Abdominal or stomach pain is a very common symptom, and most people experience pain at some point in their lives. Most cases of abdominal pain are due to harmless causes and the pain resolves after a few days.
The most common causes of abdominal pain are indigestion or acid reflux, gastroenteritis or stomach bug, constipation, and trapped wind.
Indigestion
Indigestion can present with heartburn where there is usually a painful burning feeling in the chest, particularly after eating.
There may also be bloating feeling, nausea, burping and bitter-tasting fluid in the mouth.
Over the counter medications such as Gaviscon, ranitidine or omeprazole can help with indigestion symptoms.
It is recommended to avoid smoking, excess alcohol, spicy food, fizzy drinks, excess tea and coffee as these can all aggravate indigestion. It is best to avoid late meals as this can cause issues while sleeping.
Gastroenteritis
Gastroenteritis or stomach bug can cause vomiting, diarrhoea and high temperature as well abdominal pain.
This is usually a self-limiting condition and resolves on its own without any treatment. It is advised to avoid heavy meals and to have light diet such as soup and dry toast. Fluids should be consumed in small amounts and more often.
Paracetamol can help with abdominal pain, cramps and high temperature.
Constipation
Constipation can be defined as a condition where there are infrequent bowel movements or discomfort with motions where there is a small amount of hard and dry stools.
The common causes of constipation are related to diet and fluid intake. These causes are lack of adequate fibre in diet, insufficient fluid intake, not being active or lack of exercise, recent diet change, side effect of medication, stress and anxiety.
It is recommended to drink plenty of fluids, to consume oranges and orange juice, prunes and prune juice, and to massage the abdomen. These measures can treat current constipation and help prevent future episodes.
If constipation is more severe, an over the counter laxative can be considered.
Trapped Wind
Trapped wind is usually nothing to worry about. This can be managed with smaller meals, plenty of fluids, regular exercise and peppermint tea.
If these measures do not work, it is advisable to see a doctor for further assessment and to rule out other causes such as lactose intolerance, coeliac disease, IBS or irritable bowel syndrome or constipation.
The other possible causes of abdominal pain are period pain, gallstones, IBS, kidney stones and appendicitis.
Period Pain
Period pain or discomfort is common before or during a period. This is often a normal part of the menstrual cycle.
Sometimes the pain can be due to various health issues such as endometriosis, fibroids, pelvic inflammatory disease, or IUD coil.
One of the main treatments for period pain is anti-inflammatory painkillers such as naproxen and mefenamic acid. These should not be used if there is history of asthma or stomach issues.
Various forms of contraception can be considered to treat period pain as well.
Heat pad or hot water bottle, warm bath, abdominal massaging, and gentle exercise can also be beneficial.
Gallstones
Gallstones are small stones that form in the gallbladder. Gallstones do not usually cause any symptoms, but some people can experience persistent pain, high temperature and jaundice which is yellowing of the skin and eyes.
If gallstones cause chronic symptoms, keyhole surgery or laparoscopic cholecystectomy will be required to remove the stones.
Kidney Stones
Kidney stones can develop in one or both kidneys and ureters.
The pain associated with kidney stones is usually quite severe and there could be nausea and vomiting.
Small kidney stones may not require any intervention, and they can be passed in the urine. Painkillers such as paracetamol can be taken if there is any pain.
If the kidney stones are larger, surgery may be required to remove them.
IBS
IBS is a common condition that affects the digestive system. The symptoms of IBS are stomach cramps, bloating, alternating diarrhoea and constipation.
There is currently no cure or single diet or medication that works for everyone with IBS. It is recommended to avoid any triggers, to eat meals made from fresh ingredients, to get regular exercise and to try probiotics for a month to see if they would help.
Appendicitis
Appendicitis is infection or inflammation of the appendix. This usually causes pain in the right lower abdomen above the hip joint.
The pain may start in the middle of the abdomen around the belly button and then move to the right lower abdomen.
There may also be other symptoms such as high temperature, nausea or vomiting, diarrhoea, and urinary frequency.
Acute appendicitis requires urgent assessment in the hospital, and surgery may be required to remove the appendix. If appendicitis is not treated quickly, this can lead to bursting of the appendix.
In summary, if abdominal pain is present and if this is severe enough or associated with other symptoms, the general advice is to see a doctor in person for further treatment.
Acne is a common skin condition, and it can happen anywhere on the skin. The most common sites include face and neck, shoulders, back and chest.
Acne can present in various ways.
Blackheads: these appear black due to the presence of hair follicle and are small black or yellow bumps that occur on the skin. These are not filled with dirt or pus.
Whiteheads: these look like blackheads and could be firmer. If these are squeezed, nothing usually comes out.
Papules: these are small red bumps that can be sore and tender.
Pustules: these are similar to papules with a white tip in the centre due to the presence of pus.
Nodules: large hard lumps that occur under the skin and can be painful.
Cysts: this is most severe type of acne spots. These may look similar to boils and are large pus-filled lumps. Cysts can lead to permanent scarring.
