. Read about the causes of tuberculosis for more information about latent and active TB. Main symptoms General symptoms of TB include: lack of appetite and weight loss a high temperature (fever) night sweats extreme tiredness or fatigue These symptoms can have many different causes, however, and are not always a sign of TB. Additional symptoms TB can also cause additional symptoms depending on which part of the body is infected. Pulmonary TB Most infections affect the lungs, which can cause: a persistent cough that lasts more than 3 weeks and usually brings up phlegm, which may be bloody breathlessness that gradually gets worse This is known as pulmonary TB. Extrapulmonary TB Less commonly, TB infections develop in areas outside the lungs, such as the lymph nodes (small glands that form part of the immune system), the bones and joints, the digestive system, the bladder and reproductive system, and thenervous system (brain and nerves). This is known as extrapulmonary TB. Symptoms of extrapulmonary TB vary, but can include: persistently swollen glands abdominal (tummy) pain pain and loss of movement in an affected bone or joint confusion a persistent headache seizures (fits) Extrapulmonary TB is more common in people with a weakened immune system, such as those with HIV . Causes of tuberculosis Tuberculosis (TB) is caused by a type of bacterium called Mycobacterium tuberculosis. The condition is spread when a person with an active TB infection in their lungs coughs or sneezes and someone else inhales the expelled droplets, whichcontain TB bacteria. Although it is spread in a similar way to a cold or the flu , TB is not as contagious. You would usually have to spend prolonged periods in close contact with an infected person to catch the infection yourself. For example, TB infections usually spread between family members who live in the same house. It would be highly unlikely to become infected by sitting next to an infected person on a bus or train. Not everyone with TB is infectious. Generally, children with TB or people with TB that occurs outside the lungs (extrapulmonary TB) do not spread the infection. Latent or active TB In most healthy people the immune system is able to destroy the bacteria that cause TB. However, in some cases the bacteria infect the body but dont cause any symptoms (latent TB), or the infection begins to cause symptoms within weeks or months (active TB). Up to 10% of people with latent TB eventually develop active TB years after the initial infection. This usually happens when the immune system is weakenedfor example, during chemotherapy . Whos most at risk? Anyone can catch TB, but people particularly at risk include those: who live in, come from, or have spent time in a country or area with high levels of TB around 3 in every 4 TB cases in the UK affect people born outside the UK in prolonged close contact with someone who is infected living in crowded conditions with a condition that weakens their immune system, such as HIV having treatments that weaken the immune system, such as corticosteroids , chemotherapy or tumour necrosis factor (TNF) inhibitors (used to treat some types of arthritis and certain gut conditions) who are very young or very old the immune systems of people who are young or elderly tend to be weaker than those of healthy adults in poor health or with a poor diet because of lifestyle and other problems, such as drug misuse, alcohol misuse , or homelessness Diagnosing tuberculosis Several tests are used to diagnose tuberculosis (TB), depending on the type of TB suspected. Your GP may refer you to a TB specialist for testing and treatment if they think you have TB. Pulmonary TB A diagnosis of pulmonary TB (TB that affects the lungs) can be difficult and several tests are usually needed. This will include a chest X-ray to look for changes in the appearance of your lungs that are suggestive of TB. Samples of phlegm will also often be taken and checked for the presence of TB bacteria. These tests are important in helping todecide onthe most effective treatment for you. Extrapulmonary TB If you have suspected extrapulmonary TB (TB that occurs outside the lungs), several tests can be used to confirm a diagnosis. These may include: a computerised tomography (CT) scan , magnetic resonance imaging (MRI) scan , or ultrasound scan of the affected part of the body examining the inside of your body with along, thin, flexible tube that contains a light and camera, which is inserted either through an opening such as your mouth (endoscopy) or a small cut made in your skin (laparoscopy) urine and blood tests a biopsy a small sample of tissue or fluid is taken from the affected area and tested for TB bacteria You may also have a lumbar puncture. This involves taking a small sample of cerebrospinal fluid (CSF) from the base of your spine. CSF isfluid that surrounds the brain. It can be checked to see whether TB has infected your central nervous system (brain and spinal cord). Screening for latent TB In some circumstances, you may need to be tested to check for latent TB (when you have been infected with TB bacteria, but do not have any symptoms). For example, you may need to be screened if you have been in close contact with someone known to have an active TB infection (an infection that causes symptoms), or if you have recently spent time in a country where TB levels are high. If you have just moved to the UK from a country where TB is common, you may be screened when you arrive or your GP may suggest screening when you register as a patient. Mantoux test The Mantoux test is a widely used test for latent TB. It involves injecting a substance called PPD tuberculin into the skin of your forearm. Its also called the tuberculin skin test (TST). If you have a latent TB infection, your skin will be sensitive to PPD tuberculin and a hard red bump will develop at the site of the injection, usually within 48 to 72 hours of having the test. If you have a very strong skin reaction, you may need a chest X-ray to confirm whether you have an active TB infection. If you do not have a latent infection, your skin will not react to the Mantoux test. However, as TB can take a long time to develop, you may need to be screened again at a later stage. If you have had the BCG vaccination, you may have a mild skin reaction to the Mantoux test. This does not necessarily mean you have latent TB. Interferon gamma release assay (IGRA) The IGRA is a newer type of blood test for TB that is becoming more widely available. The IGRA may be used to help diagnose latent TB: if you have a positive Mantoux test if you previously had the BCG vaccination (as the Mantoux test may not be reliable in these cases) as part of your TB screening if you have just moved to the UK from a country where TB is common as part of a health check when you register with a GP if you are about to have treatment that will suppress your immune system if you are a healthcare worker Treating tuberculosis Treatment for tuberculosis (TB) will usually involve a long course of antibiotics lasting several months. While TB is a serious condition that can be fatal if left untreated, deaths are rare if treatment is completed. For most people, a hospital admission during treatment is not necessary. Pulmonary TB If youre diagnosed with active pulmonary TB (TB that affects your lungs and causes symptoms), you will be given a 6-month course of a combination of antibiotics. The usual course of treatment is: 2 antibiotics (isoniazid and rifampicin) for 6 months 2 additional antibiotics (pyrazinamide and ethambutol) for the first 2 months It may be several weeks or months before you start to feel better. The exact length of time will depend on your overall health and the severity of your TB. After taking the medicine for 2 weeks, most people are no longer infectious and feel better. However, it isimportant to continue taking your medicine exactly as prescribed and to complete the whole course of antibiotics. Taking medication for 6 months is the most effective method of ensuring the TB bacteria are killed. If you stop taking your antibiotics before you complete the course, oryou skip a dose, the TB infection may become resistant to the antibiotics. This is potentially serious, as it can be difficult to treat and will require a longer course of treatment. If you find it difficult to take your medication every day, your treatment team can work with you to find a solution. This may include having regular contact with your treatment team at home, the treatment clinic, or somewhere else that is more convenient. Iftreatment is completed correctly, you should not need any further checks by a TB specialist afterwards. However, you may be given advice about spotting signs that the illness has returned, although this is rare. Inrare cases TB can be fatal, even with treatment. Death can occur if the lungs become too damaged to work properly. Extrapulmonary TB Extrapulmonary TB (TB that occurs outside the lungs) can be treated using the same combination of antibiotics as those used to treat pulmonary TB. However, you may need to take them for 12 months. If you have TB in areas such as your brain or the sac surrounding your heart (pericardium), you may initially be prescribed a corticosteroid such as prednisolone for several weeks to take at the same time as your antibiotics. This will help to reduce any swelling in the affected areas. As with pulmonary TB, its important to take your medicines exactly as prescribed and to finish the whole course. Latent TB Latent TB is when you have been infected with the TB bacteria, but do not have any symptoms of active disease. Treatment for latent TB is usually recommended for anyone aged 65 or under. However, the antibiotics used to treat TB can cause liver damage in older adults, so treatment for people with latent TB aged 35 to 65 isnt recommended if this is a concern. Latent TB is also not always treated if its thought to be drug-resistant. If this is the case, you may be regularly monitored to check the infection does not become active. In some cases, testing and treatment for latent TB may be recommended for people who require treatment that will weaken their immune system, such as long-term corticosteroids, chemotherapy or TNF inhibitors. This is because there is a risk of the infection becoming active. Treatment for latent TB generally involves either taking a combination of rifampicin and isoniazid for 3 months, or isoniazid on its own for 6 months. Side effects of treatment Isoniazid can cause nerve damage ( peripheral neuropathy ), but youll be given supplements ofvitamin B6 (pyridoxine) to take alongside it to reduce this risk. Your liver function may be tested before you start treatment. In rare cases, the antibiotics used to treat TB can cause eye damage, which can be serious. If you are going to be treated with ethambutol, your vision should also be tested at the beginning of the course of treatment. Contact your TB treatment team if you develop any worrying symptoms during treatment, such as: being sick yellowing of your skin and whites of your eyes (jaundice) an unexplained high temperature (fever) tingling or numbness in your hands or feet a rash or itchy skin changes to your vision, such as blurred vision Rifampicin can reduce the effectiveness ofsome types of contraception, such as the combinedcontraceptive pill . Use an alternative method of contraception, such as condoms , while taking rifampicin. Preventing the spread of infection If you are diagnosed with pulmonary TB,you will be contagious up to about 2 to 3 weeks into your course of treatment. You will not normally need to be isolated during this time, but its important to take some basic precautions to stop TB spreading to your family and friends. You should: stay away from work, school or college until your TB treatment team advises you it is safe to return always cover your mouthpreferably with a disposable tissue when coughing, sneezing or laughing carefully dispose of any used tissues in a sealed plastic bag open windows when possible to ensure a good supply of fresh air in the areas where you spend time do not sleep in the same room as other people, as you could cough or sneeze in your sleep without realising it 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. 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Type 1 diabetes

Type 1 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 Type 1 diabetes Type 1 diabetes About type 1 diabetes Symptoms of type 1 diabetes Causes of type 1 diabetes Diagnosing type 1 diabetes Treating type 1 diabetes Complications of type 1 diabetes Living with type 1 diabetes About type 1 diabetes Diabetes is a lifelong condition that causes a persons blood glucose (sugar) level to become too high. The hormone insulin produced by the pancreas is responsible for controlling the amount of glucose in the blood. There are two main types of diabetes: Type 1 where the pancreas doesnt produce any insulin Type 2 where the pancreas doesnt produce enough insulin or the bodys cells dont react to insulin This topic is about type 1 diabetes. Read more about type 2 diabetes Another type of diabetes, known as gestational diabetes, occurs in some pregnant women and tends to disappear following birth. Its very important for diabetes to be diagnosed as soon as possible, because it will get progressively worse if left untreated. You should therefore visit your GP if you have symptoms, which include feeling thirsty, passing urine more often than usual and losing weight unexpectedly (see the list below for more diabetes symptoms). Type 1 diabetes Type 1 diabetes can develop at any age, but usually appears before the age of 40, particularly in childhood. Around 10% of all diabetes is type 1. In type 1 diabetes, the pancreas (a small gland behind the stomach) progressively reduces the amount of insulin (the hormone that regulates blood glucose levels) it produces until it stops producing any at all. If the amount of glucose in the blood is too high, it can, over time, seriously damage the bodys organs. Diabetes symptoms The symptoms of diabetes occur because the lack of insulin means that glucose is high but isnt used by your muscles as fuel for energy. When blood glucose is high, glucose is lost in your urine and you may become dehydrated. Typical symptoms include: feeling very thirsty passing urine more often than usual, particularly at night feeling very tired all the time weight loss and loss of muscle bulk persistent infections such as thrush The symptoms of type 1 diabetes usually develop very quickly in young people (over a few hours or days). In adults, the symptoms often take longer to develop (a few days or weeks). Read more about the symptoms of type 1 diabetes Causes of type 1 diabetes Type 1 diabetes is an autoimmune condition, where the immune system (the bodys natural defence against infection and illness) mistakes the cells in your pancreas as harmful and attacks them. Without insulin, your body will break down its own fat and muscle, resulting in weight loss. This can lead to a serious short-term condition called diabetic ketoacidosis. This is when the bloodstream becomes acidic, you develop dangerous levels of ketones in your blood stream and become severely dehydrated . This results in the body being unable to produce insulin, which is required to move glucose out of the blood and into your cells to be used for energy. This is called Type 1 diabetes. Read more about the causes of type 1 diabetes Treating type 1 diabetes Its important that diabetes is diagnosed as early as possible.If left untreated, type-1 diabetes is a life-threatening condition. Its essential that treatment is started early. Diabetes cant be cured, but treatment aims to keep your blood glucose levels as normal as possible and control your symptoms, to prevent health problems developing later in life. If youre diagnosed with diabetes, youll be referred to a diabetes care team for specialist treatment and monitoring. As your body cant produce insulin, youll need regular insulin injections to keep your glucose levels normal. Youll be taught how to do this and how to match the insulin you inject to the food (carbohydrate) you eat, taking into account your blood glucose level and how much exercise you do. Insulin injections come in several different forms, with each working slightly differently. Youll most likely need a combination of different insulin preparations. Insulin is given to some patients by a continuous infusion of fast (rapid)acting insulin (pump therapy). This is where a small device constantly pumps insulin (at a rate you control) into your bloodstream through a plastic tube (cannula) thats inserted under the skin with a needle. There are alternatives to insulin injections and pumps, but theyre only suitable for a small number of patients. They are: islet cell transplantation where healthy insulin-producing cells from the pancreas of a deceased donor are implanted into the pancreas of someone with type 1 diabetes a complete pancreas transplant this is still relatively rare and only a few centres of excellence offer this. Read more about diagnosing diabetes and treating type 1 diabetes Complications If diabetes is left untreated, it can cause a number of different health problems. Large amounts of glucose can damage blood vessels, nerves and organs. Having a consistentlyraised glucose level that doesnt cause any symptoms can have damaging effects in the long term. There is also complications that can arise if your insulin is not balanced with your food intake and exercise. Your diabetes team will work with you to manage your insulin correctly. Read more about the complications of type 1 diabetes Living with diabetes If you have type 1 diabetes, youll need to look after your health very carefully. Caring for your health will also make treating your diabetes easier and minimise your risk of developing complications. For example, eating a healthy, balanced diet and exercising regularly will lower your blood glucose level. Stopping smoking (if you smoke) will also reduce your risk of developing cardiovascular disease . Your healthcare team will discuss this with you, and you can see your own results through My Diabetes My Way . Its important that you learn the skills to self manage your diabetes and there are people to help and support you to do this. If you have diabetes, your eyes are at risk from diabetic retinopathy, a condition that can lead to sight loss if its not treated. Everyone with diabetes aged 12 or over should be invited to have their eyes screenedonce a year. Read more about living with type 1 diabetes Symptoms of type 1 diabetes The symptoms of type 1 diabetes should disappear when you start taking insulin and you get the condition under control. The main symptoms of diabetesare: feeling very thirsty urinating more frequently than usual, particularly at night feeling very tired weight loss and loss of muscle bulk itchiness around the genital area, or regular bouts of thrush(a yeast infection) blurred vision caused by the lens of your eye changing shape Vomiting or heavy, deep breathing can also occur at a later stage. This is a dangerous sign and requires immediate admission to hospital for treatment. When to seek urgent medical attention You should seek urgent medical attention if you have diabetes and develop: a loss of appetite nausea or vomiting a high temperature stomach pain fruity smelling breath which may smell like pear drops or nail varnish (some people can smell this themselves) Hypoglycaemia (low blood glucose) If you have diabetes, your blood glucose levels can become very low. This is known as hypoglycaemia (or a hypo). In most cases, hypoglycaemia occurs as a result of taking too much insulin, although it can also develop if you skip a meal, exercise very vigorously or drink alcoholon an empty stomach. Symptoms of a hypo include: feeling shaky and irritable sweating tingling lips feeling weak feeling confused hunger nausea (feeling sick) A hypo can be brought under control simply by eating or drinking something sugary. If it isnt brought under control, a hypo can cause confusion, slurred speech and, eventually, unconsciousness. In this case, an emergency injection of a hormone called glucagon will be needed. Glucagon increases the glucose in your blood.Your diabetes team will advise you in more detail about avoiding, recognising and treating a hypo. Hyperglycaemia (high blood glucose) As diabetes occurs as a result of your body being unable to produce any, or enough, insulin to regulate your blood glucose, your blood glucose levels may become very high. This happens because theres insufficient insulin to move glucose out of your bloodstream and into your cells to produce energy. If your blood glucose levels become too high, you may experience hyperglycaemia. The symptoms of hyperglycaemia are similar to the main symptoms of diabetes, but they may come on suddenly and be more severe. They include: extreme thirst a dry mouth blurred vision drowsiness a need to pass urine frequently Left untreated or if you already have an infection, hyperglycaemia can lead to diabetic ketoacidosis. This is a life-threateningcondition, where the body breaks down fat and muscle as an alternative source of energy. This leads to a build-up of acids in your blood, which can cause vomiting, dehydration, unconsciousness and even death. Your healthcare team will teach you about looking out for these symptoms and how to manage your Sick Day rules . The Diabetes UK website has more information about type 1diabetes symptoms . Causes of type 1 diabetes Type 1 diabetes occurs when the body is unable to produce insulin. Insulin is a hormone thats needed to control the amount of glucose (sugar) in your blood. When you eat, your digestive system breaks down food and passes its nutrients including glucose into your bloodstream. The pancreas (a small gland behind your stomach) usually produces insulin, which transfers any glucose out of your blood and into your cells, where its converted to energy. However, if you have type 1 diabetes, your pancreas is unable to produce any insulin (see below). This means that glucose cant be moved out of your bloodstream and into your cells. Autoimmune condition Type 1 diabetes is an autoimmune condition. Your immune system (the bodys natural defence against infection and illness) mistakes the cells in your pancreas as harmful and attacks them, destroying them completely or damaging them enough to stop them producing insulin. Its not known exactly what triggers the immune system to do this, but some researchers have suggested that it may be due to a viral infection. Type 1 diabetes is often inherited (runs in families), so the autoimmune reaction may also be genetic. If you have a close relative such as a parent, brother or sister with type 1 diabetes, you have about a 6% chance of also developing the condition. The risk for people who dont have a close relative with type 1 diabetes is just under 0.5%. Readabout diagnosing type 1 diabetes Diagnosing type 1 diabetes If you experience the symptoms of diabetes , you should visit your GP as soon as possible. Theyll ask about your symptoms and may request a urine and blood test. Urine and blood tests Your urine sample will be tested to see whether it contains glucose. Urine doesnt usually contain glucose, but if you have diabetes, some glucose can overflow through the kidneys and into the urine. Your urine may also be tested for ketones (chemicals) that indicate type 1 diabetes. The GP may do a finger prick blood test for glucose and ketones. A sample will be sent to the laboratory to confirm the diagnosis. These results will be discussed with the specialist diabetes service if there is concern you have Type 1 Diabetes. Glycated haemoglobin (HbA1c) The glycated haemoglobin (HbA1c) test is another blood test that can be used to diagnose diabetes.nd to monitor our long-term diabetes control. In people whove already been diagnosed with diabetes, the HbA1c test is often used to show how well their diabetes is being controlled. The HbA1c test gives your average blood glucose level over the previous two to three months. The results can indicate whether the measures youre taking to control your diabetes are working. If youve been diagnosed with diabetes, its recommended that you have your HbA1c measured at least twice a year. However, you may need to have your HbA1c measured more frequently if: youve recently been diagnosed with diabetes your blood glucose remains too high your treatment plan has been changed youre planning a pregnancy Unlike other tests, the HbA1c test can be carried out at any time of day and doesnt require any special preparation, such as fasting. However, its less reliable in certain situations, such as during pregnancy. The advantages associated with the HbA1c test make it the preferred method of assessing how well blood glucose levels are being controlled in a person with diabetes. Read about treating type 1 diabetes Treating type 1 diabetes Monitoring blood glucose An important part of your treatment is to make sure that your blood glucose level is as normal and stable as possible. Youll be able to manage this using insulin treatment and by eating a healthy, balanced diet , but you will also have to regularly check your blood glucose levels to make sure theyre not too high or too low. Exercise, illness, stress, drinking alcohol, taking other medicines and, for women, changes to your hormone levels during your monthly period can all affect your blood glucose levels. In most cases, youll need to check your blood glucose levels during the day, both at home and at work or school, using a simple finger prick blood test. You may need to do this up to four or more times a day, depending on the type of insulin treatment youre taking. There are different methods of checking your blood glucose that doesnt involve pricking your finger. Discuss your options with your diabetes care team. The normal blood glucose level is 4-7 mmol/l before meals and less than 8.5 mmol/l two hours after meals. Mmol/l means millimoles per litre, and its a way of defining the concentration of glucose in your blood. There is another method to check glucose levels without pricking your finger. This is called a flash glucose monitor (Freestyle Libre). The Diabetes UK website has more information on testing your glucose levels . Having your blood glucose levels checked Youll be measuring your blood glucose yourself every day, to check your levels. Your GP or diabetes care team will also carry out a different blood test every two to six months, called the HbA1c test. This gives a clearer idea of how well your treatment plan is working, by measuring how stable your glucose levels have been over the past 6-12 weeks. It measures the amount of haemoglobin, which is the oxygen-carrying substance in red blood cells that has glucose attached to it. A high HbA1c level may indicate that your blood glucose level is consistently high and that your diabetes treatment plan needs to be altered. The ideal HbA1c target for people with diabetes is below 53 mmol/mol. Treating hypoglycaemia (low blood glucose) Hypoglycaemia can occur when your blood glucose level becomes very low. Its likely that youll develop hypoglycaemia from time to time. Mild hypoglycaemia (or a hypo) can make you feel shaky, weak and hungry, and can be controlled by eating or drinking something sugary, such as: 200ml pure fruit juice 5 to 7 Dextrose tablets 4 to 5 Glucotabs 60ml Glucojuice 5 jelly babies You may also be able to take pure glucose, in the form of a tablet or fluid, if you need to control the symptoms of a hypo quickly. If you develop severe hypoglycaemia, you can become drowsy and confused, and you may even lose consciousness. If this occurs, youll need assistance from another person who may be able to give you a glucose gel rubbed into your cheeks or an injection of glucagon into your muscle. Glucagon is a hormone that quickly increases your blood glucose levels. Your diabetes care team may show several of your family members and close friends how to inject glucagon or give you glucose gel, should you need it. Once you begin to come round, youll need to eat something sugary when youre alert enough to do so. If you lose consciousness as a result of hypoglycaemia, theres a risk that it could happen again within a few hours. Youll need to rest afterwards and have someone with you to ensure that you eat some food to replace the glucose stores in your body. If the glucagon injection into your muscle doesnt work, and youre still drowsy or unconscious 10 minutes after the injection, youll need urgent medical attention. Youll need to have an injection of dextrose straight into a vein, which must be given by a trained healthcare professional. If you have type 1 diabetes, its recommended that you carry identification with you so that people are aware of the problem if you become hypoglycaemic. If significant hypoglycaemia is a regular problem or you have lost your awareness of hypoglycaemia your health care team may consider using a continuous glucose monitor (CGM) . Islet cell transplantation Some people with type 1 diabetes may benefit from a fairly new procedure known as islet cell transplantation. It involves implanting healthy islet cells from the pancreas of a deceased donor into the pancreas of someone with type 1 diabetes. In 2008, a government-funded islet cell transplant programme was introduced, and the procedure is now available through the NHS for people who satisfy certain criteria (see below). You may be suitable for an islet cell transplant if youve had: two or more severe hypos within the last two years and you have a poor awareness of hypoglycaemia a working kidney transplant, severe hypos and poor hypoglycaemia awareness, or poor blood glucose control even after receiving the best medical treatment You may not be suitable for an islet cell transplant if you: weigh over 85kg (13st 5.4lb) have poor kidney function need a lot of insulin for example, over 50 units a day for a 70kg (11st) person An islet cell transplant is a minor, low-risk procedure thats carried out under local anaesthetic. The procedure has been shown to be effective at reducing the risk of severe hypos. So far, the results of islet cell transplants carried out in the UK have shown a significant reduction in the number of hypos, from 23 per person per year before transplantation to less than one per person per year afterwards. Pancreas transplant People with type 1 diabetes who are having a kidney transplant from a donor may also be offered a pancreas transplant at the same time. Others may be offered a pancreas transplant after theyve had a kidney transplant because theyre already on anti-rejection tablets. If youre having repeated, severe and life-threatening hypoglycaemic attacks, a pancreas transplant may also be recommended. During the procedure, your faulty pancreas will be replaced with a healthy pancreas from a donor. This will allow you to get a new source of insulin. Pancreas transplants are complicated operations and, like other types of major surgery, theres a risk of complications. In the UK, about 200 pancreas transplants are carried out each year, with more than 300 people on the waiting list. The waiting time for a pancreas transplant is one to two years, because theres a shortage of suitable donor organs. Treating high blood glucose (hyperglycaemia) Hyperglycaemia can occur when your blood glucose levels become too high. It can happen for several reasons, such as eating too much, being unwell or not taking enough insulin. If you develop hyperglycaemia, you may need to adjust your diet or your insulin dose to keep your glucose levels normal. Your diabetes care team can advise you about the best way to do this. If hyperglycaemia isnt treated, it can lead to a condition called diabetic ketoacidosis, where the body begins to break down fats for energy instead of glucose, resulting in a build-up of ketones (acids) in your blood. Diabetic ketoacidosis is very serious and, if not addressed quickly, it can lead to unconsciousness and, eventually, death. The signs of diabetic ketoacidosis include: frequently passing urine thirst tiredness and lethargy (lack of energy) blurry vision abdominal (stomach) pain nausea and vomiting deep breathing smell of ketones on breath (described as smelling like pear drops) collapse and unconsciousness Read more about the symptoms of diabetic ketoacidosis Your healthcare team will educate you on how to decrease your risk of ketoacidosis by testing your own blood for ketones using blood ketone sticks if youre unwell. If you develop diabetic ketoacidosis, youll need urgent hospital treatment. Youll be given insulin directly into a vein (intravenously). You may also need other fluids given by a drip if youre dehydrated, including salt solution and potassium. Other treatments Type 1 diabetes can lead to long-term complications. If you have the condition, you have an increased risk of developing heart disease , stroke , eyeand kidney disease . To reduce the chance of this, you may be advised to take: anti-hypertensive medicines to control high blood pressure a statin such as simvastatin to reduce high cholesterol levels low-dose aspirin to prevent stroke angiotensin-converting enzyme (ACE) inhibitor such as enalapril, lisinopril or ramipril if you have the early signs of diabetic kidney disease Diabetic kidney disease is identified by the presence of small amounts of a protein called albumin in your urine. Its often reversible if treated early enough. Care standards for diabetes The aim of treating diabetes is to help people with the condition control their blood glucose levels and minimise the risk of developing future complications. In Scotland there is a National Diabetes Improvement Plan produced by the Scottish Diabetes Group, patients and health care professionals. The Diabetes National Service Framework has also been developed by diabetes clinical experts and patients with diabetes. Good diabetes care includes: access to information and appropriate support for people with type 1 diabetes, including access to a structured education programme an agreed care plan, helping all people with diabetes to manage their care and lead a healthy lifestyle including a named contact for their care information, care and support to enable all people with diabetes to control their blood glucose, maintain an acceptable blood pressure and minimise other risk factors for developing complications access to services to identify and treat possible complications such as screening for diabetic retinopathy (where high blood glucose levels damage the retina at the back of the eye) and specialised foot care effective care for all people with diabetes admitted to hospital, for whatever reason Complications of type 1 diabetes If diabetes isnt treated, it can lead to a number of different health problems. High glucose levels can damage blood vessels, nerves and organs. A consistently raised glucose level that doesnt cause any symptoms can have damaging effects in the long term. Heart disease and stroke If you have diabetes, youre up to five times more likely to develop heart disease or have a stroke . Prolonged, poorly controlled blood glucose levels increase the likelihood of developing atherosclerosis (furring and narrowing of your blood vessels). This may result in a poor blood supply to your heart or to your lower limbs, causing angina (a dull, heavy or tight pain in the chest) or claudication (pain in the back of your calves when walking). It also increases the chance that a blood vessel in your heart or brain will become completely blocked, leading to a heart attack or stroke. Nerve damage High blood glucose levels can damage the tiny blood vessels of your nerves. This can cause a tingling or burning pain that spreads from your fingers and toes up through your limbs. If the nerves in your digestive system are affected, you may experience nausea, vomiting, diarrhoea or constipation . Retinopathy Retinopathyis where the retina (the light-sensitive layer of tissue) at the back of the eye is damaged. Blood vessels in the retina can become blocked or leaky, or can grow haphazardly. This prevents the light from fully passing through to your retina. If it isnt treated, it can damage your vision. The better you control your blood glucose levels, the lower your risk of developing serious eye problems. Having an annual eye check with a specialist (an ophthalmologist or optometrist) can help pick up signs of a potentially serious eye problem early so that it can be treated. Treatment for diabetic retinopathy is only necessary if screening detects significant problems that mean your vision is at risk. If the condition hasnt reached this stage, the advice on managing your diabetes, BP and cholesterol level is recommended. The main treatments for more advanced diabetic retinopathy are: laser treatment injections of medication into your eyes an operation to remove blood or scar tissue from your eyes Read about diabetic eye screening Kidney disease If the small blood vessels in your kidney become blocked and leaky, your kidneys will work less efficiently. In rare, severe cases, this can lead to kidney failureand the need for dialysis (treatment to replicate the functions of the kidneys). In some cases, a kidney transplant may be necessary. Foot problems Damage to the nerves of the foot can mean that small nicks and cuts arent noticed, which can lead to a foot ulcer developing. About 1 in 10 people with diabetes get a foot ulcer, which can cause serious infection. If you develop nerve damage, you should check your feet every day and report any changes to your doctor, nurse or podiatrist. Look out for sores and cuts that dont heal, puffiness or swelling, and skin that feels hot to the touch. You should also have a foot examination at least once a year. Sexual dysfunction In men with diabetes, particularly those who smoke, nerve and blood vessel damage can lead to erection problems. This can usually be treated with medication. Women with diabetes may experience: a reduced sex drive (loss of libido) reduced pleasure from sex vaginal dryness a reduced ability to orgasm pain during sex If you experience a lack of vaginal lubrication, or you find sex painful, you can use a vaginal lubricant or a water-based gel. Miscarriage and stillbirth Pregnant women with diabetes have an increased risk of miscarriage and stillbirth. If your blood glucose level isnt carefully controlled immediately before and during early pregnancy, theres also an increased risk of the baby developing a serious birth defect. Pregnant women with diabetes will usually have their antenatal check-ups in hospital or a diabetes clinic. This allows doctors to keep a close eye on their blood glucose levels and control their insulin dosage more easily. Read more about diabetes and pregnancy: Diabetes UK My Diabetes My Way Living with type 1 diabetes Look after your feet Having diabetes means that youre more likely to develop problems with your feet, including foot ulcers and infections from minor cuts and grazes. This is because blood glucose can damage the nerves in your feet. To prevent problems with your feet, keep your nails short and wash your feet daily using warm water. Wear shoes that fit properly and see a podiatrist or chiropodist (a foot care specialist) regularly so that any problems are detected early. Regularly check your feet for cuts, blistersor grazes because you may not be able to feel them if the nerves in your feet are damaged. See your GP if you have a minor foot injury that doesnt start to heal within a few days. The Diabetes UK website has more information and advice about taking care of your feet . Regular eye tests If you have type 1 diabetes, you should be invited to have your your eyes screened at once a year to check for diabetic retinopathy. Retinopathy is an eye condition where the small blood vessels in your eye become damaged. It can occur if your blood glucose level is too high for a long time (hyperglycaemia). If it isnt treated, retinopathy can eventually cause sight loss. Read more about diabetic eye screening Diabetes sick day rules If you need to take insulin to control your diabetes, you should have received instructions about looking after yourself when youre ill known as your sick day rules. Contact your diabetes care team or GP for advice if you havent received these. The advice youre given will be specific to you, but some general measures that your sick day rules may include could be to: keep taking your insulin its very important not to stop treatment when youre ill; your treatment plan may state whether you need to temporarily increase your dose test your blood glucose level more often than usual most people are advised to check the level at least four times a day keep yourself well hydrated make sure you drink plenty of sugar-free drinks keep eating eat solid food if you feel well enough to, or liquid carbohydrates such as milk, soup and yoghurt if this is easier check your ketone levels if your blood glucose level is high Seek advice from your diabetes care team or GP if your blood glucose or ketone level remains high after taking insulin, if: youre not sure whether to make any changes to your treatment you develop symptoms of diabetic ketoacidosis you have any other concerns Pregnancy If you have diabetes and youre thinking about having a baby, its a good idea to discuss this with your diabetes care team. A planned pregnancy enables you to make sure your blood glucose levels are as well controlled as possible before you get pregnant.Most women with diabetes have a healthy baby. Youll need to keep your blood glucose under tight control, particularly before becoming pregnant and during the first eight weeks of pregnancy, to reduce the risk of the baby developing serious birth defects. You should also take a higher dose of folic acidtablets. Folic acid helps prevent your baby developing spinal cord problems. Doctors now recommend that all women planning to have a baby take folic acid. Women with diabetes are advised to take 5mg a day until theyre 12 weeks pregnant (only available on prescription). Folic acid should be taken alongside pregnancy multivitamins that include vitamin D . Insulin and metformin are safe to take during pregnancy. Its important to review any other medications you take to ensure these are safe to take during pregnancy. You should also have your eyes checked. Retinopathy (see above) affects the blood vessels in the eyes and is a risk for all people with diabetes. Pregnancy can place extra pressure on the small vessels in your eyes, so its important to treat retinopathy before you become pregnant. Your GP or diabetes care team can give you further advice. Diabetes UK and JDRF also provide more useful information about pregnancy and diabetes to help you get your pregnancy off to a healthy start. Education Youll be best equipped to manage your diabetes if youre given information and education when youre diagnosed, and then on an ongoing basis. The National Institute for Health and Care Excellence (NICE) strongly recommends that all people who have diabetes should be offered a structured patient education programme, providing information and education to help them care for themselves. This gives people the best chance of developing the skills they need to effectively treat their condition, maintain their glucose levels at a normal level and help prevent long-term complications. It also reduces the risk of developing hypoglycaemia (low blood glucose levels). Structured patient education Structured patient education means theres a planned course that: covers all aspects of diabetes is flexible in content is relevant to a persons clinical and psychological needs is adaptable to a persons educational and cultural background There are also several local adult education programmes, many of which are working towards the criteria for structured education. Ask your diabetes care team about the adult education programmes they provide. Diabetes and your child For a parent whose child is diagnosed with a life-long condition, the job of parenting becomes even tougher. Although being diagnosed with type 1 diabetes will involve coming to terms with the diagnosis, getting used to treatment and makingchanges toeveryday life, your child can still lead a normal and healthy life. The Diabetes UK website has information and advice about your child and diabetes . Help and support Many people find it helpful to talk to others in a similar position, and you may find support from a group for people with diabetes. Patient organisations have local groups where you can meet others whove been

