added nhs search app scripts

integrations/haystack/nhs-search/.gitignore

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+# Byte-compiled / optimized / DLL files
+__pycache__/
+*.py[cod]
+*$py.class
+
+# C extensions
+*.so
+
+# Distribution / packaging
+.Python
+build/
+develop-eggs/
+dist/
+downloads/
+eggs/
+.eggs/
+lib/
+lib64/
+parts/
+sdist/
+var/
+wheels/
+share/python-wheels/
+*.egg-info/
+.installed.cfg
+*.egg
+MANIFEST
+
+# PyInstaller
+#  Usually these files are written by a python script from a template
+#  before PyInstaller builds the exe, so as to inject date/other infos into it.
+*.manifest
+*.spec
+
+# Installer logs
+pip-log.txt
+pip-delete-this-directory.txt
+
+# Unit test / coverage reports
+htmlcov/
+.tox/
+.nox/
+.coverage
+.coverage.*
+.cache
+nosetests.xml
+coverage.xml
+*.cover
+*.py,cover
+.hypothesis/
+.pytest_cache/
+cover/
+
+# Translations
+*.mo
+*.pot
+
+# Django stuff:
+*.log
+local_settings.py
+db.sqlite3
+db.sqlite3-journal
+
+# Flask stuff:
+instance/
+.webassets-cache
+
+# Scrapy stuff:
+.scrapy
+
+# Sphinx documentation
+docs/_build/
+
+# PyBuilder
+.pybuilder/
+target/
+
+# Jupyter Notebook
+.ipynb_checkpoints
+
+# IPython
+profile_default/
+ipython_config.py
+
+# pyenv
+#   For a library or package, you might want to ignore these files since the code is
+#   intended to run in multiple environments; otherwise, check them in:
+# .python-version
+
+# pipenv
+#   According to pypa/pipenv#598, it is recommended to include Pipfile.lock in version control.
+#   However, in case of collaboration, if having platform-specific dependencies or dependencies
+#   having no cross-platform support, pipenv may install dependencies that don't work, or not
+#   install all needed dependencies.
+#Pipfile.lock
+
+# poetry
+#   Similar to Pipfile.lock, it is generally recommended to include poetry.lock in version control.
+#   This is especially recommended for binary packages to ensure reproducibility, and is more
+#   commonly ignored for libraries.
+#   https://python-poetry.org/docs/basic-usage/#commit-your-poetrylock-file-to-version-control
+#poetry.lock
+
+# PEP 582; used by e.g. github.com/David-OConnor/pyflow
+__pypackages__/
+
+# Celery stuff
+celerybeat-schedule
+celerybeat.pid
+
+# SageMath parsed files
+*.sage.py
+
+# Environments
+.env
+.venv
+env/
+venv/
+ENV/
+env.bak/
+venv.bak/
+
+# Spyder project settings
+.spyderproject
+.spyproject
+
+# Rope project settings
+.ropeproject
+
+# mkdocs documentation
+/site
+
+# mypy
+.mypy_cache/
+.dmypy.json
+dmypy.json
+
+# Pyre type checker
+.pyre/
+
+# pytype static type analyzer
+.pytype/
+
+# Cython debug symbols
+cython_debug/
+
+# PyCharm
+#  JetBrains specific template is maintainted in a separate JetBrains.gitignore that can
+#  be found at https://github.com/github/gitignore/blob/main/Global/JetBrains.gitignore
+#  and can be added to the global gitignore or merged into this file.  For a more nuclear
+#  option (not recommended) you can uncomment the following to ignore the entire idea folder.
+#.idea/
+.DS_STORE

integrations/haystack/nhs-search/README.md

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+# NHS Search App \[Pinecone x Haystack\]
+
+Here is the code covering the NHS search app presented at the Pinecone x Haystack webinar on 14th July 2022.

integrations/haystack/nhs-search/data/www.nhs.uk_conditions_abdominal-aortic-aneurysm-screening_.txt

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+Cookies on the NHS website
+We've put some small files called cookies on your device to make our site work.
+We'd also like to use analytics cookies. These send information about how our site is used to services called Adobe Analytics, Hotjar and Google Analytics. We use this information to improve our site.
+Let us know if this is OK. We'll use a cookie to save your choice. You can read more about our cookies before you choose.
+I'm OK with analytics cookies Do not use analytics cookies
+Search the NHS website
+Search
+Health A-Z
+Live Well
+Mental health
+Care and support
+Pregnancy
+Browse
+More
+Home Health A to Z
+Overview
+-
+Abdominal aortic aneurysm screening
+Contents
+Overview
+FAQs
+Abdominal aortic aneurysm (AAA) screening is a way of checking if there's a bulge or swelling in the aorta, the main blood vessel that runs from your heart down through your tummy.
+This bulge or swelling is called an abdominal aortic aneurysm, or AAA.
+It can be serious if it's not spotted early on because it could get bigger and eventually burst (rupture).
+Important:
+Coronavirus (COVID-19) update
+AAA screening services are now running.
+You'll be prioritised if a previous screening test has shown you have an AAA that has a higher risk of rupturing.
+It's important to go to your appointment unless you have symptoms of COVID-19. All NHS services are making sure it's safe for you to attend.
+Who's screened for AAA
+In England, screening for AAA is offered to men during the year they turn 65.
+Men aged 65 or over are most at risk of getting AAAs. Screening can help spot a swelling in the aorta early on when it can usually be treated.
+Screening for AAA is not routinely offered to:
+women
+men under 65
+people who have already been treated for an AAA
+This is because the risk of getting an AAA is much smaller in these groups.
+If you're over 65 years old, you can ask for a scan to check for an AAA if you think you might need one but have not been offered a screening test.
+How to get screened for AAA
+If you're a man and registered with a GP, you'll get a screening invitation in the post when you're 64 or soon after your 65th birthday. You can then arrange an appointment that suits you.
+If you're a man over 65 and have not been screened before, you can ask for a test by contacting your local AAA screening service directly.
+Benefits of AAA screening
+An AAA will often cause few or no obvious symptoms, but if it's left to get bigger, it could burst and cause life-threatening bleeding inside your tummy.
+About 8 in every 10 people who have a burst AAA die before they get to hospital or do not survive emergency surgery to repair it.
+Screening can pick up an AAA before it bursts. If an AAA is found, you can choose to have regular scans to monitor it or surgery to stop it bursting.
+The screening test is very quick, painless and reliable. Research suggests it can halve the risk of dying from an AAA.
+Deciding to be screened
+It's up to you to decide if you want to be screened for AAA.
+While there are clear benefits of screening, you should also consider the possible risks.
+There's no risk from the screening test itself, but there's a risk of:
+anxiety from being told you have a potentially life-threatening condition
+serious complications of surgery carried out to treat an AAA
+Call your local screening service and ask to be removed from its list if you do not want to be screened.
+What happens during AAA screening
+Screening for AAA involves a quick and painless ultrasound scan of your tummy.
+This is similar to the scan pregnant women have to check on their baby.
+When you arrive for your appointment, a screening technician will check your details, explain the scan and ask if you have any questions.
+For the scan:
+you lie down on a table and lift up or unbutton your top (you do not need to undress)
+the technician rubs a clear gel on your tummy and moves a small handheld scanner over your skin – pictures from the scanner are shown on a monitor and the technician will measure how wide your aorta is
+the gel is wiped away and you pull down or button up your top
+the technician tells you the result straight away
+The whole test usually takes about 10 to 15 minutes.
+Sometimes the technician might not be able to see your aorta clearly. This is not anything to worry about.
+If this happens, you'll be asked to have another scan, usually on a different day.
+Results of AAA screening
+You'll be told your result at the end of the test. 
+If a problem is found, you'll also be a sent letter confirming the result and letting you know what happens next.
+There are 4 possible screening results.
+No aneurysm found
+If your aorta is less than 3cm wide, this means it's not enlarged. Most men have this result.
+You will not need to have any treatment or monitoring afterwards, and will not be invited for AAA screening again.
+Small AAA
+If you have a small AAA, this means your aorta measures 3cm to 4.4cm across.
+Just over 1% of men screened have a small AAA.
+You will not need any treatment at this stage as the chance of the AAA bursting is small.
+You'll be invited back for a scan every year to check its size.
+Treatment will usually only be needed if it becomes a large AAA.
+You'll also be given advice on how you can stop an AAA getting bigger, such as stopping smoking, eating healthily and exercising regularly.
+Medium AAA
+If you have a medium AAA, this means your aorta measures 4.5cm to 5.4cm across.
+About 0.5% of men screened have a medium AAA.
+You will not need any treatment at this stage as the chance of the AAA bursting is small.
+You'll be invited back for a scan every 3 months to check its size.
+Treatment will usually only be needed if it becomes a large AAA.
+You'll also be given advice on how you can stop an AAA getting bigger, such as stopping smoking, eating healthily and exercising regularly.
+Large AAA
+If you have a large AAA, this means your aorta measures 5.5cm or more across.
+About 0.1% of men screened have a large AAA.
+As large AAAs have the highest risk of bursting if left untreated, you'll be referred to a specialist surgeon within 2 weeks to talk about your treatment options.
+Most men with a large AAA are advised to have surgery to stop it getting bigger or bursting.
+While surgery carries a risk of serious complications, this is generally smaller than the risk of not treating a large AAA.
+Further information
+Read more about how AAAs are treated
+Help us improve our services
+Can you answer some questions about your experiences with AAA screening to help us improve our services?
+Take our survey
+Page last reviewed: 12 January 2021
+Next review due: 12 January 2024
+Next
+:
+FAQs
+Support links
+Home
+Health A to Z
+Live Well
+Mental health
+Care and support
+Pregnancy
+NHS services
+Coronavirus (COVID-19)
+NHS App
+Find my NHS number
+Your health records
+About the NHS
+Healthcare abroad
+Contact us
+Other NHS websites
+Profile editor login
+About us
+Accessibility statement
+Our policies
+Cookies
+© Crown copyright

integrations/haystack/nhs-search/data/www.nhs.uk_conditions_abdominal-aortic-aneurysm_.txt

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+Cookies on the NHS website
+We've put some small files called cookies on your device to make our site work.
+We'd also like to use analytics cookies. These send information about how our site is used to services called Adobe Analytics, Hotjar and Google Analytics. We use this information to improve our site.
+Let us know if this is OK. We'll use a cookie to save your choice. You can read more about our cookies before you choose.
+I'm OK with analytics cookies Do not use analytics cookies
+Search the NHS website
+Search
+My account
+Health A-Z
+Live Well
+Mental health
+Care and support
+Pregnancy
+Browse
+More
+Home Health A to Z
+Overview
+-
+Abdominal aortic aneurysm
+Contents
+Overview
+Treatment
+An abdominal aortic aneurysm (AAA) is a bulge or swelling in the aorta, the main blood vessel that runs from the heart down through the chest and tummy.
+An AAA can be dangerous if it is not spotted early on.
+It can get bigger over time and could burst (rupture), causing life-threatening bleeding.
+Screening for AAA is routinely offered by the NHS to all men aged 65 and over.
+Women aged 70 or over, who have underlying risk factors such as high blood pressure, may also be advised to attend screening for AAA.
+Symptoms of an abdominal aortic aneurysm (AAA)
+AAAs do not usually cause any obvious symptoms, and are often only picked up during screening or tests carried out for another reason.
+Some people with an AAA have:
+a pulsing sensation in the tummy (like a heartbeat)
+tummy pain that does not go away
+lower back pain that does not go away
+If an AAA bursts, it can cause:
+sudden, severe pain in the tummy or lower back
+dizziness
+sweaty, pale and clammy skin
+a fast heartbeat
+shortness of breath
+fainting or passing out
+Call 999 for an ambulance immediately if you or someone else develops symptoms of a burst AAA.
+When to get medical help
+Make an appointment to see a GP as soon as possible if you have symptoms, especially if you're at a higher risk of an AAA.
+An ultrasound scan of your tummy may be done to check if you have one.
+Call 999 for an ambulance immediately if you or someone else develops symptoms of a burst AAA.
+Who's at risk of an abdominal aortic aneurysm (AAA)
+An AAA can form if the sides of the aorta weaken and balloon outwards. It's not always clear why this happens, but there are things that increase the risk.
+People at a higher risk of getting an AAA include all men aged 66 or over and women aged 70 or over who have one or more of the following risk factors:
+high blood pressure
+chronic obstructive pulmonary disease
+high blood cholesterol
+a family history of AAA
+cardiovascular disease, such as heart disease or a history of stroke
+they smoke or have previously smoked
+Speak to a GP if you're worried you may be at risk of an AAA. They may suggest having a scan and making healthy lifestyle changes to reduce your risk of an AAA.
+Treatments for an abdominal aortic aneurysm (AAA)
+The recommended treatment for an AAA depends on how big it is.
+Treatment is not always needed straight away if the risk of an AAA bursting is low.
+Treatment for a:
+small AAA (3cm to 4.4cm across) – ultrasound scans are recommended every year to check if it's getting bigger; you'll be advised about healthy lifestyle changes to help stop it growing
+medium AAA (4.5cm to 5.4cm) – ultrasound scans are recommended every 3 months to check if it's getting bigger; you'll also be advised about healthy lifestyle changes
+large AAA (5.5cm or more) – surgery to stop it getting bigger or bursting is usually recommended
+Ask your doctor if you're not sure what size your AAA is.
+Reducing your risk of an abdominal aortic aneurysm (AAA)
+There are several things you can do to reduce your chances of getting an AAA or help stop one getting bigger.
+These include:
+stopping smoking – read stop smoking advice and find out about Smokefree, the NHS stop smoking service
+eating healthily – eat a balanced diet and cut down on fatty food
+exercising regularly – aim to do at least 150 minutes of exercise a week; read about how to get started with some common activities
+maintaining a healthy weight – use the BMI healthy weight calculator to see if you need to lose weight, and find out how to lose weight safely
+cutting down on alcohol – read tips on cutting down and general advice about alcohol
+If you have a condition that increases your risk of an AAA, such as high blood pressure, your GP may also recommend taking tablets to treat this.
+Screening for AAAs
+In England, screening for AAAs is offered to men during the year they turn 65. This can help spot a swelling in the aorta early on, when it can be treated.
+The test involves a quick and painless ultrasound scan to see how big your aorta is.
+If you're a man over 65 and you have not been screened, you can ask for a test by contacting your local AAA screening service directly.
+Women aged 70 or over with underlying risk factors such as high blood pressure or chronic obstructive pulmonary disease may also benefit from an ultrasound scan. You will need to ask a GP for a referral as women are not currently routinely invited for scanning.
+Read more about screening for an AAA.
+Video: abdominal aortic aneurysm
+This video shows what an abdominal aortic aneurysm looks like.
+Play Video
+Media last reviewed: 5 November 2021
+Media review due: 5 November 2024
+Page last reviewed: 21 May 2020
+Next review due: 21 May 2023
+Next
+:
+Treatment
+Support links
+Home
+Health A to Z
+Live Well
+Mental health
+Care and support
+Pregnancy
+NHS services
+Coronavirus (COVID-19)
+NHS App
+Find my NHS number
+Your health records
+About the NHS
+Healthcare abroad
+Contact us
+Other NHS websites
+Profile editor login
+About us
+Accessibility statement
+Our policies
+Cookies
+© Crown copyright

integrations/haystack/nhs-search/data/www.nhs.uk_conditions_abortion_.txt

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+Cookies on the NHS website
+We've put some small files called cookies on your device to make our site work.
+We'd also like to use analytics cookies. These send information about how our site is used to services called Adobe Analytics, Hotjar and Google Analytics. We use this information to improve our site.
+Let us know if this is OK. We'll use a cookie to save your choice. You can read more about our cookies before you choose.
+I'm OK with analytics cookies Do not use analytics cookies
+Search the NHS website
+Search
+Health A-Z
+Live Well
+Mental health
+Care and support
+Pregnancy
+Browse
+More
+Home Health A to Z
+Overview
+-
+Abortion
+Contents
+Overview
+What happens
+Risks
+An abortion is a procedure to end a pregnancy.
+It's also sometimes known as a termination of pregnancy.
+The pregnancy is ended either by taking medicines or having a surgical procedure.
+Coronavirus update
+Abortion services are still open. You can self-refer by contacting an abortion provider directly.
+They can explain how their services are working at the moment.
+How to get an abortion
+Abortions can only be carried out under the care of an NHS hospital or a licensed clinic, and are usually available free of charge on the NHS.
+There are 3 main ways to get an abortion on the NHS:
+you can self-refer by contacting an abortion provider directly – the British Pregnancy Advisory Service (BPAS), MSI Reproductive Choices UK, the National Unplanned Pregnancy Advisory Service (NUPAS) or your local NHS sexual health website can tell you about eligibility and services in your area
+speak to a GP and ask for a referral to an abortion service – the GP should refer you to another doctor if he or she has any objections to abortion
+contact a sexual health clinic (sometimes called family planning or GUM (genitourinary medicine) clinics) and ask for a referral to an abortion service
+Waiting times can vary, but you should not have to wait more than 2 weeks from when you (or a doctor) first contact an abortion provider to having an abortion.
+You can also pay for an abortion privately (not on the NHS) if you prefer. Costs for private abortions vary depending on the stage of pregnancy and the method used to carry out the procedure.
+When an abortion can be carried out
+Most abortions in England, Wales and Scotland are carried out before 24 weeks of pregnancy.
+They can be carried out after 24 weeks in very limited circumstances – for example, if the mother's life is at risk or the child would be born with a severe disability.
+Most abortion services will ask to perform an ultrasound scan to work out how many weeks pregnant you are. The length of pregnancy is calculated from the first day of your last period.
+Abortions are safer the earlier they're carried out. Getting advice early on will give you more time to make a decision if you're unsure.
+Deciding to have an abortion
+The decision to have an abortion is yours alone.
+Some women may be certain they want to have an abortion, while others may find it more difficult to make a decision.
+All women requesting an abortion can discuss their options with, and receive support from, a trained pregnancy counsellor if they wish.
+Impartial information and support are available from:
+your GP or another doctor at your GP practice
+a counselling service at the abortion clinic
+organisations such as Brook (for under-25s), BPAS, MSI Reproductive Choices UK and NUPAS
+You may also want to speak to your partner, friends or family, but you do not have to. They do not have a say in your decision.
+If you do not want to tell anyone, your details will be kept confidential.
+If you're under 16, your parents do not usually need to be told. The doctor or nurse may encourage you to tell a parent, carer or other adult you trust, but they will not make you.
+There are organisations, usually known as crisis pregnancy centres, that offer counselling around pregnancy. They do not refer people for abortion, and may not offer balanced or accurate advice.
+If you go to a place that offers pregnancy counselling and you're not sure if they will refer you for an abortion, ask if they refer people for an abortion.
+What happens during an abortion
+Before having an abortion, you'll have an appointment to talk about your decision and what happens next.
+Whenever possible, you should be given a choice of how you would like the abortion to be carried out.
+There are 2 options:
+medical abortion ("abortion pill") – you take 2 medicines, usually 24 to 48 hours apart, to induce an abortion
+surgical abortion – you have a procedure to remove the pregnancy and normally go home soon afterwards
+After an abortion, you'll probably need to take things easy for a few days. It's likely you'll have some discomfort and vaginal bleeding for up to 2 weeks.
+Read more about how an abortion is carried out.
+Risks of an abortion
+Abortion is a safe procedure. Abortions are safest, and happen with less pain and bleeding, when carried out as early as possible in pregnancy.
+Most women will not experience any problems, but there is a small risk of complications, such as:
+infection of the womb (uterus)
+some of the pregnancy remaining in the womb
+excessive bleeding
+damage to the womb or entrance of the womb (cervix)
+If complications do occur, you may need further treatment, including surgery.
+Having an abortion will not affect your chances of becoming pregnant again and having normal pregnancies in the future.
+You may be able to get pregnant immediately after an abortion. You should use contraception if you do not want to get pregnant.
+Read more about the risks of abortion.
+Page last reviewed: 24 April 2020
+Next review due: 24 April 2023
+Next
+:
+What happens
+Support links
+Home
+Health A to Z
+Live Well
+Mental health
+Care and support
+Pregnancy
+NHS services
+Coronavirus (COVID-19)
+NHS App
+Find my NHS number
+Your health records
+About the NHS
+Healthcare abroad
+Contact us
+Other NHS websites
+Profile editor login
+About us
+Accessibility statement
+Our policies
+Cookies
+© Crown copyright