The exact cause of acne is not fully known and it is commonly linked to hormonal changes during puberty, positive family history, and menstrual cycle.
The hormonal changes can produce larger amounts of oil (sebum) next to hair follicles, and this can lead to some bacteria in the skin to cause inflammation and pus.
There is no conclusive evidence to suggest that acne is caused by bad hygiene or diet. However, it is best to avoid any possible triggers or aggravating factors if known to play a role in acne.
Frequent face washing can irritate the skin further so it should be avoided. Lukewarm water rather than very hot or cold water should be used. It is best to use non-comedogenic facial products that are water-based rather than oil-based comedogenic products.
It is advised to not pop or squeeze the spots or blackheads as this can cause scarring and infection.
There are various acne treatments in the form of creams, gels and ointments. These include benzoyl peroxide, Clearasil, Adapalene (Differin), Duac and Zineryt.
Tretinoin 0.05 % cream, Clindamycin gel, or Dapsone 5 % gel are among other treatments of acne.
Most of the these treatments are available over the counter. The general rule is to start with a mild treatment such as benzoyl peroxide and move on to a stronger treatment like tretinoin.
Epiduo Gel is a combination of Adapalene and benzoyl peroxide, and it can be an effective combination to treat more resistant acne. This is only available on prescription from a doctor.
Acnatac is another prescription only topical gel that can work well for acne, and it contains an antibiotic called clindamycin and tretinoin.
If these do not work, the next step is to try an oral antibiotic such as lymecycline or doxycycline which generally work very well.
The last option is Accutane (Isotretinoin), and this is reserved for very severe acne and is only prescribed by a dermatologist.
The other treatment options for acne are photodynamic therapy, comedone extractor to remove whiteheads and blackheads, or chemical peels.
If standard over the counter treatments do not work, it is best to see a doctor or dermatologist in person for further assessment.
Back pain is one of the commonest health issues that people suffer from. The pain usually affects the lower back, but it can sometimes be in the middle or upper back.
Back pain usually lasts a few weeks; however, some people can continue to experience the pain longer or develop recurrent pain.
In the absence of injury or other symptoms, back pain is not likely to be due to anything serious. It often resolves on its own without any treatment.
There are several causes of getting back pain, and sometimes the cause may not be obvious.
The most common cause of back pain is an injury like a pulled muscle or strain in the back.
The other possible causes are sciatica or trapped nerve, slipped or herniated disc, ankylosing spondylitis, or rarely infection, broken bone or cancer in the spine.
If the back pain is mild or tolerable, there is no need for any treatment. It should go away within a few weeks.
With this type of pain, it is advisable to stay active and try to continue with daily activities. An ice pack wrapped in a tea towel can help reduce the pain and any swelling.
A heat pack or hot water bottle can relieve joint stiffness or muscle spasms.
Gentle exercises and stretches of the back can be beneficial.
Ibuprofen, with or without paracetamol, can be tried for more severe back pain. It should be noted that ibuprofen is not recommended if there is history of asthma or stomach problems.
Staying in bed for long periods of time is not thought to be beneficial for back pain.
It is advised to see a doctor if the back pain does not improve after a few weeks of home treatment, if the pain is severe enough to stop daily activities, or if it is getting worse or causing other symptoms.
More severe back pain can be treated with stronger painkillers and muscle relaxants.
Physiotherapy and group exercise sessions can also help with back pain.
CBT or cognitive behavioural therapy is another treatment option that can help with the pain.
The last resort is a procedure used to seal off some of the nerves in the back to stop them from sending pain signals to the brain.
If the back pain is found to be due to a slipped or herniated disc and conventional treatments do not work, surgery may be considered.
Bacterial vaginosis or BV is a common cause of abnormal vaginal discharge. BV usually causes greyish-white discharge that has a strong fishy smell. This may be more noticeable after having sexual intercourse.
Bacterial vaginosis is caused by a change in the normal balance of bacteria in the vagina, but the exact cause for this is not fully understood.
The risk factors are sexual intercourse, change of sexual partner, presence of IUD coil and the use of perfumed products in or around the vagina.
It should be noted that half of women with BV do not have any symptoms. And bacterial vaginosis does not usually cause any soreness or itching.
Bacterial vaginosis is not considered a sexually transmitted infection or STI, but it can be triggered by intercourse, and it can increase the risk of getting an STI like chlamydia.
There are self-test kits at pharmacies, and these can be used to check for vaginal infections.
Bacterial vaginosis is normally treated with a course of antibiotics in the form of tablets, gels or creams.
Mild symptoms can be treated with over the counter treatments such as Multy-Gyn ActiGel, Replens MD Vaginal Gel, or Balance Activ BV Treatment Gel for bacterial vaginosis.
More severe cases of bacterial vaginosis are treated with a course of oral antibiotic like metronidazole.
Same-sex partners may also require treatment for bacterial vaginosis as a woman can pass it to another woman during sexual intercourse.