Type 1 diabetes

diagnosed with the condition. The Diabetes UK website enables you to find your local diabetes support group . If you want to contact a trained counsellor directly you can phone Diabetes UKs care line on 0345 123 2399 or email [email protected] Further information on Helpline Scotland Financial support and benefits Some people with diabetes may be eligible to receive disability benefits and incapacity benefits depending on the impact the condition has on their life. The main groups likely to qualify for welfare benefits are children elderly people people with learning disabilities or mental health problems and those with complications of diabetes . People over 65 who are severely disabled may qualify for a type of disability benefit called Attendance Allowance. Carers may also be entitled to some benefit too depending on their involvement in caring for the person with diabetes. Staff at your local Citizens Advice Scotland can check whether youre getting all of the benefits youre entitled to. Both they and your diabetes specialist nurse should also be able to give you advice about filling in the forms. Driving with diabetes Its a common myth that people with diabetes arent allowed to drive anymore. Although there are some restrictions on drivers with diabetes its not as severe as you may think. You should always tell your insurer that you are diabetic as this may affect your insurance claim. Only individuals who use insulin have to tell the DVLA that they have diabetes. A high majority of individuals who use insulin can carry on driving on a restricted licence. This usually has to be renewed every 3 years. Additional restictions may apply for different licences (e.g Group 2 HGV) so always refer to the DVLA guidelines . Unfortunately some individuals do lose their driving license most commonly due to experiencing severe hypos or being unable to recognise symptoms of a hypo (hypo unawareness). To prevent hypos whilst driving you should check your blood glucose levels before driving keep medication close by in the car take regular breaks on long journeys over 2 hours avoid missing meals

Type 2 diabetes

Type 2 diabetes - 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 Diabetes Type 2 diabetes Type 2 diabetes About type 2 diabetes Symptoms of type 2 diabetes Causes of type 2 diabetes Treating type 2 diabetes Complications of type 2 diabetes Living with type 2 diabetes About type 2 diabetes Diabetes is usually a lifelong condition that causes a persons blood glucose (sugar) level to become too high. The hormone insulin produced by the pancreas is responsible for controlling the amount of glucose in the blood There are two main types of diabetes: type 1 where the pancreas doesnt produce any insulin type 2 where the pancreas doesnt produce enough insulin or the bodys cells dont react to insulin This topic is about type 2 diabetes. Read more about type 1 diabetes Another type of diabetes, known as gestational diabetes, occurs in some pregnant women and tends to disappear after birth. Symptoms of diabetes The symptoms of diabetes occur because the lack of insulin means glucose stays in the blood and isnt used as fuel for energy. Your body tries to reduce blood glucose levels by getting rid of the excess glucose in your urine. Typical symptoms include: feeling very thirsty passing urine more often than usual, particularly at night feeling very tired weight loss and loss of muscle bulk slow to heal cuts or ulcers frequent vaginal or penile thrush blurred vision Read more about the symptoms of type 2 diabetes Its very important for diabetes to be diagnosed as soon as possible as it will get progressively worse if left untreated. Causes of type 2 diabetes Type 2 diabetes occurs when the body doesnt produce enough insulin to function properly, or the bodys cells dont react to insulin. This means glucose stays in the blood and isnt used as fuel for energy. Type 2 diabetes is often associated with obesity and tends to be diagnosed in older people. Due to increased obesity, type 2 diabetes is now being seen in young people and all ages. Its far more common than type 1 diabetes. Read about the causes and risk factors for type 2 diabetes Treating type 2 diabetes Type 2 diabetes is treated with changes in your diet and depending on the response of your blood glucose levels, sometimes tablets and insulin. Early in the course of type 2 diabetes, planned weight loss can even reverse the disease. Read more about the treatment of type 2 diabetes Complications of type 2 diabetes Diabetes can cause serious long-term health problems. Its the most common cause of vision loss and blindness in people of working age. Everyone with diabetes aged 12 or over should be invited to have their eyes screened once a year for diabetic retinopathy. Diabetes is also responsible for most cases of kidney failureand lower limb amputation, other than accidents. Read more about the complications of type 2 diabetes Preventing type 2 diabetes If youre at risk of type 2 diabetes, you may be able to prevent it developing by making lifestyle changes. These include: losing weight if youre overweight, and maintaining a healthy weight eating a healthy, balanced diet stopping smoking if you smoke drinking alcohol in moderation taking plenty of regular exercise Living with type 2 diabetes If you already have type 2 diabetes, it may be possible to control your symptoms by making the above changes. This also minimises your risk of developing complications. Read more about living with type 2 diabetes Symptoms of type 2 diabetes The symptoms of diabetes include feeling very thirsty, passing more urine than usual, and feeling tired all the time. The symptoms occur because some or all of the glucose stays in your blood and isnt used as fuel for energy. Your body tries to get rid of the excess glucose in your urine. The main symptoms oftype 2 diabetes are: urinating more often than usual, particularly at night feeling very thirsty feeling very tired unexplained weight loss itchiness around the genital area, or regular bouts of thrush(a yeast infection) cuts or wounds that heal slowly blurred vision caused by the lens of the eye becoming dry The signs and symptoms of type 1 diabetes are usually obvious and develop very quickly, often over a few weeks. These signs and symptoms arent always as obvious, however, and its often diagnosed during a routine check-up. This is because they are often mild and develop gradually over a number of years. This means you may have type 2 diabetes for many years without realising it. Early diagnosis and treatment for type 2 diabetes is very important as it may reduce your risk of developing complications later on. Hyperglycaemia Type 2 diabetes occurs when the pancreas, a large gland behind the stomach, cant produce enough insulin to control your blood glucose level, or when the cells in your body dont respond properly to the insulin that is produced. This means your blood glucose levels may become very high, and is known as hyperglycaemia. Hyperglycaemia can occur for several reasons, including: eating too much being unwell ineffective diabetes medication not taking enough medication Hyperglycaemia causes the main symptoms of diabetes, which include extreme thirst and frequent urination. Causes of type 2 diabetes Type 2 diabetes occurs when the pancreas doesnt produce enough insulin to maintain a normal blood glucose level, or the body is unable to use the insulin that is produced (insulin resistance). The pancreas is a large gland behind the stomach that produces the hormone insulin. Insulin moves glucose from your blood into your cells, where its converted into energy. In type 2 diabetes, there are several reasons why the pancreas doesnt produce enough insulin. Risk factors for type 2 diabetes Four of the main risk factors for developing type 2 diabetes are: age being over the age of 40 (over 25 for south Asian people) genetics having a close relative with the condition, such as a parent, brother or sister weight being overweight or obese ethnicity being of south Asian, Chinese, African-Caribbean or black African origin, even if you were born in the UK Age Your risk of developing type 2 diabetes increases with age. This may be because people tend to gain weight and exercise less as they get older. Maintaining a healthy weight by eating a healthy, balanced diet and exercising regularly are ways of preventing and managing diabetes. White people over the age of 40 have an increased risk of developing the condition. People of south Asian, Chinese, African-Caribbean and black African descent have an increased risk of developing type 2 diabetes at a much earlier age. However, despite increasing age being a risk factor for type 2 diabetes, over recent years younger people from all ethnic groups have been developing the condition. Its also becoming more common for children as young as seven in some cases to develop type 2 diabetes, mainly due to rising obesity levels. Genetics Genetics is one of the main risk factors for type 2 diabetes. Your risk of developing the condition is increased if you have a close relative such as a parent, brother or sister who has the condition. The closer the relative, the greater the risk. A child who has a parent with type 2 diabetes has about a one in three chance of also developing the condition. Being overweight or obese Youre more likely to develop type 2 diabetes if youre overweight or obese with a body mass index (BMI) of 30 or more. Fat around your tummy (abdomen) particularly increases your risk. This is because it releases chemicals that can upset the bodys cardiovascular and metabolic systems. This increases your risk of developing a number of serious conditions, including coronary heart disease , stroke and some types of cancer. Measuring your waist is a quick way of assessing your diabetes risk. This is a measure of abdominal obesity , which is a particularly high-risk form of obesity. Women have a higher risk of developing type 2 diabetes if their waist measures 80cm (31.5 inches) or more. Asian men with a waist size of 89cm (35 inches) or more have a higher risk, as do white or black men with a waist size of 94cm (37 inches) or more. Exercising regularly and reducing your body weight by about 5% could reduce your risk of getting diabetes by more than 50%. Read about measuring your waist size Ethnicity People of south Asian, Chinese, African-Caribbean and black African origin are more likely to develop type 2 diabetes. Type 2 diabetes is up to six times more common in south Asian communities than in the general UK population, and its three times more common among people of African and African-Caribbean origin. People of south Asian and African-Caribbean origin also have an increased risk of developing complications of type 2 diabetes , such as heart disease, at a younger age than the rest of the population. Other risks Your risk of developing type 2 diabetes is also increased if your blood glucose level is higher than normal, but not yet high enough to be diagnosed with diabetes. This is sometimes called pre-diabetes, and doctors sometimes call it impaired fasting glycaemia (IFG) or impaired glucose tolerance (IGT). Pre-diabetes is reversible if you lose weight. Discuss your options with your GP. Pre-diabetes can progress to type 2 diabetes if you dont take preventative steps, such as making lifestyle changes. These include eating healthily , losing weight if youre overweight, and taking plenty of regular exercise . Women who have had gestational diabetes during pregnancy also have a greater risk of developing diabetes in later life. Treating type 2 diabetes Medicines for type 2 diabetes Type 2 diabetes is a progressive condition andusually gets worse over time. Making lifestyle changes, such as adjusting your diet and taking more exercise, may help you control your blood glucose levels at first, but may not be enough in the long term. You may eventually need to take medication to help control your blood glucose levels. Initially, this will usually be in the form of tablets and can sometimes be a combination of more than one type of tablet. It may also include insulin or another medication that you inject. Metformin Metformin is usually the first medicine used to treat type 2 diabetes. It works by reducing the amount of glucose your liver releases into your bloodstream. It also makes your bodys cells more responsive to insulin. If youre overweight, its also likely youll be prescribed metformin. Unlike some other medicines used to treat type 2 diabetes, metformin shouldnt cause additional weight gain. However, it can sometimes cause mild side effects, such as nausea and diarrhoea , and you may not be able to take it if you have kidney damage. SGLT2 inhibitors SGLT2 inhibitors work by increasing the amount of glucose excreted in urine. Theyre particularly useful in people with type 2 diabetes and who have cardiac disease. The three SGLT2 inhibitors that may be prescribed include: dapagliflozin canagliflozin empagliflozin Each medication is taken as a tablet once a day. The main side effect is a higher risk of genital and urinary tract infections. If youre unwell and have a dehydrating illness (e.g. fever, vomiting or diarrhoea), its important you stop these medications. Get your glucose and ketone level checked by your healthcare professional to prevent diabetic ketoacidosis developing. GLP-1 agonists GLP-1 agonists acts in a similar way to the natural hormone GLP-1 (see the section on gliptins, below). Theyre given by injection and boost your owninsulin production when there are high blood glucose levels, reducing blood glucose without the risk of hypoglycaemia episodes (hypos). Theyre also particularly useful for people with type 2 diabetes and cardiac disease. Sulphonylureas Sulphonylureas increase the amount of insulin thats produced by your pancreas. Examples include: glibenclamide gliclazide glimepiride glipizide gliquidone You may be prescribed one of these medicines if you cant take metformin. Alternatively, you may be prescribed sulphonylurea and metformin if metformin doesnt control blood glucose on its own. Sulphonylureas can increase the risk of hypoglycaemia (low blood glucose) because they increase the amount of insulin in your body. They can sometimes cause side effects, including weight gain, nausea and diarrhoea. Pioglitazone Pioglitazone is a type of thiazolidinedione medicine (TZD), which make your bodys cells more sensitive to insulin so more glucose is taken from your blood. Its usually used in combination with other oral diabetes medication. It may cause weight gain and ankle swelling (oedema). You shouldnt take pioglitazone if you have heart failure or a high risk of bone fracture. Gliptins (DPP-4 inhibitors) Gliptins work by preventing the breakdown of a naturally occurring hormone called GLP-1. GLP-1 helps the body produce insulin in response to high blood glucose levels, but is rapidly broken down. By preventing this breakdown, the gliptins (linagliptin, saxagliptin, sitagliptin and vildagliptin) prevent high blood glucose levels, but dont result in episodes of hypoglycaemia. You may be prescribed a gliptin if youre unable to take sulphonylureas or glitazones, or in combination with them. Theyre not associated with weight gainand are often used with other oral diabetes medication for those who are obese. Insulin treatment If glucose-lowering tablets arent effective in controlling your blood glucose levels, you may need to have insulin treatment. This can be taken instead of or alongside your tablets, depending on the dose and the way you take it. Insulin comes in several different preparations, and each works slightly differently.Your treatment may include a combination of these different insulin preparations. Insulin injections Insulin must be injected because it would be broken down in your stomach like food and unable to enter your bloodstream if it were taken as a tablet. If you need to inject insulin, your diabetes care team will advise you about when you need to do it. They will show you how to inject it yourself, and will also give you advice about storing your insulin and disposing of your needles properly. Insulin injections are given using either a syringe or an injection pen, also called an insulin pen (auto-injector). Most people need between two and four injections of insulin a day. Your GP practiceor diabetes nurse will also teach a relative or a close friend how to inject the insulin properly. You can read more about insulin and how to inject it on the Diabetes UK website. Treatment for low blood glucose (hypoglycaemia) If you have type 2 diabetes thats controlled using insulin or certain types of tablets (e.g. sulfonylurea), you may experience episodes of hypoglycaemia . Hypoglycaemia is where your blood glucose levels become very low. Mild hypoglycaemia (a hypo) can make you feel shaky, weak and hungry, but it can usually be controlled by eating or drinking something sugary. If you have a hypo, you should initially have a form of carbohydrate that will act quickly, such as a sugary drink or glucose tablets. This should be followed by a longer-acting carbohydrate, such as a cereal bar, sandwich or piece of fruit. In most cases, these measures will be enough to raise your blood glucose level to normal. You should aim for a hypo to be treated and to recheck your blood glucose level within 15 minutes. If blood glucose still less than 4mmol/l then repeat the treatment using a fast acting carbohydrate. When your blood glucose returns to normal then have your longer acting carbohydrate. If you develop severe hypoglycaemia, you may become drowsy and confused, and you may even lose consciousness. If this occurs, you may need to have an injection of glucagon into your muscle or glucose into a vein. Glucagon is a hormone that quickly increases your blood glucose levels. You may require input from a health care professional. If the glucagon is not successful, you may require an injection of dextrose into your vein. Your diabetes care team can advise you on how to avoid a hypo and what to do if you have one. Other treatments If you have type 2 diabetes, your risk of developing heart disease , stroke , foot problems, eyeand kidney disease is increased. To reduce your risk of developing other serious health conditions, you may be advised to take other medicines, including: anti-hypertensive medicines to control high blood pressure a statin , such as simvastatin or atorvastatin, to reduce high cholesterol low-dose aspirin to prevent a stroke an angiotensin-converting enzyme (ACE) inhibitor, such as enalapril, lisinopril or ramipril, if you have the early signs of diabetic kidney disease Diabetic kidney disease is identified by the presence of small amounts of albumin (a protein) in your urine. If treated early enough, it may be reversible. Monitoring blood glucose levels If you have type 2 diabetes, your GP or diabetes care team will need to take a reading of your blood glucose level about every two to six months. This will show how stable your glucose levels have been in the recent past and how well your treatment plan is working. The HbA1c test is used to measure blood glucose levels over the previous two to three months. HbA1c is a form of haemoglobin, the chemical that carries oxygen in red blood cells, which also has glucose attached to it. A high HbA1c level means that your blood glucose level has been consistently high over recent weeks, and your diabetes treatment plan may need to be changed. Your diabetes care team can help you set a target HbA1c level to aim for. This will usually be less than 53 mmol/mol (7%) or individualised as agreed with your diabetes team. Read more about the HbA1c test Monitoring your own blood glucose If you have type 2 diabetes, as well as having your blood glucose level checked by a healthcare professional every two to six months, you may be advised to monitor your own blood glucose levels at home. Even if you have a healthy diet and are taking tablets or using insulin therapy, exercise, illness and stress can affect your blood glucose levels. Other factors that may affect your blood glucose levels include drinking alcohol, taking other medicines and, for women, hormonal changes during the menstrual cycle. A blood glucose meter is a small device that measures the concentration of glucose in your blood. It can be useful for detecting high blood glucose (hyperglycaemia) or low blood glucose (hypoglycaemia). If blood glucose monitoring is recommended, you should be trained in how to use a blood glucose meter and what you should do if the reading is too high or too low. Blood glucose meters arent currently available for free on the NHS but, in some cases, blood monitoring strips may be. Ask a member of your diabetes care team if youre unsure. Regularly monitoring your blood glucose levels will ensure your blood glucose is as normal and stable as possible. As your blood glucose level is likely to vary throughout the day, you may need to check it several times a day, depending on the treatment youre taking. In home testing, blood glucose levels are usually measured by how many millimoles of glucose are in a litre of blood. A millimole is a measurement used to define the concentration of glucose in your blood. The measurement is expressed as millimoles per litre, or mmol/l for short. A normal blood glucose level is 4-7 mmol/l before meals (preprandial) and less than 8.5 mmol/l two hours after meals (postprandial), although this can vary from person to person. Your diabetes care team can discuss your blood glucose level with you in more detail. Its important to know your individual targets. Complications of type 2 diabetes If diabetes isnt treated, it can lead to a number of other health problems. High glucose levels can damage blood vessels, nerves and organs. Even a mildly raised glucose level that doesnt cause any symptoms can have long-term damaging effects. Heart disease and stroke If you have diabetes, youre up to five times more likely to develop heart disease or have a stroke . Prolonged, poorly controlled blood glucose levels increase the likelihood of atherosclerosis, where the blood vessels become clogged up and narrowed by fatty substances. This may result in a poor blood supply to your heart or to your lower limbs, causing angina (a dull, heavy or tight pain in the chest) or claudication (pain in the back of your calves when walking). It also increases the chance that a blood vessel in your heart or brain will become blocked, leading to a heart attack or stroke. Nerve damage High blood glucose levels can damage the tiny blood vessels in your nerves. This can cause a tingling or burning pain that spreads from your fingers and toes up through your limbs. It can also cause numbness, which can lead to ulceration of the feet. Damage to the peripheral nervous system, which includes all parts of the nervous system that lie outside the central nervous system, is known as peripheral neuropathy . If the nerves in your digestive system are affected, you may experience nausea, vomiting, diarrhoea or constipation . Diabetic retinopathy Diabetic retinopathyis when the retina, the light-sensitive layer of tissue at the back of the eye, becomes damaged. Blood vessels in the retina can become blocked or leaky, or can grow haphazardly. This prevents light fully passing through to your retina. If it isnt treated, it can damage your vision. Annual eye checks are usually organised by a regional photographic unit. If significant damage is detected, you may be referred to a doctor who specialises in treating eye conditions (ophthalmologist) such as cataract and glaucoma. The better you control your blood glucose levels, the lower your risk of developing serious eye problems. Treatment for diabetic retinopathy is only necessary if screening detects significant problems that mean your vision is at risk. If the condition hasnt reached this stage, the advice on managing your diabetes, BP and cholesterol level is recommended. The main treatments for more advanced diabetic retinopathy are: laser treatment injections of medication into your eyes an operation to remove blood or scar tissue from your eyes Read about diabetic eye screening. Kidney disease If the small blood vessels of your kidney become blocked and leaky, your kidneys will work less efficiently. Its usually associated with high blood pressure, and treating this is a key part of management. In rare, severe cases, kidney disease can lead to kidney failure . This can mean a kidney replacement, treatment with dialysis or sometimes kidney transplantation becomes necessary. Foot problems Damage to the nerves of the foot can mean small nicks and cuts arent noticed and this, in combination with poor circulation, can lead to a foot ulcer. About 1 in 10 people with diabetes get a foot ulcer, which can cause a serious infection. If you have diabetes, look out for sores and cuts that dont heal, puffiness or swelling, and skin that feels hot to the touch. You should also have your feet examined at least once a year. If poor circulation or nerve damage is detected, check your feet every day and report any changes to your doctor, nurse or podiatrist. Sexual dysfunction In men with diabetes, particularly those who smoke, nerve and blood vessel damage can lead to erection problems. This can usually be treated with medication. Women with diabetes may experience: reduced sex drive (loss of libido) less pleasure from sex vaginal dryness less ability to orgasm pain during sex If you experience a lack of vaginal lubrication or find sex painful, you can use a vaginal lubricant or a water-based gel. Miscarriage and stillbirth Pregnant women with diabetes have an increased risk of miscarriage and stillbirth. If your blood glucose level isnt carefully controlled during the early stages of pregnancy, theres also an increased risk of the baby developing a birth defect. Pregnant women with diabetes will usually have their antenatal check-ups in hospital or a diabetic clinic, ideally with a doctor who specialises in pregnancy care (an obstetrician). This will allow your care team to keep a close eye on your blood glucose levels and control your insulin dosage more easily, as well as monitoring the growth and development of your baby. The Diabetes UK website has more information about diabetes complications . Looking after your eyes The NHS diabetic eye screening programme will arrange for you to have your eyes checked every year. Everyone who is on a diabetes register will be given the opportunity to have a digital picture taken of the back of their eye. Speak to your GP to register. Living with type 2 diabetes Look after your feet If you have diabetes, youre at greater risk of developing problems with your feet, including foot ulcers and infections from minor cuts and grazes. This is because diabetes is associated with poor blood circulation in the feet, and blood glucose can damage the nerves. To prevent problems with your feet, keep your nails short and wash your feet daily using warm water. Wear shoes that fit properly, and see foot care specialists (a podiatrist or chiropodist) regularly so any problems can be detected early. Regularly check your feet for cuts, blisters or grazes as you may not be able to feel them if the nerves in your feet are damaged. See your GP if you have a minor foot injury that doesnt start to heal within a few days. Regular eye tests If you have type 2 diabetes, you should be invited to have your eyes screened once a year to check for diabetic retinopathy. Diabetic retinopathy is an eye condition where the small blood vessels in your eye become damaged. It can occur if your blood glucose level is too high for a long period of time (hyperglycaemia). Left untreated, retinopathy can eventually lead to sight loss. Read more about diabetic eye screening People with diabetes should also see their optician every two years for a regular eye test. Diabetic eye screening is specifically for diabetic retinopathy and cant be relied upon for other conditions. Pregnancy If you have diabetes and youre thinking about having a baby, its a good idea to discuss this with your diabetes care team. If youre taking oral medications to manage your diabetes, this may need to change before you are pregnant. Its important that you plan your pregnancy and discuss it with your diabetes team. Planning your pregnancy means you can ensure your blood glucose levels are as well controlled as they can be before you get pregnant. Youll need to tightly control your blood glucose level particularly before becoming pregnant and during the first eight weeks of your babys development to reduce the risk of birth defects. You should also: check your medications some tablets used to treat type 2 diabetes may harm your baby, so you may have to switch to insulin injections, stop statin medication or some blood pressure medications take a higher dose of folic acid tablets folic acid helps prevent your baby developing spinal cord problems, and its recommended all women planning to have a baby take folic acid; women with diabetes are advised to take 5mg each day (only available on prescription) along with pregnancy multivitamins that include vitamin D have your eyes checked retinopathy, which affects the blood vessels in the eyes, is a risk for all people with diabetes; as pregnancy can place extra pressure on the small vessels in your eyes, its important to treat retinopathy before you become pregnant Your GP or diabetes care team can give you further advice. Diabetes education Youll be best equipped to manage your diabetes day-to-day if youre given information and education when youre diagnosed and on an ongoing basis. The National Institute for Health and Care Excellence (NICE) recommends that all people who have diabetes should be offered a structured patient education programme, providing information and education to help them care for themselves. Structured patient education Structured patient education means theres a planned course that: covers all aspects of diabetes is flexible in content is relevant to a persons clinical and psychological needs is adaptable to a persons educational and cultural background For type 2 diabetes, there are several local adult education programmes, many of which are working towards the criteria for structured education. Ask your diabetes care team about the adult education programmes they provide. Talk to others Many people find it helpful to talk to others in a similar position, and you may find support from a group for people with diabetes. Patient organisations have local groups where you can meet others diagnosed with the condition. To find your local diabetes support group , visit Diabetes UK . If you want to get in touch with a trained counsellor directly, you can call the Diabetes UK Helpline on 0345 123 2399 (Monday to Friday, 9am to 7pm) or email [email protected] Financial support and benefits Some people with diabetes may be eligible for disability and incapacity benefits, depending on the impact the condition has on their lives. The main groups likely to qualify for welfare benefits are children, the elderly, and those with learning disabilities, mental health difficulties or diabetes complications. People over the age of 65 who are severely disabled may qualify for a type of disability benefit called Attendance Allowance. Carers may also be entitled to some benefits, depending on their involvement in caring for the person with diabetes. Citizens Advice Scotland can check whether youre getting all the benefits youre entitled to. Your diabetes specialist nurse and Citizens Advice can also provide advice about filling in the forms. Driving with diabetes Its a common myth that people with diabetes arent allowed to drive anymore. Although there are some restrictions on drivers with diabetes, its not as severe as you may think. You should always tell your insurer that you have diabetes as this may affect your insurance claim. Only individuals who use insulin have to tell the DVLA that they have diabetes. A high majority of individuals who use insulin can carry on driving on a restricted licence. This usually has to be renewed every 3 years. Additional restictions may apply for different licences (e.g Group 2 HGV) so always refer to the DVLA guidelines . Unfortunately, some individuals do lose their driving license, most commonly due to experiencing severe hypos. If you start to have a hypo whilst driving you should: Pull over safely Switch off your car engine Take fast-acting carbs, like glucose tablets or sweets, and some longer-acting carbohydrates too, like plain biscuits or crackers Dont drive until 45 minutes after your blood sugar level has gone back to 5mmol/l or above For more information about driving with diabetes, visit Diabetes UK. Diabetes sick day rules If you need to take insulin to control your diabetes, you should have received instructions about looking after yourself when youre ill known as your sick day rules. Contact your diabetes care team or GP for advice if you havent received these. The advice youre given will be specific to you, but some general measures that your sick day rules may include could be to: keep taking your insulin its very important not to stop treatment when youre ill; your treatment plan may state whether you need to temporarily increase your dose test your blood glucose level more often than usual most people are advised to check the level at least four times a day keep yourself well hydrated make sure you drink plenty of sugar-free drinks keep eating eat solid food if you feel well enough to, or liquid carbohydrates such as milk, soup and yoghurt if this is easier check your ketone levels if your blood glucose level is high Seek advice from your diabetes care team or GP if your blood glucose or ketone level remains high after taking insulin, if: youre not sure whether to make any changes to your treatment you develop symptoms of diabetic ketoacidosis you have any other concerns 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 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 perso