integrations/haystack/nhs-search/data/www.nhs.uk_conditions_abscess_.txt

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+Cookies on the NHS website
+We've put some small files called cookies on your device to make our site work.
+We'd also like to use analytics cookies. These send information about how our site is used to services called Adobe Analytics, Hotjar and Google Analytics. We use this information to improve our site.
+Let us know if this is OK. We'll use a cookie to save your choice. You can read more about our cookies before you choose.
+I'm OK with analytics cookies Do not use analytics cookies
+Search the NHS website
+Search
+Health A-Z
+Live Well
+Mental health
+Care and support
+Pregnancy
+Browse
+More
+Home Health A to Z
+Overview
+-
+Abscess
+Contents
+Overview
+Symptoms
+Causes
+Diagnosis
+Treatment
+An abscess is a painful collection of pus, usually caused by a bacterial infection. Abscesses can develop anywhere in the body.
+This article focuses on 2 types of abscess:
+skin abscesses – which develop under the skin
+internal abscesses – which develop inside the body, in an organ or in the spaces between organs
+Symptoms of an abscess
+A skin abscess often appears as a swollen, pus-filled lump under the surface of the skin. You may also have other symptoms of an infection, such as a high temperature and chills.
+Credit:
+It's more difficult to identify an abscess inside the body, but signs include:
+pain in the affected area
+a high temperature
+generally feeling unwell
+Read more about the symptoms of an abscess.
+When to see your GP
+See your GP if you think you may have an abscess. They can examine a skin abscess or refer you to hospital if you may have an internal abscess.
+There are several tests available to help diagnose an abscess, depending on where it's located.
+Read about diagnosing an abscess.
+Causes of abscesses
+Most abscesses are caused by a bacterial infection.
+When bacteria enter your body, your immune system sends infection-fighting white blood cells to the affected area.
+As the white blood cells attack the bacteria, some nearby tissue dies, creating a hole which then fills with pus to form an abscess. The pus contains a mixture of dead tissue, white blood cells and bacteria.
+Internal abscesses often develop as a complication of an existing condition, such as an infection elsewhere in your body. For example, if your appendix bursts as a result of appendicitis, bacteria can spread inside your tummy (abdomen) and cause an abscess to form.
+Read about the causes of abscesses.
+Treating an abscess
+A small skin abscess may drain naturally, or simply shrink, dry up and disappear without any treatment.
+However, larger abscesses may need to be treated with antibiotics to clear the infection, and the pus may need to be drained. This will usually be done either by inserting a needle through your skin or by making a small incision in the skin over the abscess.
+Read more about treating an abscess.
+Preventing a skin abscess
+Most skin abscesses are caused by bacteria getting into a minor wound, the root of a hair or a blocked oil or sweat gland.
+Ensuring that your skin is clean, healthy and largely free of bacteria can help reduce the risk of skin abscesses developing.
+You can reduce the risk of bacteria spreading by:
+washing your hands regularly
+encouraging people in your family to wash their hands regularly
+using separate towels and not sharing baths
+waiting until your skin abscess is fully treated and healed before using any communal equipment, such as gym equipment, saunas or swimming pools
+Do not squeeze the pus out of the abscess yourself, because this can easily spread the bacteria to other areas of your skin. If you use tissues to wipe any pus away from your abscess, dispose of them straight away to avoid germs spreading. Wash your hands after you've disposed of the tissues.
+Take care when shaving your face, legs, underarm areas or bikini area to avoid nicking your skin. Do not share razors or toothbrushes.
+It may also help to reduce your risk of skin abscesses by:
+maintaining a healthy, balanced diet
+losing weight if you're overweight or obese
+stopping smoking
+It's difficult to prevent internal abscesses, as they're often complications of other conditions.
+Other types of abscess
+There are many other types of abscess not fully covered here, including:
+an anorectal abscess – a build-up of pus inside the bottom (the rectum and anus)
+a Bartholin's cyst – a build-up of pus inside one of the Bartholin's glands, which are found on each side of the opening of the vagina
+a brain abscess – a rare but potentially life-threatening build-up of pus inside the skull
+a dental abscess – a build-up of pus under a tooth or in the supporting gum and bone
+a quinsy (peritonsillar abscess) – a build-up of pus between one of the tonsils and the wall of the throat
+a pilonidal abscess – a build-up of pus in the skin of the cleft of the buttocks (where the buttocks separate)
+a spinal cord abscess – a build-up of pus around the spinal cord
+Page last reviewed: 04 November 2019
+Next review due: 04 November 2022
+Next
+:
+Symptoms
+Support links
+Home
+Health A to Z
+Live Well
+Mental health
+Care and support
+Pregnancy
+NHS services
+Coronavirus (COVID-19)
+NHS App
+Find my NHS number
+Your health records
+About the NHS
+Healthcare abroad
+Contact us
+Other NHS websites
+Profile editor login
+About us
+Accessibility statement
+Our policies
+Cookies
+© Crown copyright

integrations/haystack/nhs-search/data/www.nhs.uk_conditions_acanthosis-nigricans_.txt

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+Cookies on the NHS website
+We've put some small files called cookies on your device to make our site work.
+We'd also like to use analytics cookies. These send information about how our site is used to services called Adobe Analytics, Hotjar and Google Analytics. We use this information to improve our site.
+Let us know if this is OK. We'll use a cookie to save your choice. You can read more about our cookies before you choose.
+I'm OK with analytics cookies Do not use analytics cookies
+Search the NHS website
+Search
+My account
+Health A-Z
+Live Well
+Mental health
+Care and support
+Pregnancy
+Browse
+More
+Coronavirus (COVID-19)
+Get the latest advice about COVID-19
+Home Health A to Z
+Acanthosis nigricans
+Acanthosis nigricans is the name for dry, dark patches of skin that usually appear in the armpits, neck or groin. It could be a sign of an underlying condition, so it needs to be checked by a GP.
+Check if you have acanthosis nigricans
+The main symptom of acanthosis nigricans is patches of skin that are darker and thicker than usual.
+They can appear anywhere on the body.
+The patches are dry and feel similar to velvet.
+Credit:
+They're most common in skin folds, such as the armpits, neck or groin.
+Credit:
+Some people also have tiny growths (skin tags) on the patches.
+Credit:
+The patches often appear gradually without any other symptoms.
+Sometimes the skin may be itchy.
+Non-urgent advice:
+See a GP if you have:
+new dark patches on your skin
+any skin changes you're unsure about
+Information:
+Coronavirus (COVID-19) update: how to contact a GP
+It's still important to get help from a GP if you need it. To contact your GP surgery:
+visit their website
+use the NHS App
+call them
+Find out about using the NHS during COVID-19
+What happens at your appointment
+Although acanthosis nigricans is usually harmless, it's best to get any skin changes checked out.
+Rarely, it can be a sign of something more serious, such as cancer.
+A GP can usually tell if it's acanthosis nigricans by looking at your skin.
+You may need some tests to find out what's causing the patches.
+Causes of acanthosis nigricans
+The most common cause of acanthosis nigricans is being very overweight.
+Other causes include:
+type 2 diabetes
+conditions that affect hormone levels – such as Cushing's syndrome, polycystic ovary syndrome or an underactive thyroid
+taking certain medicines – including steroids or hormone treatments like the contraceptive pill
+rarely, cancer – usually stomach cancer
+rarely, a faulty gene inherited from your parents
+Sometimes healthy people with no other conditions get acanthosis nigricans. This is more common in people with black or brown skin.
+Treating acanthosis nigricans
+Once a GP knows what's causing acanthosis nigricans, they can recommend the best treatment.
+The patches should fade over time once the cause is treated.
+If you're very overweight, a GP may recommend losing weight.
+Depending on the cause, they may also recommend:
+medicine to balance your hormones
+medicine to balance your insulin levels
+changing your medicine to one that does not cause the patches
+There's no specific treatment for the patches themselves. A skin specialist (dermatologist) may be able to suggest treatments to improve their appearance, but finding and treating the cause is usually recommended first.
+Page last reviewed: 20 June 2021
+Next review due: 20 June 2024
+Support links
+Home
+Health A to Z
+Live Well
+Mental health
+Care and support
+Pregnancy
+NHS services
+Coronavirus (COVID-19)
+NHS App
+Find my NHS number
+Your health records
+About the NHS
+Healthcare abroad
+Contact us
+Other NHS websites
+Profile editor login
+About us
+Accessibility statement
+Our policies
+Cookies
+© Crown copyright

integrations/haystack/nhs-search/data/www.nhs.uk_conditions_achalasia_.txt

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+Cookies on the NHS website
+We've put some small files called cookies on your device to make our site work.
+We'd also like to use analytics cookies. These send information about how our site is used to services called Adobe Analytics, Hotjar and Google Analytics. We use this information to improve our site.
+Let us know if this is OK. We'll use a cookie to save your choice. You can read more about our cookies before you choose.
+I'm OK with analytics cookies Do not use analytics cookies
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+Home Health A to Z
+Achalasia
+Achalasia is a rare disorder of the food pipe (oesophagus), which can make it difficult to swallow food and drink.
+Normally, the muscles of the oesophagus contract to squeeze food along towards the stomach. A ring of muscle at the end of the food pipe then relaxes to let food into the stomach.
+In achalasia, the muscles in the oesophagus do not contract correctly and the ring of muscle can fail to open properly, or does not open at all. Food and drink cannot pass into the stomach and becomes stuck. It is often brought back up.
+Symptoms of achalasia
+Not everyone with achalasia will have symptoms.
+But most people with achalasia will find it difficult to swallow food or drink (known as dysphagia). Swallowing tends to get gradually more difficult or painful over a couple of years, to the point where it is sometimes impossible.
+Other symptoms include:
+bringing back up undigested food
+choking and coughing fits
+heartburn
+chest pain
+repeated chest infections
+drooling of vomit or saliva
+gradual but significant weight loss
+Symptoms of achalasia may start at any time of life.
+Long-term achalasia increases the risk of developing cancer of the oesophagus. This means it's important to get appropriate treatment straight away, even if your symptoms are not bothering you.
+Causes of achalasia
+Achalasia is thought to happen when the nerves in the oesophagus become damaged and stop working properly, which is why the muscles and ring of muscle do not work. The exact cause of this is unknown.
+In some people, it may be linked to a viral infection. It may also be associated with having an autoimmune condition, where the body's immune system attacks healthy cells, tissue and organs.
+In rare cases, achalasia may run in families.
+Diagnosing achalasia
+If a GP thinks you have achalasia, you'll be referred to hospital to have some diagnostic tests. Achalasia may also be diagnosed during an investigation, such as a chest X-ray, for another reason.
+The tests for achalasia include:
+Manometry – a small plastic tube is passed through your mouth or nose into your oesophagus to measure the muscle pressure along it at different points.
+Barium swallow – you drink a white liquid containing the chemical barium and X-rays are taken. The barium shows up clearly on X-ray so the doctor can see how long it takes to move into your stomach.
+Endoscopy – a thin, flexible instrument called an endoscope is passed down your throat to allow the doctor to look directly at the lining of your oesophagus, the ring of muscle and your stomach.
+Treatments for achalasia
+There is no cure for achalasia, but treatment can help relieve the symptoms and make swallowing easier.
+Your doctors will talk to you about the risks and benefits of the different treatment options.
+Medicine
+Medicines, such as nitrates or nifedipine, can help to relax the muscles in your oesophagus. This makes swallowing easier and less painful for some people, although they do not work for everyone.
+The effect only lasts for a short time, so medicine may be used to ease symptoms while you wait for a more permanent treatment. They may cause headaches, but this usually improves over time.
+Stretching the muscle (balloon dilation)
+Under a sedative or general anaesthetic, a balloon is passed into the oesophagus using a long, thin flexible tube (endoscope). The balloon is then inflated to help stretch the ring of muscle that lets food into your stomach.
+This improves swallowing for most people, but you may need treatment several times before your symptoms improve.
+Balloon dilatation does carry a small risk of tearing the oesophagus (oesophageal rupture), which may require emergency surgery.
+Botox injection
+Using an endoscope, botox is injected into the ring of muscle that lets food into your stomach, causing it to relax.
+It is usually effective for a few months and occasionally for a few years, but it has to be repeated. This is usually painless, and can be used for temporary relief in people who are not able to have other treatments.
+Surgery
+Under general anaesthetic, the muscle fibres in the ring of muscle that lets food into your stomach are cut. This is done using keyhole surgery (laparoscopy) and is called Heller's Myotomy.
+It can permanently make swallowing easier.
+Often a second procedure will be done at the same time to stop you getting acid reflux and heartburn, which can be a side effect of the Heller's Myotomy operation. Your surgeon will talk to you about this.
+In rare cases some people may need an operation to remove part of their oesophagus.
+Follow-up treatment
+Balloon dilation and surgery can both cause side effects such as acid reflux and heartburn and chest pain. A GP may be able to prescribe medicine to help with this, and your surgeon may suggest you take this medicine routinely.
+It's normal for chest pain to persist for a while after treatment. Drinking cold water may help relieve this.
+You should see a GP if you still have swallowing difficulties or are continuing to lose weight after treatment.
+Page last reviewed: 24 December 2020
+Next review due: 24 December 2023
+Support links
+Home
+Health A to Z
+Live Well
+Mental health
+Care and support
+Pregnancy
+NHS services
+Coronavirus (COVID-19)
+NHS App
+Find my NHS number
+Your health records
+About the NHS
+Healthcare abroad
+Contact us
+Other NHS websites
+Profile editor login
+About us
+Accessibility statement
+Our policies
+Cookies
+© Crown copyright

integrations/haystack/nhs-search/data/www.nhs.uk_conditions_acid-and-chemical-burns_.txt