The symptoms of bacterial vaginosis can come back within a few months of the initial infection. This is a common occurrence and requires further treatment with antibiotics.
Recurrent bacterial vaginosis with more than four episodes in a year may require long-term treatment with a vaginal antibiotic gel that is used for a few months to prevent the infection coming back.
It is recommended to have showers instead of baths, and to use water and plain soap to wash the genital area.
The general advice is to avoid perfumed soaps, antiseptic liquids, bubble baths, shampoo or shower gel in the bath. It is not advised to use vaginal deodorants, washes or douches.
Although bacterial vaginosis does not usually cause major issues in pregnancy, there is a small risk of complications in some women such as miscarriage or premature birth.
Pregnant women with unusual vaginal discharge or suspected BV should see a doctor in person.
Bad breath or halitosis is a condition where the main symptom is bad smelling breath. In the absence of other symptoms, this is unlikely to be due to anything sinister.
The most common form of bad breath is ‘morning breath’ which occurs due to normal oral bacteria build up overnight.
The other causes of bad breath or halitosis are smoking, tonsil stones, not eating or drinking properly, prolonged hunger, having a diet rich in spices, poor mouth and dental hygiene, defective or unclean dentures, and gum disease or infection.
In some people, acid reflux and Helicobacter Pylori bacteria, which is a bug that is present in the stomach, can cause halitosis.
Sometimes the bad breath can be psychological (pseudo halitosis) and this is just a perception of bad breath without any objective cause or evidence.
If a person has good mouth and dental hygiene and eats and drinks normally, the cause could be possible Helicobacter Pylori presence in the stomach. Helicobacter Pylori presence in the stomach can be checked with a test and treatment can be considered if the test is positive.
To help with bad breath, it is recommended to avoid smoking, smelly foods, and to brush the teeth regularly. Oral hygiene is the best treatment for bad breath; and regular brushing, flossing, and drinking plenty of water can help.
If dentures are worn, these should be cleaned regularly.
The other treatments for bad breath include tongue scraping, and mouth washes such as chlorhexidine, Therabreath and Peridex.
There are rarer causes of bad breath and these include chronic bronchitis, sinus infection, post nasal discharge, diabetes, kidney or liver disease. These are quite rare in the absence of other medical symptoms or previous history.
If conventional treatments do not work, it is recommended to see a doctor for further assessment.
Bedbugs are small insects that usually live on bedding and furniture. They can hide in various places such as bed frames, mattresses, clothing, behind pictures, and under loose wallpaper.
Bedbugs are quite common, and their bites can cause an allergic reaction in the form of redness, spots and itching.
The bite from bedbugs should not cause any major illness or other health problems. The bites usually resolve without any treatment in a week.
The bite sites should be kept clean and dry. It is recommended to put something cool on the affected area to help with swelling and itching.
There are several medications available that can be used to treat the symptoms of bedbug bites.
Over the counter antihistamines or anti-allergy medications such as loratadine, cetirizine or fexofenadine can help with redness, irritation and itching from the bites.
Steroid cream called hydrocortisone, which is available over the counter, could also help to relieve the redness and itching. It is not advised to use steroid creams for more than 7 days at a time as these can thin the skin.
It is recommended to wash all bedding and clothes on a hot wash at 60 degrees, and to clean and vacuum regularly.
Putting affected clothing and bedding in a plastic bag and placing that in the freezer for 3-4 days could help get rid of the bedbugs as well.
The other bugs that could cause a rash and itching are house dust mite, scabies, fleas, head lice, ants, spiders, and mosquitos.
If the symptoms of bedbugs persist or if other types of bugs are suspected, it is best to seek advice from a professional to assess the property. Seeing a doctor in person for further assessment should also be considered.
One-off episode of a small amount of blood from the back passage is unlikely to be a serious problem.
It should be noted that eating a lot of red or purple foods like tomatoes and beetroot can make poo look like it is mixed with blood.
Bleeding from the back passage can present in different ways. The blood could be noticed on wiping with toilet paper or there may be pink or blood-stained water in the toilet bowl.
There could also be red streaks of blood on the outside of the poo, bloody diarrhoea, blood mixed with the poo, or very dark or black colour poo.
If the bleeding is very mild and it occurs on one occasion only, this is likely to resolve on its own without requiring any treatment.
It is advisable to see a doctor if there has been blood in the poo for 3 weeks, if the poo has changed to softer or thinner than normal for 3 weeks, or if there is pain around the bottom.
The other symptoms that require a doctor’s assessment are pain, lump or swelling in the abdomen, unusual tiredness and weight loss.
All children with blood in their poo should also see a doctor for an assessment.
Bloody diarrhoea or very dark or black poo require an urgent assessment in the hospital.
There are various causes of bleeding from the back passage.
If there is bright red blood and pain when passing poo, itching and lumps around the anus, this could be due to haemorrhoids.
A small tear in the anus is called anal fissure and this can cause bright red blood and pain when passing poo which usually occur after constipation.