Trichomonas infection

Trichomonas 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 Sexual and reproductive Trichomonas infection Trichomonas infection British Sign Language (BSL) | | Polski | Romn | slovenina Trichomonas is a sexually transmitted infection (STI) caused by a small parasite. It infects the genitals and may lead to an infection in the urethra (the tube that carries urine out of the body) and the prostate. Symptoms of trichomonas Most people with trichomonas infection will have no symptoms but they can still pass the infection on. If you do develop symptoms you may get: a yellow or green discharge from the vagina or penis, which can sometimes have an unpleasant smell genital itching and soreness pain or a burning sensation when peeing Some women may get some pain or discomfort during sex. Testing for trichomonas If you think you might have trichomonas, get tested for free by: booking an appointment at your local sexual health service contacting your GP practice for an appointment What does a trichomonas test involve? Testing is quick and straightforward. There are 2 main ways the sample can be collected: using a swab a small cotton bud is gently wiped over the area that might be infected, such as inside the vagina or penis urine sample this should ideally be done at least 1 or 2 hours after you last peed Most sexual health clinics can look at the sample straightaway under the microscope and see the parasite. In some clinics and at your GP, the swab needs to be sent away to a lab to make the diagnosis. The test is more accurate from vagina samples. Its less accurate from penis and urine samples. Treating trichomonas Trichomonas infection is treated with antibiotics. Its advised that both you and your partner(s) are treated if you have the infection. You and your partner(s) may be asked to return to your GP practice or sexual health clinic for another test to check the infection has gone. You should avoid having sex until 1 week after you and your partner(s) treatment has finished. If your infection is untreated you may pass it on to other sexual partners. How trichomonas is passed on Trichomonas infection is spread through unprotected sex and sharing sex toys. Its not passed on through oral or anal sex. You cant pass on trichomonas through: kissing or hugging sharing cups, plates or cutlery toilet seats How to prevent trichomonas 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. Other STIs If you have been diagnosed with trichomonas, you should get tested for all STIs including: chlamydia gonorrhoea syphilis 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 (BSL) | | Polski | Romn | slovenina British Sign Language (BSL) | | Polski | Romn | slovenina Add this page to\n Info For Me Also on NHS inform Book a sexual health appointment online Trichomonas (BSL) Trichomonas (Chinese) Trichomonas (Polish) Trichomonas (Romanian) Trichomonas (Slovak) Other health sites BASHH: sexual health 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

Transverse myelitis

Transverse myelitis | 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 Transverse myelitis Transverse myelitis Transverse myelitis is a rare neurological condition. Its caused by inflammation (swelling) of the spinal cord. The swelling damages the nerves and can leave permanent scars or lesions. The scars or lesions interrupt the communication between the nerves in the spinal cord and the rest of the body. Transverse refers to the swelling being across the width of the spinal cord. Its also sometimes used to describe swelling that only affects part of the width of the spinal cord. Symptoms of transverse myelitis The symptoms of transverse myelitis can include: muscle weakness in the legs, and sometimes the arms mobility problems unusual sensations and numbness bladder problems bowel problems sexual problems pain Transverse myelitis can happen to anyone at any time in their life. In most cases there might only be one episode of symptoms, but sometimes it can happen repeatedly. Transverse myelitis can be the first sign of MS or another condition. Causes of transverse myelitis There are several different causes of transverse myelitis. Sometimes a cause isnt found, and this is called idiopathic transverse myelitis. Autoimmune disease Sometimes transverse myelitis is caused by an autoimmune reaction. In autoimmune diseases, the immune system mistakes the bodys own tissue as dangerous and attacks it. This causes swelling that results in damage to the myelin sheath. This includes: MS-like swelling neuromyelitis optica (NMO) myelin oligodendrocyte antibody (MOG) associated myelitis sarcoidosis Sjgrens syndrome lupus Viral infection Sometimes transverse myelitis is caused indirectly by a viral infection, although often the virus responsible isnt identified. Transverse myelitis often develops after a viral infection like: echovirus enterovirus Epstien-Barr hepatitis A herpes simplex HIV rubella influenza (flu) varicella zoster (the virus that causes chicken pox and shingles) Bacterial infection Bacterial infections such as syphilis might also lead to transverse myelitis. Cancer Some cancers might trigger an unusual immune response that can lead to transverse myelitis. Diagnosing transverse myelitis If your GP thinks you could have transverse myelitis, you should see a neurologist (a specialist in conditions of the nervous system) for a specialist assessment. Some of the tests you may need to confirm transverse myelitis are: neurological examination magnetic resonance imaging (MRI) scan lumbar puncture blood test s Sometimes your neurologist will do other tests to look for conditions thatcausetransverse myelitis. This might include CT scans . Treating transverse myelitis Sometimes transverse myelitis requires no treatment as it will improve on its own. Sometimes patients may require treatment for their symptoms, the swelling, or the underlying cause. Treatment for transverse myelitis symptoms There are different treatments available for transverse myelitis symptoms. Muscle weakness Physiotherapy can help improve strength, and the muscle spasms and stiffness that may sometimes develop. Techniquessuch as stretching exercises can help if your movement is restricted. If your muscle spasms are more severe, you may be prescribed a medicine that can relax your muscles. This will usually be either baclofen, gabapentin or tizanidine. These medicines all have side effects. You might experience dizziness, weakness, nausea and diarrhoea. Discuss which of these would be best for you with yourhealthcare professional. Mobility problems Mobility problems are often the result of muscle spasms and spasticity. Muscle weakness, or problems with balance can also cause mobility problems. If you have problems with mobility, your healthcare professional might suggest: an exercise programmesupervised by a physiotherapist mobility aids, such as a walking stick, or a wheelchair home adaptations such as stair lifts or railings An occupational therapist can carry out an assessment of your home and suggest adaptations. Treatment of the inflammation (swelling) Sometimes your neurologist might offer treatment with steroids. This can help with some types of transverse myelitis. Steroids are only given for a short period of time to avoid possible steroid side effects . The side effects could include reflux and stomach irritation, worsening infection, mood swings, and difficulty sleeping. Bladder problems Medication might help if you have an overactive bladder or need to pee frequently during the night. If you find it difficult to empty your bladder, advice from a continence nurse or physiotherapist can help. Hand-held external stimulators can help some people to start peeing or to empty the bladder. Sometimes a catheter can empty the bladder when needed. You might be taught how to do intermittent self catheterisation (ISC). In rare cases, people with transverse myelitis may need a long-term catheter to keep the bladder emptying safely. You might be referred to a continence adviser or urologist, for specialist treatment and advice. Read more about treating urinary incontinence . Bowel problems It might be possible to treat mild to moderate constipation by changing your diet or taking laxatives . More severe constipation may need to be treated with suppositories, which are inserted into your bottom, or an enema. During an enema, liquid medication is rinsed through your bottom and large bowel, which softens and flushes out your stools. Anti diarrhoea medication or pelvic floor exercises might help bowel incontinence. Sexual problems If you experience problems with less interest in sex or difficulty reaching orgasm, relationship counselling or seeing a sex therapist might help. If you have transverse myelitis and find it hard to get or maintain an erection ( erectile dysfunction ) you may be prescribedmedication toincrease the blood flow to the penis. Musculoskeletal pain A physiotherapist might be able to help withthis pain by suggesting exercises or better seating positions. If your pain is more severe, you may be prescribed painkillers. Or, you might have a transcutaneous electrical nerve stimulation (TENS) machine that stimulates your nerves. Neuropathic pain Neuropathic pain is caused by damage to your nerves and is usually sharp and stabbing. It can also occur in the form of extreme skin sensitivity, or a burning sensation. This type of pain can be treated using neuropathic painkillers. Other treatments for transverse myelitis You may be offered other treatments depending on the cause of your transverse myelitis. Your neurologist will discuss your options with you. 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 Other health sites Neurological Alliance of Scotland Siegel Rare Neuroimmune Association Scotland Support Group 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

Ulcerative colitis

"Ulcerative colitis | 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 Inflammatory bowel disease (IBD) Ulcerative colitis Ulcerative colitis Ulcerative colitis is a long-term condition where your large bowel (colon and rectum) gets swollen and inflamed. Your colon is your large intestine (bowel). Your rectum is the end of your bowel, where poo is stored. If you have ulcerative colitis, you get swelling, inflammation and ulcers in the lining of your large bowel. They can bleed and produce pus. Ulcerative colitis can affect people of all ages, but its usually diagnosed between the age of 15 and 40. Symptoms The main symptoms of ulcerative colitis are: recurring diarrhoea , which may contain blood, mucus or pus abdominal pain needing to poo often You may also experience: extreme tiredness (fatigue) loss of appetite weight loss Some people also get symptoms in other parts of their body. For example, some people develop: painful and swollen joints ( arthritis ) mouth ulcers areas of painful, red and swollen skin irritated and red eyes Speak to your GP practice if: you have symptoms of ulcerative colitis and you havent been diagnosed with the condition Symptoms of a flare-up Some people may go for weeks or months with very mild symptoms, or none at all. This is known as remission. This may be followed by periods where the symptoms are particularly troublesome. These are known as flare-ups or relapses. Symptoms of flare-ups vary from person-to-person. They may include: diarrhoea 6 or more times a day blood or mucus in your poo severe abdominal pain symptoms in other parts of your body Severe ulcerative colitis can also cause symptoms like: shortness of breath a fast or irregular heartbeat a high temperature (fever) blood in your poo becoming more obvious Speak to your inflammatory bowel disease (IBD) team if: you have ulcerative colitis and think youre having a flare-up Causes The exact cause of ulcerative colitis is unknown. A combination of factors may be responsible, including: problems with your immune system where the immune system mistakenly attacks the lining of your large bowel, making it inflamed genetics genes you inherit from your family environmental factors like air pollution, medication and viruses or bacteria in your gut Diagnosis To help diagnose ulcerative colitis, your GP will ask about your: your pattern of symptoms your diet any recent travel for example, you may have developed travellers diarrhoea whether youre taking any medication, including any over-the-counter medicines whether anyone else in your family has a bowel condition any health problems youve had in the past Your GP may also: examine your abdomen (tummy) ask for a stool (poo) sample and use a qFIT test to check for blood and mucus, infection or inflammation via a faecal calprotectin test arrange blood tests to check for inflammation or anaemia Additional tests for ulcerative colitis If your GP thinks that you have ulcerative colitis you may be referred to hospital for more tests. These could include: colonoscopy a thin, flexible tube with a camera is put into your bottom to look at the whole of your large bowel sigmoidoscopy a thin, flexible tube with a camera is put into your bottom to look at the end of your large bowel X-ray MRI scan or computerised tomography (CT) You will be told what tests you need and what you need to do to prepare for them. Treatment Treatment for ulcerative colitis aims to relieve and prevent symptoms. Your treatment will depend on how severe your symptoms are and how often they flare up. Mild flare-ups can be usually be treated at home. But severe flare-ups usually need treatment in hospital to reduce the risk of complications. Treatment will usually be provided by a range of healthcare professionals. Medication Most people will get medication to treat symptoms of ulcerative colitis. This includes medications like: aminosalicylates (ASAs) often the first treatment option, used to get and keep inflammation under control and can be given rectally as well as orally corticosteroids used to get inflammation under control quickly, but not suitable for long-term use If you have lots of flare-ups or aminosalicylates do not keep your inflammation under control, you may need other treatments, such as: immunosuppressants like azathioprine or mercaptopurine used to reduce the activity of the immune system biologic medicines, like adalimumab, infliximab, golimumab, ustekinumab or vedolizumab other advanced medicines like filgotinib, ozanimod, tofacitinib and upadacitinib Surgery Surgery to treat ulcerative colitis may be an option if: you choose to have surgery instead of taking medications that may cause side effects medications dont control your symptoms your quality of life is severely affected by your condition you have serious complications of ulcerative colitis Surgery for ulcerative colitis involves removing part or all of your large bowel (known as a colectomy). This means the small intestine must be used to pass waste products out of your body instead. During the surgery, your small intestine will either be: joined to the surface of your tummy (known as an ileostomy or a colostomy) after this type of surgery, poo comes out of the opening on your tummy and is collected in special bags that you wear joined directly to your rectum (the end of your large bowel), so your poo comes out of your bottom as usual used to create an internal pouch thats connected to your bottom (known as an ileo-anal pouch or J-pouch) this means your poo can pass through your bottom as usual Diet Theres no evidence that a particular diet causes ulcerative colitis. But alongside medications, some changes to your diet may help control symptoms for some people. You could: eat 5 to 6 small meals rather than 3 main meals try to eat a healthy, varied diet that includes a wide variety of fruit, vegetables, nuts, seeds, proteins and wholegrains drink plenty of water You could also speak to your IBD team about: keeping a food diary to find out if any particular foods affect your symptoms removing trigger foods from your diet but do not make major changes to your diet without talking to your IBD team and make sure you are still getting all the nutrients you need taking a food supplement if you are struggling to get enough nutrients from your diet being referred to a dietitian Managing stress Stress doesnt cause ulcerative colitis. But, managing stress may reduce how often you get symptoms. To help manage stress, you could: exercise speak to your IBD team about a suitable exercise plan try relaxation techniques like yoga, medication and breathing exercises talk to others Crohns & Colitis UK has details of local support groups speak to your GP if you think you may have depression Fertility and pregnancy A womans chance of becoming pregnant isnt usually affected by ulcerative colitis. However, surgery for ulcerative colitis might affect your fertility, especially pouch surgery. Most women with ulcerative colitis will have a normal pregnancy and a healthy baby. But if youre pregnant or planning a pregnancy you should discuss it with your IBD team. This is because they may need to change your medication. If youre having a flare-up of ulcerative colitis you may also be advised to avoid getting pregnant until its under control. Complications If you have ulcerative colitis, you may be at an increased risk of developing other problems. This can include: osteoporosis poor growth and development in children and young people More serious and rare complications can include: primary sclerosing cholangitis (PSC) inflammation in the bile ducts, which can lead to liver damage narrowings in the bowel (strictures) that may become blocked or make it difficult for poo to pass through toxic megacolon severe inflammation in the colon may lead to trapped gas so the colon becomes very enlarged and can rupture a higher risk of getting bowel cancer a higher risk of getting blood clots in your legs or lungs Source: Scottish Government - Opens in new browser window Last updated: 25 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 Crohn's disease Inflammatory bowel disease (IBD) Other health sites Crohn's & Colitis UK: Ulcerative colitis Crohn's & Colitis UK: Symptoms Crohn's & Colitis UK: Tests and investigations Crohn's & Colitis UK: Treatments Crohn's & Colitis UK: Surgery Crohn's & Colitis UK: Stoma Chron's & Colitis UK: Getting a diagnosis Crohn's & Colitis UK: Food Crohn's & Colitis UK: Wellbeing support Crohn's & Colitis UK: Reproductive health Crohn's & Colitis UK: Joints Crohn's & Colitis UK: Bones Crohn's & Colitis UK: Pregnancy and breastfeeding 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"

Underactive thyroid

Underactive thyroid - 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 Glands Underactive thyroid Underactive thyroid About underactive thyroids Symptoms of an underactive thyroid Causes of an underactive thyroid Diagnosing an underactive thyroid Treating an underactive thyroid Complications of an underactive thyroid About underactive thyroids An underactive thyroid gland (hypothyroidism) is where your thyroid gland doesnt produce enough hormones. Common signs of an underactive thyroid are tiredness, weight gain and feeling depressed. An underactive thyroid can often be successfullytreated by taking daily hormone tablets to replace the hormonesyour thyroid isnt making. Theres no way of preventing an underactive thyroid. Most cases are caused either by the immune system attacking the thyroid gland and damaging it,orby damage to the thyroid that occurs during some treatments for an overactive thyroidor thyroid cancer . Read more about the causesof an underactive thyroid When to see your GP Symptoms of an underactive thyroid are often similar to those of other conditions,and theyusually develop slowly, so you may not notice them for years. You should see your GP and ask to be tested for an underactive thyroid if you havesymptoms including: tiredness weight gain depression being sensitive tothe cold dry skin and hair muscle aches The only accurate way of finding out whether you have a thyroid problem is to haveathyroid function test, where a sample of blood is tested to measure yourhormone levels. Readmore about testing for an underactive thyroid Whos affected Both men and women can have an underactive thyroid, althoughits more commonin women. In the UK, it affects 15 in every 1,000 women and1 in 1,000 men. Children can also develop an underactive thyroid. Around 1 in 3,500 to 4,000 babiesare born with anunderactive thyroid (congenital hypothyroidism).All babies born in the UK are screened for congenital hypothyroidismusing a blood spot test when the baby is about 5 days old. Treating an underactive thyroid Treatment for an underactive thyroid involves taking dailyhormone replacement tablets, called levothyroxine,to raise yourthyroxine levels. Youll usually need treatment for the rest of your life. However, with proper treatment, you should be able to lead a normal, healthy life. If an underactive thyroid isnt treated, it can lead to complications, including heart disease ,goitre, pregnancy problems and a life-threatening condition called myxoedema coma (although this is very rare). Read more about treating an underactive thyroid and the complications of an underactive thyroid Symptoms of an underactive thyroid Many symptoms of an underactive thyroid (hypothyroidism) are the same as those of other conditions, so it can easily be confused for something else. Symptomsusually develop slowly and you may not realise you have a medical problem for several years. Common symptoms include: tiredness being sensitive to cold weight gain constipation depression slow movements and thoughts muscle aches and weakness muscle cramps dry and scaly skin brittle hair and nails loss of libido (sex drive) pain, numbness and a tingling sensation in the hand and fingers (carpal tunnel syndrome) irregular periodsor heavy periods Elderly people with an underactive thyroid may develop memory problems and depression. Children may experience slower growth and development. Teenagers may startpuberty earlier than normal. If you have any of these symptoms, see your GP and ask to be tested for an underactive thyroid. Read more about getting tested for an underactive thyroid If an underactive thyroid isnt treated Its unlikely that youd have many of the later symptoms of an underactive thyroid, because the condition is often identified before more serious symptoms appear. Later symptoms of an underactive thyroidinclude: a low-pitched and hoarse voice a puffy-looking face thinned or partly missing eyebrows a slow heart rate hearing loss anaemia Causes of an underactive thyroid An underactive thyroid (hypothyroidism) is when your thyroid gland doesnt produce enough of the hormone thyroxine (also called T4). Most cases of an underactive thyroid are caused by the immune system attacking the thyroid gland and damaging it, or by damage that occurs as a result oftreatments for thyroid cancer or an overactive thyroid . Immune system An underactive thyroid often occurs when the immune system, which usually fights infection, attacks the thyroid gland. This damages the thyroid, which means its not able to make enough of the hormone thyroxine,leading to the symptoms of an underactive thyroid . A condition called Hashimotos disease is the most common type of autoimmune reactionthatcauses an underactive thyroid. Its not clear what causes Hashimotos disease, but it runs in families. Its also common in people with another immune system disorder, such as type 1 diabetes and vitiligo. Previous thyroid treatment An underactive thyroid can also occur as a side effect or complication of previous treatment to the thyroid gland, such as surgery or a treatment called radioactive iodine therapy. These treatments are sometimes used for an overactive thyroid(where the thyroid glandproduces too much hormone) or thyroid cancer. Less common causes Worldwide,alack of dietaryiodine is a common cause of an underactive thyroid, because the body needs iodine to make thyroxine. However, iodine deficiency isuncommon in the UK. Babies are sometimes born with an underactive thyroid because the thyroid gland doesnt develop properly in the womb. This is called congenital hypothyroidism and isuncommon, affecting around 1 in 3,000 babies. Itsusually picked up during routine screening soon after birth. A problem with the pituitary gland could lead to an underactive thyroid.The pituitary gland sits at the base of the brain andregulates the thyroid. Therefore, damage to the pituitary gland may lead to an underactive thyroid. An underactive thyroid has also been linked tosome viral infections or somemedications used to treat other conditions, such as: lithium a medication sometimes used to treat certain mental health conditions, including depression and bipolar disorder amiodarone a medication sometimes used to treat irregular heartbeats (arrhythmias) interferons a class of medication sometimes used to treat certain types of cancer and hepatitis C Speak to your GP or specialist if youre concerned that a medication youre taking may be affecting your thyroid hormone levels. Diagnosing an underactive thyroid Its very important that an underactive thyroid (hypothyroidism) is diagnosed as soon as possible. Low levels of thyroid-producing hormones, such astriiodothyronine (T3) and thyroxine (T4), can change the way the body processes fat. This can cause high cholesterol and atherosclerosis (clogging of the arteries) , which can potentially lead to serious heart-related problems, such as angina and heart attack . Therefore, you should see your GP and ask for a blood test if you repeatedly have symptoms of an underactive thyroid . Thyroid function test Ablood test measuring your hormone levels is the only accurate way to find out whethertheres a problem. The test, called a thyroid function test, looks at levels of thyroid-stimulating hormone (TSH) and thyroxine (T4) in the blood. Ahigh level of TSH and a low level ofT4 in the bloodcould mean you havean underactive thyroid. If your test results show raised TSH but normalT4, you may be at risk of developing an underactive thyroid in the future. Your GP may recommend that you have a repeat blood test every so often to see whether you eventually develop an underactive thyroid. Blood tests are also sometimes used for other measurements, such as checking the level of a hormone calledtriiodothyronine (T3). However, this isnt routine, because T3 levels can often remain normal, even if you have a significantly underactive thyroid. The Lab Tests Online UK website has more information about the different types of thyroid function tests . Referral Your GP may refer you to an endocrinologist (a specialist in hormone disorders) if you: are younger than 16 are pregnant or trying to get pregnant have just given birth have another health condition, such as heart disease , which may complicate your medication are taking a medication known to cause a reduction in thyroid hormones, such as amiodarone or lithium Treating an underactive thyroid An underactive thyroid (hypothyroidism) is usually treated by taking daily hormone replacement tablets called levothyroxine. Levothyroxinereplaces the thyroxine hormone, which your thyroid doesnt make enough of. Youll initially have regular blood tests until the correct doseof levothyroxine is reached. Thiscan take a little while to get right. You may start on a low dose of levothyroxine, which may be increased gradually, depending on how your body responds.Some people start to feel bettersoon after beginning treatment,while othersdont notice an improvement in their symptoms for several months Once youre taking the correct dose, youll usually have a blood test once a year to monitor your hormone levels. Ifblood tests suggest you may have an underactive thyroid, but you dont have any symptoms or theyre very mild, you may not need any treatment. In these cases, your GP will usually monitor your hormone levels every few months and prescribe levothyroxine if you develop symptoms. Taking levothyroxine If youre prescribed levothyroxine, you should take 1 tablet at the same time every day.Its usually recommended that you take the tablets in the morning, although some people prefer to take them at night. The effectiveness of thetablets can be altered by other medications, supplements or foods, so they should be swallowed with water on an empty stomach, and you should avoid eating for 30 minutes afterwards. If you forget to take a dose, take it as soon as you remember, if this is within a few hours of your usual time. If you dont remember until later than this, skip the dose and take the next dose at the usual time, unlessadvised otherwise by your doctor. An underactive thyroid is a lifelong condition, so youll usually need to take levothyroxine for the rest of your life. Side effects Levothyroxine doesnt usually have any side effects, because the tablets simply replace a missing hormone. Side effects usually only occur if youre taking too much levothyroxine. This can cause problems includingsweating, chest pain , headaches , diarrhoea and vomiting. Tell your doctor if you develop new symptoms while taking levothyroxine. You should also let them know if your symptoms get worse or dont improve. Combination therapy In the UK, combination therapy using levothyroxine and triiodothyronine (T3) together isnt routinely used because theres insufficient evidence to show its better than using levothyroxine alone (monotherapy). In most cases,suppressing thyroid-stimulating hormone (TSH) using high dose thyroid replacement therapy should be avoided because it carries a risk of causing adverse side effects, such as atrial fibrillation (an irregular and abnormally fast heart rate), strokes , osteoporosis and fracture. However, this type of treatment may sometimes be recommended in cases where a person has a history of thyroid cancer and theres a significant risk of it reoccurring. Complications of an underactive thyroid Several complications can occur if you have an underactive thyroid that isnt treated. Heart problems If you have an untreated underactive thyroid, your risk of developing cardiovascular disease is increased. This is because having low levels of the hormone thyroxine can lead to increased levels of cholesterol in your blood. High cholesterol can cause fatty deposits to build up in your arteries, restrictingthe flow of blood. Contact your doctor if youre being treated for an underactive thyroid and you develop chest pain , so that any problems can bedetected and treated, if necessary. Goitre Agoitreis an abnormal swelling of the thyroid gland that causes a lump to form in the throat. Goitres can develop in people with an underactive thyroidwhen the body tries tostimulate the thyroid to produce more thyroid hormones. Pregnancy complications If an underactive thyroid isnt treated during pregnancy, theres a risk of problems occurring. Theseinclude: pre-eclampsia which can cause high blood pressure and fluid retentionin the mother and growth problems in the baby anaemia in the mother an underactive thyroid in the baby birth defects bleeding after birth problems with the babys physical and mental development premature birth or a low birthweight stillbirth or miscarriage These problems can usually be avoided with treatment under the guidance of a specialist in hormone disorders (an endocrinologist). Therefore, tell your GP if you have an underactive thyroid and youre pregnant or trying to get pregnant. Myxoedema coma In very rare cases, a severe underactive thyroid may lead to a life-threatening condition called myxoedema coma. This is where the thyroid hormone levels become very low, causing symptoms such as confusion, hypothermia and drowsiness. Myxoedema coma requires emergency treatment in hospital. Its usually treated with thyroid hormone replacement medication given directly into a vein. In some cases, other treatments such as breathing support, antibiotics and steroid medication ( corticosteroids ) are also required. 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 Overactive thyroid Other health sites Lab Tests Online: TSH Lab Tests Online UK: T4 test British Thyroid 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