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+Cookies on the NHS website
+We've put some small files called cookies on your device to make our site work.
+We'd also like to use analytics cookies. These send information about how our site is used to services called Adobe Analytics, Hotjar and Google Analytics. We use this information to improve our site.
+Let us know if this is OK. We'll use a cookie to save your choice. You can read more about our cookies before you choose.
+I'm OK with analytics cookies Do not use analytics cookies
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+Home Health A to Z
+Acid and chemical burns
+Burns caused by acid, alkaline or caustic chemicals can be very damaging and need immediate medical attention.
+Call 999 and ask for urgent help.
+Immediate first aid
+After calling 999, to help prevent severe injuries from a chemical burn:
+try to carefully remove the chemical and any contaminated clothing
+rinse the affected area using as much clean water as possible
+Remove the chemical and affected clothing
+try to remove the chemical and contaminated clothing from contact with the skin and eyes, but be very careful not to touch or spread the chemical
+use gloves or other protective materials to cover hands and, if possible, carefully cut away clothing such as T-shirts, rather than pulling them off over the head
+do not wipe the skin as this may spread contamination
+if the chemical is dry, brush it off the skin
+Rinse continuously with clean water
+rinse the affected area continuously with clean water as soon as possible
+try to make sure the water can run off the affected area without pooling on the skin
+only use water – do not rub or wipe the area
+Stay on the phone until the ambulance arrives and follow any other advice given by the 999 call handler to avoid further injury.
+Treatment in hospital
+Immediate treatment for chemical burns in hospital includes:
+continuing to wash off the corrosive substance with water until it's completely removed
+cleaning the burn and covering it with an appropriate dressing
+pain relief
+a tetanus jab if necessary
+Recovering from a chemical burn
+Minor burns
+Minor burns affecting the outer layer of skin and some of the underlying layer of tissue normally heal with good ongoing burn care, leaving minimal scarring.
+Your dressing will need to be checked and changed regularly until the burn has completely healed to help prevent infection.
+Severe burns
+If the burn is severe, you may be referred to a specialist burns unit, which may be in a different hospital. You may stay in hospital for a number of days.
+You may need surgery to remove the burnt area of skin and replace it with a section of skin (a graft) taken from another part of your body. See plastic surgery techniques for more information.
+More severe and deeper burns can take months or even years to fully heal and usually leave some visible scarring. In some cases, the depth and location of the burn may also lead to problems such as sight loss or restricted use of limbs or muscles.
+Specialist support
+Specialist burns teams include occupational therapists, physiotherapists and mental health professionals who can support your recovery. For chemical burns affecting the eyes, you're also likely to be urgently assessed by an eye specialist to help minimise the risk of lasting vision loss.
+If you've been the victim of an attack and continue to feel upset, anxious or afraid several days after the incident, you can ask to be referred to the hospital's mental health liaison team for support and treatment. Anyone with an existing mental health problem who has suffered an attack should also be referred to this team.
+Burns support groups also provide practical and emotional support to victims and their families. Your care team should be able to signpost you to local groups, and the following national organisations can also help:
+Changing Faces provides support for people whose condition or injury affects their appearance
+Victim Support provides help and advice to victims and witnesses of crimes
+Katie Piper Foundation provides specific help for victims and families of acid attacks and other burns
+Page last reviewed: 18 September 2020
+Next review due: 18 September 2023
+Support links
+Home
+Health A to Z
+Live Well
+Mental health
+Care and support
+Pregnancy
+NHS services
+Coronavirus (COVID-19)
+NHS App
+Find my NHS number
+Your health records
+About the NHS
+Healthcare abroad
+Contact us
+Other NHS websites
+Profile editor login
+About us
+Accessibility statement
+Our policies
+Cookies
+© Crown copyright

integrations/haystack/nhs-search/data/www.nhs.uk_conditions_acne_.txt

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+Cookies on the NHS website
+We've put some small files called cookies on your device to make our site work.
+We'd also like to use analytics cookies. These send information about how our site is used to services called Adobe Analytics, Hotjar and Google Analytics. We use this information to improve our site.
+Let us know if this is OK. We'll use a cookie to save your choice. You can read more about our cookies before you choose.
+I'm OK with analytics cookies Do not use analytics cookies
+Search the NHS website
+Search
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+Coronavirus (COVID-19)
+Get the latest advice about COVID-19
+Home Health A to Z
+Overview
+-
+Acne
+Contents
+Overview
+Causes
+Diagnosis
+Treatment
+Complications
+Acne is a common skin condition that affects most people at some point. It causes spots, oily skin and sometimes skin that's hot or painful to touch.
+Symptoms of acne
+Acne most commonly develops on the:
+face – this affects almost everyone with acne
+back – this affects more than half of people with acne
+chest – this affects about 15% of people with acne
+Credit:
+Types of spots
+There are 6 main types of spot caused by acne:
+blackheads – small black or yellowish bumps that develop on the skin; they're not filled with dirt, but are black because the inner lining of the hair follicle produces colour
+whiteheads – have a similar appearance to blackheads, but may be firmer and will not empty when squeezed
+papules – small red bumps that may feel tender or sore
+pustules – similar to papules, but have a white tip in the centre, caused by a build-up of pus
+nodules – large hard lumps that build up beneath the surface of the skin and can be painful
+cysts – the most severe type of spot caused by acne; they're large pus-filled lumps that look similar to boils and carry the greatest risk of causing permanent scarring
+Things you can try if you have acne
+These self-help techniques may be useful:
+Do not wash affected areas of skin more than twice a day. Frequent washing can irritate the skin and make symptoms worse.
+Wash the affected area with a mild soap or cleanser and lukewarm water. Very hot or cold water can make acne worse.
+Do not try to "clean out" blackheads or squeeze spots. This can make them worse and cause permanent scarring.
+Avoid using too much make-up and cosmetics.
+Avoid make-up, skincare and suncare products that are oil-based (sometimes labelled “comedogenic”). Use water-based non-comedogenic products, as they’re less likely to block the pores in your skin.
+Completely remove make-up before going to bed.
+If dry skin is a problem, use a fragrance-free water-based emollient.
+Regular exercise cannot improve your acne, but it can boost your mood and improve your self-esteem. Shower as soon as possible once you finish exercising as sweat can irritate your acne.
+Wash your hair regularly and try to avoid letting your hair fall across your face.
+Although acne cannot be cured, it can be controlled with treatment.
+If you develop mild acne, it's a good idea to speak to a pharmacist for advice.
+Several creams, lotions and gels for treating spots are available to buy from pharmacies.
+Products containing a low concentration of benzoyl peroxide may be recommended, but be careful as this can bleach clothing.
+If your acne is severe or appears on your chest and back, it may need to be treated with antibiotics or stronger creams that are only available on prescription.
+When to seek medical advice
+If you have mild acne, speak to a pharmacist about medicines to treat it.
+If these do not control your acne, or it's making you feel very unhappy, see a GP.
+You should see a GP if you have moderate or severe acne or you develop nodules or cysts, as they need to be treated properly to avoid scarring. 
+Try to resist the temptation to pick or squeeze the spots, as this can lead to permanent scarring.
+Treatments can take up to 3 months to work, so do not expect results overnight. Once they do start to work, the results are usually good.
+Why do I have acne?
+Acne is most commonly linked to the changes in hormone levels during puberty, but can start at any age.
+Certain hormones cause the grease-producing glands next to hair follicles in the skin to produce larger amounts of oil (abnormal sebum).
+This abnormal sebum changes the activity of a usually harmless skin bacterium called P. acnes, which becomes more aggressive and causes inflammation and pus.
+The hormones also thicken the inner lining of the hair follicle, causing blockage of the pores. Cleaning the skin does not help to remove this blockage.
+Other possible causes
+Acne is known to run in families. If both your mother and father had acne, it's likely that you'll also have acne.
+Hormonal changes, such as those that occur during the menstrual cycle or pregnancy, can also lead to episodes of acne in women.
+There's no evidence that diet, poor hygiene or sexual activity play a role in acne.
+Who's affected?
+Acne is very common in teenagers and younger adults. About 95% of people aged 11 to 30 are affected by acne to some extent.
+Acne is most common in girls from the ages of 14 to 17, and in boys from the ages of 16 to 19.
+Most people have acne on and off for several years before their symptoms start to improve as they get older.
+Acne often disappears when a person is in their mid-20s.
+In some cases, acne can continue into adult life. About 3% of adults have acne over the age of 35.
+Page last reviewed: 12 July 2019
+Next review due: 12 July 2022
+Next
+:
+Causes
+Support links
+Home
+Health A to Z
+Live Well
+Mental health
+Care and support
+Pregnancy
+NHS services
+Coronavirus (COVID-19)
+NHS App
+Find my NHS number
+Your health records
+About the NHS
+Healthcare abroad
+Contact us
+Other NHS websites
+Profile editor login
+About us
+Accessibility statement
+Our policies
+Cookies
+© Crown copyright

integrations/haystack/nhs-search/data/www.nhs.uk_conditions_acoustic-neuroma_.txt

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+Cookies on the NHS website
+We've put some small files called cookies on your device to make our site work.
+We'd also like to use analytics cookies. These send information about how our site is used to services called Adobe Analytics, Hotjar and Google Analytics. We use this information to improve our site.
+Let us know if this is OK. We'll use a cookie to save your choice. You can read more about our cookies before you choose.
+I'm OK with analytics cookies Do not use analytics cookies
+Search the NHS website
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+Coronavirus (COVID-19)
+Get the latest advice about COVID-19
+Home Health A to Z
+Acoustic neuroma (vestibular schwannoma)
+An acoustic neuroma is a type of non-cancerous (benign) brain tumour. It's also known as a vestibular schwannoma.
+A benign brain tumour is a growth in the brain that usually grows slowly over many years and does not spread to other parts of the body.
+Acoustic neuromas grow on the nerve used for hearing and balance, which can cause problems such as hearing loss and unsteadiness.
+They can sometimes be serious if they become very large, but most are picked up and treated before they reach this stage.
+Acoustic neuromas tend to affect adults aged 30 to 60 and usually have no obvious cause, although a small number of cases are the result of a genetic condition called neurofibromatosis type 2 (NF2).
+Symptoms of an acoustic neuroma
+An acoustic neuroma may not cause any obvious symptoms at first.
+Any symptoms tend to develop gradually and often include:
+hearing loss that usually only affects 1 ear
+hearing sounds that come from inside the body (tinnitus)
+the sensation that you're moving or spinning (vertigo)
+A large acoustic neuroma can also sometimes cause:
+persistent headaches
+temporary blurred or double vision
+numbness, pain or weakness on 1 side of the face
+problems with limb co-ordination (ataxia) on 1 side of the body
+a hoarse voice or difficulty swallowing
+Getting medical advice
+See your GP if you have persistent or troublesome symptoms that you're worried could be caused by an acoustic neuroma.
+Acoustic neuromas can be difficult to diagnose because the symptoms can be caused by other conditions, such as Ménière's disease.
+If your GP thinks you could have an acoustic neuroma, you'll be referred to a hospital or clinic for further tests, such as:
+hearing tests to check for hearing problems and determine whether they're caused by a problem with your nerves
+an MRI scan, which uses strong magnetic fields and radio waves to produce a detailed picture of the inside of your head
+a CT scan, which uses a series of X-rays to create a detailed image of the inside of your head
+Treatments for acoustic neuromas
+There are several different treatment options for an acoustic neuroma, depending on the size and position of your tumour, how fast it's growing and your general health.
+The main options are:
+monitoring the tumour – small tumours often just need to be monitored with regular MRI scans, and the treatments below are generally only recommended if scans show it's getting bigger
+brain surgery – surgery to remove the tumour through a cut in the skull may be carried out under general anaesthetic if it's large or getting bigger
+stereotactic radiosurgery – small tumours, or any pieces of a larger tumour that remain after surgery, may be treated with a precise beam of radiation to stop them getting any bigger
+All these options carry some risks. For example, surgery and radiosurgery can sometimes cause facial numbness or an inability to move part of your face (paralysis).
+Speak to your specialist about the best option for you and what the benefits and risks are.
+Outlook for acoustic neuromas
+Large acoustic neuromas can be serious because they can sometimes cause a life-threatening build-up of fluid in the brain (hydrocephalus).
+But it's rare for them to reach this stage. Many grow very slowly or not at all, and those that grow more quickly can be treated before they become too big.
+Even with treatment, symptoms such as hearing loss and tinnitus can persist and affect your ability to work, communicate and drive.
+These problems may need additional treatment.
+Read more about treating hearing loss and treating tinnitus.
+An acoustic neuroma can occasionally return after treatment. This is thought to happen to around 1 in every 20 people who have had surgical removal.
+You'll probably continue having regular MRI scans after any treatment to check if the tumour is growing again or coming back.
+The 100,000 Genomes Project
+If your doctor thinks there could be a genetic cause for your acoustic neuroma, you may be invited to take part in the 100,000 Genomes Project.
+Your DNA will be studied to find out more about the cause of your condition.
+The aim is to create a new personalised medicine service for the NHS. This should transform the way people are cared for.
+Find out if you might be able to take part
+Page last reviewed: 19 February 2019
+Next review due: 19 February 2022
+Support links
+Home
+Health A to Z
+Live Well
+Mental health
+Care and support
+Pregnancy
+NHS services
+Coronavirus (COVID-19)
+NHS App
+Find my NHS number
+Your health records
+About the NHS
+Healthcare abroad
+Contact us
+Other NHS websites
+Profile editor login
+About us
+Accessibility statement
+Our policies
+Cookies
+© Crown copyright

integrations/haystack/nhs-search/data/www.nhs.uk_conditions_acr-test_.txt

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+Cookies on the NHS website
+We've put some small files called cookies on your device to make our site work.
+We'd also like to use analytics cookies. These send information about how our site is used to services called Adobe Analytics, Hotjar and Google Analytics. We use this information to improve our site.
+Let us know if this is OK. We'll use a cookie to save your choice. You can read more about our cookies before you choose.
+I'm OK with analytics cookies Do not use analytics cookies
+Search the NHS website
+Search
+My account
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+Mental health
+Care and support
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+More
+Home Health A to Z
+Urine albumin to creatinine ratio (ACR)
+Urine albumin to creatinine ratio (ACR), also known as urine microalbumin, helps identify kidney disease that can occur as a complication of diabetes.
+If kidney disease is diagnosed early in people with diabetes, appropriate treatment can be given and its effects can be closely monitored.
+This means a person's ACR level should be checked as soon as diabetes is diagnosed.
+It should also be measured each year, or more frequently, if your ACR level is significantly raised.
+If you have a slightly raised ACR level, you may have early-stage kidney disease. A very high ACR level indicates more severe kidney disease. A very low ACR value probably means your kidneys are functioning normally.
+If diabetes is well managed, it's easier to control or prevent complications developing, such as high blood pressure, which can sometimes lead to kidney disease.
+Read more about treating type 1 diabetes and treating type 2 diabetes.
+Read more about ACR at Lab Tests Online UK.
+Page last reviewed: 09 August 2018
+Next review due: 09 August 2021
+Support links
+Home
+Health A to Z
+Live Well
+Mental health
+Care and support
+Pregnancy
+NHS services
+Coronavirus (COVID-19)
+NHS App
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+Your health records
+About the NHS
+Healthcare abroad
+Contact us
+Other NHS websites
+Profile editor login
+About us
+Accessibility statement
+Our policies
+Cookies
+© Crown copyright

integrations/haystack/nhs-search/data/www.nhs.uk_conditions_acromegaly_.txt

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+Cookies on the NHS website
+We've put some small files called cookies on your device to make our site work.
+We'd also like to use analytics cookies. These send information about how our site is used to services called Adobe Analytics, Hotjar and Google Analytics. We use this information to improve our site.
+Let us know if this is OK. We'll use a cookie to save your choice. You can read more about our cookies before you choose.
+I'm OK with analytics cookies Do not use analytics cookies
+Search the NHS website
+Search
+My account
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+Live Well
+Mental health
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+More
+Coronavirus (COVID-19)
+Get the latest advice about COVID-19
+Home Health A to Z
+Acromegaly
+Acromegaly is a rare condition where the body produces too much growth hormone, causing body tissues and bones to grow more quickly.
+Over time, this leads to abnormally large hands and feet, and a wide range of other symptoms.
+Acromegaly is usually diagnosed in adults aged 30 to 50, but it can affect people of any age. When it develops before the end of puberty, it's known as "gigantism".
+Symptoms of acromegaly
+Acromegaly can cause a wide range of symptoms, which tend to develop very slowly over time.
+Early symptoms include:
+swollen hands and feet – you may notice a change in your ring or shoe size
+tiredness and difficulty sleeping, and sometimes sleep apnoea
+gradual changes in your facial features, such as your brow, lower jaw and nose getting larger, or your teeth becoming more widely spaced
+numbness and weakness in your hands, caused by a compressed nerve (carpal tunnel syndrome)
+Children and teenagers will be abnormally tall.
+As time goes on, common symptoms include:
+abnormally large hands and feet
+large, prominent facial features (such as the nose and lips) and an enlarged tongue
+skin changes – such as thick, coarse, oily skin, skin tags, or sweating too much
+deepening of the voice as a result of enlarged sinuses and vocal cords
+joint pain
+tiredness and weakness
+headaches
+blurred or reduced vision
+loss of sex drive
+abnormal periods (in women) and erection problems (in men)
+Symptoms often become more noticeable as you get older.
+See a GP straight away if you think you have acromegaly.
+Acromegaly can usually be successfully treated, but early diagnosis and treatment is important to prevent the symptoms getting worse and reduce the chance of complications.
+Risks of acromegaly
+If you do not get treatment, you may be at risk of developing:
+type 2 diabetes
+high blood pressure (hypertension)
+heart disease
+disease of the heart muscle (cardiomyopathy)
+arthritis
+bowel polyps, which can potentially turn into bowel cancer if left untreated
+Because of the risk of bowel polyps, a procedure known as a colonoscopy might be recommended if you've been diagnosed with acromegaly. Regular colonoscopy screening may also be necessary.
+Causes of acromegaly
+Acromegaly happens because your pituitary gland (a pea-sized gland just below the brain) produces too much growth hormone.
+This is usually caused by a non-cancerous tumour in the pituitary gland called an adenoma.
+Most of the symptoms of acromegaly are due to the excess of growth hormone itself, but some come from the tumour pressing on nearby tissues. For example, you may get headaches and vision problems if a tumour pushes against the nearby nerves.
+Acromegaly sometimes runs in families, but most of the time it's not inherited. Adenomas usually spontaneously develop because of a genetic change in a cell of the pituitary gland. This change causes uncontrolled growth of the affected cells, creating the tumour.
+Rarely, acromegaly is caused by a tumour in another part of the body, such as the lungs, pancreas or another part of the brain. It may also be linked to some genetic conditions.
+Treating acromegaly
+Treatment for acromegaly depends on your symptoms. Usually the goal is to:
+reduce growth hormone production to normal levels
+relieve the pressure a tumour may be putting on surrounding tissues
+treat any hormone deficiencies
+improve your symptoms
+Most people with acromegaly have surgery to remove a pituitary tumour. Medicine or radiotherapy may sometimes be needed after, or instead of, surgery.
+Surgery
+Surgery is usually effective and can completely cure acromegaly. But sometimes the tumour is too large to be removed entirely, and you may need another operation or further treatment with medicine or radiotherapy.
+Under general anaesthetic, the surgeon will make a small cut inside your nose or behind your upper lip to access the pituitary gland.
+A long, thin, flexible tube with a light and video camera at one end, called an endoscope, is fed into the opening so your doctor can see the tumour. Surgical instruments are passed through the same opening and used to remove the tumour.
+Removing the tumour should instantly lower your levels of growth hormone and relieve pressure on the surrounding tissue. Facial features often start to return to normal and swelling improves within a few days.
+With surgery, there's risk of:
+damaging the healthy parts of your pituitary gland
+leakage of the fluid that surrounds and protects your brain
+meningitis – although this is rare
+Your surgeon will discuss these risks with you and answer any questions you have.
+Medicine
+Medicine may be prescribed if your growth hormone levels are still higher than normal after surgery, or if surgery was not possible.
+3 different types of medicine are used:
+a monthly injection of either octreotide, lanreotide or pasireotide – this slows down the release of growth hormone and can sometimes also shrink tumours
+a daily pegvisomant injection – this blocks the effects of growth hormone and can significantly improve symptoms
+bromocriptine or cabergoline tablets – these can stop growth hormone being produced, but they only work in a small proportion of people
+Each of these medicines has different advantages and disadvantages. Speak to your doctor about the options available to you, and the benefits and risks of each.
+Radiotherapy
+If surgery is not possible, or not all of the tumour could be removed, or if medicine has not worked, you may be offered radiotherapy.
+This can eventually reduce your growth hormone levels, but it may not have a noticeable effect for several years and you may need to take medicine in the meantime.
+2 main types of radiotherapy are used to treat acromegaly:
+stereotactic radiotherapy – a high-dose beam of radiation is aimed very precisely at your adenoma; you'll need to wear a rigid head frame or a plastic mask to hold your head still during the treatment, which can usually be done in one session
+conventional radiotherapy – this also uses a beam of radiation to target the adenoma, but it's wider and less precise than the one used in stereotactic radiotherapy; this means this treatment can damage the surrounding pituitary gland and brain tissue, so it's given in small doses over 4 to 6 weeks to give your tissues time to heal between treatments
+Stereotactic radiotherapy is more commonly used to treat adenomas because it minimises the risk of damage to nearby healthy tissue.
+Radiotherapy can have a number of side effects. It will often cause a gradual drop in the levels of other hormones produced by your pituitary gland, so you'll usually need hormone replacement therapy for the rest of your life. It may also have an effect on your fertility.
+Your doctor will be able to talk to you about these risks and other possible side effects.
+Follow-up
+Treatment is often effective at stopping the excessive production of growth hormone and improving the symptoms of acromegaly.
+After treatment, you'll need regular follow-up appointments with your specialist for the rest of your life. These will be used to monitor how well your pituitary gland is working, check you're on the correct hormone replacement treatment and make sure the condition does not return.
+Diagnosing acromegaly
+Because the symptoms of acromegaly often develop gradually over several years, you may not get a diagnosis straight away. Your doctor may ask you to bring in photographs of yourself that span the past few years to look for the tell-tale gradual changes.
+Blood tests
+If your doctor suspects you have acromegaly, you'll need to have a blood test to measure your growth hormone levels.
+To make sure the blood test gives an accurate result, you may be asked to drink a sugary solution before having a series of blood samples taken. For people without acromegaly, drinking the solution should stop growth hormone being released. In people with acromegaly, the level of growth hormone in the blood will remain high. This is called a glucose tolerance test.
+Your doctor will also measure the level of another hormone, called insulin-like growth factor 1 (IGF-1). A higher level of IGF-1 is a very accurate indication that you may have acromegaly.
+Brain scans
+If your blood tests show a high level of growth hormone and IGF-1, you might have an MRI scan of your brain. This will show where the adenoma is in your pituitary gland and how big it is. If you cannot have an MRI scan, a CT scan can be carried out, but this is less accurate.
+National Congenital Anomaly and Rare Disease Registration Service
+If you have acromegaly, your clinical team will pass information about you on to the National Congenital Anomaly and Rare Disease Registration Service (NCARDRS).
+The NCARDRS helps scientists look for better ways to treat and prevent acromegaly. You can opt out of the register at any time.
+Page last reviewed: 12 October 2020
+Next review due: 12 October 2023
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integrations/haystack/nhs-search/data/www.nhs.uk_conditions_actinic-keratoses_.txt