Bleeding with or without lumps, itching or pain in back passage could be related to sexually transmitted infection or STI like genital warts, or damage from anal sex.
Bright red blood without any pain or other issues could be a side effect of blood thinning medications such as warfarin, apixaban or aspirin which are used to prevent blood clots in some people.
A rare cause of rectal bleeding is anal fistula. This is a small tunnel or connection that develops between the end of the bowel and the skin near the opening of the anus. This would cause blood and yellow slime when passing poo, irritation, and non-stop anal pain.
Bloody diarrhoea with clear slime and nausea or vomiting can be due to stomach bug or gastroenteritis.
Bloody diarrhoea, abdominal pain or cramps, and bloating can be a sign of inflammatory bowel disease or IBD such as Crohn’s disease or ulcerative colitis.
Dark or black poo and abdominal pain can suggest bleeding in the stomach. Blood from the stomach changes as it goes through the digestive system and can appear dark or black when it comes out. The bleeding from the stomach could be due to stomach ulcer, blood thinners, or from injury.
Bleeding from the back passage is sometimes a sign of bowel cancer or bowel polyps but these are quite rare. These would cause blood in poo, diarrhoea, loose stools or constipation and slime with poo.
If there is unusual or concerning bleeding from the back passage or other symptoms, it is advisable to see a doctor in person for further assessment.
The assessment for rectal bleeding may involve examination of the rectum with a gloved finger, poo or stool testing, and a referral to see a specialist if necessary.
The presence of blood in urine is not usually due to anything serious if the bleeding is mild and there are no other symptoms with it. The medical term for blood in urine is haematuria.
The blood in urine could come from anywhere in the urinary tract which consists of urethra, bladder, ureters and kidneys.
The common causes of blood in the urine or haematuria are urinary tract infection or UTI, trauma, kidney stones, and benign prostatic hyperplasia or enlarged prostate gland.
The other possible causes are urinary catheter, strenuous exercise, foods such as beetroot and blackberries, or blood due to a period.
There are rarer causes, and these include clotting disorders, sickle cell disease, endometriosis, anticoagulation or blood thinners, medications such as rifampicin and chloroquine, SLE, Alport syndrome, and benign familial haematuria.
Benign familial haematuria is a condition that runs in families.
Haematuria that results from strenuous exercise usually resolves within 24-48 hours.
If the bleeding is very mild and if there are no other concerning symptoms, a ‘wait and watch’ approach can be followed to see if the bleeding settles down on its own.
However, if the bleeding is more severe or if there are other symptoms, an urgent doctor assessment is required to rule out serious causes.
UTI is usually the most common cause of haematuria. If this is confirmed, it can be treated with a course of oral antibiotics.
The general advice is to drink plenty of fluids as this can help clear the blood and possible infection.
Cardiovascular disease or CVD is a general term used to describe conditions affecting the heart and blood vessels. The prevention and treatment of cardiovascular diseases are crucial as these are the leading cause of death globally.
There are several different types of CVDs, of which there are four main types.
Coronary heart disease: this is a condition affecting the coronary arteries which are the blood vessels that carry oxygen to the heart. The blood flow to the heart through these arteries can be reduced or blocked by various causes, leading to heart disease.
If the blood flow is restricted, this can cause angina, and this usually presents with chest pain.
If the blood flow is blocked suddenly, this can cause heart attacks. The common symptoms of a heart attack are chest pain which can radiate to the jaw, neck or left arm, breathing difficulties, sweating, nausea or vomiting, and dizziness.
If the blood flow to the heart is not restored promptly, this could lead to heart failure where the heart is unable to pump blood around the body properly.
Stroke and transient ischaemic attack or TIA: a stroke occurs when the blood supply to a part of the brain is blocked. If this is severe enough, it can cause brain damage and possibly death.
A TIA is also known as a mini-stroke. This is similar to stroke but there is only a temporary blockage of blood flow to the brain. The clot usually dissolves on its own or gets dislodged. And any symptoms may resolve within 24 hours.
Cerebrovascular disease is a general term for stroke and TIA.
Peripheral artery disease: in this condition, there is blockage of blood flow in the arteries to the limbs, usually the legs. Peripheral artery disease can cause symptoms such as leg pain, numbness or weakness in the legs, hair loss on the legs and feet, and possible ulcers or sores on the feet and legs.
Aortic disease: this refers to a group of conditions affecting the aorta, which is the largest blood vessel in the body, and it is responsible for carrying blood from the heart to the rest of the body.
One of the most common aortic diseases is called aortic aneurysm. Aneurysm refers to a weakened and bulging blood vessel. People with an aortic aneurysm do not usually have any symptoms, but they require regular monitoring as there is a chance the aneurysm could burst and cause life-threatening bleeding.
The exact cause of cardiovascular diseases is not fully known, but it is usually associated with a build-up of fatty deposits or cholesterol in the arteries, blood clots and damage to the arteries.
There are several risk factors that can increase the chances of getting CVD. Having more risk factors usually means there is a greater risk of developing CVD.