Urinary incontinence

"Urinary incontinence | 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 Urinary incontinence Urinary incontinence Urinary incontinence is when you pee by accident. It can happen when doing exercise like running, lifting weights at the gym or jumping on a trampoline. Urinary incontinence can affect anyone. It tends to be more common in women. Further information about urinary incontinence in women Although its common, it shouldnt be thought of as normal. There are things you can do to reduce the chance of this happening and improve your symptoms. How to prevent urinary incontinence There are things you can do that may help reduce the chance of urinary incontinence in the future. Do strengthen you pelvic floor muscles with simple pelvic floor exercises stay active maintain a healthy weight avoid or cut down on alcohol and caffeinated drinks, such as coffee, tea and some fizzy drinks Types of urinary incontinence The 2 most common types of urinary incontinence are: stress incontinence pee leaking out when your bladder is under pressure (life when you laugh, cough, sneeze, exercise or lift something heavy) urge incontinence feeling a sudden and very intense need to pee and being unable to stop it Less common types of incontinence are: mixed incontinence having both stress and urge incontinence overflow incontinence (also called chronic urinary retention) the bladder cannot completely empty total incontinence severe and continuous urinary incontinence When to get medical advice Speak to your GP practice if: You have any symptoms of urinary incontinence, such as: peeing by accident feeling a sudden need to pee and are unable to stop it What causes urinary incontinence? The causes of urinary incontinence depend on the type. Certain things can increase the chances of urinary incontinence developing, including: being overweight a family history of incontinence getting older but incontinence doesnt happen just because youve aged if youre a woman, pregnancy and vaginal birth if youre a man, having surgery to remove the prostate gland Diagnosing urinary incontinence Your GP will ask you some questions to understand what may be causing the incontinence and how bad it is. They may also: try to rule out other things that could be causing your symptoms, such as a urinary tract infection suggest you keep a diary of how much fluid you drink and how often you have to pee carry out a pelvic examination (in women) or rectal examination (in men) as this is an intimate examination, there may be another person (chaperone) present refer you to a specialist, usually a physiotherapist Treatment for urinary incontinence Treatments which do not involve taking medication or having surgery are usually tried first. These include: treating the underlying cause, if urinary incontinence is caused by another condition lifestyle changes such as reducing your caffeine intake, changing how much you drink, and maintaining a healthy weight pelvic floor muscle training your healthcare professional will explain how to do these exercises bladder training techniques to increase the length of time between feeling the need to go to the toilet and peeing Incontinence products (like pads or pants) arent a treatment for urinary incontinence. But you might find them helpful while you are waiting for assessment or for a treatment to start working. If these treatments dont work for you, your doctor may suggest trying other treatments, like medication or surgery. This will depend on the cause and type of incontinence you are experiencing. Its ok to ask any questions about your care to help you get the information you might need. Source: Scottish Government - Opens in new browser window Last updated: 11 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 Urinary incontinence in women Pelvic floor muscles Menopause It's OK To Ask Urinary tract infection (UTI) Bowel incontinence Urinary catheterisation Other health sites Pelvic, Obstetric and Gynaecological Physiotherapy: Bladder & Bowel Incontinence Pelvic, Obstetric and Gynaecological Physiotherapy: Promoting continence with physiotherapy (PDF, 609 KB) Pelvic, Obstetric and Gynaecological Physiotherapy: Mens pelvic health The Chartered Society of Physiotherapy: Training for pelvic floor muscles Age UK: Urinary incontinence 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"

Urinary tract infection (UTI)

Urinary tract infection (UTI) | 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 Urinary tract infection (UTI) Urinary tract infection (UTI) 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 Urinary tract infections (UTIs) are common infections that affect the bladder, the kidneys and the tubes connected to them. Anyone can get them, but theyre particularly common in women. Some women experience them regularly (called recurrent UTIs). UTIs can be painful and uncomfortable, but usually pass within a few days and can be treated with antibiotics . This page is about UTIs in adults. There is a separate page about UTIs in children . Urinary infection self-help guide Complete our self-help guide to check your symptoms and find out what to do next. Symptoms of UTIs Lower UTIs Infections of the bladder (cystitis) or urethra (tube that carries urine out of the body) are known as lower UTIs. These can cause: a need to pee more often than usual pain or discomfort when peeing sudden urges to pee feeling as though youre unable to empty your bladder fully pain low down in your tummy urine thats cloudy, foul-smelling or contains blood feeling generally unwell, achy and tired You can speak to your pharmacist for advice and treatment on lower UTIs. Lower UTIs are common and arent usually a cause for major concern. Find your nearest pharmacy Upper UTIs Infections of the kidneys or ureters (tubes connecting the kidneys to the bladder) are known as upper UTIs. These can cause the same symptoms as lower UTIs and also: a high temperature (fever) of 38C (100.4F) or above pain in your sides or back shivering and chills feeling and being sick confusion agitation or restlessness Upper UTIs can be serious if left untreated, as they could damage the kidneys or spread to the bloodstream. Speak to your GP urgently if: You think you, your child or someone you care for may have a urinary tract infection (UTI) and: have a very high temperature, or feel hot and shivery have a low temperature below 36C are confused or drowsy have pain in the lower tummy or in the back, just under the ribs can see blood in your pee If your GP is closed, phone 111. These symptoms could mean you have a kidney infection , which can be serious if its not treated as it could cause sepsis . Speak to your GP if: you have symptoms of an upper UTI your child has symptoms of a UTI the symptoms are severe or getting worse the symptoms havent started to improve after a few days you get UTIs frequently your symptoms come back after treatment Your GP team can: rule out other possible causes of your symptoms by testing a sample of your urine prescribe antibiotics if you have an infection Treatment for UTIs UTIs are normally treated with a short term course of antibiotics. Most women are given a 3-day course of antibiotic capsules or tablets. Men, pregnant women and people with more serious symptoms may need a slightly longer course. Your symptoms will normally pass within 3 to 5 days of starting treatment. Make sure you complete the whole course of antibiotics that youve been prescribed, even if youre feeling better. Over-the-counter pain relief such as paracetamol can help with any pain. Drinking plenty of fluids may also help you feel better. Return to your GP if your symptoms dont improve, get worse, or come back after treatment. Causes of UTIs UTIs occur when the urinary tract becomes infected, usually by bacteria. In most cases, bacteria from the gut enter the urinary tract through the urethra. This may happen when wiping your bottom or having sex. But often its not clear why it happens. The following may increase your risk of getting a UTI: conditions that obstruct your urinary tract, such as kidney stones difficulty emptying your bladder fully using a contraceptive diaphragm or condoms coated in spermicide diabetes a weak immune system for example from chemotherapy or HIV a urinary catheter (a tube in your bladder used to drain urine) an enlarged prostate gland in men Women may be more likely to get UTIs because their urethra is shorter than a mans and is closer to their anus (back passage). Preventing UTIs There are some things you can do to try to prevent UTIs. Do go to the toilet as soon as you need to pee always empty your bladder fully stay well hydrated wipe your bottom from front to back when you go to the toilet pee as soon as possible after having sex have a shower rather than a bath wear underwear made from cotton, rather than synthetic material such as nylon avoid tight jeans and trousers Dont do not use perfumed bubble bath, soap or talcum powder around your genitals use plain, unperfumed ones instead do not use a diaphragm or condoms with spermicidal lubricant on them try another type of contraception Speak to your GP if these measures dont work. Drinking cranberry juice or using probiotics arent proven to reduce your chances of getting UTIs. 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 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

Urinary tract infection (UTI) in children

Urinary tract infection (UTI) 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 Kidneys, bladder and prostate Urinary tract infection (UTI) in children Urinary tract infection (UTI) in children Urinary tract infections (UTIs) are common infections. They can affect the urinary tract, including the: bladder urethra (the tube where urine leaves the body) kidneys UTIs arent usually serious and can be treated with antibiotics if needed. Speak to your GP if your child has symptoms of a UTI like: vomiting tiredness and lack of energy (lethargy) irritability not eating properly not gaining weight yellowing of the skin and whites of the eyes (jaundice) in very young children pain or a burning sensation when peeing needing to pee frequently deliberately holding in their pee a change in their normal toilet habits, like wetting themselves or wetting the bed unpleasant-smelling pee cloudy pee Phone 111 or speak to a GP urgently if: You think a child has a urinary tract infection (UTI) and they: are under 3 have a very high temperature, or feel hot and shivery have a very low temperature below 36C are confused or drowsy have pain in the lower tummy or in the back, just under the ribs have blood in their pee Types of UTI A UTI may be either: upper lower An upper UTI means an infection of the kidneys or ureters. Ureters are the tubes connecting the kidneys to the bladder. A lower UTI means an infection of the bladder (cystitis) or urethra. This is the tube that carries urine out of the body. Causes of UTIs in children UTIs occur when the urinary tract becomes infected, usually by bacteria. Bacteria from the gut can enter the urinary tract through the tube that carries pee out of the body (urethra). This may happen when a child: wipes their bottom soils their nappy Some children may be more likely to get UTIs due to problems emptying their bladder. This can be due to: constipation dysfunctional elimination syndrome a child holds on to their pee, even though they have the urge to pee vesicoureteral reflux urine leaks back up from the bladder into the ureters and kidney Treating UTIs in children UTIs in children will often improve within 24 to 48 hours of treatment. A UTI wont usually cause any long term problems. Antibiotics UTIs can usually be treated at home with antibiotics as long as the child is: over 3 months not at risk of serious illness The most suitable antibiotic depends on what type of UTI the child has. Sometimes children can experience side effects whilst taking antibiotics. This can include feeling sick or having an upset stomach. These symptoms are usually mild and should stop once the antibiotics have finished. Its very important to finish the prescribed course of antibiotics. Thisll prevent the infection from coming back. Other treatments If necessary, children can also take liquid paracetamol to help ease the symptoms of a UTI. As a precaution, some children with a UTI may have to be treated in hospital. Your GP may advise you if this is necessary. Dont use non-steroidal anti-inflammatory drugs (NSAIDs) like ibuprofen to treat a UTI. These can harm the kidneys. Aspirin should never be given to children under the age of 16. Preventing UTIs in children It isnt possible to prevent all childhood UTIs. But, there are some things you can do to reduce the risk of your child getting one. Do encourage girls to wipe their bottom from front to back make sure children are well hydrated and go to the toilet regularly avoid nylon and other synthetic underwear pick loose, cotton underwear avoid scented soaps or bubble baths these can increase the risk of developing a UTI Recurrent UTIs in children A small number of children have recurring UTIs. If your child has had a UTI before, its important to watch out for any symptoms. If any symptoms do come back, tell your GP as soon as possible. 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

Urticaria (hives)

Hives | 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 Hives Hives 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 The main symptom of hives (urticaria) is a rash. The rash may: be raised be very itchy be on one part of the body spread over large areas range is size from a few millimetres to the size of a hand change in appearance within 24 hours The image shows a hives rash on the side of the stomach. The rash is small, circular patches of pink on pale skin. https://dermnetnz.org/ More images of hives Image 1 Image 2 Image 3 Diagnosing hives Hives can usually be diagnosed by examining the distinctive red rash. The pharmacist or GP may also ask you questions to find out what triggered your symptoms. If your symptoms last a while (chronic urticaria), a doctor may arrange for tests to help work out the cause. Theyll also ask about anything that makes your symptoms worse. Treating hives Most hives rashes dont need treatment. The symptoms are usually mild and often get better within a few days. If necessary, a pharmacist can give you advice about antihistamines to help treat hives. Antihistamines may not be suitable for young children or if youve got a long term condition. You should discuss this with the pharmacist. Find your nearest pharmacy Treating severe hives If hives are more severe, your doctor may prescribe: steroid tablets ( oral corticosteroids ) antihistamines menthol cream to relieve itchiness If hives dont go away with treatment, a doctor may also refer you to a skin specialist (dermatologist). Phone 999 or go to A&E if you: have swelling in your mouth, eyes, face, lips, tongue, throat, feet or hands are wheezing feel lightheaded or faint get tightness in your chest or throat have trouble breathing or talking have abdominal pain, nausea and vomiting You could be having a serious allergic reaction (anaphylaxis) and may need immediate treatment in hospital. Speak to a GP if: the symptoms dont improve after 2 days youre worried about your childs hives the rash is spreading the symptoms are severe hives keeps coming back (you may be allergic to something) you also have a high temperature and feel unwell you also have swelling under your skin (this might be angioedema) the symptoms cause distress the symptoms disrupt daily activities Causes of hives Hives occur when histamine and other chemicals are released from under the skins surface. This causes the tissues to swell. Histamine can be released for many reasons, including: eating certain foods an insect bite or sting cold including exposure to cold water or wind heat including from exercise or eating spicy food emotional stress an infecti o n like a cold having drinks like alcohol or caffeine taking medicines like non-steroidal anti-inflammatory drugs (NSAIDs) or antibiotics a reaction to environmental factors like pollen, dust mites or chemicals an allergic reaction to latex scratching or pressing on your skin like wearing itchy or tight clothing a problem with your immune system water or sunlight (though this is rare) If you can, try to work out whats causing your hives. This can help to avoid them in the future. Rash self-help guide Complete our self-help guide to check your symptoms and find out what to do next. Complications of hives Complications of hives can include: angioedema a deeper swelling of tissues psychological and emotional problems like stress and anxiety anaphylaxis a severe allergic reaction that should be treated as a serious medical emergency 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: Rash 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

Vaginal cancer

Vaginal 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 Vaginal cancer Vaginal cancer About vaginal cancer Causes of vaginal cancer Diagnosing vaginal cancer Treating vaginal cancer About vaginal cancer Vaginal cancer is a rare type of cancer that begins in the vagina. Cancer that begins in the vagina is called primary vaginal cancer. Cancer that begins in another part of the body such as the cervix, womb or ovaries and spreads to the vagina is known as secondary vaginal cancer. This topic is about primary vaginal cancer. There are separate topics on cervical cancer , ovarian cancer and womb cancer . Signs and symptoms The most common symptom of vaginal cancer is abnormal vaginal bleeding. This includes: bleeding between your normalperiods, or after sex bleeding after the menopause (post-menopausal bleeding) Other symptoms can include: smelly or bloody vaginal discharge pain during sex pain when urinating needing to urinate more frequently than usual blood in your urine pelvic pain an itch or lump in your vagina Speak to your GP if you experience any abnormal vaginal bleeding, changes in your usual pattern of periods (such as irregular periods or heavier periods than usual), or problems urinating. While its highly unlikely that these symptoms are caused by vaginal cancer, they should still be investigated by your GP. Read more about diagnosing vaginal cancer. What causes vaginal cancer? The exact causes of vaginal cancer are unknown, but things that may increase your risk of developing it include: being infected with a particularly persistent type of the human papilloma virus (HPV), which can be spread during sex your age 7out of every 10 cases of vaginal cancer affect women and anyone with a vagina over 60 a previous history of vaginal intraepithelial neoplasia (VAIN) or cervical intraepithelial neoplasia (CIN) abnormal cells in the vagina or cervix that can sometimes become cancerous As there is a possible link with HPV, it may be possible to reduce your risk of vaginal cancer by practising safe sex. The HPV vaccination ,which is routinely offered to girls who are 12 to 13 years old, provides protection against 2strains of HPV thought to be responsible for most cases of vaginal and cervical cancer. Read more about the causes of vaginal cancer . How vaginal cancer is treated Treatment for vaginal cancer depends on which part of your vagina is affected and how far the cancer has spread (known as the stage). The main treatments for vaginal cancer are: radiotherapy radiation is used to destroy the cancerous cells surgery to remove the cancerous cells chemotherapy medication is used to kill the cancerous cells; this is often used in combination with radiotherapy These treatments can cause both short- and long-term side effects that should be discussed with your care team before treatment begins. Read more about treating vaginal cancer Causes of vaginal cancer Cancer occurs when the cells in a certain area of your body divide and multiply too rapidly. This produces a lump of tissue known as a tumour. The exactreason why this happens in casesof vaginal cancer is unknown, but certain things canincrease your chances of developing the condition. Human papilloma virus (HPV) Human papilloma virus (HPV) is the name given to agroup of viruses that affect the skin and the moist membranes that line the body, such as those in the cervix, anus, mouth and throat. HPV is spread during sex, including anal and oral sex. There are many different types of HPV and up to 8out of every 10 people are infected withthevirusat some time during their lives. In most cases, the virus goes away without causing any harm and doesnt lead to vaginal cancer. However, HPV is present inmore thantwo-thirds of people with vaginal cancer, which suggests that it may increase your risk of developing the condition. HPV is known to cause changes in the cells of the cervix, which can lead to cervical cancer . Its thought that the virus could have a similar effect on the cells of the vagina. Abnormal cells in the cervix or vagina Youre more likely to develop vaginal cancer if youve previously been found to have abnormal cells in your: cervix known as cervical intraepithelial neoplasia (CIN) vagina known asvaginal intraepithelial neoplasia (VAIN) CIN and VAIN are terms used to describe cells that are abnormal, but not different enough to be considered cancerous. Both are thought to be closely linked to having a persistent HPV infection. Theabnormal cellsdontusually cause any problems themselves andmay only be detected during cervical screening , but left untreated there is a small chance they could eventually become cancerous. If youre found to have CIN or VAIN, a procedure to remove or destroy the abnormal cells may be recommended. Diethylstilbestrol A medicine called diethylstilbestrol is known to increase your risk of vaginal cancer. The medicationwas widely prescribed during pregnancy between 1938and 1971, because it was thought itcould help reduce the risk of miscarriage . However, in 1971, researchers discovered a link between diethylstilbestrol and cancer in the children of women given the medicine.The use of diethylstilbestrol during pregnant was then banned. The risk of vaginal cancer associated withdiethylstilbestrol is small and as its nowover 40 years since it was lastused during pregnancies, cases of vaginal cancer linked to the medication are very rare. Other possible factors Other things that may increase your risk of vaginal cancer include: your age 7out of every 10 cases of vaginal cancer occur in women and anyone with a vagina over 60 having a history of reproductive cancers, such as cervical cancer or vulval cancer particularly if you were treatedwith radiotherapy smoking having HIV Read further information: Cancer Research UK: risks and causes of vaginal cancer Diagnosing vaginal cancer To help diagnose vaginal cancer, your GP will ask you about your symptoms and may carry out a physical examination. They may also refer you for blood tests to rule out other causes of your symptoms, such as infection. If your GP cannot find an obvious cause of your symptoms, they will probably refer you to a gynaecologist for further testing. A gynaecologist is a specialist in treating conditions of the female reproductive system. If your GP refers you urgently because they think you have cancer, you have the right to be seen by a specialist within 2weeks. The National Institute for Health and Care Excellence ( NICE ) recommends that GPs consider referring a woman who has an unexplained mass in or at the entrance to their vagina. Seeing a gynaecologist If you are referred to a gynaecologist, you may have: external and internal vaginal examinations to look for any unusual lumps or swellings a colposcopy an examination where a special instrument (colposcope) that acts like a magnifying glass is used to study your vagina in greater detail If yourgynaecologist thinks there may be abnormal tissue inside your vagina, a small sample of the tissue will be removed and checked under a microscope for cancerous cells. This is known as a biopsy . If the results of the biopsy suggest you have cancer, youmay have further tests to see if the cancer has spread. These tests may include a moredetailed internal vaginal examination carried out under general anaesthetic , X-rays , computerised tomography (CT) scans and magnetic resonance imaging (MRI) scans . Staging Healthcare professionals use a staging system to describe how far vaginal cancer has advanced. stage 1 the cancer has started to grow into the wall of the vagina stage 2 the cancer has begun to spread outside the vagina into the surrounding tissues stage 3 the cancer has spread into your pelvis and may have spread to nearby lymph nodes stage 4a the cancer has spread beyond your vagina and into organs such as your bladder or back passage (rectum) stage 4b the cancer has spread into organs further away, such as the lungs The stage of your cancer is important in determining which treatment is most appropriate and whether a cure is possible. Generally, the lower the stage when cancer is diagnosed, the better the chance of a cure. If a cure is not possible, treatment can still helprelieveany symptoms and slow down the spread of the cancer. Read more about how vaginal cancer is treated . Read further information: Cancer Research UK: tests for vaginal cancer Cancer Research UK: stages of vaginal cancer Treating vaginal cancer Treatment for vaginal cancer will depend on where the cancer is in your vagina and how far it has spread. Possible treatments include radiotherapy, surgery and chemotherapy. When you are diagnosed with cancer, you will be cared for by a group of different healthcare professionals, known as a multidisciplinary team (MDT). Your MDT will include a range of specialists, including surgeons, clinical oncologists (specialists in the non-surgical treatment of cancer), andspecialist cancer nurses. Your MDT will recommend a treatment plan they feel is most suitable for you, but the final decision will be yours. Before going to hospital to discuss your treatment options, you may find it useful to write a list of questions to ask the specialist. For example, you may want to find out the advantages and disadvantages of particular treatments. Radiotherapy Radiotherapy is the main treatment for vaginal cancer. It can be used: as an initial treatment to cure the cancer in combination with chemotherapy (chemoradiation) after surgery to prevent the cancer from returning to control symptoms when a cure is not possible (palliative radiotherapy) How its carried out There are 2main ways that radiotherapy for vaginal cancer can be given: external radiotherapy a machine beams high-energy rays at your vagina and pelvis internal radiotherapy a small radioactive device, which looks like a tampon, is inserted into your vagina The type of radiotherapy you receive depends on where the cancer is in your body. For example, internal radiotherapy may be used if the cancer is in the lining of your vagina, and external radiotherapy may be used if the cancer is deeper in the tissues of the vagina. You canreceive a combination of internal and external radiotherapy. External radiotherapy is usually given for around 4to 6weeks in short daily sessions, from Monday to Friday. You return home between treatments and have a breakat the weekends. Internal radiotherapy may involve either a long treatment session where you need to stay in hospital for 24 hours, or several short day-case treatments. Read more about how radiotherapy is performed . Side effects Following radiotherapy, its likely you will have some side effects. These occur because radiotherapy temporarily damages some healthy cells as well as destroying cancerous ones. Possible side effects of radiotherapy for vaginal cancer include: sore, red skin similar to sunburn vaginal discharge pain while passing urine diarrhoea tiredness feeling sick narrowing of the vagina (see below) early menopause and infertility (see below) Read more about the side effects of radiotherapy . Effects on sex Radiotherapy may cause you to lose interest in sex, particularly if you have side effects such as tiredness or nausea, or you are anxious about your condition or treatment. Radiotherapy can also cause scar tissue to form in your vagina, which can make it narrower and means having sex is difficult or uncomfortable. If you feel up to it, your care team may suggest having sex regularly during treatment to help stop this happening. Devices called dilators, which are inserted into the vagina, can also be used after treatment stops to helpstop your vagina getting narrower. You may also experience somevaginal dryness or pain when having sex. If this happens, you can try using lubricants or asking yourcare team aboutpossible treatments. Menopause and fertility If you have external radiotherapy to your pelvis, you may experience an early menopause (if you have not had the menopause already). This means you will no longer be able to have children (infertility). Before your treatment, yourcare team will explain whether this is a risk and discuss the options and supportavailable. Surgery There are 4main types of surgery used to treat vaginal cancer: partial vaginectomy removing the upper section of your vagina radical vaginectomy removing all of your vagina and pelvic lymph nodes radical vaginectomy and radical hysterectomy removing all of your vagina, womb, ovaries, fallopian tubes and pelvic lymph nodes pelvic exenteration removing all of your vagina and surrounding tissue, including the bladder and/or rectum (back passage) Partial vaginectomy A partial vaginectomy can be used to treatstage 1vaginal cancer, when radiotherapy has failed to remove the cancer or where a woman prefers to have surgery rather than radiotherapy because she still wants to have children. Your surgeon will remove the cancerous section of the vagina, as well assome surrounding healthy tissue, just in case a small number of cancerous cells have spread. Your surgeon will repair the defect in the vaginal wall, which means you will be able to have sex after you have recovered from the operation. Radical vaginectomy A radical vaginectomymay beused to treat cases of advanced stage 1 and stage 2 vaginal cancer. The surgeon will remove most, or all, of your vagina. A plastic surgeon may be able to make a new vagina using skin, muscle and tissue taken from another part of your body usually one of your thighs or buttocks. You will still be able to have sex after a vaginal reconstruction, although you will need to use lubricant, becausethe lining of the new vagina cannot make the mucus it would naturally make. Radical hysterectomy A radical hysterectomy is oftenperformed at the same time as a radical vaginectomy. During a radical hysterectomy, all of the reproductive system is removed, including the womb, fallopian tubes, ovaries and nearby lymph nodes. Pelvic exenteration Pelvic exenteration is used in a few cases to treat recurrent or advanced cases of vaginal cancer. Ifyou no longer have a bladder, you will need another way to pass urine. One solution is for your surgeon to make a hole (stoma) in your tummy. A bag is then attached to the stoma so that urine can be passed into it. The bag is known as a urostomy bag. Similarly, as youmay no longer have a rectum, you will need a way to pass stools (faeces) out of your digestive system. Another stoma can be made and attached to a collection bag, known as a colostomy bag. Read more about colostomies . A vaginal reconstruction can be carried out aftera pelvic exenteration. Itmay also be possible to reconstruct your rectum and attach it to the remaining section of your bowel once this has healed. In this case, you will only need a temporary colostomy. As pelvic exenteration is major surgery, it may take you several months to fully recover from the operation. Chemotherapy Chemotherapy is usually used in combination with radiotherapy or to control symptoms when a cure is not possible (palliative chemotherapy). Its usually given by injection (intravenous chemotherapy). Like radiotherapy, the powerful cancer-killing medicines used in chemotherapy can also damage healthy tissue and cause a range of side effects. Side effects of chemotherapy for vaginal cancer can include: tiredness feeling sick increased risk of infections diarrhoea hair loss Read more about the side effects of chemotherapy . Coping with treatment Treatment for vaginal cancer can have a significant emotional impact, particularly for young women who experience an early menopause as a result of treatment. The removal of some or all of the vagina can be traumatic for pre- and post-menopausal women alike, andsome women feel less womanly than they did before. Its not uncommon to feel a sense of loss and bereavement after treatment. In some women, this may lead to depression . You may find it helpful to talk to other women who have had similar treatment. Your GP or hospital staff may be able to recommend a suitable local support group. Charities can also help: Macmillan Cancer Support has informationon groups you can join and a support line that you can call for free on 0808 808 00 00 (Monday to Friday, 9am to 8pm) Cancer Research UK provides a free phone number that you can call on 0808 800 40 40 (Monday to Friday, 9am to 5pm) If feelings of depression persist,speak to yourGP about the treatment and support available. Clinical trials As vaginal cancer is rare, you may be asked to take part in aclinical trial. Clinical trials are an important way for healthcare professionals to learn more about the best way to treat specific conditions. Most clinical trials involve comparing a new treatment with an existing treatment to determine whether the new treatment is more or less effective. If you do receive a new treatment, there is no guarantee it will be more effective than an existing one. You can find out whether there are currently anyclinical trials for vaginal cancer, or ask your care team if there are clinical trials in your area. Your care team can explain the advantages and disadvantages of taking part. Read further information: Cancer Research UK: Treatment for vaginal cancer Macmillan Cancer Support: Vaginal cancer 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 Cervical cancer Radiotherapy Other health sites Cancer Research UK: Vaginal cancer The Eve Appeal: vaginal cancer Macmillan Cancer Support: Vaginal 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