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+Cookies on the NHS website
+We've put some small files called cookies on your device to make our site work.
+We'd also like to use analytics cookies. These send information about how our site is used to services called Adobe Analytics, Hotjar and Google Analytics. We use this information to improve our site.
+Let us know if this is OK. We'll use a cookie to save your choice. You can read more about our cookies before you choose.
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+Actinic keratoses (solar keratoses)
+Actinic keratoses (also called solar keratoses) are dry scaly patches of skin that have been damaged by the sun.
+The patches are not usually serious. But there's a small chance they could become skin cancer, so it's important to avoid further damage to your skin.
+Check if you have actinic keratoses
+The patches:
+can feel dry, rough and scaly, or like sandpaper
+are usually between 1cm to 2cm in size
+can be the same colour as your skin or range from pink to red to brown
+may feel itchy
+Credit:
+The patches usually appear on areas of your body that are often exposed to the sun, such as your face, hands and arms, ears, scalp and legs.
+Non-urgent advice:
+See a GP if
+this is the first time you have noticed patches on your skin
+the patches begin to bleed, get bigger, change colour, feel tender or develop into a lump
+
+It's important to get these skin changes checked, in case they could be caused by something more serious, such as skin cancer.
+Information:
+Coronavirus (COVID-19) update: how to contact a GP
+It's still important to get help from a GP if you need it. To contact your GP surgery:
+visit their website
+use the NHS App
+call them
+Find out about using the NHS during COVID-19
+Treatment for actinic keratoses
+If you only have 1 skin patch, a GP might suggest waiting to see if the patch goes away by itself.
+If you have more than 1 patch, or a patch is causing you problems such as pain and itchiness, treatment is usually recommended. A GP may refer you to a skin specialist (dermatologist).
+Treatments for actinic keratoses include:
+prescription creams and gels
+freezing the patches (cryotherapy), this makes the patches turn into blisters and fall off after a few weeks
+surgery to cut out or scrape away the patches – you will be given a local anaesthetic first, so it does not hurt
+photodynamic therapy (PDT), where special cream is applied to the patches and a light is shone onto them to kill abnormal skin cells
+Things you can do to help
+If you have actinic keratoses it's important to avoid any further sun damage. This will stop you getting more skin patches and will lower your chance of getting skin cancer.
+Do
+use sunscreen with a sun protection factor (SPF) of at least 30 before going out into the sun and reapply regularly
+wear a hat and clothing that fully covers your legs and arms when you're out in the sunlight
+Don’t
+do not use sunlamps or sunbeds as these can also cause skin damage
+do not go into the sun between 11am and 3pm – this is when the sun is at its strongest
+Information:
+Consider taking 10 micrograms of vitamin D a day if you always cover up outdoors. This is because you may not get enough vitamin D from sunlight.
+Page last reviewed: 08 June 2020
+Next review due: 08 June 2023
+Support links
+Home
+Health A to Z
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+Mental health
+Care and support
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+NHS services
+Coronavirus (COVID-19)
+NHS App
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+Your health records
+About the NHS
+Healthcare abroad
+Contact us
+Other NHS websites
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+Our policies
+Cookies
+© Crown copyright

integrations/haystack/nhs-search/data/www.nhs.uk_conditions_actinomycosis_.txt

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+Cookies on the NHS website
+We've put some small files called cookies on your device to make our site work.
+We'd also like to use analytics cookies. These send information about how our site is used to services called Adobe Analytics, Hotjar and Google Analytics. We use this information to improve our site.
+Let us know if this is OK. We'll use a cookie to save your choice. You can read more about our cookies before you choose.
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+Actinomycosis
+Actinomycosis is a rare type of bacterial infection. It can be very serious but can usually be cured with antibiotics.
+Treatment for actinomycosis
+Actinomycosis is treated with antibiotics. Treatment starts off in hospital with antibiotics given directly into a vein (intravenously).
+When you're well enough to go home, you'll be given tablets to take for a few months.
+It's important to keep taking antibiotics until they're finished, even when you feel better.
+You might also need surgery to drain areas of pus (abscesses) and cut out the surrounding area if it's infected.
+Non-urgent advice:
+Contact your GP or specialist if:
+your symptoms get worse or do not improve after leaving hospital
+Get help quickly if treatment does not seem to be working. The infection can spread to other parts of your body and can be life-threatening.
+Information:
+Coronavirus (COVID-19) update: how to contact a GP
+It's still important to get help from a GP if you need it. To contact your GP surgery:
+visit their website
+use the NHS App
+call them
+Find out about using the NHS during COVID-19
+How you get actinomycosis
+The bacteria that cause actinomycosis normally live harmlessly in the body. They only cause an infection if they get into the lining of areas such as the mouth or gut.
+You cannot spread the infection to other people.
+Any part of the body can be infected, but the head and neck, chest, tummy and pelvis are most commonly affected.
+Possible causes of actinomycosis
+Possible causes Symptoms
+Jaw or mouth: tooth decay, an injury, dental surgery lumps on your cheek or neck, difficulty chewing, pus leaking from small holes in your skin
+Lungs: inhaling liquid or food contaminated with the bacteria shortness of breath, chest pain, a cough, pus leaking from small holes in your skin
+Tummy: burst appendix, surgery diarrhoea or constipation, pain, a lump or swelling in your tummy, pus leaking from small holes in your skin
+Pelvis: leaving an IUD contraceptive coil in for too long pain low down in your tummy, vaginal bleeding or unusual discharge, a lump or swelling in your lower tummy
+You cannot always prevent actinomycosis
+Actinomycosis is very rare, so the chances of getting it are extremely small.
+You can help reduce your risk by:
+looking after your teeth and gums
+not leaving an IUD in for longer than recommended – they usually last 5 to 10 years, depending on the type you have
+Page last reviewed: 09 October 2020
+Next review due: 09 October 2023
+Support links
+Home
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+Mental health
+Care and support
+Pregnancy
+NHS services
+Coronavirus (COVID-19)
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+Your health records
+About the NHS
+Healthcare abroad
+Contact us
+Other NHS websites
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+About us
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+Our policies
+Cookies
+© Crown copyright

integrations/haystack/nhs-search/data/www.nhs.uk_conditions_acupuncture_.txt

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+Cookies on the NHS website
+We've put some small files called cookies on your device to make our site work.
+We'd also like to use analytics cookies. These send information about how our site is used to services called Adobe Analytics, Hotjar and Google Analytics. We use this information to improve our site.
+Let us know if this is OK. We'll use a cookie to save your choice. You can read more about our cookies before you choose.
+I'm OK with analytics cookies Do not use analytics cookies
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+Get the latest advice about COVID-19
+Home Health A to Z
+Acupuncture
+Acupuncture is a treatment derived from ancient Chinese medicine. Fine needles are inserted at certain sites in the body for therapeutic or preventative purposes.
+It is used in many NHS GP practices, as well as in most pain clinics and hospices in the UK.
+Acupuncture is often seen as a form of complementary or alternative medicine (CAM).
+How acupuncture works
+Western medical acupuncture is the use of acupuncture following a medical diagnosis. It involves stimulating sensory nerves under the skin and in the muscles.
+This results in the body producing natural substances, such as pain-relieving endorphins. It's likely that these naturally released substances are responsible for the beneficial effects experienced with acupuncture.
+A course of acupuncture usually creates longer lasting pain relief than when a single treatment is used.
+Traditional acupuncture is based on the belief that an energy, or "life force", flows through the body in channels called meridians. This life force is known as Qi (pronounced "chee").
+Practitioners who use acupuncture in the traditional way believe that when Qi does not flow freely through the body, this can cause illness. They also believe acupuncture can restore the flow of Qi, and so restore health.
+Uses of acupuncture
+Acupuncture practitioners – sometimes called acupuncturists – use acupuncture to treat a wide range of health conditions. However, the use of acupuncture is not always based on rigorous scientific evidence.
+The National Institute for Health and Care Excellence (NICE) provides guidelines for the NHS on the use of treatments and care of patients.
+Currently, NICE only recommends considering acupuncture as a treatment option for:
+chronic (long-term) pain
+chronic tension-type headaches
+migraines
+Acupuncture is also often used to treat other musculoskeletal conditions (of the bones and muscles) and pain conditions, including:
+joint pain
+dental pain
+postoperative pain
+However, the evidence on the effectiveness of acupuncture compared with other treatments is unclear.
+Acupuncture on the NHS
+Acupuncture is sometimes available on the NHS, most often from GP surgeries or physiotherapists, although access is limited.
+Most acupuncture patients pay for private treatment. The cost of acupuncture varies widely between practitioners.
+If you're being treated by an acupuncture practitioner for a health condition or are considering having acupuncture, it's advisable to discuss this with your GP.
+How acupuncture is performed
+An initial acupuncture session usually lasts 20 minutes to 1 hour and involves an assessment of your general health, medical history and a physical examination, followed by insertion of the acupuncture needles.
+Courses of treatment often involve several separate sessions, but this can vary.
+Insertion of the needles
+Credit:
+The needles are inserted into specific places on the body, which practitioners call acupuncture points.
+During the session, you'll usually be asked to sit or lie down. You may also be asked to remove some clothes so the practitioner can access certain parts of your body.
+The needles used are very fine and are usually a few centimetres long. They should be single-use, pre-sterilised needles that are disposed of immediately after use.
+Acupuncture practitioners choose specific points to place the needles based on your condition. Several points may be used during a typical session, depending on the number of symptoms you have.
+The needles may be inserted just under the skin, or deeper so they reach muscle. Once the needles are in place, they may be left in position for a length of time lasting from a few minutes up to around 30 minutes.
+You may feel a tingling or a dull ache when the needles are inserted but you should not experience any significant pain. If you do, let your practitioner know straight away.
+Acupuncture safety and regulation
+There's no statutory regulation of acupuncture in England.
+If you choose to have acupuncture, it is recommended that you check the acupuncture practitioner is either a regulated healthcare professional such as a doctor, nurse or physiotherapist or a member of a national acupuncture organisation.
+You can find an accredited register of acupuncture practitioners on the Professional Standards Authority for Health and Social Care website.
+When it's done by a qualified practitioner, acupuncture is generally very safe. Rarely, some people experience mild, short-term side effects such as:
+pain where the needles puncture the skin
+bleeding or bruising where the needles puncture the skin
+drowsiness
+feeling sick
+feeling dizzy or faint
+worsening of pre-existing symptoms
+If you have a bleeding disorder, such as haemophilia, or are taking anticoagulants, talk to your GP before you have acupuncture. 
+Acupuncture is also not usually advised if you have a metal allergy or an infection in the area where needles may be inserted.
+It's generally safe to have acupuncture when you're pregnant. However, let your acupuncture practitioner know if you're pregnant because certain acupuncture points cannot be used safely during pregnancy.
+Read more about the safety of complementary therapies in pregnancy.
+Page last reviewed: 13 August 2019
+Next review due: 13 August 2022
+Support links
+Home
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+Live Well
+Mental health
+Care and support
+Pregnancy
+NHS services
+Coronavirus (COVID-19)
+NHS App
+Find my NHS number
+Your health records
+About the NHS
+Healthcare abroad
+Contact us
+Other NHS websites
+Profile editor login
+About us
+Accessibility statement
+Our policies
+Cookies
+© Crown copyright

integrations/haystack/nhs-search/data/www.nhs.uk_conditions_acute-cholecystitis_.txt