Reducing or eliminating these risk factors can significantly improve overall health of a person.
This is the primary goal of raising awareness for the public so that everyone can take certain actions to tackle these modifiable risk factors. As well as improving health outcomes for everybody, this can also greatly reduce the burden on healthcare systems.
There are many risk factors that can be addressed to prevent the development of CVDs.
Hypertension or high blood pressure is one of the most important risk factors for CVD. High blood pressure can cause damage to blood vessels over time.
Smoking and other tobacco use is another very important risk factor for CVD. Smoking can cause damage and narrowing of blood vessels.
This is a completely modifiable risk factor, and public awareness plays a crucial role in helping people to quit smoking.
High cholesterol from fatty and unhealthy foods can cause narrowing of blood vessels and increase the risk of developing a blood clot.
Diabetes is characterized by high sugar level in the blood. High blood sugar levels can damage the vessels, leading to narrowing.
Obesity or being overweight is another modifiable risk factor for developing CVD and also diabetes and high blood pressure.
Chronic kidney disease is a long-term condition that some people suffer from. This can increase the risk of getting CVD.
Sedentary lifestyle and inactivity can lead to being overweight, high blood pressure and high cholesterol, all of which would increase the risk of CVD.
The other risk factors for developing CVD include positive family history, south Asian and Black African or African Caribbean background, being over 50 years of age, male gender, excessive alcohol consumption, and air pollution.
Risk factors such as family history, ethnicity, age and gender cannot be modified. However, other risk factors are modifiable, and a healthy lifestyle can lower the risk of CVD.
Stopping smoking is one of the most beneficial steps that a person can take to reduce the risk of CVD and improve their overall health. If this is challenging, there is help available through pharmacies and doctors.
A healthy, balanced diet is recommended for a healthy heart and body. It is advisable to reduce unhealthy saturated fat found in fatty cuts of meat, lard, cream, cakes and biscuits, and instead to consume healthier fat that is found in oily fish, nuts and seeds, and olive oil.
High amounts of salt in diet can lead to high blood pressure. The general advice is to aim for low levels of salt, and this should be less than 6g or 1 teaspoon a day.
A balanced diet should also include plenty of fruit and vegetables, lots of fibre and wholegrain foods, and low levels of sugar.
Regular exercise and maintaining a healthy weight can improve overall health and reduce the risk of developing CVD later on. If there are difficulties with losing weight, it is best to see a doctor in person as they can arrange a visit to specialised weight management clinic.
Excessive alcohol consumption should be avoided, and the current recommended limit is 14 alcohol units a week for men and women.
Air pollutions is an environmental risk factor, and it is advised to avoid heavily polluted areas and to wear a face mask.
People with confirmed high blood pressure and high cholesterol may require treatment with medications.
Identifying those at highest risk of CVDs and ensuring they receive appropriate advice treatment can prevent premature deaths. This is why public awareness and prevention is very important.
Chlamydia is a cause of abnormal vaginal discharge. Chlamydia is a sexually transmitted infection or STI and it is passed on through unprotected sexual intercourse. It can be spread from person to person by having vaginal, anal or oral sex without a condom.
Chlamydia affects both men and women.
Most people who have contracted chlamydia do not have any symptoms. Those who develop symptoms, they can start from one week to several months after the initial infection or exposure.
The common symptoms in women are abnormal vaginal discharge, burning sensation on urination, bleeding after sexual intercourse or between periods, and lower abdominal pain.
In men, the symptoms of chlamydia are white, cloudy or watery discharge from the tip of the penis, itching and burning around the penis and testicles, swelling and pain in the testicles, and burning sensation on urination.
It should be noted that chlamydia can cause other symptoms in men and women. It can affect other parts of the body that come into contact with semen and vaginal fluid. This can lead to discharge, pain or bleeding from the back passage, a sore throat, or discharge, redness and pain in the eyes.
Chlamydia can be tested at home with a self-test kit that can be obtained from some pharmacies and a sexual health clinic. The test involves taking a sample of fluid from the penis or vagina.
If the symptoms are from the back passage or anus or from the eyes, a swab test needs to be taken from these sites.
The test for chlamydia can be carried out even if there are no symptoms, particularly if there has been an exposure. Tests for other STIs may also be considered at the same time.
If chlamydia has been confirmed in a person, their current and recent sexual partners need to be tested as well.
The treatment for chlamydia is with antibiotics like azithromycin or doxycycline. This can be given as a single dose, or as tablets that are taken for 7 to 14 days.
The antibiotic treatment can be started before the test results come back.
A repeat test can be considered after the treatment to ensure the infection has been cleared.
It is recommended to avoid vaginal, anal and oral sex until the treatment has been completed and tests show that there is no further infection.
Chlamydia can be prevented by using condoms when having vaginal, anal and oral sex. An annual test is advised if a person has a new sexual partner.