Vaginal discharge

Vaginal discharge | 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 Vaginal discharge Vaginal discharge You can experience vaginal discharge for many reasons. It doesnt always mean you have an STI. Vaginal discharge is nothing to worry about if its: odourless (no unpleasant smell) clear or white thick and sticky slippery and wet The amount of discharge you might experience can vary. You might experience heavier or more frequent discharge if youre: pregnant sexually active using contraception , such as the contraceptive pill During ovulation, youll notice more slippery and wet discharge, which is normal. Contact your GP or sexual health service if: You have vaginal discharge and: you experience pelvic pain youre bleeding between periods or after sex you experience pain when peeing you feel itchy, sore or have blisters your vaginal discharge changes in colour, smell or texture You should look out for anything that doesnt seem normal for you. This can include discharge which is: foul-smelling thick and white (like cottage cheese) green or yellow and frothy accompanied by pain or bleeding accompanied by itchiness, blister or sores STIs that can cause vaginal discharge include: chlamydia gonorrhoea genital herpes trichomonas If youre sexually active and you experience any abnormal discharge, contact your local sexual health clinic to get tested for STIs. Vaginal discharge can also be caused by thrush or bacterial vaginosis . You might be asked to visit your local sexual health clinic for a vaginal examination to ensure you get the correct treatment. Free treatment If youre experiencing discharge that you dont think has been caused by an STI, you can visit your local pharmacy for advice. If you experience discharge and think theres a chance it could be caused by an STI, you should contact your local sexual health clinic . If they think you need treatment or aftercare for anything thats caused vaginal discharge, youll be given this for free. Free treatment is available for: vaginal infections such as bacterial vaginosis (BV) and thrush all STIs Genital hygiene You cant always prevent vaginal discharge. But its important to keep your vagina clean and healthy. Your vagina cleans itself internally. So you dont need to clean inside with things like a vaginal douche. You can use panty liners if you experience heavy discharge. But dont use them all the time as they can cause irritation. Read genital washing advice 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

Varicose eczema

Varicose eczema - 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 Skin, hair and nails Varicose eczema Varicose eczema About varicose eczema Causes of varicose eczema Diagnosing varicose eczema Treating varicose eczema About varicose eczema Varicose eczema is a long-term skin condition that affects the lower legs and is common in people with varicose veins . Itisalso known as venous eczema, gravitational eczema andstasis eczema. Signs and symptoms Like all types of eczema,the affected skin becomes: itchy red andswollen dry andflaky scaly or crusty There may be periodswhen these symptomsimprove and periods when they become more severe. Your legs may become swollen, especially towards the end of the day or after long periods of standing. Varicose veins (swollen and enlarged veins) are often visible on the legs. Some people also have other symptoms, such as: brown discolouration of the skin red, tender and tight skin that can eventually become hardened (lipodermatosclerosis) small, white scars (atrophie blanche) pain eczema affecting other parts of the body Left untreated, leg ulcers can develop. These arelong-lasting wounds that form where the skin has become damaged. When to seek medical advice See your GP if you have symptoms of varicose eczema. They willoften be able to make a diagnosis simply by looking at the skin. Read more about diagnosing varicose eczema . What causes varicose eczema? Varicose eczema is caused by increased pressure in the leg veins. When the small valves in the veins stop working properly, its difficult for blood to be pushed against gravity and itcan leakbackwards. This increases thepressure in the veins, which can cause fluid to leak into the surrounding tissue. It is thought that varicose eczema may develop as a result of the immune system reacting to this fluid. Varicose eczema is more common in people with varicose veins, as these are also often a sign that the leg veins arent working properly. Read more about the causes of varicose eczema . How varicose eczema is treated Varicose eczema tends to be a long-termproblem. However, treatments are available to help keepit under control. For most people, treatment involves a combination of: self-help measures including ways to improve your circulation, such as keeping active and frequently raising your legs emollients moisturisers applied to the skin to stop it becoming dry) topical corticosteroids ointments and creams applied to the skin to help treat the eczema and relieve symptoms compression stockings specially designed stockings, usually worn every day, that steadily squeeze your legs and help to improve your circulation If these treatments dont help, your GP may refer you to a dermatologist (skin specialist) in case there is another cause for your symptoms or if they are concerned you may also have a type of eczema called contact dermatitis. If you also have varicose veins, you may be referred to a vascular specialist (a doctor or surgeon specialising in conditions affecting the blood vessels) who can talk to you about the treatment options for varicose veins . Readmore about treating varicose eczema . Causes of varicose eczema Varicose eczema is usually caused by increased pressure in your leg veins. Inside your veins there arevalves that let the blood through in one direction and prevent it flowing backwards. Sometimes, the walls of the veins can become stretched and lose their elasticity, causing the valves to become weakened. If the valves do not function properly,blood may leak backwards. Thisincreases the pressure in your veins, which may cause fluid to leak into surrounding tissues. It is thought that varicose eczema may develop as a result of your immune system reacting to these fluids in the tissues under your skin. This increase in pressure can also cause blood to collect in your veins, which become swollen and enlarged ( varicose veins ). Whosmost at risk? It is not fully understood why the walls of the veins stretch and the valves weaken.Somepeople develop the conditionfor no obvious reason, although there are certainfactors that increase the chances of this happening, including: gender varicose eczema is more common in women obesity this can increase the pressure in your leg veins pregnancy this can alsoincrease the pressure in yourleg veins not being able to move for a long period of time this can affect the circulation inyour leg veins having previously had deep vein thrombosis (DVT) blood clots that develop inleg veins, which can damage thevalves in your veins increasing age people generally find it harder to move about as they get older, which can affect their circulation Diagnosing varicose eczema See your GP if you have symptoms of varicose eczema. They can usually make a diagnosis by simply looking at the affected areas. Your GP will also ask you questions to determine whether you have a problem with the flow of blood in your leg veins, as this is the main cause of varicose eczema. To help make a diagnosis, your GP may want to know if you have a history of: varicose veins swollen and enlarged veins deep vein thrombosis (DVT) a blood clot in one of the deep veins of your legs leg ulcers areas of damaged skin that take several weeks to heal cellulitis an infection of the deeper layers of the skin and underlying tissue surgery or injury to your legs Your GP may also check the pulse in your feet and they may carry out an ankle brachial pressure index (ABPI) test to see if compression stockings are suitable for you. See the section on treating varicose eczema for more information about these. The ABPI test involves comparing blood pressure readings taken from your ankles and upper arms. A significant difference in the readings suggests a problem with the flow of blood in your arteries in which case, compression stockings may not be safe to use. Referral to a specialist You may be referred to a specialist in a local hospital for further tests. This might bea vascular specialist (a doctor or surgeonspecialising in conditions affecting the blood vessels) or a dermatologist (a specialist in skin conditions) if: you have varicose veins and changes to your skin, such as varicose eczema, lipodermatosclerosis (hard, tightened skin) or a history ofleg ulcers you have very poor blood flow in the blood vessels in your legs your symptoms dont get better, despite treatment it is possible that you may havecontact dermatitis Treating varicose eczema Treatment for varicose eczema aims to improve the condition of your skin, treat your symptoms and help improve your circulation (blood flow). For many people, this will involve long-term treatment with a combination of: emollients (moisturisers) topical corticosteroids compression stockings There are also some self-help techniques that you can try. These treatment options are described in more detail below. Lipodermatosclerosis (hardened,tight skin) is treated in a similar way to varicose eczema. If you have a venous leg ulcer , you can alsoread about treating venous leg ulcers . Self-help There are some steps you can take to reduce the symptoms of varicose eczema and help prevent further problems, such as: try to avoid injuring your skin injuries to your skin could lead to an ulcerdeveloping raise your legs when you are resting for example, by propping up your feet on some pillows(ideally so that they are above the level of your heart), as this can help reduce swelling keep physically active this will improve your circulation andhelp you maintain a healthy weight Fluidcan build upin the lower legs if you sit or stand for too long, so it is important to keep moving. Walking will get your muscles working and help to push the blood through the veins to your heart. The National Eczema Society also recommends regularly flexing your feet and rising up onto your toes or bending down at the knees. Emollients Emollients aremoisturising 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 Anumber of different emollients are available. Some can be bought over the counter without a prescription, but if you have varicose eczema it may be helpful to ask your GPto recommend a suitable product. You may need to try several different emollients to find one that works for you. You may also be prescribed a mixture of emollients, for example: 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 The difference between lotions, creams and ointments is the amount of oil thatthey contain. Ointments contain the most oil, so they can be quite greasy, butare the most effective at keeping moisture in the skin. Lotions contain the least amount ofoil, so are not greasy, but can be less effective. Creams are somewhere in between. How to use emollients If you have varicose eczema, you should usean emollient at least twice a day, even if you do not have any symptoms. To apply the emollient: use a large amount you should aim to cover all of the skin on your lower leg, not just the obviously affected areas dont rub it ininstead, smooth it into the skin in the same direction that the hair grows applyevery 2to 3hours for very dry skin after a bath or shower, gently dry the skin, then immediately apply the emollient while the skin is still moist do not share emollients with other people It is very important to keep using emollients during a flare-up of varicose eczema, because this is when the skin needs the most moisture.Apply emollients frequently and in generous amounts during a flare-up. Side effects Its unusual for emollients to cause side effects, but they can occasionally cause a rash, and greasy emollients may sometimes cause folliculitis (inflammation of the hair follicles). If you experience any side effects from your emollient, speak to your GP, who can prescribe 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 If your skin is inflamed from a flare-up of varicose eczema, your GP may prescribe a topical corticosteroid (corticosteroid medication that is applied directly to your skin in the form of a cream or ointment) to quickly reduce the inflammation. They are also commonly known as topical steroids. Different strength topical corticosteroids can be prescribed, depending on the severity of your varicose eczema. If you have flare-ups of lipodermatosclerosis, you may need a very strong topical corticosteroid. How to use topical corticosteroids When using corticosteroids, only apply the treatment to the affected areas. Your doctor can advise youon how much to apply and how often. You can also check the advice in the patient information leaflet that comes with your medication. Most people only have to apply a topical corticosteroid once a day. When applying the medication, you should: apply your emollient first and wait around 30 minutes before applying the topical corticosteroid (until the emollient has soaked into your skin) apply it only to the affected area use the topical corticosteroid for7 to 14 days and continue to apply the treatment for 48 hours after the flare-up has cleared If your varicose eczema is moderate to severe, you may need to apply topical corticosteroids both between flare-ups and during them. If you need to use topical corticosteroids on a long-term basis, you should apply them less frequently. Your GP will advise youon how often you should be applying them. You should also speak to your GP 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, particularly if using a cream. Generally, using a strong topical corticosteroid for prolonged periods will increase your risk of getting more serious side effects, such as thinning of the skin. Your doctor will advise you as to the strength of the medication you require and when you should use it. Compression stockings Medical compression stockings are specially designed to steadily squeeze your legs to help improve your circulation. They are tightest at the ankle and get gradually looser as they go further up your leg. This encourages blood to flow upwards towards your heart. Medical compression stockings are used to treat varicose eczema and lipodermatosclerosis by improving the flow of blood through your leg veins and reducing the pressure in the veins. Choice of compression stockings Compression stockings are available in a variety of different sizes and pressures. They are also available in: different colours different lengths some come up to the knee and others also cover the thigh (you should only need knee-high stockings for varicose eczema) different foot styles some cover the whole foot and some stop before the toes Support stockings or tights that lightly compress the legs can be bought from pharmacies. Compression stockings that compress the legs more are available on prescription and will require you to be measured by a nurse first. In some cases, if you find it difficult to put on your stockings, you may be advised to use a tubular bandage instead. Wearing compression stockings You will usually need to put your compression stockings on as soon as you get up in the morning and take them off when you go to bed. Wearing compression stockings can be uncomfortable, particularly during hot weather, but it is important to wear them correctly to get the most benefit from them. Pull them all the way up so that the correct level of compression is applied to each part of your leg. Do not let the stocking roll down, or it may dig into your skin in a tight band around your leg. Speak to your GP if the stockings are uncomfortable, they do not seem to fit, or you have difficulty putting them on. It may be possible to get custom-made stockings that will fit you exactly. Take care whenputting compression stockings on and taking them off,as thiscan damage fragile skin. If you have a leg ulcer, it ideally needs to heal before you start wearing compression stockings. Caring for compression stockings Compression stockings usually have to be replaced every 3to 6months. Speak to your GP if your stockings become damaged, as they may no longer be effective. You should be prescribed 2stockings (or 2sets of stockings if you are wearing 1on each leg) so that 1stocking can be worn while the other is being washed and dried. Compression stockings should be hand-washed in warm water and dried away from direct heat. Treating varicose veins If you have varicose veins ,as well asvaricose eczema, treating these may sometimes be helpful. If your GP thinks treatment may be beneficial, they can refer you to a vascular surgeon, who can arrange for an ultrasound scan of your leg to find the faulty blood vessels. Treatment of your varicose veins can then be planned. There are a number of treatments available that can improve the symptoms and appearance of varicose veins, including: endothermal ablation where energy from either high-frequency radio waves or lasers is usedto seal the affected veins sclerotherapy where aspecial foam is injectedinto your veins to seal them ligation and stripping where affected veins are tied off and surgically removed These procedures are usually performed in the day surgery department of a hospital. Read more about treating varicose veins . Source: NHS 24 - Opens in new browser window Last updated: 07 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 Atopic eczema Venous leg ulcer Other health sites BAD: venous eczema Circulation 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

Venous leg ulcer

Venous leg ulcer - 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 Skin, hair and nails Venous leg ulcer Venous leg ulcer About venous leg ulcers Symptoms of venous leg ulcers Causes of venous leg ulcers Diagnosing venous leg ulcers Treating venous leg ulcers Preventing venous leg ulcers About venous leg ulcers A leg ulcer is a long-lasting (chronic) sore that takes more than 4to 6weeks to heal. They usually develop on the inside of the leg, just above the ankle. The symptoms of a venous leg ulcer include pain, itching and swelling in the affected leg. There may also be discoloured or hardened skin around the ulcer, and the sore may produce a foul-smelling discharge. See your GP if you think you have a leg ulcer, as it will need specialist treatment to help it heal. Your GP will examine your leg and may carry out additional tests to rule out other conditions. Read more about how a venous leg ulcer is diagnosed . What causes venous leg ulcers? A venous leg ulcer is the most common type of leg ulcer, accounting for over 90% of all cases. Venous leg ulcers can develop after a minor injury, where persistently high pressure in the veins of the legs has damaged the skin. Read more about the causes of venous leg ulcers . Whos affected? Venous leg ulcers are estimated to affect around 1 in 500 people in the UK, although they become much more common with age. Its estimated that around 1 in 50 people over the age of 80 has one. Youre more at risk of developing one if youve previously had deep vein thrombosis (DVT) orfind it difficult towalk because of a problem such as: osteoarthritis a leg injury obesity paralysis Youre also more at risk ifyouve recently had an operation on your leg, such as a hip replacement or knee replacement . People with varicose veins (swollen and enlarged veins) also have a higher risk of developing venous leg ulcers. How venous leg ulcers are treated Most venous leg ulcers heal within 3to 4months if theyre treated by a healthcare professional trained in compression therapy for leg ulcers. However, some ulcers may take longer to heal, and a very small number never heal. Treatment usually involves: cleaning and dressing the wound using compression, such as bandages or stockings, to improve the flow of blood in the legs Antibiotics may also be used if the ulcer becomes infected, but they dont help ulcers to heal. However, unless the underlying cause of the ulcer is addressed, theres a high risk of a venous leg ulcer recurring after treatment. Underlying causes could include immobility, obesity, previous DVT, or varicose veins. Read more about treating venous leg ulcers . Can venous leg ulcers be prevented? There are several ways to help prevent a venous leg ulcer in people at risk, such as: wearing compression stockings losing weight if youre overweight exercising regularly elevating your leg when possible This is particularly important if youve previously had a leg ulcer once a leg has suffered a venous ulcer, youre at risk of further ulcers developing within months or years. Read more about preventing venous leg ulcers . Symptoms of venous leg ulcers Venous leg ulcers are open, often painful, sores in the skin that take more than a month to heal. They usually develop on the inside of the leg, just above the ankle. If you have a venous leg ulcer, you may also have: swollen ankles (oedema) discolouration and darkening of the skin around the ulcer hardened skin around the ulcer, which may make your leg feel hard or evenresemble the shape of an upside-down champagne bottle a heavy feeling in your legs aching or swelling in your legs red, flaky, scaly and itchy skin on your legs ( varicose eczema ) swollen and enlarged veins on your legs ( varicose veins ) an unpleasant and foul-smelling discharge from the ulcer Signs of an infection A venous leg ulcer can be susceptible to bacterial infection. Symptoms of an infected leg ulcer can include: worsening pain a green or unpleasant discharge coming from the ulcer redness and swelling of the skin around the ulcer a high temperature (fever) When to seek medical advice Contact your GP if you think youve developed a venous leg ulcer. Theyre unlikely to get better on their own, as they usually require specialist medical treatment. You should also contact your GP or leg ulcer specialist if youve been diagnosed with a venous leg ulcer and have symptoms that suggest it could be infected. Read more about how venous leg ulcers are treated . Causes of venous leg ulcers A venous leg ulcer can develop after a minor injury if theres a problem with the circulation of blood in your leg veins. If this happens, pressure inside the veins increases. This constant high pressure can gradually damage the tiny blood vessels in your skin and make it fragile. As a result, your skin can easily break and form an ulcer after a knock or scratch. Unless you have treatment to improve the circulation in your legs, the ulcermay notheal. Read more about treating venous leg ulcers . Whos most at risk? Anumber of factors can increase your risk of developing a venous leg ulcer, including: obesity or being overweight this increases the pressure in the leg veins if you have difficulty walking this can weaken the calf muscles, which can affect circulation in the leg veins previous deep vein thrombosis (DVT) blood clots that develop in the leg can damage valves inthe veins varicose veins swollen and enlarged veins caused by malfunctioning valves previous injury to the leg, such as a broken or fractured bone, which may cause DVT or impair walking previous surgery to the leg, such as a hip replacement or knee replacement , which can prevent you from moving about increasing age people find it harder to move around as they get older, particularly if they suffer from arthritis Diagnosing venous leg ulcers See your GP if you think you have a venous leg ulcer. The ulcer is unlikely to heal without specialist treatment. Diagnosis is largely based on your symptoms and examination of your affected leg, although additional tests may be required. Medical history and examination Your GP or practice nurse will ask whether you have any other symptoms associated with venous leg ulcers, such as: swelling in your ankles discoloured or hard skin Theyll try to determine the cause of the ulcer by asking about underlying conditions or previous injuries, such as: diabetes deep vein thrombosis (DVT) injury or surgery in the affected leg a previous leg ulcer Theyll also examine your leg, both when youre standing up and lying down. Varicose veins will be more obvious when youre standing up, and it will be easier to look at the ulcer when youre lying down. Theyll also feel your pulse at your ankles to make sure the arteries in your leg are working properly. Doppler study To rule outperipheral arterial disease(acondition affecting the arteries) as apossible cause of your symptoms, your GP or nurse will carry out a test known as a Doppler study. This involves measuring the blood pressure in the arteries at your ankles and comparing itto the pressure in your arms.If you have peripheral arterial disease, the blood pressure in your ankles will be lower than your arms. Its important to carry out this check as the main treatment for venous ulcers is compression bandages or stockings to improve thevein circulation in your legs. Its not safe to apply compression if the ankle artery pressures are low. Read more about how venous leg ulcers are treated . Referral to a specialist In some cases, your GP or nurse may decide to refer you toa specialist in conditions affecting the blood vessels (vascular specialist). For example, you may be referred to a vascular specialist if your GP or nurse is unsure about your diagnosis, or if they suspect your ulcer may be caused by artery diseases, diabetesor rheumatoid arthritis . After taking your medical history and examining you, the vascular specialist may need to arrange further investigations to plan your treatment. Treating venous leg ulcers With appropriate treatment, most venous leg ulcers heal within 3to 4months. Treatment should always be carried out by a healthcare professional trained in compression therapy for leg ulcers. Usually, this will be a practice or district nurse. Cleaning and dressing the ulcer The first step is to remove any debris or dead tissue from the ulcer and apply an appropriate dressing. This provides the best conditions for the ulcer to heal. A simple, non-sticky dressing will be used to dress your ulcer. This usually needs to be changed once a week. Many people find they can manage cleaning and dressing their own ulcer under the supervision of a nurse. Compression To improve vein circulation in your legs and treat swelling, your nurse will apply a firm compression bandage over the affected leg. These bandages are designed to squeeze your legs and encourage blood to flow upwards, towards your heart. There are many different types of bandageor elastic stockings used to treat venous leg ulcers, whichmay be madein 2, 3or 4different layers. The application of a compression bandage is a skilled procedure and they should only be applied by trained healthcare staff. The bandage is changed once a week, when the dressing is changed. When compression bandages are first applied to an unhealthy ulcer, its usually painful.Ideally, you should have paracetamol or an alternative painkiller prescribed by your GP.The pain will lessen once the ulcer starts to heal, but this can take up to 10-12 days. Its important to wear your compression bandage exactly as instructed. If you have any problems, its usually best to contact your nurse, instead of trying to remove it yourself. If the compression bandage feels a little too tight and is uncomfortable in bed at night, getting up for a short walk will usually help. However,youll need to cut the bandage off if: you get severe pain at the front of your ankle you get severe pain on the top of your foot your toes become blue and swollen Once you remove the bandage,make sure you keep your leg highly elevated and contact your doctor or nurse as soon as possible. In some clinics, specialist teams are using new alternatives to compression bandages, such as special stockings or other compressive devices. These may not be available in every clinic butcould change the way ulcers are treated in future. Your specialist will be able to advise you whether a different approach may help you. Treating associated symptoms Swelling in the legs and ankles Venous leg ulcers are often accompanied by swelling of your feet and ankles (oedema), which is caused by fluid. This can be controlled by compression bandages. Keeping your leg elevated whenever possible, ideally with your toes at the same level as your eyes, will also help ease swelling. You should put a suitcase, sofa cushion or foam wedge under the bottom of your mattress, to help keep your legs raised while you sleep. You should also keep as active as possible and aim to continue with your normal activities. Regular exercise, such as a daily walk, will help reduce leg swelling. However, you should avoid standing or sitting still with your feet down. You should elevate your feet at least every hour. Itchy skin Some people with venous leg ulcers develop rashes with scaly and itchy skin. This isoften due to varicose eczema , which can be treated with a moisturiser (emollient) and occasionally a mild corticosteroid cream or ointment. Inrare cases,you may need to be referred to a dermatologist (skin specialist) for treatment. Itchy skin can also sometimes be caused by an allergic reaction to the dressings or creams applied by your nurse. If this happens, you may need to be tested for allergies. Its important to avoid scratching your legs if they feel itchy, because this damages the skin and may lead to further ulcers. Looking after yourself duringtreatment To help your ulcer heal more quickly, follow the advice below: Try to keep active by walking regularly. Sitting and standing still without elevating your legs can make venous leg ulcers and swelling worse Whenever youre sitting or lying down, keep your affected leg elevated withyourtoes level with your eyes Regularly exercise your legs by moving your feet up and down, and rotating them at the ankles. This can help encourage better circulation If youre overweight, try to reduce your weight witha healthy diet and regular exercise Stop smoking Moderate your alcohol consumption Be careful not to injure your affected leg, and wear comfortable, well-fitting footwear You may also find it helpful to attend a local healthy leg club, such as those provided by the Lindsay Leg Club Foundation , for support and advice. Treating an infected ulcer An ulcer sometimes produces a large amount of discharge and becomes more painful. There may also be redness around the ulcer. These symptomsand feeling unwell are signs of infection. If your ulcer becomes infected, it should be cleaned and dressed as usual. You should also elevate your leg most of the time and youll be prescribed a 7-day course of antibiotics . The aim of antibiotic treatment is toclear the infection. However, antibiotics dont heal ulcers and should only be used in short courses to treatinfected ulcers. Follow-up You should visit your nurse once a week to have your dressings and compression bandages changed. Theyll also monitor the ulcer to see how well its healing. Once your ulcer is healing well, your nurse will see you less often. After the ulcer has healed Once youve had a venous leg ulcer, another ulcer could develop within months or years. The most effective method of preventing this is to wear compression stockings at all times when youre out of bed. Your nurse will help you find a stocking that fits correctly and that you can manage yourself. Various accessories are available to help you put them on and take them off. Read more about preventing venous leg ulcers . Preventing venous leg ulcers You can help reduce your risk of developing a venous leg ulcer in several ways, such as wearing a compression stocking, losing weight and taking care of your skin. People most at risk of developing a venous leg ulcer are those who have previously had a leg ulcer. Compression stockings If youve previously had a venous leg ulcer, or youre at risk of developing one,treatment withcompression stockings may be recommended by your GP. These stockingsare specially designed to squeeze your legs, improving your circulation. Theyreusually tightest at the ankle and less tight further up your leg this encourages blood to flow upwards, towards your heart. To be most effective, these stockings should be put on as soon as you get up and only taken off at night. Compression stockings are available in a variety of sizes, colours, styles and pressures. A nurse can help you find a stocking that fits correctly and that you can manage yourself. There are various accessories you can buy to help get the stockings on and off. Losing weight If youre obese or overweight, losing weight can help treat and prevent venous leg ulcers. Excess weight leads to high pressure in the veins in your legs, which can damage your skin. Venous ulcers are much more common among people who are overweight. To help you lose weight, regular exercise and a healthy, balanced diet are recommended. You should also avoid sitting or standing for long periods.Elevating your legs whenever possible can also help. Read moreabout: losing weight health and fitness healthy eating Treating underlying problems Treating severe varicose veins may help prevent leg swelling or ulcers. This may involve a procedure where a catheter (a thin, flexible tube) is inserted into the affected veins withhigh-frequency radio waves or lasers used to seal them. Alternatively, you may need surgery to repair the damage to your leg veins, or to remove the affected veins altogether. Read more about treating varicose veins . Source: NHS 24 - Opens in new browser window Last updated: 22 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 Deep vein thrombosis High blood pressure (hypertension) Varicose veins Varicose eczema Other health sites British Association of Dermatologists The Lindsay Leg Club Foundation Circulation Foundation: Leg ulcers 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