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+Cookies on the NHS website
+We've put some small files called cookies on your device to make our site work.
+We'd also like to use analytics cookies. These send information about how our site is used to services called Adobe Analytics, Hotjar and Google Analytics. We use this information to improve our site.
+Let us know if this is OK. We'll use a cookie to save your choice. You can read more about our cookies before you choose.
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+Acute cholecystitis
+Acute cholecystitis is inflammation of the gallbladder. It usually happens when a gallstone blocks the cystic duct.
+Gallstones are small stones, usually made of cholesterol, that form in the gallbladder. The cystic duct is the main opening of the gallbladder.
+Gallstones are very common, affecting about 1 in 10 adults in the UK.
+They do not usually cause symptoms, but can occasionally cause episodes of pain (biliary colic) or acute cholecystitis.
+Acute cholecystitis is potentially serious because of the risk of complications.
+It usually needs to be treated in hospital with rest, intravenous fluids and antibiotics.
+Symptoms of cholecystitis
+The main symptom of acute cholecystitis is a sudden, sharp pain in the upper right-hand side of your tummy (abdomen). This pain spreads towards your right shoulder.
+The affected part of the tummy is usually very tender, and breathing deeply can make the pain worse.
+Unlike other types of abdominal pain, the pain of acute cholecystitis is usually persistent and does not go away within a few hours.
+Some people may have additional symptoms, such as:
+a high temperature (fever)
+feeling sick
+being sick
+sweating
+loss of appetite
+yellowing of the skin and the whites of the eyes (jaundice)
+a bulge in the tummy
+When to seek medical advice
+See a GP as soon as possible if you develop sudden and severe abdominal pain, particularly if it lasts longer than a few hours or is accompanied by other symptoms, such as jaundice and a high temperature.
+If you're unable to contact a GP immediately, phone your local out-of-hours service or call NHS 111 for advice.
+It's important for acute cholecystitis to be diagnosed as soon as possible, as there's a risk serious complications could develop if it's not treated promptly.
+What causes acute cholecystitis?
+The causes of acute cholecystitis can be grouped into 2 main categories: calculous cholecystitis and acalculous cholecystitis.
+Calculous cholecystitis
+Calculous cholecystitis is the most common, and usually less serious, type of acute cholecystitis. It accounts for around 95% of all cases.
+Calculous cholecystitis develops when the main opening to the gallbladder, the cystic duct, gets blocked by a gallstone or a substance known as biliary sludge.
+Biliary sludge is a mixture of bile, a liquid produced by the liver that helps digest fats, and small cholesterol and salt crystals.
+The blockage in the cystic duct causes bile to build up in the gallbladder, increasing the pressure inside it and causing it to become inflamed.
+In around 1 in every 5 cases, the inflamed gallbladder also becomes infected by bacteria.
+Acalculous cholecystitis
+Acalculous cholecystitis is a less common, but usually more serious, type of acute cholecystitis.
+It usually develops as a complication of a serious illness, infection or injury that damages the gallbladder.
+Acalculous cholecystitis can be caused by accidental damage to the gallbladder during major surgery, serious injuries or burns, sepsis, severe malnutrition or HIV/AIDS.
+Diagnosing acute cholecystitis
+If you have severe tummy pain, a GP will probably carry out a simple test called Murphy's sign.
+You'll be asked to breathe in deeply with the GP's hand pressed on your tummy, just below your rib cage.
+Your gallbladder will move downwards as you breathe in. If you have cholecystitis, you'll experience sudden pain as your gallbladder reaches your doctor's hand.
+If your symptoms suggest you have acute cholecystitis, your GP will refer you to hospital immediately for further tests and treatment.
+Tests you may have in hospital include:
+blood tests – to check for signs of inflammation in your body
+an ultrasound scan of your tummy – to check for gallstones or other signs of a problem with your gallbladder
+Other scans, such as an X-ray, CT scan or MRI scan, may also be carried out to examine your gallbladder in more detail if there's any uncertainty about your diagnosis.
+Treating acute cholecystitis
+If you're diagnosed with acute cholecystitis, you'll probably need to be admitted to hospital for treatment.
+Initial treatment
+Initial treatment will usually involve:
+not eating or drinking (fasting) to take the strain off your gallbladder
+receiving fluids through a drip directly into a vein (intravenously) to prevent dehydration
+taking medicine to relieve your pain
+You'll also be given antibiotics if it's thought you have an infection.
+These often need to be continued for up to a week, during which time you may need to stay in hospital, or you may be able to go home.
+After initial treatment, any gallstones that may have caused acute cholecystitis usually fall back into the gallbladder and the inflammation will often settle down.
+Surgery
+Removing your gallbladder may be recommended at some point after initial treatment to prevent acute cholecystitis coming back and reduce your risk of developing potentially serious complications. 
+This type of surgery is known as a cholecystectomy.
+Although uncommon, an alternative procedure called a percutaneous cholecystostomy may be carried out if you're too unwell to have surgery.
+This is where a needle is inserted through your tummy to drain away the fluid that's built up in the gallbladder.
+If you're fit enough to have surgery, your doctors will decide when the best time to remove your gallbladder is.
+In some cases you may need to have surgery immediately or in the next day or 2, or it may be necessary to wait a few weeks until the inflammation has settled down.
+Surgery can be carried out in 3 ways:
+laparoscopic cholecystectomy – a type of keyhole surgery where the gallbladder is removed using special surgical instruments inserted through a number of small cuts in your abdomen
+single-incision laparoscopic cholecystectomy – where the gallbladder is removed through a single cut, which is usually made near the bellybutton
+open cholecystectomy – where the gallbladder is removed through a single larger cut in the tummy
+Although some people who have had their gallbladder removed have reported symptoms of bloating and diarrhoea after eating certain foods, it's possible to lead a perfectly normal life without a gallbladder.
+The organ can be useful, but it's not essential as your liver will still produce bile to digest food.
+Find out more about recovering from gallbladder removal
+Possible complications
+Without appropriate treatment, acute cholecystitis can sometimes lead to potentially life-threatening complications.
+The main complications of acute cholecystitis are:
+the death of gallbladder tissue (gangrenous cholecystitis) – which can cause a serious infection that could spread throughout the body
+the gallbladder splitting open (perforated gallbladder) – which can spread the infection within your tummy (peritonitis) or lead to a build-up of pus (abscess)
+Emergency surgery to remove the gallbladder is needed to treat these complications in about 1 in every 5 cases of acute cholecystitis.
+Preventing acute cholecystitis
+It's not always possible to prevent acute cholecystitis, but you can lower your risk of developing it by reducing your risk of getting gallstones.
+One of the main things you can do to lower your chances of getting gallstones is to adopt a healthy, balanced diet and reduce the number of high-cholesterol foods you eat, as cholesterol is thought to contribute to the formation of gallstones.
+Being overweight, particularly being obese, also increases your risk of developing gallstones.
+You should therefore control your weight by eating a healthy diet and exercising regularly.
+But low-calorie rapid weight loss diets should be avoided because there's evidence they can disrupt your bile chemistry and actually increase your risk of developing gallstones.
+A more gradual weight loss plan is best. 
+Find out more about preventing gallstones
+The gallbladder
+The gallbladder is a small pear-shaped organ located beneath the liver. It's main purpose is to store and concentrate bile.
+The liver produces bile, a liquid that helps digest fats and carries toxins excreted by the liver.
+Bile is passed from the liver through a series of channels called bile ducts into the gallbladder, where it's stored.
+Over time bile becomes more concentrated, which makes it more effective at digesting fats.
+The gallbladder releases bile into the digestive system when it's needed.
+The gallbladder is an organ that's useful, but not essential. It can safely be removed without interfering with your ability to digest food.
+Page last reviewed: 07 August 2019
+Next review due: 07 August 2022
+Support links
+Home
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+Mental health
+Care and support
+Pregnancy
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+Coronavirus (COVID-19)
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+Your health records
+About the NHS
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+Contact us
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integrations/haystack/nhs-search/data/www.nhs.uk_conditions_acute-kidney-injury_.txt

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+Cookies on the NHS website
+We've put some small files called cookies on your device to make our site work.
+We'd also like to use analytics cookies. These send information about how our site is used to services called Adobe Analytics, Hotjar and Google Analytics. We use this information to improve our site.
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+Acute kidney injury
+Acute kidney injury (AKI) is where your kidneys suddenly stop working properly. It can range from minor loss of kidney function to complete kidney failure.
+AKI normally happens as a complication of another serious illness. It's not the result of a physical blow to the kidneys, as the name might suggest.
+This type of kidney damage is usually seen in older people who are unwell with other conditions and the kidneys are also affected.
+It's essential that AKI is detected early and treated promptly.
+Without quick treatment, abnormal levels of salts and chemicals can build up in the body, which affects the ability of other organs to work properly. 
+If the kidneys shut down completely, this may require temporary support from a dialysis machine, or lead to death.
+Symptoms of acute kidney injury
+Symptoms of AKI include:
+feeling sick or being sick
+diarrhoea
+dehydration
+peeing less than usual
+confusion
+drowsiness
+Even if it does not progress to complete kidney failure, AKI needs to be taken seriously.
+It has an effect on the whole body, changes how some drugs are handled by the body, and could make some existing illnesses more serious.
+AKI is different from chronic kidney disease, where the kidneys gradually lose function over a long period of time.
+Who's at risk of acute kidney injury?
+You're more likely to get AKI if:
+you're aged 65 or over
+you already have a kidney problem, such as chronic kidney disease
+you have a long-term disease, such as heart failure, liver disease or diabetes
+you're dehydrated or unable to maintain your fluid intake independently
+you have a blockage in your urinary tract (or are at risk of this)
+you have a severe infection or sepsis
+you're taking certain medicines, including non-steroidal anti-inflammatory drugs (NSAIDS, such as ibuprofen) or blood pressure drugs, such as ACE inhibitors or diuretics; diuretics are usually beneficial to the kidneys, but may become less helpful when a person is dehydrated or suffering from a severe illness
+you're given aminoglycosides – a type of antibiotic; again, this is only an issue if the person is dehydrated or ill, and these are usually only given in a hospital setting
+Causes of acute kidney injury
+Most cases of AKI are caused by reduced blood flow to the kidneys, usually in someone who's already unwell with another health condition.
+This reduced blood flow could be caused by:
+low blood volume after bleeding, excessive vomiting or diarrhoea, or severe dehydration
+the heart pumping out less blood than normal as a result of heart failure, liver failure or sepsis
+problems with the blood vessels – such as inflammation and blockage in the blood vessels within the kidneys (a rare condition called vasculitis)
+certain medicines that can affect the blood supply to the kidney – other medicines may cause unusual reactions in the kidney itself
+AKI can also be caused by a problem with the kidney itself, such as glomerulonephritis.
+This may be caused by a reaction to some drugs, infections or the liquid dye used in some types of X-rays.
+It may also be the result of a blockage affecting the drainage of the kidneys, such as:
+an enlarged prostate
+a tumour in the pelvis, such as an ovarian or bladder tumour
+kidney stones
+Diagnosing acute kidney injury
+A doctor may suspect AKI if you're:
+in an "at risk" group and suddenly fall ill
+get symptoms of AKI
+AKI is usually diagnosed with a blood test to measure your levels of creatinine, a chemical waste product produced by the muscles.
+If there's a lot of creatinine in your blood, it means your kidneys are not working as well as they should.
+You may also be asked to give a pee sample and an ultrasound scan of your kidneys may be done to look for any blockages.
+Find out more about AKI in children
+Investigating the underlying cause
+Urine can be tested for protein, blood cells, sugar and waste products, which may give clues to the underlying cause.
+Doctors also need to know about:
+any other symptoms, such as signs of sepsis or signs of heart failure
+any other medical conditions
+any medication that's been taken in the past week, as some medicines can cause AKI
+An ultrasound scan should reveal if the cause is a blockage in the urinary system, such as an enlarged prostate or bladder tumour.
+Treating acute kidney injury
+Treatment of AKI depends on what's causing your illness and how severe it is.
+You may need:
+to increase your intake of water and other fluids if you're dehydrated
+antibiotics if you have an infection
+to stop taking certain medicines (at least until the problem is sorted)
+a urinary catheter, a thin tube used to drain the bladder if there's a blockage
+You may need to go to hospital for some treatments.
+Most people with AKI make a full recovery, but some people go on to develop chronic kidney disease or long-term kidney failure as a result.
+In severe cases, dialysis, where a machine filters the blood to rid the body of harmful waste, extra salt and water, may be needed.
+Preventing acute kidney injury
+Those at risk of AKI should be monitored with regular blood tests if they become unwell or start new medication. 
+It's also useful to check how much urine you're passing.
+Any warning signs of AKI, such as vomiting or producing little urine, require immediate investigation for AKI and treatment.
+People who are dehydrated or at risk of dehydration may need to be given fluids through a drip.
+Any medicine that seems to be making the problem worse or directly damaging the kidneys needs to be stopped, at least temporarily.
+The National Institute for Health and Care Excellence (NICE) has produced detailed guidelines on preventing, detecting and managing AKI.
+Read the NICE guidelines
+Complications of acute kidney injury
+The most serious complications of acute kidney injury are:
+high levels of potassium in the blood – in severe cases, this can lead to muscle weakness, paralysis and heart rhythm problems
+fluid in the lungs (pulmonary oedema)
+acidic blood (metabolic acidosis) – which can cause nausea, vomiting, drowsiness and breathlessness
+Page last reviewed: 25 February 2019
+Next review due: 25 February 2022
+Support links
+Home
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+Coronavirus (COVID-19)
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+About the NHS
+Healthcare abroad
+Contact us
+Other NHS websites
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+Our policies
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integrations/haystack/nhs-search/data/www.nhs.uk_conditions_acute-lymphoblastic-leukaemia_.txt

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+Cookies on the NHS website
+We've put some small files called cookies on your device to make our site work.
+We'd also like to use analytics cookies. These send information about how our site is used to services called Adobe Analytics, Hotjar and Google Analytics. We use this information to improve our site.
+Let us know if this is OK. We'll use a cookie to save your choice. You can read more about our cookies before you choose.
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+Overview
+-
+Acute lymphoblastic leukaemia
+Contents
+Overview
+Diagnosis
+Treatment
+Complications
+Acute lymphoblastic leukaemia is a type of cancer that affects white blood cells. It progresses quickly and aggressively and requires immediate treatment. Both adults and children can be affected.
+Acute lymphoblastic leukaemia is rare, with around 790 people diagnosed with the condition each year in the UK. Most cases of acute lymphoblastic leukaemia develop in children, teenagers and young adults.
+Although it is rare, acute lymphoblastic leukaemia is the most common type of leukaemia that affects children. About 85% of the cases that affect children happen in those younger than 15 (mostly between the ages of 0 and 5). It affects slightly more boys than girls.
+Acute lymphoblastic leukaemia is different to other types of leukaemia, including acute myeloid leukaemia, chronic lymphocytic leukaemia and chronic myeloid leukaemia.
+Information:
+Coronavirus advice
+Get advice about coronavirus and cancer:
+Macmillan: Coronavirus guidance for people with cancer
+Cancer Research UK: Coronavirus and cancer
+What happens in acute lymphoblastic leukaemia
+All the blood cells in the body are produced by bone marrow, which is a spongy material found inside bones.
+Bone marrow produces stem cells, which have the ability to develop into three important types of blood cells:
+red blood cells – which carry oxygen around the body
+white blood cells – which help fight infection
+platelets – which help stop bleeding
+Bone marrow does not usually release stem cells into the blood until they have become fully developed blood cells. But in acute lymphoblastic leukaemia, large numbers of white blood cells are released before they are ready. These are known as blast cells.
+As the number of blast cells increases, the number of red blood cells and platelet cells decreases. This causes the symptoms of anaemia, such as tiredness, breathlessness and an increased risk of excessive bleeding.
+Also, blast cells are less effective than mature white blood cells at fighting bacteria and viruses, making you more vulnerable to infection.
+Symptoms of acute lymphoblastic leukaemia
+Acute lymphoblastic leukaemia usually starts slowly before rapidly becoming severe as the number of immature white blood cells (blast cells) in your blood increases.
+Most of the symptoms are caused by a lack of healthy blood cells. Symptoms include:
+pale skin
+feeling tired and breathless
+repeated infections over a short time
+unusual and frequent bleeding, such as bleeding gums or nosebleeds
+high temperature
+night sweats
+bone and joint pain
+easily bruised skin
+swollen lymph nodes (glands)
+tummy (abdominal pain) – caused by a swollen liver or spleen
+unintentional weight loss
+a purple skin rash (purpura)
+In some cases, the affected cells can spread from your bloodstream into your central nervous system. This can cause neurological symptoms (related to the brain and nervous system), including:
+headaches
+seizures or fits
+being sick
+blurred vision
+dizziness
+When to get medical advice
+If you or your child has some or all the symptoms listed on this page, it's still highly unlikely that acute leukaemia is the cause. However, see a GP as soon as possible because any condition that causes these symptoms needs prompt investigation and treatment.
+Find out more about diagnosing acute lymphoblastic leukaemia.
+What causes acute lymphoblastic leukaemia
+A genetic change (mutation) in the stem cells causes immature white blood cells to be released into the bloodstream.
+What causes the DNA mutation to happen is not yet understood, but known risk factors include:
+previous chemotherapy – if you've had chemotherapy to treat another type of cancer in the past, your risk of developing acute lymphoblastic leukaemia is increased. The risk relates to certain types of chemotherapy medicine, such as etoposide, and how much treatment you had
+smoking – smokers are much more likely to develop acute leukaemia than non-smokers, and studies have shown that parents who smoke in the home may increase the risk of leukaemia in their children
+being very overweight (obese) – some studies have shown that people who are very overweight have a slightly higher risk of developing leukaemia than those who are a healthy weight
+genetic disorders – a small number of cases of childhood acute lymphoblastic leukaemia are thought to be related to genetic disorders, including Down's syndrome
+having a weakened immune system – people with lowered immunity (as a result of having HIV or AIDS or taking immunosuppressants) have an increased risk of developing leukaemia
+Environmental factors
+Extensive research has been done to determine whether the following environmental factors could be a trigger for leukaemia:
+living near a nuclear power station
+living near a power line
+living near a building or facility that releases electro-magnetic radiation, such as a mobile phone mast
+There's currently no firm evidence to suggest that any of these environmental factors increases the risk of developing leukaemia.
+Cancer Research UK has more information about acute lymphoblastic leukaemia risks and causes.
+Treating acute lymphoblastic leukaemia
+As acute lymphoblastic leukaemia is an aggressive condition that develops quickly, treatment usually begins a few days after diagnosis.
+Treatment is usually done in the following stages: 
+remission induction – the first stage of treatment aims to kill the leukaemia cells in your bone marrow, restore the balance of cells in your blood and resolve any symptoms you may have
+consolidation – this stage aims to kill any remaining leukaemia
+maintenance – this stage involves taking regular doses of chemotherapy medicines to prevent leukaemia from returning
+Chemotherapy is the main treatment for acute lymphoblastic leukaemia. Other treatments you may need include antibiotics and blood transfusions. Sometimes a stem cell transplant may also be needed to achieve a cure.
+Find out more about treating acute lymphoblastic leukaemia.
+Complications of acute lymphoblastic leukaemia
+If a cure for acute lymphoblastic leukaemia is not possible, there's a risk that the lack of healthy blood cells can make the person:
+extremely vulnerable to life-threatening infections (because they do not have enough healthy white blood cells to fight infections)
+prone to uncontrolled and serious bleeding (because there are not enough platelets in their blood)
+These two complications, and others, are discussed further in complications of acute lymphoblastic leukaemia.
+Outlook
+One of the biggest factors that affects the outlook for people with acute lymphoblastic leukaemia is age. The younger a person is when they are diagnosed and treatment begins, the better the outlook.
+From the available data in England it is estimated that:
+in those aged 14 or younger, more than 9 in 10 will survive leukaemia for 5 years or longer after diagnosis
+in those aged 15 to 24, almost 7 in 10 will survive leukaemia for 5 years or longer after diagnosis
+in those aged 25 to 64, almost 4 in 10 will survive leukaemia for 5 years or longer after diagnosis
+in those aged 65 or older, almost 15 in 100 will survive leukaemia for 5 years or longer after diagnosis
+Help and support
+Find more information about cancer.
+If you or a family member has been diagnosed with acute lymphoblastic leukaemia, Leukaemia Care provides further information, advice and support.
+Call Leukaemia Care's free helpline on 08088 010 444 or email: support@leukaemiacare.org.uk
+The charity Cancer UK also has more information about acute lymphoblastic leukaemia.
+Page last reviewed: 30 September 2019
+Next review due: 30 September 2022
+Next
+:
+Diagnosis
+Support links
+Home
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+Mental health
+Care and support
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+Contact us
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+About us
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+Our policies
+Cookies
+© Crown copyright

integrations/haystack/nhs-search/data/www.nhs.uk_conditions_acute-myeloid-leukaemia_.txt