It should be noted that untreated chlamydia during pregnancy can be passed to the baby during birth. This can lead to various complications in the newborn baby. The common complications are pneumonia, or conjunctivitis which is an eye infection. These infections can be treated with antibiotics if they occur.
Pregnant women are usually tested again 4 weeks after the initial treatment.
The complications in non-pregnant women include pelvic inflammatory disease, which is infection of the uterus, fallopian tubes and ovaries. This can lead to ectopic pregnancy or infertility.
In men, chlamydia can lead to infection in the testicles.
The other complication seen with chlamydia is reactive arthritis which presents with pain in the joints. Reactive arthritis usually resolves after a few months.
Early treatment of chlamydia can reduce the risk of these complications.
Chronic fatigue syndrome (CFS) is also known as myalgic encephalomyelitis (ME). This is a chronic condition and the exact cause of it is not fully understood. It can affect both children and adults.
CFS can affect different parts of the body. The most common symptom of this syndrome is extreme tiredness or fatigue.
There is no specific test to diagnose CFS. The diagnosis is clinical, and it is based on the symptoms someone presents with and by ruling out other possible causes. Routine blood tests and urine test can be arranged as part of the initial assessment to rule out other possible causes of tiredness such as thyroid disease, anaemia, and vitamin deficiencies.
CFS can present with extreme fatigue which can have detrimental effects on normal daily activities, school and work. There can also be problems with sleep, memory, concentration and thinking.
The other possible symptoms of CFS are pain that can occur in different parts of the body and flu-like symptoms.
There is currently no holistic treatment for CFS, and the aim is to relieve the symptoms of it. The treatment depends on the presenting symptoms.
For extreme fatigue, energy management is recommended to ensure the best use of energy without worsening the symptoms.
Painkillers can be considered if there is associated pain and sleeping tablets for sleep difficulties.
The other treatment options are CBT (cognitive behavioural therapy), and antidepressants.
Some people find yoga, acupuncture, and massage helpful for controlling the feeling of fatigue.
Since CFS is a chronic illness, this can have an effect on mental and emotional health, leading to problems with work, relationships and family.
It can be useful to talk to someone about this condition and this could be a family member, friend, or other people with CFS.
If conventional therapies do not work, it is best to see a specialist for further input.
Cold sores are common and are caused by herpes virus, more precisely Herpes Simplex Virus Type 1 (HSV-1).
These sores usually clear up without any treatment within 10-14 days.
Cold sores or oral herpes can occur on the lips, front of the tongue, gums, inside of the cheeks, throat and roof of the mouth. Rarely cold sores can appear on the chin and neck.
A cold sore usually starts with symptoms of tingling, itching and burning sensation. One or more painful blisters usually appear over the next 48 hours.
The incubation period or the time to develop symptoms after an exposure for oral herpes is 2-12 days, although this can be a little longer in some people.
Most people are exposed to oral herpes virus when they are children through skin to skin contact with someone who has a cold sore.
This virus stays in the body for life once someone has been infected with it.
It is more common to get flare ups of cold sores when the immune system is down, when there are other infections such as a cold or flu, during times of stress and anxiety, with poor diet, sunshine and sunbeds, and during periods.
Cold sore or oral herpes is typically transmitted by oral-to-oral contact such as kissing and skin contact with an active sore.
Cold sores are considered contagious from the moment the first signs of infection appear to when the sores have completely healed.
Oral herpes or HSV-1 can cause genital herpes as well as cold sores. It is recommended to avoid oral sex until the cold sore has completely healed as it can cause genital herpes in your partner.
It is advised to avoid kissing anyone while there are active cold sores. Hands should be washed thoroughly with soap and water after touching a cold sore.
The treatment options are creams to reduce the pain, antiviral creams to speed up healing time, and cold sore patch to protect the skin.
Over the counter cold sore remedies such as aciclovir (Zovirax) or Docosanol 10 % are available to treat the sores.
Valtrex (valacyclovir) can be used to treat cold sores as well. This is a prescription only medication.
The cream should not be rubbed into the cold sore but rather dabbed on it instead.
There are also electronic devices available at pharmacies that can treat cold sores with light or lasers, but their effectiveness can be variable.
Antiviral creams can work better when applied at the first sign of cold sore appearing and they may not always work effectively after sores have appeared.
It is recommended to use sunblock lip balm with sun protection factor (SPF 15 or more) if outside in the sun. It is best to drink plenty of fluids to avoid dehydration. Paracetamol can be used to alleviate the pain, burning and discomfort.
Acidic and salty food can make cold sore worse and so should be avoided.
If the cold sore does not heal within 10 days, if it is very large or painful, if there are complications such as swollen gums or mouth sores, or weak immunity, it is advised to consult a doctor in person.
The doctor may prescribe oral antiviral medication to treat the cold sores.
The most common cause of a cough or cold is viral illness. The use of antibiotics is not always required as these do not work against viruses. This type of viral infection can last up to 7-10 days.
There may be a lingering cough in some people that could last a few weeks.
If there are not any other major symptoms or breathing difficulties, a ‘wait and watch’ approach can be followed to see if the symptoms resolve on their own.