Vertigo

Vertigo | 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 Vertigo Vertigo Vertigo is a symptom, rather than a condition itself. Its the feeling that you, or the environment around you, is moving or spinning. This feeling may be barely noticeable, or it may be so severe that you find it difficult to keep your balance and do everyday tasks. Vertigo can develop suddenly and last for a few seconds or much longer. If you have severe vertigo, your symptoms may be constant and last for several days, making daily life very difficult. Symptoms of vertigo may include: loss of balance which can make it difficult to stand or walk feeling sick or being sick dizziness When to get medical advice Speak to your GP practice if: your vertigo comes on suddenly you have vertigo that will not go away you have vertigo that keeps coming back vertigo is affecting your daily life Diagnosing vertigo Your GP will ask about your symptoms and can carry out an examination to help determine some types of vertigo. They may also refer you for further tests. What causes vertigo? Inner ear problems, which affect balance, are the most common causes of vertigo. It can also be caused by problems in certain parts of the brain. Causes of vertigo may include: benign paroxysmal positional vertigo (BPPV) where certain head movements trigger vertigo migraine labyrinthitis or vestibular neuronitis an inner ear infection Mnires disease Depending on the condition causing vertigo, you may have other symptoms, such as: a high temperature ringing in your ears ( tinnitus ) hearing loss Treatment for vertigo Most people with vertigo get better without treatment. Treatment will depend on the cause. Medicines, such as prochlorperazine and some antihistamines, can help in most cases of vertigo. Your GP may refer you to an ear nose and throat (ENT) specialist or a balance physiotherapist if needed. Things you can do to help your symptoms There may be things you can do yourself to help your symptoms, and reduce how often you have vertigo. Do lie still in a quiet, dark room to reduce the spinning feeling move your head carefully and slowly during daily activities sit down straight away when you feel dizzy turn on the lights if you get up at night use a walking stick if youre at risk of falling sleep with your head slightly raised on 2 or more pillows get up slowly when getting out of bed and sit on the edge of the bed for a minute or so before standing try to relax and avoid stress anxiety can make vertigo worse Dont do not bend over to pick things up squat to lower yourself instead do not stretch your neck for example, while reaching up to a high shelf Safety If you have vertigo, there are some safety issues to consider. For example: you should tell your employer if your job involves operating machinery or climbing ladders you may have a higher chance of falling read about preventing falls for advice on reducing your risk Driving and vertigo If you drive, you must tell the DVLA about your vertigo. Further information on driving with vertigo on GOV.UK Fear of heights The term vertigo is often incorrectly used to describe a fear of heights. The medical term for a fear of heights and the dizzy feeling associated with looking down from a high place is acrophobia. Further information and advice about phobias Source: ENT Scotland - Opens in new browser window Last updated: 05 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 Tinnitus Other health sites Brain and Spine Foundation: Dizziness and balance problems Action on Hearing Loss: protect your hearing 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

Vitamin B12 or folate deficiency anaemia

Vitamin B12 & folate 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 Vitamin B12 or folate deficiency anaemia Vitamin B12 or folate deficiency anaemia About vitamin B12 or folate deficiency anaemia Symptoms of vitamin B12 or folate deficiency anaemia Causes of vitamin B12 or folate deficiency anaemia Diagnosing vitamin B12 or folate deficiency anaemia Treating vitamin B12 or folate deficiency anaemia Complications of vitamin B12 or folate deficiency anaemia About vitamin B12 or folate deficiency anaemia Vitamin B12 or B9 (commonly called folate) deficiency anaemia occurs when a lack of vitamin B12 or folate causes the body to produce abnormally large red blood cells that cant function properly. Red blood cells carry oxygen around the body using a substance called haemoglobin. Anaemia is the general termfor having either fewer red blood cells than normal or having an abnormally low amount of haemoglobin in each red blood cell. There are several different types of anaemia, and each one has a different cause. For example, iron deficiency anaemia , which occurswhen the body doesnt contain enough iron. Symptoms of vitamin B12or folate deficiency Vitamin B12 and folate perform several important functions in the body, including keeping the nervous system healthy. A deficiency in either of these vitamins can cause a wide range of problems, including: extreme tiredness a lack of energy pins and needles (paraesthesia) a sore and red tongue mouth ulcers muscle weakness disturbed vision psychological problems, which may include depression andconfusion problems withmemory, understanding and judgement Some of these problems can also occur if you have a deficiency in vitamin B12 or folate, but dont have anaemia. Read about the symptoms of vitamin B12 or folate deficiency anaemia When to see your GP See your GP if you think you may have a vitamin B12 or folate deficiency. These conditions can often be diagnosed based on your symptoms and the results of a blood test . Its important for vitamin B12 or folate deficiency anaemia to be diagnosed and treated as soon as possible because, although many of the symptoms improve with treatment, some problems caused by the condition can be irreversible. Read about diagnosing vitamin B12 or folate deficiency anaemia Causes of a vitamin B12 or folate deficiency There are a number of problems that can lead to a vitamin B12 or folate deficiency, including: pernicious anaemia where your immune system attacks healthy cells in your stomach, preventing your body from absorbing vitamin B12 from the food you eat; thisis the most common cause of vitamin B12 deficiency in the UK a lack of these vitamins in your diet this is uncommon, but can occur if you have a vegan diet, follow a fad diet or have a generally poor diet for a long time medication certain medications, including anticonvulsants and proton pump inhibitors (PPIs), can affect how much of these vitamins your body absorbs Both vitamin B12 deficiency and folate deficiency are more common in older people, affecting around 1 in 10 people aged 75 or over, and 1 in 20 people aged 65 to 74. Read about the causes of vitamin B12 or folate deficiency anaemia Treating vitamin B12 or folatedeficiency anaemia Most cases of vitamin B12 and folate deficiency can beeasily treated with injections or tablets to replace themissing vitamins. Vitamin B12 supplements are usually given by injection at first. Then, depending on whether your B12 deficiency is related to your diet, youll either require B12 tablets between mealsor regular injections. These treatments may be needed for the rest of your life. Folic acid tablets are used to restore folate levels. These usually need to be taken for four months. In some cases, improving your diet can help treat the condition and prevent it recurring. Vitamin B12 is found in meat, fish, eggs,dairy products, yeast extract (such as Marmite) and specially fortified foods. The best sources of folate include green vegetables such as broccoli, Brussels sprouts and peas. Read about treating vitamin B12 or folate deficiency Complications of vitamin B12 or folate deficiency anaemia Although its uncommon, vitamin B12 or folate deficiency (with or without anaemia) can lead to complications, particularly if youve been deficient in vitamin B12 or folate for some time. Potential complications can include: problems with the nervous system temporary infertility heart conditions pregnancy complications and birth defects Adults with severe anaemia are also at risk of developing heart failure. Somecomplications improve with appropriate treatment, but others such as problems with the nervous system can be permanent. Read about the complications of vitamin B12 or folate deficiency anaemia Symptoms of vitamin B12 or folate deficiency anaemia Vitamin B12 or folate deficiency anaemia can cause a wide range of symptoms. These usually develop gradually but can worsen if the condition goes untreated. Anaemia is whereyou have fewer red blood cells than normal oryou havean abnormally low amountof a substance called haemoglobin in each red blood cell. General symptoms of anaemia may include: extreme tiredness (fatigue) lack of energy (lethargy) breathlessness feeling faint headaches pale skin noticeable heartbeats (palpitations) hearing soundscoming from inside the body, rather than from an outside source ( tinnitus ) loss of appetite and weight loss Symptoms of vitamin B12deficiency If you have anaemia caused by a vitamin B12 deficiency, you may have othersymptoms in addition to those listed above, such as: a pale yellow tinge to your skin a sore and red tongue (glossitis) mouth ulcers pins and needles (paraesthesia) changes in the way that you walk and move around disturbed vision irritability depression changes in theway you think, feel and behave a decline in your mental abilities, such asmemory, understanding and judgement ( dementia ) Some of these symptoms can also occur in people who have a vitamin B12 deficiency, but have not developed anaemia. Symptoms of folate deficiency Additional symptoms in people withanaemia caused by a folate deficiency can include: symptoms related to anaemia reduced sense of taste diarrhoea numbness and tingling in the feet and hands muscle weakness depression When to see your GP See your GP if youre experiencing symptoms of vitamin B12 or folate deficiency anaemia.These conditions can often be diagnosed based on your symptoms and the results of a blood test. Read more about diagnosingvitamin B12 or folate deficiency anaemia Its important forvitamin B12 or folate deficiency anaemia to be diagnosed and treated as soon as possible. Although many of the symptoms improve with treatment, some problems caused by the condition can be irreversible if left untreated. The longer the condition goes untreated, the higher the chance of permanent damage. Causes of vitamin B12 or folate deficiency anaemia Vitamin B12 or folate deficiency anaemia occurs when a lack of either of these vitamins affects the bodys ability to produce fully functioning red blood cells. Red blood cells carry oxygen around the body. Most people withvitamin B12 or folate deficiency anaemia have underdeveloped red blood cells that arelarger than normal. The medical term for this is megaloblastic anaemia. A vitamin B12 or folate deficiency can be the result of a variety of problems, some of which are described below. Causes of vitamin B12 deficiency Pernicious anaemia Pernicious anaemia is the most common cause of vitamin B12 deficiency in the UK. Pernicious anaemia is an autoimmune condition that affects your stomach. An autoimmune condition meansyourimmune system (the bodys natural defence system that protects against illness and infection) attacks your bodys healthy cells. In your stomach, vitamin B12is combined withaprotein called intrinsic factor. This mix of vitamin B12 and intrinsic factor is then absorbed into the body in part of the gut called the distal ileum. Pernicious anaemia causes your immune system to attack the cells in your stomach that produce the intrinsic factor, which meansyour body is unable to absorb vitamin B12. The exact causeof pernicious anaemia is unknown, but the condition is more common inwomen around 60 years of age, people with a family history of the condition and those with another autoimmune condition, such as Addisons disease orvitiligo. Diet Some people can develop a vitamin B12 deficiency as a result of not getting enough vitamin B12 from their diet. A diet that includes meat, fish and dairy products usually provides enough vitamin B12, but people who dont regularly eat these foods such as those following avegan diet or who havea generallyvery poor diet can become deficient. Stores of vitamin B12 in the body canlastaround two to four years without being replenished, so it can take a long time forany problems to develop after a dietary change. Conditions affecting the stomach Some stomach conditions or stomach operations can prevent the absorption ofenough vitamin B12. For example, agastrectomy (a surgical procedure where part of your stomach is removed) increases your risk of developing a vitamin B12 deficiency. Conditions affecting the intestines Some conditions that affect your intestinescan alsostop you from absorbing the necessary amount of vitamin B12. For example, Crohns disease (a long-term condition that causes inflammation of the lining of the digestive system) can sometimes mean your body doesntget enough vitamin B12. Medication Some types of medicine can lead to a reduction inthe amount of vitamin B12 in your body. For example, proton pump inhibitors (PPIs) a medication sometimes used totreat indigestion can make a vitamin B12 deficiency worse. PPIs inhibit the production of stomach acid, which is needed to release vitamin B12 from the food you eat. Your GP will be aware of medicines that can affect your vitamin B12 levels and will monitor you if necessary. Functional vitamin B12 deficiency Some people can experience problems related to a vitamin B12 deficiency, despite appearing to have normal levels of vitamin B12 in their blood. This can occur due to a problem known as functional vitamin B12 deficiency where theres a problem with the proteins that help transport vitamin B12 between cells. This results inneurological complications involving the spinal cord. Causes of folate deficiency Folate dissolves in water, which means your body is unable to store it for long periods of time. Your bodys store of folate is usually enough to last four months. This means you need folate in your daily diet to ensure your body has sufficient stores of the vitamin. Like vitamin B12 deficiency anaemia, folate deficiency anaemia can develop for a number of reasons. Some are described below. Diet Goodsources of folate includebroccoli, Brussels sprouts, asparagus, peas, chickpeas and brown rice. If you dont regularly eat these types of foods, you may develop a folate deficiency. Folate deficiency caused by a lack of dietary folate is more common in people who have a generally unbalanced and unhealthy diet, people who regularly misuse alcohol and people following a fad diet that doesnt involve eating good sources of folate. Malabsorption Sometimes your body may be unable to absorb folate as effectively as it should. This is usually due to an underlying condition affecting your digestive system, such as coeliac disease . Excessive urination You may lose folate from your body if you urinate frequently. This can be caused by an underlying condition that affects one of your organs, such as: congestive heart failure where the heart is unable to pump enough blood around the body acute liver damage often caused by drinking excessive amounts of alcohol long-term dialysis where a machine that replicates the kidney function is used to filter waste products from the blood Medication Some types of medicine reduce the amount of folate in your body, or make the folate harder to absorb. These include someanticonvulsants (medication used to treat epilepsy), colestyramine, sulfasalazine and methotrexate. Your GP will be aware of medicines that can affect your folate levels and will monitor you if necessary. Other causes Your body sometimes requires more folate than normal. This can cause folate deficiencyif you cant meet your bodys demands for the vitamin. Your body may need more folate than usual if you: are pregnant (see below) have cancer have a blood disorder such as sickle cell anaemia (an inherited blood disorder which causes red blood cells to develop abnormally) are fighting an infection or health condition that causes inflammation (redness and swelling) Premature babies (born before the 37th weekof pregnancy) are also morelikely to develop a folate deficiency, because their developing bodies require higher amounts of folate than normal. Pregnancy If youre pregnant or trying to get pregnant, its recommended that you take a 400 microgram folic acid tablet every day until youre 12 weeks pregnant. This will ensure that both you and your baby have enough folate and help your baby grow and develop. Folic acid tablets are available with a prescription from your GP, or you can buy them over the counter from pharmacies, large supermarkets and health food stores. If youre pregnant and have another condition that may increase your bodys need for folate, such as those mentioned above, your GP will monitor you closely to prevent you from becoming anaemic. In some cases, you may need a higher dose of folic acid. For example, if you have diabetes, you should take a 5 milligrams (5mg or 5,000 micrograms) supplement of folic acid instead of the standard 0.4 milligrams (0.4mg or 400 micrograms). Read more about vitamins and minerals in pregnancy Diagnosing vitamin B12 or folate deficiency anaemia A diagnosis of vitamin B12 or folate deficiency anaemia can often be made by your GP based on your symptoms and the results of blood tests. Blood tests Different types of blood tests can be carried out tohelp identify people with a possiblevitamin B12 or folate deficiency. These tests check: whether you have a lower level of haemoglobin (a substance that transports oxygen)than normal whether your red blood cells are larger than normal the level of vitamin B12 in your blood the leveloffolate in your blood However, some people can have problems with their normal levels of these vitaminsor mayhave low levels despite having no symptoms.This is why its important for your symptoms to be taken into account when a diagnosis is made. A particular drawback of testing vitamin B12 levels is that the current widely-used blood test only measures the total amount of vitamin B12 in your blood. This meansit measuresforms of vitamin B12 that are active and can be used by your body, as well as the inactive forms, which cant. If a significant amount of the vitamin B12 in your blood is inactive, a blood test may show that you have normal B12 levels,even though your body cant use much of it. There are some types of blood test thatmay help determine if the vitamin B12 in your blood can be used by your body, but these arent yet widely available. Identifying the cause If your symptoms and blood test results suggest a vitamin B12 or folate deficiency, your GP may arrange further tests. If the cause can be identified,it willhelpto determine the most appropriate treatment. For example,you may have additional blood tests to check for a condition called pernicious anaemia. This is an autoimmune condition (where your immune system produces antibodies to attack healthy cells), which means youre unable to absorb vitamin B12 from the food you eat. Tests for pernicious anaemia arent always conclusive, but they can oftengive your GP a good idea of whether you have the condition. Referral to a specialist You may be referred to a specialist for further tests or treatment. This may include: ahaematologist (specialist in treating blood conditions) if you have vitamin B12 or folate deficiency anaemia and your GP is uncertain of the cause, youre pregnant or symptoms suggest your nervous system has been affected agastroenterologist (specialist in conditions that affect the digestive system) if your GP suspects you dont have enough vitamin B12 or folate because your digestive system isnt absorbing it properly adietitian (specialist in nutrition) if your GP suspects youhave a vitamin B12 or folate deficiency caused by a poor diet Adietitian can devise a personalised eating plan for you to increase the amount of vitamin B12 or folate in your diet. Treating vitamin B12 or folate deficiency anaemia The treatment for vitamin B12 or folate deficiency anaemia depends on whats causing the condition. Most people can be easily treated with injections or tablets to replace the missing vitamins. Treating vitamin B12 deficiency anaemia Vitamin B12 deficiency anaemia is usually treated with injections of vitamin B12, in a form called hydroxocobalamin. At first, youll have these injections every other day for two weeks, or until your symptoms have stopped improving. Your GP or nurse will give the injections. After this initialperiod, yourtreatment will depend on whether the cause of your vitamin B12 deficiency is related to your diet. The most common cause of vitamin B12 deficiency in the UK is pernicious anaemia, which isnt related to your diet. Read more about the causes of vitamin B12 or folate deficiency Diet-related If your vitamin B12 deficiency is caused by a lack of the vitamin in your diet, you may be prescribed vitamin B12 tablets to take every day between meals. Alternatively, you may need to have an injection of hydroxocobalamin twice a year. People who find it difficult to get enough vitamin B12 in their diets, such asthose following a vegan diet, may need vitamin B12 tablets for life. Although its less common, peoplewith vitamin B12 deficiency caused by a prolonged poor diet may be advisedto stop taking the tablets once their vitamin B12 levels have returned to normal andtheir diet has improved. Good sources of vitamin B12 include: meat salmon and cod milk and other dairy products eggs If youre a vegetarian and vegan, orare looking for alternatives to meat and dairy products, there are other foods that contain vitamin B12, such as yeast extract (including Marmite), as well as some fortified breakfast cereals and soy products. Check the nutrition labels while food shopping to see how much vitamin B12different foods contain. Not diet-related If your vitamin B12 deficiency isnt caused by a lack of vitamin B12 in your diet, youll usually need to have an injection of hydroxocobalamin every three months for the rest of your life. If youve had neurological symptoms (symptoms that affect your nervous system, such as numbnessor tingling in your hands and feet) caused by a vitamin B12 deficiency, youll be referred to a haematologist, and you may need to have injections every two months. Your haematologist will adviseonhow long you need to keep taking the injections. Forinjections of vitamin B12 given in the UK, hydroxocobalamin is preferred to an alternative called cyanocobalamin. This is because hydroxocobalamin stays in the body for longer. If you need regular injections of vitamin B12, cyanocobalaminwould need to be given once a month, whereas hydroxocobalamin can be given every three months. Cyanocobalamin injections arent routinely available on the NHS. However, if you need replacement tablets of vitamin B12, these will be cyanocobalamin. Treating folate deficiency anaemia To treat folate deficiency anaemia, your GP will usually prescribe daily folic acidtablets to build up your folate levels. They may also give youdietary advice so you can increase your folate intake. Good sources of folate include: broccoli Brussels sprouts asparagus peas chickpeas brown rice Most people need to take folic acid tablets for about four months. However, if the underlying cause of your folate deficiency anaemia continues, you may have to take folic acid tablets for longer possibly for life. Before you start taking folic acid, your GP will check your vitamin B12 levels to make sure theyre normal. This is because folic acid treatment can sometimes improve your symptoms so much that it masks an underlying vitamin B12 deficiency. If a vitamin B12 deficiency isnt detected and treated, it could affect your nervous system. Monitoring your condition To ensure your treatment is working, you may need to have further blood tests . Ablood test is often carried out around 10-14 days after starting treatment to assess whether treatment is working. Thisis to check your haemoglobin level and the number of the immature red blood cells (reticulocytes) in your blood. Another blood test may also be carried out after approximately eight weeks to confirm your treatment has been successful. If youve been taking folic acid tablets, you may be tested again once the treatment has finished (usually after four months). Most people who have had a vitamin B12 or folate deficiency wont need further monitoring unless their symptoms return, or their treatment is ineffective. If your GP feelsits necessary, you may have to return for an annual blood test to see whether your condition has returned. Complications of vitamin B12 or folate deficiency anaemia As most cases of vitamin B12 deficiency or folate deficiency can be easily and effectively treated, complications are rare. However, complications can occasionally develop, particularly if youve been deficientin either vitaminfor some time. Anaemia complications All types of anaemia, regardless of the cause, can lead to heart and lung complications as the heart struggles to pump oxygen to the vital organs. Adults with severe anaemia are at risk of developing: an abnormally fast heart beat(tachycardia) heart failure where the heart fails to pump enough blood around the body at the right pressure Complications of vitamin B12 deficiency A lack of vitamin B12 (with or without anaemia) can cause the following complications: Neurological changes A lack of vitamin B12 can cause neurological problems (issues affecting your nervous system), such as: vision problems memory loss pins and needles (paraesthesia) loss of physical coordination (ataxia), which can affect your whole body and cause difficulty speaking or walking damage to parts of the nervous system ( peripheral neuropathy ), particularly in the legs If neurological problems do develop, they may be irreversible. Infertility Vitamin B12 deficiency can sometimeslead to temporary infertility (an inability to conceive). Thisusually improves with appropriate vitamin B12 treatment. Stomach cancer If you have a vitamin B12 deficiency caused by pernicious anaemia (a condition where your immune system attacks healthy cells in your stomach), your risk of developing stomach cancer is increased. Neural tube defects If youre pregnant, not having enough vitamin B12 can increase the risk of your baby developing a serious birth defect known as aneural tube defect. The neural tube is a narrow channel that eventuallyforms the brain and spinal cord. Examples of neural tube defects include: spina bifida where the babys spine doesnt develop properly anencephaly wherea baby is born without parts of the brain and skull encephalocele where a membrane or skin-covered sac containing part of the brain pushes out of a hole in the skull Complications of folate deficiency A lack of folate (with or without anaemia) can also cause complications, some of which are outlined below. Infertility As with a lack of vitamin B12, a folate deficiency can also affect your fertility. However,this is only temporary and can usually be reversedwith folate supplements. Cardiovascular disease Research has showna lack of folate in your body may increase your risk of cardiovascular disease (CVD) . CVD is a general term that describes a disease of the heart or blood vessels, such as coronary heart disease (CHD) . Cancer Research has shown that folate deficiency can increase your risk of some cancers, such as colon cancer . Problems in childbirth Alack of folate during pregnancy may increase the risk of the baby being born prematurely (before the 37th week of pregnancy) or having a low birthweight. The risk ofplacental abruption may also be increased. Thisis a serious condition where the placenta starts to come away from the inside of the womb wall, causing tummy (abdominal) pain and bleeding from the vagina. Neural tube defects As with a vitamin B12 deficiency, a lack of folate can also affect an unborn babys growth and development in the womb (uterus). This increases the risk of neural tube defects such as spina bifida developing in the unborn baby. 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 Iron deficiency anaemia Blood tests Other health sites Pernicious Anaemia Society British Nutrition 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

Vomiting in adults

Vomiting 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 Stomach, liver and gastrointestinal tract Vomiting in adults Vomiting 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 Nausea and vomiting in adults isnt usually a sign of anything serious. It tends to only last 1 or 2 days. Vomiting is the bodys way of getting rid of harmful substances from the stomach, or it may be a reaction to something that has irritated the gut. One of the most common causes of vomiting in adults is gastroenteritis . This is an infection of the gut usually caused by bacteria or a virus. Itll normally improve within a few days. Vomiting can occasionally be a sign of something more serious, such as appendicitis . There is a separate page on vomiting in children and babies . Vomiting 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: Youre vomiting and you also have: sudden, severe abdominal (tummy) pain severe chest pain blood in your vomit or what looks like coffee granules have green or yellow-green vomit a stiff neck and high temperature (fever) a sudden, severe headache thats unlike any headache youve had before swallowed something poisonous, or think you may have have a stiff neck and pain when looking at bright lights Speak to your GP if: youve been vomiting repeatedly for more than a day or two youre unable to keep down any fluids because youre vomiting repeatedly you have signs of severe dehydration , such as confusion, a rapid heartbeat, sunken eyes and passing little or no urine youve lost a lot of weight since you became ill you experience episodes of vomiting frequently youre worried about your vomiting and are feeling very unwell you have diabetes and have been vomiting a lot, particularly if you take insulin as it can affect your blood sugar level Common causes of vomiting in adults Gastroenteritis If you have diarrhoea as well as vomiting, its likely you have gastroenteritis. This is one of the most common causes of vomiting in adults. Its often caused by: a virus, like norovirus food poisoning caused by bacteria in contaminated food Your immune system will usually fight off the infection after a few days. Pregnancy Pregnant women often experience nausea and vomiting, particularly during the early stages of pregnancy. This is often called morning sicknessbut it can happen at any time of the day. Migraines If you have recurrent episodes of vomiting along with intense, throbbing headaches that last for a few hours to days at a time, you may be experiencing migraines . Pain relief, such as paracetamol and ibuprofen , can sometimes help control the pain. Your GP can prescribe anti-sickness medicine to help prevent vomiting. Labyrinthitis If you also feel dizzy, or feel like youre spinning ( vertigo ), you may have an inner ear infection called labyrinthitis . Labyrinthitis will usually improve over a few days. Your GP can prescribe medication to reduce your symptoms if needed. Motion sickness Nausea and vomiting when travelling could be a sign of motion sickness. You can try: looking at the horizon distracting yourself by listening to music Appendicitis As well as vomiting, appendicitis can cause severe pain in your abdomen (tummy). You should phone 999 for an ambulance if you experience pain that suddenly becomes worse and spreads across your abdomen. These are signs that you appendix may have burst. If you have appendicitis, you will often need surgery to remove your appendix. Other causes of vomiting in adults Vomiting in adults can also be caused by a number of other things, including: certain medicines, such as antibiotics and opioid painkillers drinking too much alcohol kidney infections and kidney stones a blockage in your bowel, which may be caused by a hernia or gallstones chemotherapy or radiotherapy acute cholecystitis (inflammation of the gallbladder) Looking after yourself at home Mostly, you can take care of yourself at home until you feel better. Do keep taking small sips of water frequently so you dont become dehydrated drink a sweet drink such as fruit juice to replace lost sugar, unless it make you feel sick eat salty snacks, such as crisps, which can help replace lost salt try ginger (in supplements, biscuits or tea) but check with your pharmacist or GP before using ginger supplements 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 Dehydration 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