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+Cookies on the NHS website
+We've put some small files called cookies on your device to make our site work.
+We'd also like to use analytics cookies. These send information about how our site is used to services called Adobe Analytics, Hotjar and Google Analytics. We use this information to improve our site.
+Let us know if this is OK. We'll use a cookie to save your choice. You can read more about our cookies before you choose.
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+Overview
+-
+Acute myeloid leukaemia
+Contents
+Overview
+Symptoms
+Causes
+Diagnosis
+Treatment
+Complications
+Leukaemia is cancer of the white blood cells. Acute leukaemia means it progresses quickly and aggressively, and usually requires immediate treatment.
+Acute leukaemia is classified according to the type of white blood cells affected.
+The 2 main types of white blood cells are:
+lymphocytes – which fight viral infections
+myeloid cells – which do different things, such as fighting bacterial infections, defending the body against parasites and preventing the spread of tissue damage
+This topic focuses on acute myeloid leukaemia (AML), which is an aggressive cancer of the myeloid cells.
+The following types of leukaemia are covered separately:
+acute lymphoblastic leukaemia
+chronic myeloid leukaemia
+chronic lymphocytic leukaemia
+Information:
+Coronavirus advice
+Get advice about coronavirus and cancer:
+Macmillan: Coronavirus guidance for people with cancer
+Cancer Research UK: Coronavirus and cancer
+Symptoms of AML
+The symptoms of AML usually develop over a few weeks and become worse over time.
+Symptoms can include:
+looking pale or "washed out"
+feeling tired or weak
+breathlessness
+frequent infections
+unusual and frequent bruising or bleeding, such as bleeding gums or nosebleeds
+losing weight without trying to
+Seeking medical advice
+Speak to a GP if you or your child have possible symptoms of AML.
+Although it's highly unlikely that leukaemia is the cause, these symptoms should be investigated.
+If your GP thinks you may have leukaemia, they'll arrange blood tests to check your blood cell production.
+If the tests suggest there's a problem, you'll be urgently referred to a specialist in treating blood conditions (haematologist) for further tests and treatment.
+Find out more about diagnosing AML
+What causes AML?
+It's not clear exactly what causes AML and, in most cases, there's no identifiable cause.
+But some things can increase your risk of getting AML, including:
+previous chemotherapy or radiotherapy
+exposure to very high levels of radiation (including previous radiotherapy treatment)
+smoking and other exposure to benzene, a chemical used in manufacturing that's also found in cigarette smoke
+having a blood disorder or some genetic conditions, such as Down's syndrome
+Find out more about the causes of AML
+Who's affected
+AML is a rare type of cancer, with around 3,100 people diagnosed with it each year in the UK.
+The risk of developing AML increases with age. It's most common in people over 75.
+How AML is treated
+Treatment for AML needs to begin as soon as possible, as it can develop quickly.
+Chemotherapy is the main treatment for AML. It's used to kill as many leukaemia cells in your body as possible and reduce the risk of the condition coming back (relapsing).
+In some cases, intensive chemotherapy and radiotherapy may be needed, in combination with a bone marrow or stem cell transplant.
+Find out more about treating AML
+Help and support
+There are organisations that offer information, advice and support if you or a family member has been diagnosed with AML.
+These include:
+Leukaemia Care – you can also call their freephone helpline on 08088 010 444, or email support@leukaemiacare.org.uk
+Cancer Research UK
+Macmillan Cancer Support
+Page last reviewed: 28 February 2019
+Next review due: 28 February 2022
+Next
+:
+Symptoms
+Support links
+Home
+Health A to Z
+Live Well
+Mental health
+Care and support
+Pregnancy
+NHS services
+Coronavirus (COVID-19)
+NHS App
+Find my NHS number
+Your health records
+About the NHS
+Healthcare abroad
+Contact us
+Other NHS websites
+Profile editor login
+About us
+Accessibility statement
+Our policies
+Cookies
+© Crown copyright

integrations/haystack/nhs-search/data/www.nhs.uk_conditions_acute-pancreatitis_.txt

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+Cookies on the NHS website
+We've put some small files called cookies on your device to make our site work.
+We'd also like to use analytics cookies. These send information about how our site is used to services called Adobe Analytics, Hotjar and Google Analytics. We use this information to improve our site.
+Let us know if this is OK. We'll use a cookie to save your choice. You can read more about our cookies before you choose.
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+Overview
+-
+Acute pancreatitis
+Contents
+Overview
+Symptoms
+Causes
+Diagnosis
+Treatment
+Complications
+Prevention
+Acute pancreatitis is a condition where the pancreas becomes inflamed (swollen) over a short period of time.
+The pancreas is a small organ, located behind the stomach, that helps with digestion.
+Most people with acute pancreatitis start to feel better within about a week and have no further problems. But some people with severe acute pancreatitis can go on to develop serious complications.
+Acute pancreatitis is different to chronic pancreatitis, where the pancreas has become permanently damaged from inflammation over many years.
+Symptoms of acute pancreatitis
+The most common symptoms of acute pancreatitis include:
+suddenly getting severe pain in the centre of your tummy (abdomen)
+feeling or being sick
+diarrhoea
+a high temperature of 38C or more (fever)
+Read more about the symptoms of acute pancreatitis and diagnosing acute pancreatitis.
+When to get medical help
+See a GP immediately if you suddenly develop severe abdominal pain. If this isn't possible, contact NHS 111 for advice.
+Causes of acute pancreatitis
+Acute pancreatitis is most often linked to:
+gallstones 
+drinking too much alcohol
+But sometimes the cause is not known.
+By reducing how much alcohol you drink and altering your diet to make gallstones less likely, you can reduce your chances of developing acute pancreatitis.
+Read more about the causes of acute pancreatitis and preventing acute pancreatitis.
+How it's treated
+Treatment for acute pancreatitis aims to help control the condition and manage any symptoms.
+This usually involves admission to hospital. You may be given fluids directly into a vein (intravenous fluids), pain relief, liquid food through a tube in your tummy and oxygen through tubes in your nose.
+Most people with acute pancreatitis get better within a week and are well enough to leave hospital after a few days.
+Recovery can take longer in severe cases, as some people can develop complications.
+Read more about treating acute pancreatitis and the possible complications of acute pancreatitis.
+Page last reviewed: 29 October 2018
+Next review due: 29 October 2021
+Next
+:
+Symptoms
+Support links
+Home
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+© Crown copyright

integrations/haystack/nhs-search/data/www.nhs.uk_conditions_acute-respiratory-distress-syndrome_.txt

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+Cookies on the NHS website
+We've put some small files called cookies on your device to make our site work.
+We'd also like to use analytics cookies. These send information about how our site is used to services called Adobe Analytics, Hotjar and Google Analytics. We use this information to improve our site.
+Let us know if this is OK. We'll use a cookie to save your choice. You can read more about our cookies before you choose.
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+My account
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+Mental health
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+Home Health A to Z
+Acute respiratory distress syndrome
+Acute respiratory distress syndrome (ARDS) is a life-threatening condition where the lungs cannot provide the body's vital organs with enough oxygen.
+It's usually a complication of a serious existing health condition. This means most people are already in hospital by the time they develop ARDS.
+Symptoms of ARDS
+Symptoms of ARDS can include:
+severe shortness of breath
+rapid, shallow breathing
+tiredness, drowsiness or confusion
+feeling faint
+When to get urgent medical help
+Although most people get ARDS when they're already in hospital, this is not always the case. It can start quickly as a result of an infection, such as pneumonia, or if someone accidentally inhales their vomit.
+Call 999 immediately to ask for an ambulance if a child or adult is having breathing problems.
+What causes ARDS?
+ARDS happens when the lungs become severely inflamed from an infection or injury. The inflammation causes fluid from nearby blood vessels to leak into the tiny air sacs in your lungs, making breathing increasingly difficult.
+The lungs can become inflamed after:
+pneumonia or severe flu
+sepsis
+a severe chest injury
+accidentally inhaling vomit, smoke or toxic chemicals
+near drowning
+acute pancreatitis – a serious condition where the pancreas becomes inflamed over a short time
+an adverse reaction to a blood transfusion
+Diagnosing ARDS
+There's no specific test to diagnose ARDS. A full assessment is needed to identify the underlying cause and rule out other conditions.
+The assessment is likely to include:
+a physical examination
+blood tests to measure the amount of oxygen in the blood and check for an infection
+a pulse oximetry test, where a sensor attached to your fingertip, ear or toe is used to measure how much oxygen your blood is absorbing
+a chest X-ray and a CT scan to look for evidence of ARDS
+an echocardiogram – a type of ultrasound scan that's used to look at your heart and nearby blood vessels
+Treating ARDS
+If you develop ARDS, you'll probably be admitted to an intensive care unit (ICU) and use a breathing machine (ventilator) to help your breathing.
+You breathe through a mask attached to the machine. If your breathing is severely affected, a breathing tube may be inserted down your throat and into your lungs.
+Fluids and nutrients will be supplied through a feeding tube (nasogastric tube) that's passed through your nose and into your stomach.
+The underlying cause of ARDS should also be treated. For example, if it's caused by a bacterial infection, you may need antibiotics.
+How long you'll need to stay in hospital depends on your individual circumstances and the cause of ARDS. Most people respond well to treatment, but it may be several weeks or months before you're well enough to leave hospital.
+Complications of ARDS
+Because ARDS is often caused by a serious health condition, about 1 in 3 people who get it will die. But most deaths are the result of the underlying illness, rather than ARDS itself.
+For those who survive, the main complications are linked with nerve and muscle damage, which causes pain and weakness.
+Some people also develop psychological problems, such as post-traumatic stress disorder (PTSD) and depression.
+The lungs usually recover and long-term lung failure after ARDS is rare.
+Page last reviewed: 12 March 2020
+Next review due: 12 March 2023
+Support links
+Home
+Health A to Z
+Live Well
+Mental health
+Care and support
+Pregnancy
+NHS services
+Coronavirus (COVID-19)
+NHS App
+Find my NHS number
+Your health records
+About the NHS
+Healthcare abroad
+Contact us
+Other NHS websites
+Profile editor login
+About us
+Accessibility statement
+Our policies
+Cookies
+© Crown copyright

integrations/haystack/nhs-search/data/www.nhs.uk_conditions_addisons-disease_.txt

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+Cookies on the NHS website
+We've put some small files called cookies on your device to make our site work.
+We'd also like to use analytics cookies. These send information about how our site is used to services called Adobe Analytics, Hotjar and Google Analytics. We use this information to improve our site.
+Let us know if this is OK. We'll use a cookie to save your choice. You can read more about our cookies before you choose.
+I'm OK with analytics cookies Do not use analytics cookies
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+My account
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+Browse
+More
+Home Health A to Z
+Overview
+-
+Addison's disease
+Contents
+Overview
+Symptoms
+Causes
+Diagnosis
+Treatment
+Addison's disease, also known as primary adrenal insufficiency or hypoadrenalism, is a rare disorder of the adrenal glands.
+The adrenal glands are 2 small glands that sit on top of the kidneys. They produce 2 essential hormones: cortisol and aldosterone.
+The adrenal gland is damaged in Addison's disease, so it does not produce enough cortisol or aldosterone.
+About 9,000 people in the UK have Addison's disease, with over 300 new cases diagnosed each year.
+It can affect people of any age, although it's most common between the ages of 30 and 50. It's also more common in women than men.
+Symptoms of Addison's disease
+Early-stage symptoms of Addison's disease are similar to other more common health conditions, such as clinical depression or flu. 
+You may experience:
+lack of energy or motivation (fatigue)
+muscle weakness
+low mood
+loss of appetite and unintentional weight loss
+increased thirst
+Over time, these problems may become more severe and you may experience further symptoms, such as dizziness, fainting, cramps and exhaustion.
+You may also develop small areas of darkened skin, or darkened lips or gums.
+Although these symptoms are not always caused by Addison's disease, you should see a GP so they can be investigated.
+Why it happens
+Addison's disease is usually the result of a problem with the immune system, which causes it to attack the outer layer of the adrenal gland (the adrenal cortex), disrupting the production of the steroid hormones aldosterone and cortisol.
+It's not clear why this happens, but it's responsible for 70% to 90% of cases in the UK.
+Other potential causes include conditions that can damage the adrenal glands, such as tuberculosis (TB), although this is uncommon in the UK.
+Treating Addison's disease
+Addison's disease is treated with medicine to replace the missing hormones. You'll need to take it for the rest of your life.
+With treatment, symptoms of Addison's disease can largely be controlled. Most people with the condition have a normal lifespan and are able to live an active life with few limitations.
+But many people with Addison's disease also find they must learn to manage bouts of fatigue, and there may be associated health conditions, such as diabetes or an underactive thyroid (hypothyroidism).
+Adrenal crisis
+People with Addison's disease must be constantly aware of the risk of a sudden worsening of symptoms, called an adrenal crisis.
+This can happen when the levels of cortisol in your body fall significantly.
+An adrenal crisis is a medical emergency. If left untreated, it can be fatal.
+If you or someone you know has Addison's disease and is experiencing severe symptoms, they will need a hydrocortisone injection immediately, either injected by themselves or by a person who is with them.
+Then call 999 for an ambulance, saying it's an "adrenal crisis" or "Addisonian crisis".
+Information about you
+If you have Addison's disease, your clinical team will pass information about you on to the National Congenital Anomaly and Rare Disease 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 NCARDRS on GOV.UK
+Page last reviewed: 17 December 2021
+Next review due: 17 December 2024
+Next
+:
+Symptoms
+Support links
+Home
+Health A to Z
+Live Well
+Mental health
+Care and support
+Pregnancy
+NHS services
+Coronavirus (COVID-19)
+NHS App
+Find my NHS number
+Your health records
+About the NHS
+Healthcare abroad
+Contact us
+Other NHS websites
+Profile editor login
+About us
+Accessibility statement
+Our policies
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integrations/haystack/nhs-search/data/www.nhs.uk_conditions_adenoids-and-adenoidectomy_.txt

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+Cookies on the NHS website
+We've put some small files called cookies on your device to make our site work.
+We'd also like to use analytics cookies. These send information about how our site is used to services called Adobe Analytics, Hotjar and Google Analytics. We use this information to improve our site.
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+Adenoidectomy
+An adenoidectomy is an operation to remove the adenoids.
+What are adenoids?
+Adenoids are small lumps of tissue at the back of the nose, above the roof of the mouth. You cannot see a person's adenoids by looking in their mouth.
+Adenoids are part of the immune system, which helps fight infection and protects the body from bacteria and viruses.
+Adenoids are bigger when you are a child. They then start to shrink, and usually disappear by the time you are an adult.
+When adenoids need to be removed
+A child's adenoids can sometimes become swollen or enlarged. This can happen after a bacterial or viral infection, or after a substance triggers an allergic reaction.
+In most cases, swollen adenoids only cause mild discomfort and treatment is not needed. However, for some children, it can cause severe discomfort and interfere with their daily life.
+Adenoids may need to be removed if your child has:
+breathing problems – your child may have difficulty breathing through their nose and may have to breathe through their mouth instead, which can cause problems such as cracked lips and a dry mouth
+difficulty sleeping – your child may start to snore and in severe cases, some children have irregular breathing during sleep and become very sleepy during the day (sleep apnoea)
+recurrent or persistent problems with the ears, such as middle ear infections (otitis media) or glue ear (where the middle ear becomes filled with fluid)
+recurrent or persistent sinusitis leading to symptoms such as a constantly runny nose, facial pain and nasal-sounding speech
+Adults do not often need an adenoidectomy. Their adenoids have usually shrunk so they are not likely to cause problems.
+How an adenoidectomy is done
+The adenoids can be removed during an adenoidectomy.
+The operation is usually done by an ear, nose and throat (ENT) surgeon and takes around 30 minutes. Afterwards, your child will need to stay in the recovery ward for up to an hour until the anaesthetic has worn off.
+Adenoidectomies are sometimes day cases if they're done in the morning, in which case your child may be able to go home on the same day. However, if the procedure is done in the afternoon, your child may need to stay in hospital overnight.
+Before the operation
+Tell your ENT surgeon if your child has had a cold or sore throat in the week before the operation.
+If your child has a high temperature and cough, the operation may have to be postponed for a few weeks to ensure they've fully recovered and to reduce their risk of developing complications as a result of the surgery.
+The procedure
+An adenoidectomy is done under general anaesthetic, so your child will be asleep during the operation and will not feel any pain.
+The adenoids are removed through the mouth. Heat is used to stop any bleeding.
+Removal of the tonsils
+If your child has large tonsils, or has had severe or frequent bouts of tonsillitis, the doctor may suggest removing the tonsils and adenoids at the same time. This is called an adenotonsillectomy.
+Removing the adenoids and tonsils at the same time reduces the chance of complications. However, adenoidectomies, tonsillectomies and adenotonsillectomies are quick and straightforward procedures with few complications.
+Complications
+An adenoidectomy is a very safe operation and complications are rare. However, as with any type of surgery, there is still a chance of complications.
+There’s a small chance of:
+bleeding
+a tooth being knocked or chipped during the operation
+infection – your child may be given antibiotics to help prevent this
+a reaction to the anaesthetic
+When to seek medical advice
+Contact your GP immediately or go to your nearest A&E if your child has the following symptoms shortly after surgery:
+bright red bleeding from their mouth
+blood in their sick, or black or brown sick
+very high temperature, or they feel hot or shivery
+a lot of pain that does not get better when they take painkillers
+not drinking any fluids
+Recovery
+It's normal to have a sore throat after an adenoidectomy. Your child will usually be given painkillers while in hospital to help ease discomfort.
+Your child may also feel groggy and sleepy after having an anaesthetic. After the operation, they'll be checked for several hours to make sure they're recovering normally. Once the doctor is satisfied, you'll be able to take your child home.
+Minor problems during recovery
+After an adenoidectomy, some children have some minor health problems. However, most of these are temporary and rarely require further treatment. They can include:
+sore throat
+earache
+stiff jaw
+blocked nose or nasal discharge
+bad breath
+a change in voice (your child may sound like they're speaking through their nose)
+finding it hard to swallow
+finding it hard to brush their teeth
+Most of these symptoms will pass within a few weeks. Contact your GP if your child is still affected after a few weeks.
+Pain relief
+Your child may need painkillers for a few days after the operation.
+Over-the-counter painkillers, such as paracetamol, are usually suitable. Younger children may find it easier to take liquid or soluble paracetamol, particularly if they have a sore throat.
+Always make sure you follow the dosage instructions on the packet, and never give aspirin to a child who's under the age of 16.
+Eating and drinking
+Your child should start eating normally as soon as possible.
+Giving your child a dose of painkillers about an hour or so before they eat may make swallowing food easier.
+It's also important for them to drink plenty of fluids to avoid dehydration.
+Returning to school
+Your child will need to rest for several days after an adenoidectomy and should be kept off school for about 10 days. This is to reduce their risk of getting an infection.
+The area will take a while to heal.
+Keep your child away from people with coughs or colds, and from smoky environments.
+Page last reviewed: 10 February 2020
+Next review due: 10 February 2023
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integrations/haystack/nhs-search/data/www.nhs.uk_conditions_age-related-macular-degeneration-amd_.txt