Paracetamol or ibuprofen are available for a fever, aches and pains, provided there is no history of allergy to these medicines and no history of asthma or stomach issues.
Ibuprofen is NOT recommended if there is history of asthma, stomach issues, heart disease or if on blood thinners.
Having warm drinks with lemon and honey, and steaming can help with the cough and any phlegm that might be present.
There are various cough and decongestion medicines available over the counter, however, these don't always work. Steaming can be as effective as those cough medicines for some people.
Common over the counter remedies that are available for cough and excess phlegm include Clarinase, Mucinex, Mucolit, Sudafed, Actifed or Brontex . These can break up the mucus or phlegm and help to remove it.
For babies and children, saline drops and HydraSense for congestion and mucus; and Sterimar Breathe Easy or Benzydamine Oromucusal spray for breathing issues are available.
If there are severe symptoms or if a person is unwell, it is recommended to see doctor in person for further assessment.
A persistent cough lasting a few weeks without any other symptoms is not usually due to anything serious. This type of cough can be caused by a recent cold or flu virus. The cough should go away on its own without needing any treatment.
Chronic cough is defined as a cough that lasts 8 weeks or longer. This is usually a dry cough with an irritation or tickling sensation. It can be triggered by talking, laughing, strong smells, perfumes, dust, smoke, and changes in temperature.
Chronic cough can have a negative impact on person’s daily life as it can cause sleeping difficulties, headaches, fatigue, and disordered breathing.
There are several causes of a chronic cough.
Smoking is a common cause of a chronic cough. The chemicals or irritants in tobacco can lead to inflammation and changes in the airways, leading to a cough.
Stopping smoking usually resolves the cough as the inflammation heals over time.
Gastro-oesophageal reflux disease or GORD is another common cause of a chronic cough. Acid from the stomach can travel up to the level of vocal cords irritating the back of the throat.
It should be noted that acid reflux can be silent that there may be no other symptoms apart from the cough. Once GORD has been confirmed, it can be treated with lifestyle changes and antacids.
Cough variant asthma or COPD can also cause a chronic cough. These are both chronic diseases and their treatment is more complex and requires input from different healthcare professionals.
A persistent cough may be due to post-nasal drip. This is a condition where excess mucus from the nose or sinuses can drip down the back of the throat leading to a cough.
Post-nasal drip can be treated with steam inhalation, plenty of fluids to keep hydrated, and nasal sprays.
Chronic bronchitis is a type of COPD where there is long-term inflammation of bronchi or airways. This is quite common in smokers, and it causes a productive cough of more than 3 months occurring within a span of 2 years.
Chronic bronchitis can be treated with inhalers or oral medications that help to relieve the symptoms by relaxing and opening the airways.
The other possible cause of a chronic cough is certain medications such as ACE inhibitors. ACE inhibitors like ramipril are prescribed for high blood pressure, but these can cause a persistent cough as a side effect.
The rarer causes of a chronic cough are environmental irritants, pets, interstitial lung disease, heart failure, sarcoidosis, and lung cancer.
The cough could be controlled with the ‘hold, blow, sip, swallow’ technique. This involves holding the breath for a count of 5, blowing the air out of the mouth with pursed lips, sipping water and swallowing whilst the chin is tucked down towards the chest.
There is no guarantee that this technique will work but it can help some people.
Warm drinks with lemon and honey may help alleviate the severity of the cough.
Cough medicines such as pholcodine linctus or dextromethorphan may be beneficial. If there is mucus with the cough, Clarinase or Mucinex can be more effective.
It is advisable to sip water frequently throughout the day to keep the throat moist, to try steam inhalation for 10 to 15 minutes every day, and to practise breathing through the nose.
It is recommended to avoid alcohol, caffeine and medicated cough lozenges as these can dry out the throat. Non-medicated lozenges, chewing gum and honey could have a soothing effect.
There is no effective solution to clear the cough quickly. It is best to practise the techniques that work best regularly so that these can be used promptly when the cough is about to come on.
If these measures do not work or if there is a persistent cough lasting more than 6 weeks, it is recommended to see a doctor for further assessment. The doctor can perform a thorough examination and arrange a chest X-ray or other tests if necessary.
Cough is one of the most common symptoms in children. In a healthy child, it is usually not due to anything serious.
Cough is more common in the pre-school age group over winter months. Young children can develop 6 to 12 respiratory tract infections or viral illnesses per year and the cough is typically self-limiting and lasts less than 4 weeks.
Studies show that an acute cough can last up to 25 days in children. Chronic cough is defined as cough lasting for more than 4 weeks. This is a persistent and continuous cough which does not improve.
It should be noted that if a child gets several episodes of acute cough from common colds over a period of months and if the cough goes away each time, this is not considered a chronic cough.
Chronic cough is common in children, and this can arise from causes anywhere along the airway, from the nose to the lungs.
The risk factors for chronic cough in young children include prematurity, pre-existing medical conditions, previous wheeze, and childcare attendance.