Vulval cancer

Vulval 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 Vulval cancer Vulval cancer About vulval cancer Causes of vulval cancer Diagnosing vulval cancer Treating vulval cancer About vulval cancer Cancer of the vulva is a rare type of cancer that affects women and anyone with a vulva. The vulva is a womans external genitals. It includesthe lips surrounding the vagina (labia minora and labia majora), the clitoris (sexual organthat helps reach sexual climax), and the Bartholins glands (2small glands each side of the vagina). Most of those affected by vulval cancer are older women and anyone with a vulva over the age of 65. The condition is rare in women and anyone with a vulva under 50 who have not yet gone through the menopause . Symptoms of vulval cancer Symptoms of vulval cancer can include: a persistent itch in the vulva pain, soreness or tendernessinthe vulva raised and thickened patches of skin that canbe red, white or dark a lump or wart-like growth on the vulva bleeding from the vulva orblood-stainedvaginal discharge between periods an open sore in the vulva a burning painwhen passing urine amole on the vulva that changes shape or colour Speak to your GP if you notice any changes in the usual appearance of your vulva. While its highly unlikely to be the result ofcancer, these changes should be investigated. Read more about diagnosing vulval cancer . What causes vulval cancer? The exact cause of vulval cancer is unclear, but your risk of developing the conditionis increased by the following factors: increasing age vulval intraepithelial neoplasia (VIN) where the cellsin the vulva are abnormal and at risk of turning cancerous persistent infection with certain versionsof thehuman papilloma virus (HPV) skin conditions affecting the vulva,such aslichen sclerosus smoking You may be able to reduce your risk of vulval cancer by stopping smoking and taking steps to reduce the chances of picking up an HPV infection. Read more about the causes of vulval cancer . How vulval cancer is treated The main treatment for vulval cancer is surgery to remove the cancerous tissue from the vulva and any lymph nodes containing cancerous cells. Some people may also have radiotherapy (where radiation is used to destroy cancer cells) or chemotherapy (where medication is used to kill cancer cells), or both. Radiotherapy and chemotherapy may be used without surgery if youre not well enough to have an operation, or ifthe cancer has spread and it isnt possible to remove it all. Read more about treating vulval cancer . Canvulval cancer be prevented? Its not thought to be possible to prevent vulval cancer completely, but you may be able to reduce your risk by: practisingsafer sex using a condom during sex can offer some protection against HPV attending cervical screening appointmentscervical screening can detect HPV and pre-cancerous conditions such as VIN stopping smoking The HPV vaccination may also reduce your chances of developing vulval cancer. This is offered to all girlswho are 12 to 13 years old as part of their routine childhood immunisation programme. Causes of vulval cancer Cancer occurs when the cells in a certain area of your body divide and multiply too rapidly. This produces a lump of tissue known as a tumour. The exact reason why this happens in cases of vulval cancer is unknown, but certain things can increase your chances of developing the condition. These include: increasing age vulval intraepithelial neoplasia (VIN) human papilloma virus (HPV) infection skin conditions that can affect the vulva, such aslichen sclerosus smoking Increasing age The risk of developing vulval cancer increases as you get older. Most cases develop in women and anyone with a vulva aged 65 or over. Very occasionally women and anyone with a vulva under 50 can be affected. Vulval intraepithelial neoplasia (VIN) Vulval intraepithelial neoplasia (VIN) is a pre-cancerous condition. This meansthere are changes to certain cells in the vulva that arent cancerous, butcould potentially turn into cancer at a later date. This is a gradual process thatusually takes well over 10 years. In some cases, the abnormal cells may go away by themselves. However, because of the risk of cancer, treatment to remove the affected cells is often recommended. Symptoms ofVINare similar to those of vulval cancer, and include persistent itchinessof the vulva and raised discoloured patches. Speak to your GP if you have these symptoms. There are 2types ofVIN: usual or undifferentiated VIN thisusually affectswomen and anyone with a vulva under 50 and is thought to be caused by an HPV infection differentiated VIN (dVIN) this is a rarer type, usually affecting women and anyone with a vulva over 60, associated with skin conditions that affect the vulva Human papilloma virus (HPV) Human papilloma virus (HPV) is the name given to a group of viruses that affect the skin and the moist membranes that line the body, such as those in the cervix, anus, mouth and throat.Its spread during sex, including anal and oral sex. There are many different types of HPV, and mostpeople are infected with the virus at some time during their lives. In most cases, the virus goes away without causing any harm and doesnt lead to further problems. However, HPV is present in at least 40% of people with vulval cancer, which suggests it may increase your risk of developing the condition. HPV is known to cause changes in the cells of the cervix, which can lead to cervical cancer . Its thought the virus could have a similar effect on the cells of the vulva, which isknown as VIN. Skin conditions Several skin conditions can affect the vulva. In a small number of cases these are associated with an increasedrisk of vulval cancer. Two of the main conditions associated with vulval cancer are lichen sclerosus and lichen planus . Both of these conditions cause the vulva to become itchy, sore and discoloured. Its estimated that less than 5% of those who develop one of these conditions will go on to develop vulval cancer. Its not clear whether treating these conditions reduces this risk. Smoking Smoking increases your risk of developing VIN and vulval cancer. This may be becausesmoking makes the immune system less effective, and less able to clear the HPV virus from your body and more vulnerable to the effects of the virus. Diagnosing vulval cancer Speak to your GP if you notice any changes in the normal appearance of your vulva. Your GP will ask you about your symptoms, look at your medical history, andexamine your vulva to look for any lumps or unusual areas of skin. If you would prefer to be examined by afemale doctor or you would like a nurse present during the examination, it may help to let your GP practice know in advance of your appointment. Referral to a gynaecologist If your GP feels some further tests are necessary, they will refer you to a hospital specialist called a gynaecologist. A gynaecologist is a specialist in treating conditions of the female reproductive system. The National Institute for Health and Care Excellence ( NICE ) recommends that GPs consider referring a woman who has an unexplained vulval lump orulcer, or unexplained bleeding. The gynaecologistwillaskabout your symptoms and examine your vulva again, and they may recommendatest called a biopsy to determine whether you do have cancer. Biopsy A biopsy is wherea small sample oftissue is removed so it can be examined under a microscope to see if the cells are cancerous. This is often doneafter a local anaesthetic has been given to numb the area, whichmeans the procedure shouldnt be painful and you can go home the same day. Occasionally, it may be done under general anaesthetic (where youre asleep), which may require an overnight stay in hospital. Your doctor may put a few stitches in the area where the biopsy was taken from.You may have slight bleeding and soreness for a few days afterwards. Your doctor will usually see you 7to 10 days later to discuss the results with you. Further tests If the results of the biopsy show cancer, you may need further tests to assess how widespread it is. These may include: a colposcopya procedure where a microscope is used to check for abnormal cells in the vagina a cystoscopy an examination of the inside of the bladder using a thin, hollowtubeinserted into the bladder a proctoscopy an examination of the inside of the rectum biopsies of the lymph nodes near your vulvatocheck whether cancer has spread through your lymphatic system a computerised tomography (CT) scan or magnetic resonance imaging (MRI) scan scans to check for signs of cancer in your lymph nodes or other organs an X-ray to check that cancer has not spread to your lungs The results of these tests will allow your doctor to stage your cancer. This means using a number system to indicate how far the cancer has spread. Staging Vulval cancers are staged using a number from 1 to 4. The lower the stage, the less the cancer has spread and the greater the chance of treatment being successful. The staging system for vulval cancer is: stage 1 the cancer is confined to the vulva stage 2 the cancer has spread to other nearby parts of the body, such as the lower vagina, anus or lower urethra (the tube urine passes throughout of the body), but the lymph nodes are unaffected stage 3 the cancer has spread into nearby lymph nodes stage 4 the cancer has spreadto other parts of the body, including more distant lymph nodes Stage 1 and 2 vulval cancers are generally regarded as early-stage cancers with a relatively good chance of being treated successfully. Stage 3 and 4 cancers are usually regarded as advanced-stage cancers and a complete cure for these types of cancers may not always be possible. Treating vulval cancer Treatment for vulval cancer depends on factors such as how far the cancer has spread, your general health, and personal wishes. The mainoptions are surgery, radiotherapy and chemotherapy . Many women and anyone with a vulva with vulval cancer have a combination of these treatments. If your cancer is at an early stage, its often possible to get rid of it completely.However, this may not be possible if the cancer has spread. Even after successful treatment, there is up to a 1in 3chance of the cancer returning at some point later on, so youll need regular follow-up appointments to check for this. Your treatment plan Most hospitals use multidisciplinary teams (MDTs) to treat vulval cancer. MDTs are teams of specialists that work together to make decisions about the best way to proceed with your treatment. Members of your MDT will probably include a specialist surgeon, a specialist in the non-surgical treatment of cancer (clinical oncologist) and a specialist cancer nurse. Deciding which treatment is best for you can often be confusing. 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 you would like to ask the specialist. For example, you may want to find out the advantages and disadvantages of particular treatments. Surgery to remove vulval cancer In most cases, your treatment plan will involve some form of surgery. The type of surgery will depend on the stage of the cancer. There are 3surgical options to treat vulval cancer: radical wide local excision the cancerous tissue from your vulva is removed, as a well as a margin of healthy tissue, usually at least1cm wide, as a precaution radical partial vulvectomy a larger sectionofyour vulva is removed, such as 1 or both of the labia and the clitoris radical vulvectomy thewhole vulva is removed, including the inner and outer labia, and possibly the clitoris The time it will take you to recover from surgery will depend on the type of surgery and how extensive it was. For extensive operations, such as a pelvic exenteration, it may be many weeks or monthsbefore you start tofeel better. Your surgeon will talk to you about the possible risks associated with the type of procedure youre having. Possible risks include infection, bleeding, blood clots, altered sensation in your vulva, and problems having sex. Assessing and removing groin lymph nodes An additional operation may also be required to assess whether the cancerous cells have spread into one or more lymph nodes in your groin, and remove these if theyre found to contain cancer. Sentinel node biopsy If the cancer has spread to nearby lymph nodes, its sometimes possible to only remove certain lymph nodes, known assentinel nodes. Sentinelnodes are identified by injecting a dye at the site of the tumour and studyingits flowto locate the nodes closest to the tumour. These are then removed and checked for cancerous cells. Groin lymphadenectomy In some cases, some or all of the nodes in your groinmay need to be surgically removed. This is called a groin oringuinofemoral lymphadenectomy. Further treatment with radiotherapy may also berecommended. Removing cancerous lymph nodesreduces the risk of the cancer returning, but it can make you more vulnerable to infection and cause swelling in your legs from a build-up of lymphatic fluid (lymphoedema) . Pelvic exenteration In cases of advanced vulval cancer or where the cancer returns after previous treatment, an operation called a pelvic exenteration may be recommended. This involves removing your entire vulva as well as your bladder, womb and part of your bowel. This is a major operation and isnt carried out very often these days. If a section of your bowel is removed, it will be necessary for your surgeon to divert your bowel throughan opening made in your tummy (a stoma). Stools then pass along this piece of bowel and into a bag you wear over the stoma. This is known asa colostomy . If your bladder is removed, urine can be passed out of your body into a pouch via a stoma. This isknown as a urostomy. Alternatively,it may be possible to create a new bladder by removing a section of your bowel and using it to create a pouch to store urine in. Reconstructive surgery If only a small amount of tissue has been removed during surgery, the skin of the vulvacan often be neatly stitched together. Otherwise, it may be necessary to reconstruct the vulva using askin graft,where a piece of skin is taken from your thigh ortummy and moved tothe wound in yourvulva. Another option is to have askin flap, whereanarea of skin near the vulva is used to create a flap andcover the wound. These reconstructive procedures are usually carried out at the same time as the operation to remove the cancer. Radiotherapy Radiotherapy involves using high-energy radiation to destroy cancerous cells. There are several ways itcan be used to treat vulval cancer: before surgery totrytoshrink a large cancer this is tohelp make the operation possible without removing nearby organs after surgeryto destroy any cancerous cells that may be left for example, for cases where cancer cellshave spread to the lymph nodes in the groin as an alternative to surgery, if youre not well enough to have an operation to relieve symptoms in cases where a complete cure is not possible this is known as palliative radiotherapy In most cases, youll have external radiotherapy, where a machine directs beams of radiationon to the section of the body that contains the cancer. Thisis normally given in daily sessions, 5days a week, with each session lasting a few minutes.The whole course of treatment will usually last a few weeks. Side effects While radiation is effective in killing cancerous cells, it can also damage healthy tissues. This canlead to a number of side effects, such as: sore skin around the vulva area diarrhoea feeling tired all the time loss of pubic hair, which may be permanent swelling of the vulva narrowing of your vagina, which can make sex difficult inflammation of your bladder (cystitis) In younger people, external radiotherapy can sometimes trigger an early menopause .This means theywill no longer be able to have any children. Read more about the side effects of radiotherapy . Chemotherapy Chemotherapy is where medication is used to kill cancer cells. Its usually given by injection. Its usually used if vulval cancer comes back or to control symptoms when a cure is not possible. Sometimes it may be combined with radiotherapy. Side effects The medicines used in chemotherapy can sometimes damage healthy tissue, as well as the cancerous tissue. Side effects are common and include: tiredness feeling and beingsick hair thinning orhairloss sore mouth and mouth ulcers an increased risk of infections tell your care team if you develop any symptoms of an infection, and try to avoid close contact with people known to have an infection These side effects should pass once treatment has finished. Read more about the side effects of chemotherapy . Emotional support The emotional impact of living with vulval cancer can be significant. Many people report experiencing a kind of rollercoaster effect. You may feel down at receiving a diagnosis, feel up when the cancer has been removed from your body, and then feel down again as you try to come to terms with the after-effects of surgery. Some people experience feelings of depression . If you think you may be depressed, contact your GP or care team for advice. There are a range of treatments that can help. You may also find it useful to contact one of the main cancer charities, such as: Macmillan Cancer Support the helplineis availableon 0808 808 00 00, Monday to Friday, 9am to 8pm Cancer Research UK a cancer nurse helpline is availableon 0808 800 4040, Monday to Friday, 9am to 5pm 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 Other health sites Cancer Research UK: Vulval cancer Macmillan Cancer Support: Understanding vulval cancer The Eve Appeal: vulval 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

Warts and verrucas

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 Skin, hair and nails Warts and verrucas Warts and verrucas Warts are small lumps that often develop on the skin of the hands and feet. They vary in appearance and may develop singly or in clusters. Most people will have warts at some point in their life. They tend to affect children and teenagers more than adults. Warts are caused by certain strains of the human papilloma virus (HPV). More images of warts Warts can develop on the hands and feet Source: dermnetnz.org Wart on finger Source: dermnetnz.org Cause of warts and verrucas Warts are caused by certain strains of the human papilloma virus (HPV). There are lots of different strains of HPV and these cause different types of warts. HPV causes too much keratin (a hard protein) to develop in the top skin layer (epidermis). The extra keratin produces the rough, hard texture of a wart. How warts spread HPV is passed on through close skin-to-skin contact. It can also be passed on indirectly by contact with contaminated objects like: towels shoes areas surrounding swimming pools the floors of communal changing areas Youre more likely to get infected if your skin is wet or damaged. Warts can also be spread to other parts of your own body. You can spread the virus if you: scratch, knock or bite a wart bite your nails or suck your fingers (if they have warts on them) shave your face or legs After you become infected, it can take weeks or even months for a wart or verruca to appear. When to get help Warts and verrucas arent usually serious and can be treated by a pharmacist. Your pharmacist will give you advice about the best treatment for you. Find your nearest pharmacy Speak to a GP if you have a: growth on your skin that youre worried about wart or verruca that keeps coming back wart or verruca thats very large or painful wart that bleeds wart that changes in how it looks wart on your face or genitals Types of wart There are several different types of warts. These vary in size and shape. Common warts (verruca vulgaris) Source: dermnetnz.org If you have a common wart, it will: be round or oval-shaped be firm and raised have a rough, irregular surface often develop on the knuckles, fingers and knees vary in size, from less than 1mm to more than 10mm (1cm) in diameter You may develop one common wart or several. Filiform warts (verruca filiformis) Source: dermnetnz.org Filiform warts are long and slender in appearance. They often develop on the neck or face. Mosaic warts Mosaic warts grow in clusters and form a tile-like pattern. They often develop on the palms of the hands and soles of the feet. Periungual warts Source: dermnetnz.org Periungual warts develop under and around the fingernails or toenails. They: have a rough surface can affect the shape of the nail can be painful Plane warts Source: dermnetnz.org Its possible to have between one and several hundred plane warts, which can develop in clusters. They are usually: a yellowish colour smooth, round and flat-topped 2 to 4mm in diameter common in young children mainly affecting the hands, face and legs Plane warts can sometimes develop on the lower legs of women. This is because the human papilloma virus (HPV) can be spread through shaving. Verrucas (plantar warts) Verrucas usually develop on the soles of the feet. The affected area of skin will be: white, often with a black dot (blood vessel) in the centre flat rather than raised Verrucas can sometimes be painful if theyre on a weight-bearing part of th Treating warts and verrucas Warts usually clear up without treatment. The length of time it takes for a wart to disappear will vary from person to person. It can take up to 2 years for the virus to leave your system and for warts to disappear. Warts tend to last longer in older children and adults. Leaving the wart to go away by itself is one option. But, you may want to consider treatment if your wart is: painful in an awkward position causing you distress or embarrassment A wart will sometimes return following treatment. Types of treatment Common ways to treat warts and verrucas include: salicylic acid available from pharmacies in creams, gels, paints and medicated plasters cryotherapy liquid nitrogen is applied to the wart to freeze and destroy affected skin cells chemical treatments chemicals are applied to warts to kill affected skin cells Surgery is not usually recommended for warts. Preventing warts and verrucas There are steps you can take to lower your chances of getting warts, and prevent them spreading to others. Do keep your feet dry change your socks every day take care when shaving the virus can be spread easily if you cut yourself wear gloves when using shared gym equipment if you have a wart on your hand wear pool slippers or flip flops in communal changing rooms and showers cover the wart or verruca with a waterproof plaster or a verruca sock when swimming or while doing PE at school Dont do not touch other peoples warts do not share towels, flannels or other personal items with someone who has a wart do not share shoes or socks with someone who has a verruca do not scratch or pick a wart or verruca itll encourage the HPV to spread to other parts of your body 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 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

Whooping cough

Whooping cough | 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 Whooping cough Whooping cough Whooping cough, also called pertussis, is a highly contagious bacterial infection of the lungs and airways. It causes repeatedcoughing bouts that can last for 2 to 3months or more, and can make babies and young children in particular very ill. Whooping cough is spread inthe dropletsof the coughs or sneezes of someone with the infection. Symptoms of whooping cough The first symptomsof whooping cough aresimilar to those of a cold , such asa runny nose,red and watery eyes,a sore throat, anda slightly raised temperature. Intensecoughing bouts start about a week later. The boutsusually last a few minutes at a time and tend to be more common at night. Coughing usually brings up thickmucus and may be followed by vomiting. Between coughs, you or your child may gasp for breath thismay cause a whoop sound,although not everyone has this. The strain of coughing cancause thefaceto become very red, and there may be some slight bleeding under the skin or inthe eyes. Young children can sometimes brieflyturn blue (cyanosis)if they have trouble breathingthis often looks worse than it is and their breathing shouldstart againquickly. In very young babies, the cough may not be particularly noticeable, but there may be brief periods where they stop breathing. The bouts will eventually start to become less severe and less frequent over time,but it may be afewmonths before they stop completely. Whos at risk of whooping cough Whooping cough can affect people of any age, including: babies and young children young babies under 6 months of age are at a particularly increased risk ofcomplications of whooping cough older children and adults it tends to be less serious in these cases, but can still be unpleasant andfrustrating people whove had whooping cough before youre not immune to whooping coughif youve had it before, although it tends to be less severe the second time around people vaccinated against whooping cough as a child protection from thewhooping cough vaccine tends to wear off after a few years You can get whooping cough if you come into close contact with someone with the infection. A person with whooping cough is infectious from about 6 days after they were infected when they just have cold-like symptoms until three weeks after the coughing bouts start. Antibiotic treatment can reduce the length of time someone is infectious. When to get medical advice Phone 999 or go to A&E if: You or your child: have significant breathing difficulties, such as long periods of breathlessness or choking, shallow breathing, periods where breathing stops, or dusky, blue skin develop signs of seriouscomplications of whooping cough, such as fits (seizures) or pneumonia Speak to your GP practice or phone 111 if: You or your child: have symptoms ofwhooping cough have had a cough for more than 3 weeks have a cough that is particularly severe or is getting worse Treatment for whooping cough Treatment for whooping cough depends on your ageand how long youve had the infection. Children under 6 months who are very ill and people with severe symptoms will usually be admitted to hospital for treatment. Peoplediagnosed during the first 3 weeks of infection may be prescribed antibiotics to take at home. These will help stop the infection spreading to others, but may not reducethe symptoms. People whove had whooping cough for more than 3 weeks wont normally need any specific treatment, as theyre no longer contagious and antibiotics are unlikelytohelp. While youre recovering at home, it can help to get plenty of rest, drink lots of fluids, clean away mucus and sick fromyour or your childs mouth, and take painkillers such as paracetamol or ibuprofen for a fever. Avoid using cough medicines, as theyre not suitable for young children and are unlikely to be of much help. Stopping the infection spreading If you or your child are taking antibiotics for whooping cough, you need to be careful not to spread the infection to others. Do stay away from nursery, school or work until 2 days after the start of antibiotic treatment or, if not taking antibiotics 3 weeks from when the coughing bouts started cover your or your childs mouth and nose with a tissue when coughing and sneezing dispose of used tissues immediately wash your and your childs hands regularly with soap and water Other members of your household may also be given antibiotics and adose of the whooping cough vaccine to stop them becoming infected. Vaccinations for whooping cough There are 3 routine vaccinations that can protect babies and children from whooping cough: the whooping cough vaccine in pregnancy this can protect your baby during the first few weeks of life;the best time to have it is soon after the 16th week of your pregnancy the 6-in-1 vaccineoffered to babies at 8,12 and 16 weeks of age the 4-in-1 pre-school booster offered to childrenby3 years and 4 months These vaccines dont offer lifelong protection from whooping cough, but they can help stopchildren getting it when theyre young and more vulnerable to the effects of the infection. Older children and adults arent routinely vaccinated, except during pregnancy or a whooping cough outbreak. Complications of whooping cough Babies and young children under 6 months are usually most severely affected by whooping cough. Theyre at anincreased risk of: dehydration breathing difficulties weight loss pneumonia an infection of the lungs fits (seizures) kidney problems brain damage caused by a lack of oxygen reachingthe brain death although this is very rare Older children and adults tend to be less severely affected, although they may experience problems caused by repeated coughing, such as nosebleeds , bruised ribs or ahernia. 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 Other health sites MHRA study: safety of whooping cough vaccination in 20,000 pregnant women 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

Wilms tumour

"Wilms tumour | 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 Wilms tumour Wilms tumour Wilms tumour is a type of kidney cancer in children. It most often affects children under the age of 5. 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. It is devastating to hear that your child has cancer, and at times it can feel overwhelming. 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. If you have any questions its important to ask the specialist doctor or nurse who knows your childs individual situation. Wilms tumour is a type of kidney cancer that was named after Dr Max Wilms, who first described it. Its thought to come from very specialised cells in the embryo known as metanephric blastema. These cells are involved in the development of the childs kidneys while they are in the womb. The cells usually disappear at birth, but in many children with Wilms tumour, clusters of primitive kidneys cells, called nephrogenic rests can still be found. The kidneys are a pair of organs found at the back of the abdomen. They clean the blood by removing excess fluids and waste products, which are then converted into urine. Causes In most children, the causes of Wilms tumour are unknown. Very rarely, people who develop Wilms tumour have other specific conditions which are present at birth (congenital malformations). These include the lack of an iris in the eye (aniridia), abnormalities of the genitals, and a condition where one side of the body is slightly larger than the other (hemihypertrophy). In 1 in 100 people with Wilms tumour, another family member will also have Wilms tumour. Signs and symptoms The most common symptom is a swollen abdomen, which is usually painless. Sometimes a parent or carer may feel a lump in the abdomen which can be quite large. Occasionally, the tumour may bleed slightly and this can irritate the kidney and may be painful. There may be blood in your childs urine (pee), or their blood pressure may be raised. The child may also have a high temperature (fever), upset stomach, weight loss or a lack of appetite. How Wilms tumour is diagnosed A variety of tests and investigations may be needed to diagnose a Wilms tumour. An abdominal ultrasound scan is usually the first thing that is done. This will be followed by an MRI and/or CT scan of the abdomen and chest. These scans help doctors to identify exactly where the tumour is and whether it has spread beyond the kidney. This is known as staging. Urine and blood samples will also be taken to check your childs kidney function and general health. Most children will go on to have a biopsy , where a sample of tissue is taken from the tumour to confirm the diagnosis. Any tests and investigations that your child needs will be explained to you. Staging The stage of a cancer is a term used to describe its size and whether it has spread beyond its original site. Knowing the particular type and the stage of the cancer helps doctors decide on the most appropriate treatment. In the case of a Wilms tumour, the stage is finalised after surgery to remove the tumour. As most Wilms tumour patients receive chemotherapy before surgery, you may not know the exact stage of your childs tumour straight away. An exception is that babies under 6 months old usually have surgery straight away. Stage 1 The tumour is only affecting the kidney and has not begun to spread. It can be completely removed with surgery. Stage 2 The tumour has begun to spread beyond the kidney to nearby structures, but its still possible to remove it completely with surgery. Stage 3 The tumour has spread beyond the kidney; either because the tumour has burst before (or during) the operation, has spread to lymph glands (nodes), or has not been completely removed by surgery. Stage 4 The tumour has spread to other parts of the body such as the lungs or liver. Tumours in other parts of the body are known as metastases. Stage 5 There are tumours in both kidneys (bilateral Wilms tumour). If the tumour comes back after initial treatment, this is known as recurrent cancer or relapse. Treatment Treatment is planned by specialists in childrens tumours and cancers. This is usually based in a childrens oncology unit within a main hospital, but some treatment may be given closer to home. Treatment will depend on a number of factors including how the cells appear under the microscope (histology) and the stage of the tumour. Treatment may include chemotherapy, radiotherapy or surgery. Surgery All children with Wilms tumour will have surgery. Initially, this may only involve taking a small sample of cells from the tumour to confirm the diagnosis. This is called a biopsy and is usually done under a general anaesthetic using a needle inserted through the skin. Apart from very young children (under 6 months), most patients will receive chemotherapy before having a bigger operation to remove the entire tumour. The operation usually involves removing the whole of the affected kidney (nephrectomy). After examining the whole tumour under the microscope, Wilms tumours can be divided into a number of risk groups based on knowledge about how these different types of tumours are likely to behave. The treatment following surgery will depend on these risk groups. The risk groups are known as LOW, STANDARD (or INTERMEDIATE), and HIGH. The majority of tumours are in the standard risk group. So-called low risk tumours require less treatment than standard risk tumours. Two types of Wilms tumour anaplastic and blastemal are considered to be higher risk than other Wilms tumours and require more intensive (stronger) chemotherapy. Anaplastic Wilms tumour About 5% to 10% of Wilms tumours have an appearance called anaplasia, which means the cells look very disorganised under a microscope. Blastemal Wilms tumour This group of high-risk tumours cannot be identified by looking at the biopsy because they occur when a particular type of early kidney cell survives the pre-surgery chemotherapy. These cells are known as blastemal cells. Tumours, where most of these cells survive chemotherapy, are called blastemal tumours. Other kidney tumours Other, less common types of kidney tumours may occur in children. These are usually only recognised after surgery to obtain a tumour sample. Clear cell sarcoma and malignant rhabdoid tumour of the kidney are 2 types of cancerous tumour, with their own treatment recommendations. Congenital mesoblastic nephroma is a non-cancerous (benign) tumour that occurs in very young children. This type of tumour usually only needs surgery and no other treatment. Chemotherapy Chemotherapy is the use of anti-cancer (cytotoxic) drugs to destroy cancer cells. Its usually given as an injection or drip into a vein (intravenously). Chemotherapy given before surgery is called neoadjuvant chemotherapy. What doctors find out about the tumour after surgery for example, how the cells look under the microscope and how far the cancer has spread helps them to decide whether additional chemotherapy should be given (adjuvant chemotherapy). This is to help reduce the risk of the cancer coming back (recurring). This chemotherapy may be given as inpatient or outpatient depending on tumour staging and risk group. Radiotherapy Radiotherapy treats cancer by using high-energy rays to destroy the cancer cells, while doing as little harm as possible to normal cells. Not all children with Wilms tumour need radiotherapy. For those that do, the area to be treated depends on the stage of the tumour at diagnosis. Some children receive radiotherapy to the area around the affected kidney or, less commonly, to the whole abdomen. If the tumour has spread to the lungs, then lung radiotherapy may be needed but this depends on how well the cancer responds to initial chemotherapy; its not always needed. Radiotherapy may occasionally be used to shrink tumours that are too large to remove surgically. This will, ideally, allow an operation to be done. Radiotherapy can also be used when tumours have spread elsewhere in the body. Treatment for bilateral Wilms tumour In about 1 in 20 cases, Wilms tumour affects both kidneys. Treatment usually involves surgery to both. The aim of the treatment is to remove as much of the cancer as possible, while leaving as much healthy kidney as possible. Chemotherapy is always given. Sometimes radiotherapy is needed as well. Side effects of treatment Treatment for Wilms tumour often causes side effects. Your childs doctor will discuss this with you before treatment starts. Many side effects are expected and managed effectively. Side effects can include feeling sick (nausea) and being sick (vomiting), hair loss, bruising and bleeding, tiredness, diarrhoea, and an increased risk of infection. Less common effects may include impact on the heart, kidneys, and liver. Late side effects A small number of children may develop late side effects, sometimes many years later. These include a possible reduction in bone growth, a change in the way the heart and lungs work, and a slight increase in their risk of developing another cancer in later life. Infertility is a possible late side effect, although this is rare. Your childs doctor or nurse will talk to you about any possible late side effects. These will depend on the exact treatments given. 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. The trial may include comparing the standard treatment with a new or modified version. It may just involve collecting patient and tumour details including response to treatment to increase specialists knowledge. 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. Taking part in a research trial is completely voluntary, and you will 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 Most children with Wilms tumour are cured. If the cancer comes back, its usually within the first 2 years. When one kidney is removed, the other will be able to work normally and can take over the work of the other kidney. Very few children have long-term kidney problems. Your child will have regular check-ups to look for any recurrence or problems following treatment. 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 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"