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+Cookies on the NHS website
+We've put some small files called cookies on your device to make our site work.
+We'd also like to use analytics cookies. These send information about how our site is used to services called Adobe Analytics, Hotjar and Google Analytics. We use this information to improve our site.
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+What is AMD?
+-
+Age-related macular degeneration (AMD)
+Contents
+What is AMD?
+Symptoms
+Getting diagnosed
+Treatments
+Living with AMD
+Age-related macular degeneration (AMD) is a common condition that affects the middle part of your vision. It usually first affects people in their 50s and 60s.
+It does not cause total blindness. But it can make everyday activities like reading and recognising faces difficult.
+Without treatment, your vision may get worse. This can happen gradually over several years ("dry AMD"), or quickly over a few weeks or months ("wet AMD").
+The exact cause is unknown. It's been linked to smoking, high blood pressure, being overweight and having a family history of AMD.
+Page last reviewed: 20 April 2021
+Next review due: 20 April 2024
+Next
+:
+Symptoms
+Support links
+Home
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+Mental health
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integrations/haystack/nhs-search/data/www.nhs.uk_conditions_air-embolism_.txt

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+Cookies on the NHS website
+We've put some small files called cookies on your device to make our site work.
+We'd also like to use analytics cookies. These send information about how our site is used to services called Adobe Analytics, Hotjar and Google Analytics. We use this information to improve our site.
+Let us know if this is OK. We'll use a cookie to save your choice. You can read more about our cookies before you choose.
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+Get the latest advice about COVID-19
+Home Health A to Z
+Air or gas embolism
+An air or gas embolism is a bubble that becomes trapped in a blood vessel and blocks it.
+Air or gas embolism in scuba divers
+It can happen if a scuba diver:
+spends too long underwater
+surfaces too quickly
+holds their breath as they come up
+Air can escape from the lungs into the blood vessels (arterial gas embolism) or nitrogen bubbles can form in the blood vessels (decompression sickness or "the bends").
+Air or gas embolisms can cause serious and potentially fatal conditions, such as a stroke or heart attack.
+Call 999 and ask for an ambulance if you or someone you're with feels unwell after scuba diving and you suspect an air or gas embolism.
+Symptoms of an air or gas embolism after diving
+Symptoms of an air or gas embolism after diving include:
+joint or muscle pain
+low blood pressure, which may cause dizziness
+an irregular heartbeat
+breathlessness and fast breathing
+blurred vision
+chest pain
+strong feelings of anxiety
+itchy skin
+a blue tinge to the skin, lips or tongue (cyanosis)
+bloody froth from the mouth
+paralysis or weakness, possibly of one or more limbs
+seizures or fits
+loss of consciousness
+You may not have these symptoms immediately. They can develop within 10 to 20 minutes or sometimes even longer after surfacing. Do not ignore these symptoms – get medical help immediately.
+Getting medical help
+Call 999 and ask for an ambulance if you or someone you're with feels unwell after scuba diving.
+A diver with a suspected air or gas embolism should be transferred to an A&E department as soon as possible.
+They should be laid down flat and given 100% oxygen until they reach hospital. Once stabilised, they'll be taken to a pressurised room called a hyperbaric chamber, either at the hospital or at another location.
+Why diving can lead to an air or gas embolism
+If a diver surfaces too quickly, nitrogen bubbles can form in their tissues and bloodstream. This is often referred to as decompression sickness or "the bends".
+Surfacing too quickly or holding your breath while you swim to the surface can cause the air in your lungs to expand. This may rupture lung tissue (pulmonary barotrauma), which can lead to gas bubbles being released into the arterial circulation (arterial gas embolism).
+In some divers, underlying conditions can increase the chance of decompression sickness. These should be discussed with a doctor who specialises in diving medicine.
+If the gas bubble blocks an artery, it can cut off the blood supply to a particular area of the body.
+The seriousness of the blockage depends on which part of the body is affected, the size of the gas bubble and the amount of inert gases (unreactive gases) within the diver's tissues.
+An air or gas embolism can cause different problems depending on where the blockage is:
+arteries leading to the brain – immediate loss of consciousness and may lead to seizures or fits, or a stroke
+arteries leading to the heart – a heart attack or an abnormal heartbeat (arrhythmia)
+a blood vessel to the lungs – a pulmonary embolism
+These conditions are very serious and can be fatal, particularly if the air embolism is not treated quickly.
+Treating an air or gas embolism caused by diving
+After a diver with an air or gas embolism has received emergency medical attention and their condition has stabilised, they'll be transferred to a hyperbaric chamber.
+A person being treated in a hyperbaric chamber
+Credit:
+They'll need to lie in the hyperbaric chamber for several hours, breathing a mixture of gases and oxygen in a pressurised environment. The high pressure restores normal blood flow and oxygen to the body's tissues, and reduces the size of the air bubbles in the body.
+In cases of decompression sickness, the pressure forces the bubbles of nitrogen to dissolve into the bloodstream.
+The pressure in the chamber is then gradually reduced to allow the gases to leave the body, mimicking slowly surfacing from a dive.
+Depending on the severity of symptoms, treatment may need to be continued for several days.
+Preventing an air or gas embolism while diving
+To reduce your risk of getting an air or gas embolism when diving you should:
+limit the depth and duration of your dives
+always surface slowly and perform safety stops to allow any air in your tissues and blood vessels to escape safely; use a dive computer or dive tables to maintain a safe rate of ascent, and do not dive again until you've spent a suitable amount of time at the surface
+relax and breathe normally as you ascend
+do not dive with a cold, cough or chest infection
+avoid vigorous exercise before, during and after a dive
+make sure you're well hydrated before diving
+leave adequate surface intervals between dives (if planning several dives) to allow the nitrogen to leave your body
+wait 24 hours after diving before flying or going to a higher altitude
+The British Sub-Aqua Club (BSAC) has more information about diving safety
+Other causes of air or gas embolisms
+Although uncommon, it's possible to get an air or gas embolism during surgery, some medical procedures, and when ascending to a high altitude.
+In hospitals and health centres, care should be taken to prevent air embolisms by:
+removing air from syringes before injections and from intravenous lines before connecting them
+using techniques when inserting and removing catheters and other tubes that minimise the risk of air getting into blood vessels
+closely monitoring patients during surgery to help ensure air bubbles do not form in their blood vessels
+Air embolisms caused by surgery, anaesthesia or other medical procedures can be difficult to treat. Treatment is usually needed to support the heart, blood vessels and lungs.
+For example, fluids may be used to treat a fall in blood pressure, and oxygen may be given to correct reduced oxygen levels. Treatment in a hyperbaric chamber is occasionally needed in these cases.
+Page last reviewed: 16 December 2020
+Next review due: 16 December 2023
+Support links
+Home
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+Mental health
+Care and support
+Pregnancy
+NHS services
+Coronavirus (COVID-19)
+NHS App
+Find my NHS number
+Your health records
+About the NHS
+Healthcare abroad
+Contact us
+Other NHS websites
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+Our policies
+Cookies
+© Crown copyright

integrations/haystack/nhs-search/data/www.nhs.uk_conditions_albinism_.txt

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+Cookies on the NHS website
+We've put some small files called cookies on your device to make our site work.
+We'd also like to use analytics cookies. These send information about how our site is used to services called Adobe Analytics, Hotjar and Google Analytics. We use this information to improve our site.
+Let us know if this is OK. We'll use a cookie to save your choice. You can read more about our cookies before you choose.
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+Albinism
+Albinism affects the production of melanin, the pigment that colours skin, hair and eyes. It's a lifelong condition, but it does not get worse over time.
+People with albinism have a reduced amount of melanin, or no melanin at all. This can affect their colouring and their eyesight.
+People with albinism often have white or very light blonde hair, although some have brown or ginger hair. The exact colour depends on how much melanin their body produces.
+Very pale skin that burns easily in the sun and does not usually tan is also typical of albinism.
+Eye problems
+The reduced amount of melanin can cause eye problems. This is because melanin is involved in the development of the retina, the thin layer of cells at the back of the eye.
+Possible eye problems linked to albinism include:
+poor eyesight – either short-sightedness or long-sightedness, and low vision (sight loss that cannot be corrected)
+astigmatism – where the cornea (clear layer at the front of the eye) is not perfectly curved or the lens is an abnormal shape, causing blurred vision
+photophobia – where the eyes are sensitive to light
+nystagmus – where the eyes move involuntarily from side to side, causing reduced vision; you do not see the world as "wobbling" because your brain adapts to your eye movement
+squint – where the eyes point in different directions
+Some young children with albinism may appear clumsy. This is because problems with their eyesight can make some movements difficult for them, such as picking up an object. This should improve as they get older.
+How albinism is passed on
+The 2 main types of albinism are:
+oculocutaneous albinism (OCA) – the most common type, affecting the skin, hair and eyes
+ocular albinism (OA) – a rarer type that mainly affects the eyes
+Autosomal recessive inheritance
+In all types of OCA and some types of OA, albinism is passed on in an autosomal recessive inheritance pattern. This means a child has to get 2 copies of the gene that causes albinism (1 from each parent) to have the condition.
+If both parents carry the gene, there's a 1 in 4 chance that their child will have albinism and a 1 in 2 chance that their child will be a carrier. Carriers do not have albinism but can pass on the gene.
+X-linked inheritance
+Some types of OA are passed on in an X-linked inheritance pattern. This pattern affects boys and girls differently: girls who get the albinism gene become carriers, while boys who get it will have albinism.
+When a mother is a carrier of an X-linked type of albinism, each of her daughters has a 1 in 2 chance of becoming a carrier. Each of her sons has a 1 in 2 chance of having albinism.
+When a father has an X-linked type of albinism, his daughters will become carriers, and his sons will not have albinism and will not be carriers.
+Genetic counselling
+If you have a history of albinism in your family or you have a child with the condition, you may want to talk to a GP about getting a referral for genetic counselling.
+A genetic counsellor provides information, support and advice about genetic conditions. For example, you can discuss with them how you inherited albinism and the chances of passing it on.
+Read more about genetic testing and counselling
+Diagnosing albinism
+Albinism is usually obvious from a baby's appearance when they're born. Your baby's hair, skin and eyes may be examined to look for signs of missing pigment.
+As albinism can cause a number of eye problems, your baby may be referred to an eye specialist (ophthalmologist) for tests.
+Electrodiagnostic testing is also sometimes used to help diagnose albinism. This is where small electrodes are stuck to the scalp to test the connections of the eyes to the part of the brain that controls vision.
+Treatments for eye problems due to albinism
+Although there's no cure for the eye problems caused by albinism, there are a number of treatments, such as glasses and contact lenses, that can improve vision.
+A child with albinism may also need extra help and support at school.
+Glasses and contact lenses
+As a child with albinism gets older, they'll need regular eye tests, and it's likely they'll need to wear glasses or contact lenses to correct vision problems.
+Low-vision aids
+Vision aids include:
+large-print or high-contrast books and printed materials
+magnifying lenses
+a small telescope or telescopic lenses that attach to glasses to read writing in the distance, such as on a school whiteboard
+large computer screens
+software that can turn speech into typing or vice versa
+tablets and phones that allow you to magnify the display to make writing and images easier to see
+The Royal National Institute of Blind People (RNIB) has more information about living with low vision, including a section on education and learning.
+Photophobia or sensitivity to light
+Sunglasses, tinted glasses and wearing a wide-brimmed hat outside can help with sensitivity to light.
+Nystagmus
+There's currently no cure for nystagmus (where the eyes move from side to side involuntarily). However, it is not painful and does not get worse.
+Certain toys or games may help a child make the most of the vision they have. An ophthalmologist will be able to provide further advice.
+Surgery, involving dividing and then reattaching some of the eye muscles, may sometimes be an option.
+Squint and lazy eye
+The main treatments for squints are glasses, eye exercises, surgery and injections into the eye muscles.
+If your child has developed a lazy eye, they may benefit from wearing a patch over their "good" eye to encourage their other eye to work harder.
+Read more about treatments for squints
+Reducing the risk of sunburn and skin cancer
+Because people with albinism lack melanin in their skin, they're at increased risk of getting sunburn and skin cancer.
+If you have albinism, you should wear sunscreen with a high sun-protection factor (SPF). An SPF of 30 or more will provide the best protection.
+It's also a good idea to look out for skin changes, such as:
+a new mole, growth or lump
+any moles, freckles or patches of skin that change in size, shape or colour
+Report these to a doctor as soon as possible. Skin cancer is much easier to treat if it's found early.
+Read more about protecting your skin and eyes from the sun
+Help and support
+There's usually no reason why someone with albinism cannot do well in normal schooling, further education and employment.
+With appropriate help and support, most children with albinism can attend a mainstream school.
+You might like to talk to other people with albinism. The Albinism Fellowship has a contact person network that can provide advice and support locally.
+Information about you
+If you or your child has albinism, your clinical team will pass information on to the National Congenital Anomaly and Rare Disease Registration Service (NCARDRS).
+The NCARDRS helps scientists look for better ways to prevent and treat this condition. You can opt out of the register at any time.
+Page last reviewed: 30 November 2020
+Next review due: 30 November 2023
+Support links
+Home
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+Mental health
+Care and support
+Pregnancy
+NHS services
+Coronavirus (COVID-19)
+NHS App
+Find my NHS number
+Your health records
+About the NHS
+Healthcare abroad
+Contact us
+Other NHS websites
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+About us
+Accessibility statement
+Our policies
+Cookies
+© Crown copyright

integrations/haystack/nhs-search/data/www.nhs.uk_conditions_alcohol-misuse_.txt

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+Cookies on the NHS website
+We've put some small files called cookies on your device to make our site work.
+We'd also like to use analytics cookies. These send information about how our site is used to services called Adobe Analytics, Hotjar and Google Analytics. We use this information to improve our site.
+Let us know if this is OK. We'll use a cookie to save your choice. You can read more about our cookies before you choose.
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+Overview
+-
+Alcohol misuse
+Contents
+Overview
+Risks
+Treatment
+Alcohol misuse is when you drink in a way that's harmful, or when you're dependent on alcohol. To keep health risks from alcohol to a low level, both men and women are advised not to regularly drink more than 14 units a week.
+A unit of alcohol is 8g or 10ml of pure alcohol, which is about:
+half a pint of lower to normal-strength lager/beer/cider (ABV 3.6%)
+a single small shot measure (25ml) of spirits (25ml, ABV 40%)
+A small glass (125ml, ABV 12%) of wine contains about 1.5 units of alcohol.
+Find out more about alcohol units
+Low-risk drinking advice
+To keep your risk of alcohol-related harm low:
+men and women are advised not to drink more than 14 units of alcohol a week on a regular basis
+if you drink as much as 14 units a week, it's best to spread this evenly over 3 or more days
+if you're trying to reduce the amount of alcohol you drink, it's a good idea to have several alcohol-free days each week
+if you're pregnant or trying to become pregnant, the safest approach is to not drink alcohol at all to keep risks to your baby to a minimum
+Regular or frequent drinking means drinking alcohol most days and weeks.
+The risk to your health is increased by drinking any amount of alcohol on a regular basis.
+Risks of alcohol misuse
+Short term
+The short-term risks of alcohol misuse include:
+accidents and injuries requiring hospital treatment, such as a head injury
+violent behaviour and being a victim of violence
+unprotected sex that could potentially lead to unplanned pregnancy or sexually transmitted infections (STIs)
+loss of personal possessions, such as wallets, keys or mobile phones
+alcohol poisoning – this may lead to vomiting, fits (seizures) and falling unconscious
+People who binge drink (drink heavily over a short period of time) are more likely to behave recklessly and are at greater risk of being in an accident.
+Long term
+Persistent alcohol misuse increases your risk of serious health conditions, including:
+heart disease
+stroke
+liver disease
+liver cancer
+bowel cancer
+mouth cancer
+breast cancer
+pancreatitis
+As well as causing serious health problems, long-term alcohol misuse can lead to social problems for some people, such as unemployment, divorce, domestic abuse and homelessness.
+If someone loses control over their drinking and has an excessive desire to drink, it's known as dependent drinking (alcoholism).
+Dependent drinking usually affects a person's quality of life and relationships, but they may not always find it easy to see or accept this. 
+Severely dependent drinkers are often able to tolerate very high levels of alcohol in amounts that would dangerously affect or even kill some people.
+A dependent drinker usually experiences physical and psychological withdrawal symptoms if they suddenly cut down or stop drinking, including:
+hand tremors – "the shakes"
+sweating
+seeing things that are not real (visual hallucinations)
+depression
+anxiety
+difficulty sleeping (insomnia)
+This often leads to "relief drinking" to avoid withdrawal symptoms.
+Find out more about the risks of alcohol misuse
+Am I drinking too much alcohol?
+You could be misusing alcohol if:
+you feel you should cut down on your drinking
+other people have been criticising your drinking
+you feel guilty or bad about your drinking
+you need a drink first thing in the morning to steady your nerves or get rid of a hangover
+Someone you know may be misusing alcohol if:
+they regularly drink more than 14 units of alcohol a week
+they're sometimes unable to remember what happened the night before because of their drinking
+they fail to do what was expected of them as a result of their drinking (for example, missing an appointment or work because they're drunk or hungover)
+Getting help
+If you're concerned about your drinking or someone else's, a good first step is to see a GP.
+They'll be able to discuss the services and treatments available. 
+Your alcohol intake may be assessed using tests, such as the:
+Alcohol use disorders identification test (PDF, 224kb) – a widely used screening test that can help determine whether you need to change your drinking habits
+Alcohol use disorders identification test consumption (PDF, 382kb) – a simpler test to check whether your drinking has reached dangerous levels
+As well as the NHS, there are a number of charities and support groups across the UK that provide support and advice for people with an alcohol misuse problem.
+For example, you may want to contact:
+Drinkline national alcohol helpline on 0300 123 1110
+Alcohol Change UK
+Alcoholics Anonymous helpline on 0800 9177 650
+Al-Anon Family Groups helpline on 0800 0086 811
+See a full list of alcohol charities and support groups
+Treating alcohol misuse
+How alcohol misuse is treated depends on how much alcohol a person is drinking.
+Treatment options include:
+counselling – including self-help groups and talking therapies, such as cognitive behavioural therapy (CBT)
+medicines
+detoxification – this involves a nurse or doctor supporting you to safely stop drinking; this can be done by helping you slowly cut down over time or by giving you medicines to prevent withdrawal symptoms
+There are 2 main types of medicines to help people stop drinking.
+The first is to help stop withdrawal symptoms and is given in reducing doses over a short period of time. The most common of these medicines is chlordiazapoxide (Librium).
+The second is a medicine to reduce any urge you may have to drink. The most common medicines used for this are acamprosate and naltrexone.
+These are both given at a fixed dose, and you'll usually be on them for 6 to 12 months.
+Further reading
+Alcohol units
+Carers Trust: caring for an alcoholic
+Social drinking: the hidden risks
+The risks of drinking too much
+Tips for cutting down on your drinking
+Alcohol and pregnancy
+The Department of Health and Social Care recommends pregnant women and women trying to conceive should avoid drinking alcohol.
+Drinking in pregnancy can lead to long-term harm to the baby, and the risk increases the more you drink.
+The Chief Medical Officers for the UK recommend that if you're pregnant or planning to become pregnant, the safest approach is not to drink alcohol at all to keep the risk to your baby to a minimum.
+If you're worried about alcohol use during pregnancy, talk to your doctor or midwife.
+If you're trying to conceive, your partner should drink no more than 14 units of alcohol a week, which should be spread evenly over 3 days or more.
+Drinking alcohol excessively can affect the quality of his sperm.
+Page last reviewed: 21 August 2018
+Next review due: 21 August 2021
+Next
+:
+Risks
+Support links
+Home
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+Other NHS websites
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+Our policies
+Cookies
+© Crown copyright

integrations/haystack/nhs-search/data/www.nhs.uk_conditions_alcohol-poisoning_.txt