There are several causes of chronic cough in children.
One of the commonest causes of chronic cough in children is asthma. Children with suspected asthma require a thorough assessment and various tests to confirm the diagnosis.
The treatment for asthma includes inhalers and oral medication, depending on the severity of symptoms.
Post-nasal drip can cause chronic cough in children. This occurs when excess mucus from the nose or sinuses drips down the back of the throat.
This can be treated with steam inhalation, nasal sprays and plenty of fluids to keep hydrated.
Environmental chemicals such as tobacco smoke, charcoal or kerosene heaters may also cause chronic cough. Avoiding these chemicals usually resolves the cough.
Acid reflux is another possible cause of chronic cough in young children. Acid from the stomach can travel up the food pipe or oesophagus to the throat, leading to cough.
This can be treated with medications such as Gaviscon for children.
Infections such as RSV or respiratory syncytial virus, Mycoplasma pneumoniae, whooping cough and tuberculosis can cause chronic cough in children. Most of these infections are rare but should be considered in cases of chronic cough.
The treatment depends on the exact infection and may require oral antibiotics and referral to see a specialist doctor.
There are rarer causes of chronic cough in children, and these include cystic fibrosis, immune deficiency, abnormalities affecting trachea or windpipe like tracheomalacia, or neurological issues such as tics and psychogenic cough.
Coughing in children is a very common symptom that can cause anxiety in some parents. The cough usually goes away without needing any treatment.
The general advice is to see a doctor in person for further assessment if the cough lasts more than 4 weeks.
Although the symptoms of cold and flu are similar, there are some differences.
Flu symptoms tend to be more severe, and they can cause exhaustion and difficulty with carrying out daily activities. With a cold, people feel unwell but they are usually able to carry on as normal.
Cold symptoms appear gradually whereas flu symptoms appear more quickly within a few hours.
Cold mainly affects the nose and throat whereas flu can be more widespread and affect more than just the nose and mouth.
It should be noted that cold weather itself does not cause viruses or infection, but it can increase the chances of getting an infection by creating more optimal conditions.
Common cold and flu can spread more easily in cold weather as people tend to spend more time indoors in close contact.
Cold, dry air can lower the immune system and dry out nasal passages, making it easier for viruses to enter the body.
Some viruses like flu virus thrive in lower temperatures and humidity.
Some people tend to get a runny nose in cold weather due to a natural reflex called cold-induced rhinitis. In cold weather, nasal passages try to warm and humidify cold, dry air before it reaches the lungs.
The body does this by expanding the blood vessels in the nose to generate heat. Glands in the nose also produce more mucus to add moisture to the air. When warm air from the body meets the cold air outside this causes moisture inside the nose to turn into liquid, leading to runny nose.
This can have beneficial effects against infections as nasal discharge would expel viruses from nasal passages before they fully enter the body to cause an illness.
Steam inhalation or steaming refers to a simple measure for breathing in steam from heated water. This is recommended for colds and flu, sinus infection, blocked nose, and general airway congestion.
Steam inhalation can soothe and open nasal passages as the warm, moist air is thought to loosen mucus and relieve symptoms.
This can help with hoarse and sore voice, dry throat, persistent cough and thick mucus.
Steam inhalation can be carried out in a few simple ways.
There are inexpensive steam-inhaling mugs available at most large pharmacies. This is the most relaxing way to steam for most people. It can be done while reading or watching TV.
Another way to steam is by sitting over a basin of boiled water with a towel over the head.
With steam-inhaling mug and basin, it is advisable to allow the steam to enter the nose and mouth by breathing normally through the nose and mouth. This can be done for 10 to 15 minutes.
The boiled water can be topped up if it cools and loses the steam. Ordinary water from a boiled kettle can be used, and there is no need to add anything to it.
Electrical steam inhalers are also available and these pump out a steady stream of temperature-controlled water vapour.
Steam inhalation can be used once or twice a day for 10 to 15 minutes.
Extra caution should be taken while handling just-boiled water as there is risk of scalding from the steam. The just-boiled water can be rested for a minute before using it.
Steaming is not recommended if there is history of heart failure. And the hot, humid air can trigger airway irritation and exacerbate asthma symptoms in some people.
A lemon and honey drink can help with cold and flu symptoms, cough, congestion, and sore throat.
The warmth of the drink can help loosen mucus and relieve congestion.
Honey can coat the throat, reducing throat irritation and suppressing cough. It also has antimicrobial properties.
Lemon contains vitamin C and antioxidants, which can boost the immune system and help the body fight infections.
The lemon and honey drink can be prepared by squeezing half a lemon into a mug of warm water and adding 1 to 2 teaspoons of honey.
It is best to use warm water rather than boiling water to preserve honey’s nutrients.
If preferred, fresh ginger can be added to the drink.
The drink can be consumed while still warm.
Hot drinks should not be given to small children, and honey should be avoided under 12 months old.
Any possible allergies must also be checked.