Womb (uterus) cancer

Womb (uterus) 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 Womb (uterus) cancer Womb (uterus) cancer About womb cancer Symptoms of womb cancer Causes of womb cancer Diagnosing womb cancer Treating womb cancer Living with womb cancer About womb cancer Cancer of the womb (uterus) is a common cancer that affects the female reproductive system. Its also called uterine cancer and endometrial cancer. Abnormal vaginal bleeding is the most common symptom of womb cancer. If you have been through the menopause , any vaginal bleeding is considered abnormal. If you have not yet been through the menopause, unusual bleeding may include bleeding between your periods. You should speak to your GP as soon as possible if you experience any unusual vaginal bleeding. While its unlikelyto becaused by womb cancer, its best to be sure. Your GP will examine you and ask about your symptoms. They will refer you to a specialist for further tests if they suspect you may have a serious problem, or if they are unsure about a diagnosis. Read more about the symptoms of womb cancer and diagnosing womb cancer Types of womb cancer The vast majority of womb cancersbegin in the cells that make up the lining of thewomb (called the endometrium), which is why cancer of the wombis often called endometrial cancer. In rare cases, womb cancer can start in the muscles surrounding the womb. This type of cancer is called uterine sarcoma and may be treated in a different way from endometrial cancer. This article uses the term womb cancer, andmostly includes information about endometrial cancer. Read more information about soft tissue sarcomas . Womb cancer is separatefrom other cancers of the female reproductive system, such as ovarian cancer and cervical cancer . Why does womb cancer happen? Its not clear exactly what causes womb cancer, but certain things can increase your risk of developing the condition. A hormone imbalance is one of the most important risks for womb cancer. Specifically, your risk is increased if you have high levels of a hormone called oestrogen in your body. A number ofthings can cause this hormone imbalance, including obesity, diabetes, and hormone replacement therapy (HRT) .There is also a small increase in the risk of womb cancer with long-term use of the breast cancer drug tamoxifen. Its not always possible to prevent womb cancer, but some things are thought to reduce your risk. This includes maintaining a healthy weight and the long-term use of some types of contraception . Read more about the causes of womb cancer How is womb cancer treated? The most common treatment for womb cancer is the surgical removal of the womb (hysterectomy). A hysterectomy can cure womb cancer in its early stages, butyouwill no longer be able to get pregnant.Surgery for womb cancer is also likely to include the removal of the ovaries and fallopian tubes. Radiotherapy or chemotherapy are also sometimes used, often in conjunction with surgery. A type of hormone therapy may be used if you are yet to go through the menopause and would still like to have children. Even if your cancer is advanced and the chances of a cure are small, treatment can still help to relieve symptoms and prolong your life. Read more about treating womb cancer Living with womb cancer Living with cancer is challenging and womb cancer can affect your life in specific ways. For example, your sex life may be affected if you have a hysterectomy. You may find it physically more difficult to have sex and have a reduced sex drive. You may find it beneficial to talk to other people about your condition, including family members, your partner, or other people with womb cancer. Read more about living with womb cancer Who is affected? Womb cancer is the most commonly occurring cancer of the female reproductive system. Its the fourth most common cancer diagnosedin women after breast cancer , lung cancer , and cancer of the colon and rectum . Womb cancer is more common in women and anyone with a womb who has been through the menopause. Most cases are diagnosed in women and anyone with a womb aged 40 to 74. Symptoms of womb cancer The most common symptom of womb cancer is abnormal bleeding from the vagina, although most people with abnormal bleeding dont have cancer. Bleeding may start as light bleeding accompanied by a watery discharge, which may get heavier over time. Most women and anyone with a womb diagnosed with womb cancer have been through the menopause , so any vaginal bleeding will be unusual. In women and anyone with a womb who hasnt been through the menopause, unusual vaginal bleeding may consist of: periods that are heavier than usual vaginal bleeding in between normal periods Less common symptoms include pain in the lower abdomen (tummy) and pain during sex. If womb cancer reaches a more advanced stage, it may cause additional symptoms. These include: pain in the back, legs, or pelvis loss of appetite tiredness nausea When to seek medical advice If you havepostmenopausal vaginal bleeding, or notice a change in the normal pattern of your period, visit your GP. Only1 in 10 cases of unusual vaginal bleeding after the menopause are caused bywomb cancer, so its unlikely your symptomswill be caused by this condition. However, if you have unusual vaginal bleeding, its important to get the cause of your symptoms investigated.The bleeding may be the result of a number of other potentially serious health conditions, such as: endometriosis where tissue that behaves like the lining of the womb is found on the outside of the womb fibroids non-cancerous growths that can develop inside the uterus polyps in the womb lining Other types of gynaecological cancer can alsocause unusualvaginal bleeding, particularly cervical cancer . Read further information: Cancer Research UK: womb cancer symptoms Macmillan: symptoms of womb cancer Causes of womb cancer Its not known exactly what causes womb cancer, but certain things can increase your risk of developing it. Cancer begins with a change (mutation) in the structure of the DNA in cells, which can affect how they grow. This means cells grow and reproduce uncontrollably, producing a lump of tissue called a tumour. If left untreated, cancer can grow and spread to other parts of your body, either directly or through the blood and lymphatic system. Increased risk A number of things have been identified thatincrease the risk of developingwomb cancer. Age The risk of developingwomb cancer increases with age. The majority of casesoccur in women and anyone with a womb aged 40 to 74. Oestrogen The risk of developing womb cancer is linked to the bodysexposure to oestrogen. Oestrogen is one of the hormones that regulate the reproductive system. oestrogen stimulates the release of eggs from your ovaries and causes the cells of thewomb lining to divide progesterone gets the lining of your uterus ready to receive the egg from the ovaries The levels of oestrogen and progesterone in your body are usually balanced with each other. If oestrogen isnt kept in balance by progesterone, the level in the body can increase. This is called unopposed oestrogen. After the menopause , the body stops producing progesterone. However, there are still small amounts of oestrogen being produced. This unopposed oestrogen causes the cells of the endometrium to divide, whichcan increase the risk ofwomb cancer. Hormone replacement therapy (HRT) Because of the link between increased levels of unopposed oestrogen andwomb cancer, oestrogen-only hormone replacement therapy (HRT) should only be given to those who have had their womb surgically removed (hysterectomy). In all other cases, both oestrogen and progesterone (combination HRT) must be used in HRT to reduce the risk of womb cancer. Being overweight or obese As oestrogen can be produced in fatty tissue, being overweight or obeseincreases the level of oestrogen in your body. This significantly increases your chances of developing womb cancer. Women and anyone with a womb who is overweight is 3times more likely to develop womb cancer compared with those who are a healthy weight. One way to assess whether your weight is healthy is to understand your healthy body mass index (BMI) . Reproductive history Women and anyone with a womb who has not had children are at a higher risk ofwomb cancer. This may be because the increased levels of progesterone and decreased levels of oestrogen that occur during pregnancyhave a protective effect on the lining of the womb. Tamoxifen Women and anyone with a womb who are treated with tamoxifen (a hormone treatment for breast cancer ) can be at an increased risk of developing womb cancer. However, this risk is outweighed by the benefits that tamoxifen provides in preventing breast cancer. Its important to visit your GP if youre taking tamoxifen and experience any abnormal vaginal bleeding. Diabetes Women and anyone with a womb with diabetes are twice as likely to develop womb cancer as those without the condition. Diabetes causes an increase in the amount of insulin in your body, which in turn can raise your oestrogen levels. Many women and anyone with ovaries with type 2 diabetes are also overweight, which further increases the risk. Polycystic ovarian syndrome (PCOS) Women and anyone with ovaries with polycystic ovarian syndrome (PCOS) are at a higher risk of developing womb cancer, as they have high levels of oestrogen in their bodies. PCOS can cause symptoms such as irregular or light periods, or no periods at all, as well asproblems getting pregnant, weight gain, acne, and excessive hair growth (hirsutism). Endometrial hyperplasia Endometrial hyperplasia is when the lining of the womb becomes thicker. Itmay be increase risk of developingwomb cancer. Read further information: Cancer Research UK: womb cancer risks and causes Macmillan: causes of womb cancer Diagnosing womb cancer You should visit your GP if you have abnormal vaginal bleeding. While its unlikely to be caused by womb cancer, its best to be sure. Your GP will probably carry out a physical examination of your pelvic area, including your vagina, womb, ovaries, and bladder. They will ask about your symptoms, when they happen, and how often. You may be referred to a specialist in conditions of the female reproductive organs (a gynaecologist) 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 gynaecological cancer and refer people for the right tests faster. To find out if you should be referred for further tests for suspected endometrial cancer, read the NICE 2015 guidelines on Suspected Cancer: Recognition and Referral . Transvaginal ultrasound (TVU) Another test you may have is called a transvaginal ultrasound (TVU). TVU is a type of ultrasound scan that uses a small scanner in the form of a probe. This is placed directly into the vagina to obtain a detailed picture of the inside of the uterus. The probe can feel a little uncomfortable, but shouldnt be painful. The TVU checks whether there are any changes to the thickness of the lining of your uterus that could be caused by the presence of cancerous cells. Biopsy If the results of the TVU detect changes in the thickness of the lining of the uterus, you will usually have a biopsy to confirm the diagnosis. Ina biopsy, a small sample of cells is taken from the lining of the womb (the endometrium). The sample is then checked at a laboratory for the presence of cancerous cells. The biopsy can be carried out inseveral ways, including: aspiration biopsy a small flexible tube is inserted into your vagina and up into your womb, and then sucks up a small sample of cells hysteroscopy this allows the doctor to look at the inside of the womb using a thin type of telescope called a hysteroscope, which is inserted through your vagina and into your womb, allowing the doctor to look at the lining of the womb and take a sample from it In some cases, a hysteroscopy may be used before dilatation and curettage (D&C). D&C is a minor surgical procedurecarried out under general anaesthetic ,where some tissue from the womb lining is removed. The tissueis then sent off to a laboratory for further testing. Blood test A blood test can sometimes help diagnose womb cancer. This is because some cancerous tumours release certain chemicals into your blood, known as tumour markers, which can be detected during a blood test. However, this type of test isnt very reliable. The presence of these chemicals doesnt mean you definitely have womb cancer. Some people with womb cancer dont have these chemicals in their blood. Read further information: Cancer Research UK: womb cancer tests Macmillan: how womb cancer is diagnosed Tests if you havewomb cancer If youre diagnosed with womb cancer, you may have further teststo help determine the stage of the cancer. Staging the cancer will allow the doctors to work out how large the cancer is, whether or not it has spread, and the best treatment options for you. These tests may include: achest X-ray where radiation is used to check if the cancer has spread to the lungs magnetic resonance imaging (MRI) where magnetic fields are used to create adetailed image of the inside of your bodyto check if the cancer has spread a computerised tomography (CT) scan where a series of X-rays are used to create a detailed image of the inside of your bodyto check if the cancer has spread further blood tests these are usually doneto check your general health and how well some of your organs are functioning Read treating womb cancer for more information about staging. Treating womb cancer Health professionals use a staging system to describe how far womb cancer has advanced. These stages are: stage 1 the cancer is still contained inside the womb (uterus) stage 2 the cancer has spread to the neck of the womb (the cervix) stage 3 the cancer has spread outside the womb into nearby tissues in the pelvis or the lymph nodes stage 4 the cancer has spread to the soft tissues of the abdomen, or into other organs, such as the bladder, bowel, liver, or lungs Your chances of surviving womb cancer depend on the stage at which its diagnosed. Read further information: Cancer Research UK: stages of womb cancer Cancer Research UK: statistics and outlook for womb cancer Treatment overview The main treatment for womb cancer is to remove the womb (hysterectomy), together with the ovaries and fallopian tubes. This is sometimes followed by radiotherapy or chemotherapyto try to kill any possible remaining cancer cells, depending on the stage and grade of the cancer. Treatment if you havent been through the menopause Having a hysterectomy means you willno longer beable to get pregnant. Younger women who havent already reached the menopause may not want to have their womb and ovaries removed if they wish to have children. In this case, under very specific circumstances it may be possible to treat the cancer using hormone therapy. Treating advanced cancer Advanced womb cancerrequires a different course of treatment, usually depending more on chemotherapy. Advanced cancer may not be curable, but the treatment aims to achieve a remission, where the cancer shrinks, making you feel normal and able to enjoy life to the full. Even if theres no chance of a cure, surgery may be carried out to remove as much of the cancer as possible. Radiotherapy, chemotherapy or hormone therapy can reduce symptoms such as pain by shrinking the cancer or slowing its growth. Read further information: Cancer Research UK: controlling symptoms of advanced womb cancer Cancer Research UK: which treatment for womb cancer? Surgery Surgery for stage1womb cancer If you have stage1 cancer, youll probably have a hysterectomy. This involves removing both ovaries and the fallopian tubes in a procedure called a bilateral salpingo-oophorectomy (BSO), as well asthe uterus (hysterectomy). The surgeon may also take samples from the lymph nodes in the pelvis and abdomen and other nearby tissue. These will be sent to the laboratory to see whether the cancer has spread. The most common hysterectomy technique involves using one large cut across your tummy to access the womb and remove it. Its sometimes possible to use a technique called a laparoscopic hysterectomy, also known as akeyhole hysterectomy. This involves using several small cuts so a special type of telescope (laparoscope) and other surgical instrumentscan be used. Thismeans the surgeoncan see inside your body and remove your womb through your vagina with little scarring. Youll probably be ready to go home 3to 5days after your operation, or less if you had keyhole surgery. But it can take many weeks to recover fully. After your operation, youll be encouraged to start moving about as soon as possible. This is very important, and even if you have to stay in bed youll need to keep doing regular leg movements to help your circulation and prevent blood clots. Youll be shown exercises by the nurses or physiotherapist to help prevent complications. When you go home, youll need to exercise gently to build up your strength and fitness. Discuss with your doctor or physiotherapist which types of exercise would be suitable for you. Surgery for stage2 or 3womb cancer If you have stage2 or3 womb cancer and the cancer has spread to the cervix or nearby lymph nodes in the pelvis, you may have a radical or total hysterectomy. This involves the additional removal of the cervix and the top of your vagina, as well as the removal of the pelvic lymph nodes. You may also need radiotherapy or chemotherapy treatment after surgery to reduce the riskof the cancer returning. Surgery for advanced cancer (stage 4) If you have advanced womb cancer, you may have surgery to remove as much of the cancer as possible. This is called debulking surgery. This wont cure the cancer, but it may ease some of the symptoms. Your doctor will discuss whether debulking surgery is suitable for you. Read further information: Cancer Research UK: having your operation for womb cancer National Institute for Health and Care Excellence (NICE): laparoscopic hysterectomy for endometrial cancer Radiotherapy A course of radiotherapy will be recommended if your treatment team thinks theres a significant risk the cancer could return in the pelvis. Radiotherapy may also be used to slow the spread of cancer when a surgical cure is not possible. There are 2types of radiotherapy used to treatwomb cancer: internal radiotherapy (also known as brachytherapy) wherea plastic tube is inserted inside the uterus and radiation treatment is passed down the tube into the womb external radiotherapy wherea machine is used to deliver pulses of radiation to your pelvis A course of external radiotherapy is usually given to you as an outpatient for 5days a week with a break at the weekend. The treatment takes a few minutes. The whole course of radiotherapy may last approximately 4weeks depending on the stage and position of the womb cancer. Some women and anyone with a womb have internal radiotherapy (brachytherapy) as well as external radiotherapy. During brachytherapy, the device that delivers radiation is placed in your vagina. There are different types of brachytherapy, involving either low, medium, or high dose rates. With low dose rate methods the radiation is delivered more slowly, so the device has to stay inside you for longer. Youll have to stay in hospital while you have the treatment. Your doctor will discuss this with you. Radiotherapy has some side effects. Skin in the treated area can become red and sore, and hair loss may occur. Radiotherapy to the pelvic area can affect the bowel and cause sickness and diarrhoea . As your course of treatment progresses, youre likely to get very tired. Most of these side effects will go away when your treatment finishes. Chemotherapy If you have stage3 or4womb cancer, you may be given a course of chemotherapy . Chemotherapy can be used after surgery to try to prevent the return of the cancer. In cases of advanced cancer, it may be used to slow the spread of the cancer and relieve symptoms. Chemotherapy is usually given as an injection into the vein (intravenously). Youll usually be able to go home the same day you have chemotherapy, but sometimes you may need a short stay in hospital. Chemotherapy is usually given in cycles, with a period of treatment being followed by a period of rest to allow the body to recover. Side effects of chemotherapy can include: nausea vomiting hair loss fatigue There is also an increased risk of an infection developing in your bloodstream (sepsis) , as your bodys ability to fight infection is reduced by chemotherapy. The side effects should stop once treatment has finished. Read further information: Cancer Research UK: chemotherapy for womb cancer Macmillan: chemotherapy for womb cancer Hormone therapy Somewomb cancers are affected by the female hormone oestrogen. These cancers may respond to treatment with hormone therapy. Your doctor will discusswhether this is a possible treatment for yourwomb cancer. Hormone therapyusuallyreplacesa hormone called progesterone, which naturally occurs in your body. Artificial progesterone is used and isusually given as tablets. Its mainly used to treat advanced-stagewomb cancers, or cancer that has come back, and can help shrink the tumour and control any symptoms. The treatment may have some side effects, including mild nausea, mild muscle cramps, and weight gain. Your doctor will discuss these with you. Read further information: Cancer Research UK: hormone therapy for womb cancer Macmillan: hormonal treatment for womb cancer Clinical trials A lot of progress has been made in the treatment of womb cancer. More people are living longer with fewer side effects. Some of these advances were discovered through clinical trials,where new treatments and combinations of treatments are compared with standard treatment. All cancer clinical trials in the UK are carefully monitored to make sure the trial is worthwhile and safely conducted. Participants in clinical trials often do better overall than those in routine care. If youre invited to take part in a trial, youll be given an information sheet. If you wish to take part, youll be asked to sign your consent. Youre always free to refuse or withdraw from a clinical trial without it affecting your care. Read further information: Cancer Research UK: trials and research Cancer Research UK: womb cancer research Living with womb cancer Women and anyone with a womb with womb cancer usually have a hysterectomy. This can be a major operation, and recovery may takefrom6 to 12 weeks. During this time you will have to avoid lifting things (for example, children and heavy shopping bags) and doing heavy housework. You wont be able to drive for between 3and 8weeks after the operation. Most people need4 to12 weeks off work after a hysterectomy. The recovery time will depend on the type of surgery you have, whether or notany problems develop, and what type of work you will return to. Some of the treatments for endometrial cancer, particularly radiotherapy, can make you very tired. You may need to take a break from some of your normal activities for a while. Dont be afraid to ask for practical help from family and friends if you need it. Follow-up After your course of treatment has finished, youll probably be invited back for regular check-ups. At the check-up, your doctor will examine you (this is likely to include an internal examination) and possibly carry out blood tests or scans to see how your cancer is responding to treatment. Read further information: Macmillan: follow-up after treatment for womb cancer Relationships and sex Relationships with friends and family Knowing how to talk to your friends and family about your cancer can be difficult, and they may find it hard to talk to you, too. People deal with serious problems in different ways. Its hard to predict how a diagnosis of cancer will affect you. Being open and honest about how you feel and what your family and friends can do to helpmay put them at ease. But dont feel shy about telling people that you want some time to yourself, if thats what you need. Read further information: Talking to your kids about cancer Macmillan: the emotional effects of cancer Macmillan: telling your friends and family Your sex life Wombcancer and its treatment can affect your sex life. This can happen in several ways. If you havent already had the menopause, removing the ovaries means youll go through an early menopause. Symptoms can include vaginal dryness and loss of sexual desire. Radiotherapy for endometrial cancer can make your vagina narrower and less flexible. Sometimes the vagina gets so narrow that having sex becomes difficult. To stop this happening, you should be offered a set of vaginal dilators, which are plastic cones you put into your vagina to stretch it. You can also stretch your vagina by having sex, or by using your fingers or a vibrator. Its common to lose interest in sex after treatment forwomb cancer. Your treatment may leave you feeling very tired. You may feel shocked, confused or depressed about being diagnosed with cancer, and you alsomay be grieving the loss of your fertility. Its understandable that you may not feel like having sex while having to cope with all this. Try to share your feelings with your partner. If you feel you have problems with sex that arent getting better with time, you may want to speak to a counsellor or a sex therapist. Read further information: Macmillan: how treatment for womb cancer may affect your sex life andrelationships Talk to others Being diagnosed with cancer can be hard, both for patients and their families. Youll need to deal with the emotional and practical difficulties. Withwomb cancer, you have to cope physically with recovering from a hysterectomy, as well asthe possible emotional impact of losing your womb. Younger women may have to face the fact they wont be able to have children and all the grief and anger that may cause. Often, it can help to discuss your feelings and other difficulties with a trained counsellor or therapist. You can ask for this kind of help at any stage of your illness. There are various waysto find help and support: your hospital doctor, specialist nurse or GP can refer you to a counsellor if youre struggling with feelings of depression, talk to your GPa course of antidepressant drugs may be helpful, or your GP can arrange for you to get help from a counsellor or psychotherapist it may be helpful to talk to someone whos had the same experience as you many organisations have telephone helplines and forums that may be useful to you, and they can put you in touch with other people who have been through cancer treatment Read further information: Cancer Research UK: coping with cancer Money and financial support If you have to reduce or stop work because of your cancer, you may find it hard to cope financially. If you have cancer or you are caring for someone with cancer, you may be entitled to financial support. if you have a job but cant work because of your illness, youre entitled to Statutory Sick Pay from your employer if you dont have a job and cant work because of your illness, you may be entitled to Employment and Support Allowance if youre caring for someone with cancer, you may be entitled to Carers Allowance you may be eligible for other benefits if you have children living at home, or you have a low household income Find out what help is available to youearly on. You can ask to speak to the social worker at your hospital, who can give you the information you need. Read further information: Find your nearest Citizens Advice Bureau GOV.UK: benefits Macmillan: financial issues Money Advice Service Dealing with dying If youre told nothing more can be done to treat your womb cancer, your care will focus on controlling your symptoms and helping you to be as comfortable as possible. This is called palliative care. Palliative care also includes psychological, social and spiritual support for you and your family or carers. Read further information: Palliative care End of life care Macmillan : support if youre caring for someone with womb cancer (support line: 0808 808 00 00) Marie Curie Cancer Care 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 Cervical cancer Ovarian cancer Other health sites Cancer Research UK: Womb cancer The Eve Appeal: womb cancer Macmillan Cancer Support: Womb 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

Yellow fever

Yellow 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 Yellow fever Yellow fever Yellow fever is a serious viral infection that is spread by certain types of mosquito. Its mainly found in sub-Saharan Africa, South America and parts of the Caribbean. The condition can be prevented with a vaccination and is a very rare cause of illness in travellers. Between 1999 and 2018, there were12 cases of yellow fever reported among European travellers. None of these travellers were vaccinated, 5 of these cases occurred in 2018. If youre planning to visit places where yellow fever infection is found, you should seek travel health advice before you travel. A map and list of countries where yellow fever is found is available on the NHS Fit for Travel website. How yellow fever is spread The virus that causes yellow fever is passed to humans through the bites of infected mosquitoes. The mosquitoes that spread the infection are usually active and bite during daylight hours, and are found in both urban and rural areas. Yellow fever cant be passed directly from person to person through close contact. Yellow fever symptoms The symptoms of yellow fever occur in 2 stages. The initial symptoms develop 3 to 6 days after infection, and can include: a high temperature (fever) a headache nausea or vomiting muscle pain, including backache loss of appetite This stage will usually pass after 3 to 4 days and most people will make a full recovery. However, around 15% of people go on to develop more serious problems, including jaundice (yellowing of the skin and whites of the eyes), kidney failure and bleeding from the mouth, nose, eyes or stomach (causing blood in your vomit and stools). Up to half of those who experience these symptoms will die. When to seek medical advice You should see a doctor as soon as possible if you develop symptoms of yellow fever and are currently travelling in an area where the virus is found, or have recently returned from one of these areas. To help determine whether you have yellow fever, the doctor will want to know exactly where you have been travelling and what symptoms you have. A blood test will be needed to confirm the diagnosis. Treating yellow fever There is no specific treatment for yellow fever, but you will be monitored and the symptoms can be treated. You will be admitted to hospital for assessment and supportive care. Yellow fever vaccination The yellow fever vaccine protects you from infection when you travel to a country where yellow fever virus occurs and prevents the disease from spreading between countries. After you have received the vaccine you are given a yellow fever vaccine certificate to prove that you have received the vaccine and are protected from infection. This certificate is designed to fit inside your passport and is valid for life. The countries that require proof of vaccination are those where either the disease occurs, or where it could occur because they have the correct mosquito and monkey species that could harbour the infection. More about the yellow fever vaccine Find your nearest yellow fever vaccination centre Information about you If you have yellow fever, your clinical team will pass information about you 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: Public Health Scotland - 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 Other health sites fitfortravel: Yellow fever NaTHNaC: find a yellow fever vaccination centre 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