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+Cookies on the NHS website
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+We'd also like to use analytics cookies. These send information about how our site is used to services called Adobe Analytics, Hotjar and Google Analytics. We use this information to improve our site.
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+Alcohol poisoning
+Alcohol poisoning occurs when a person drinks a toxic amount of alcohol, usually over a short period of time (binge drinking).
+Being poisoned by alcohol can damage your health or even put your life in danger.
+Alcohol poisoning is a leading cause of poisoning in England, especially among young people.
+It's important to avoid misusing alcohol and to be aware of how much you're drinking and the effect this could have on your body.
+Signs and symptoms of alcohol poisoning
+The signs and symptoms of alcohol poisoning include:
+confusion
+severely slurred speech
+loss of co-ordination
+vomiting
+irregular or slow breathing
+pale or blue-tinged skin caused by low body temperature (hypothermia)
+being conscious but unresponsive (stupor)
+passing out and being unconscious
+In the most severe cases, alcohol poisoning can lead to coma, brain damage and death.
+When to seek medical help
+If you suspect alcohol poisoning, dial 999 immediately to request an ambulance.
+While you're waiting:
+try to keep them sitting up and awake
+give them water if they can drink it
+if they have passed out, lie them on their side in the recovery position and check they're breathing properly
+keep them warm
+stay with them
+Never leave a person alone to "sleep it off". 
+The level of alcohol in a person's blood can continue to rise for up to 30 to 40 minutes after their last drink.
+This can cause their symptoms to suddenly become much more severe.
+You also should not try to "sober them up" by giving them coffee or putting them under a cold shower, for example.
+These methods will not help and may even be dangerous.
+How alcohol poisoning is treated in hospital
+In hospital, the person will be carefully monitored until the alcohol has left their system.
+If treatment is required, this may include:
+inserting a tube into their mouth and windpipe (intubation) to open the airway, remove any blockages and help with breathing
+fitting an intravenous drip, which goes directly into a vein, to top up their water, blood sugar and vitamin levels
+fitting a catheter to their bladder to drain urine straight into a bag so they do not wet themselves
+Dangers of alcohol poisoning
+If a person is poisoned by alcohol, they could:
+stop breathing
+have a heart attack
+die by choking on their own vomit
+become severely dehydrated, which can cause permanent brain damage in extreme cases
+develop more severe hypothermia
+have fits (seizures) as a result of lowered blood sugar levels
+Repeated vomiting and retching can lead to vomiting blood, caused by a torn blood vessel at the junction of the stomach and gullet.
+Other related risks
+Drinking too much alcohol can affect a person's judgement and put them in situations where their health and safety are at risk.
+For example, they may:
+have an accident or get injured
+become involved in violent or antisocial behaviour
+have unsafe sex, which can lead to an unplanned pregnancy or a sexually transmitted infection (STI)
+lose personal possessions
+How alcohol poisoning happens
+Every time you drink alcohol, your liver has to filter it out of your blood.
+Alcohol is absorbed quickly into your body (much quicker than food), but the body can only process around 1 unit of alcohol an hour.
+If you drink a lot of alcohol over a short space of time, such as on a night out, your body will not have time to process it all. 
+Alcohol poisoning can also occur if a person drinks household products that contain alcohol. Children sometimes drink these by accident.
+The amount of alcohol in your bloodstream, known as your blood alcohol concentration (BAC), will rise.
+The effects of alcohol
+Around 1 to 2 units
+your heart rate will speed up and your blood vessels will expand
+you get the warm, sociable feeling associated with moderate drinking
+Around 4 to 6 units
+your decision making and judgement will start to be affected, making you lose your inhibitions and become more reckless
+the cells in your nervous system will start to be affected, making you feel lightheaded
+your co-ordination will be affected and your reaction time may be slower
+Around 8 to 9 units
+your reaction times will be much slower
+your speech will be slurred
+your vision will begin to lose focus
+your liver will not be able to remove all of the alcohol overnight, so it's likely you'll wake up with a hangover
+At this stage you should seriously consider not drinking any more alcohol.
+If you do:
+Around 10 to 12 units
+your co-ordination will be seriously impaired, placing you at high risk of having an accident
+you may stagger around or feel unstable on your feet
+you'll feel drowsy or dizzy
+the amount of alcohol in your body will begin to reach toxic levels
+you may need to go to the toilet more often as your body attempts to quickly pass the alcohol out of your body in your urine
+you'll be dehydrated in the morning, and probably have a severe headache
+the excess alcohol in your system may upset your digestive system, leading to nausea, vomiting, diarrhoea or indigestion
+More than 12 units
+you're at high risk of developing alcohol poisoning, particularly if you're drinking lots of units in a short space of time
+the alcohol can begin to interfere with the automatic functions of your body, such as your breathing, heart rate and gag reflex
+you're at risk of losing consciousness
+Recommended alcohol limits
+If you drink most weeks, to reduce your risk of harming your health:
+men and women are advised not to regularly drink more than 14 units a week
+spread your drinking over 3 days or more if you drink as much as 14 units a week
+A unit of alcohol is equivalent to:
+half a pint of lower strength lager, beer or cider (ABV 3.6%)
+a single small shot of spirits (25ml, ABV 40%)
+Find out more about alcohol units
+You should also avoid binge drinking as it's dangerous and puts you at risk of alcohol poisoning.
+Read more about drinking and alcohol, including tips on cutting down on your drinking.
+Page last reviewed: 01 April 2019
+Next review due: 01 April 2022
+Support links
+Home
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+Mental health
+Care and support
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+NHS services
+Coronavirus (COVID-19)
+NHS App
+Find my NHS number
+Your health records
+About the NHS
+Healthcare abroad
+Contact us
+Other NHS websites
+Profile editor login
+About us
+Accessibility statement
+Our policies
+Cookies
+© Crown copyright

integrations/haystack/nhs-search/data/www.nhs.uk_conditions_alcohol-related-liver-disease-arld_.txt

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+Cookies on the NHS website
+We've put some small files called cookies on your device to make our site work.
+We'd also like to use analytics cookies. These send information about how our site is used to services called Adobe Analytics, Hotjar and Google Analytics. We use this information to improve our site.
+Let us know if this is OK. We'll use a cookie to save your choice. You can read more about our cookies before you choose.
+I'm OK with analytics cookies Do not use analytics cookies
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+Get the latest advice about COVID-19
+Home Health A to Z
+Overview
+-
+Alcohol-related liver disease
+Contents
+Overview
+Symptoms
+Causes
+Diagnosis
+Treatment
+Complications
+Alcohol-related liver disease (ARLD) refers to liver damage caused by excess alcohol intake. There are several stages of severity and a range of associated symptoms.
+Symptoms of alcohol-related liver disease (ARLD)
+ARLD does not usually cause any symptoms until the liver has been severely damaged.
+When this happens, symptoms can include:
+feeling sick
+weight loss
+loss of appetite
+yellowing of the eyes and skin (jaundice)
+swelling in the ankles and tummy
+confusion or drowsiness
+vomiting blood or passing blood in your stools
+This means ARLD is frequently diagnosed during tests for other conditions, or at a stage of advanced liver damage.
+If you regularly drink alcohol to excess, tell your GP so they can check if your liver is damaged.
+Information:
+Coronavirus advice
+Get advice about coronavirus and liver disease from the British Liver Trust
+Alcohol and the liver
+With the exception of the brain, the liver is the most complex organ in the body. 
+Its functions include:
+filtering toxins from the blood
+aiding digestion of food
+regulating blood sugar and cholesterol levels
+helping fight infection and disease
+The liver is very resilient and capable of regenerating itself. Each time your liver filters alcohol, some of the liver cells die.
+The liver can develop new cells, but prolonged alcohol misuse (drinking too much) over many years can reduce its ability to regenerate. This can result in serious and permanent damage to your liver.
+ARLD is very common in the UK. The number of people with the condition has been increasing over the last few decades as a result of increasing levels of alcohol misuse.
+Read more about the causes of ARLD.
+Stages of ARLD
+There are 3 main stages of ARLD, although there's often an overlap between each stage. These stages are explained below.
+Alcoholic fatty liver disease
+Drinking a large amount of alcohol, even for just a few days, can lead to a build-up of fats in the liver.
+This is called alcoholic fatty liver disease, and is the first stage of ARLD.
+Fatty liver disease rarely causes any symptoms, but it's an important warning sign that you're drinking at a harmful level.
+Fatty liver disease is reversible. If you stop drinking alcohol for 2 weeks, your liver should return to normal.
+Alcoholic hepatitis
+Alcoholic hepatitis, which is unrelated to infectious hepatitis, is a potentially serious condition that can be caused by alcohol misuse over a longer period.
+When this develops, it may be the first time a person is aware they're damaging their liver through alcohol.
+Less commonly, alcoholic hepatitis can occur if you drink a large amount of alcohol in a short period of time (binge drinking).
+The liver damage associated with mild alcoholic hepatitis is usually reversible if you stop drinking permanently.
+Severe alcoholic hepatitis, however, is a serious and life-threatening illness.
+Many people die from the condition each year in the UK, and some people only find out they have liver damage when their condition reaches this stage.
+Cirrhosis
+Cirrhosis is a stage of ARLD where the liver has become significantly scarred. Even at this stage, there may not be any obvious symptoms.
+It's generally not reversible, but stopping drinking alcohol immediately can prevent further damage and significantly increase your life expectancy.
+A person who has alcohol-related cirrhosis and does not stop drinking has a less than 50% chance of living for at least 5 more years.
+Treating alcohol-related liver disease (ARLD)
+There's currently no specific medical treatment for ARLD. The main treatment is to stop drinking, preferably for the rest of your life.
+This reduces the risk of further damage to your liver and gives it the best chance of recovering.
+If a person is dependent on alcohol, stopping drinking can be very difficult.
+But support, advice and medical treatment may be available through local alcohol support services.
+A liver transplant may be required in severe cases where the liver has stopped functioning and does not improve when you stop drinking alcohol.
+You'll only be considered for a liver transplant if you have developed complications of cirrhosis despite having stopped drinking.
+All liver transplant units require a person to not drink alcohol while awaiting the transplant, and for the rest of their life.
+Complications
+Death rates linked to ARLD have risen considerably over the last few decades.
+Alcohol misuse is now one of the most common causes of death in the UK, along with smoking and high blood pressure.
+Life-threatening complications of ARLD include:
+internal (variceal) bleeding
+build-up of toxins in the brain (encephalopathy)
+fluid accumulation in the abdomen (ascites) with associated kidney failure
+liver cancer
+increased vulnerability to infection
+Read more about the complications of ARLD.
+Preventing alcohol-related liver disease (ARLD)
+The most effective way to prevent ARLD is to stop drinking alcohol or stick to the recommended limits:
+men and women are advised not to regularly drink more than 14 units a week
+spread your drinking over 3 days or more if you drink as much as 14 units a week
+A unit of alcohol is equal to about half a pint of normal-strength lager or a pub measure (25ml) of spirits.
+Even if you have been a heavy drinker for many years, reducing or stopping your alcohol intake will have important short- and long-term benefits for your liver and overall health.
+See our drinking and alcohol pages for more information and advice.
+Video: liver disease
+In this video, consultant hepatologist Mark Wright explains liver disease and how not drinking alcohol can help.
+Play Video
+Media last reviewed: 1 July 2021
+Media review due: 1 July 2024
+Page last reviewed: 10 August 2018
+Next review due: 10 August 2021
+Next
+:
+Symptoms
+Support links
+Home
+Health A to Z
+Live Well
+Mental health
+Care and support
+Pregnancy
+NHS services
+Coronavirus (COVID-19)
+NHS App
+Find my NHS number
+Your health records
+About the NHS
+Healthcare abroad
+Contact us
+Other NHS websites
+Profile editor login
+About us
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+Our policies
+Cookies
+© Crown copyright

integrations/haystack/nhs-search/data/www.nhs.uk_conditions_alexander-technique_.txt

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+Cookies on the NHS website
+We've put some small files called cookies on your device to make our site work.
+We'd also like to use analytics cookies. These send information about how our site is used to services called Adobe Analytics, Hotjar and Google Analytics. We use this information to improve our site.
+Let us know if this is OK. We'll use a cookie to save your choice. You can read more about our cookies before you choose.
+I'm OK with analytics cookies Do not use analytics cookies
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+Home Health A to Z
+Alexander technique
+The Alexander technique teaches improved posture and movement, which is believed to help reduce and prevent problems caused by unhelpful habits.
+During a number of lessons you're taught to be more aware of your body, how to improve poor posture and move more efficiently.
+Teachers of the Alexander technique believe it helps get rid of tension in your body and relieves problems such as back pain, neck ache, sore shoulders and other musculoskeletal problems.
+Evidence suggests the technique has the potential to improve certain health conditions, but there are some claims made about the technique that haven't been scientifically tested.
+Key principles
+The main principles of the Alexander technique are:
+"how you move, sit and stand affects how well you function"
+"the relationship of the head, neck and spine is fundamental to your ability to function optimally"
+"becoming more mindful of the way you go about your daily activities is necessary to make changes and gain benefit"
+"the mind and body work together intimately as one, each constantly influencing the other"
+Teachers of the technique say that conditions such as backache and other sorts of long-term pain are often the result of misusing your body over a long period of time, such as moving inefficiently and standing or sitting with your weight unevenly distributed.
+The aim of the Alexander technique is to help you "unlearn" these bad habits and achieve a balanced, more naturally aligned body.
+Learning the Alexander technique
+The Alexander technique is taught by a qualified teacher in 1-to-1 lessons.
+Lessons often take place in a studio, clinic or the teacher's house and usually last 30 to 45 minutes. You'll be asked to wear loose-fitting, comfortable clothing so you're able to move easily.
+The teacher will observe your movements and show you how to move, sit, lie down and stand with better balance and less strain. They'll use their hands to gently guide you in your movements, help you maintain a better relationship between your head, neck and spine, and to release muscle tension.
+You'll need to attend a number of lessons to learn the basic concepts of the Alexander technique. Often, around 20 or more weekly lessons are recommended.
+Teachers of the technique say you may see an improvement in aches and pains fairly soon after starting the lessons, but that you need to be committed to putting what you learn into practice and it may take a considerable amount of time to see the full benefits.
+The overall aim is to help you gain an understanding of the main principles involved so you can apply them to everyday life, allowing you to benefit from the technique without the need for frequent ongoing lessons.
+Does the Alexander technique work?
+Supporters of the Alexander technique often claim it can help people with a wide range of health conditions. Some of these claims are supported by scientific evidence, but some have not yet been properly tested.
+There's evidence suggesting the Alexander technique can help people with:
+long-term back pain – lessons in the technique may lead to reduced back pain-associated disability and reduce how often you feel pain for up to a year or more
+long-term neck pain – lessons in the technique may lead to reduced neck pain and associated disability for up to a year or more
+Parkinson's disease – lessons in the technique may help you carry out everyday tasks more easily and improve how you feel about your condition
+If you have one of these conditions and you're considering trying the Alexander technique, it's a good idea to speak to your GP or specialist first to check if it might be suitable for you.
+Some research has also suggested the Alexander technique may improve general long-term pain, stammering, and balance skills in older people to help them avoid falls. But the evidence in these areas is limited and more studies are needed.
+There's currently little evidence to suggest the Alexander technique can help improve other health conditions, including asthma, headaches, osteoarthritis, difficulty sleeping (insomnia) and stress.
+Availability and regulation
+Alexander technique lessons are mostly available privately. Each lesson usually costs around £35 to £50.
+However, in recent years some NHS trusts have started to offer Alexander technique lessons as part of their outpatient pain clinics. Ask your GP whether it's available through the NHS in your local area.
+Finding a teacher
+If you're thinking about trying the Alexander technique, it's important to choose a teacher who's experienced and qualified.
+There aren't currently any laws or regulations stating what training someone must have to teach the Alexander technique. Professional organisations offer courses (often for 3 years) and membership upon successful completion of the course.
+Teachers must meet certain requirements to register with these organisations and agree to comply with their code of ethics.
+In the UK, the main organisations for teachers of the Alexander technique are the:
+Complementary and Natural Healthcare Council (CHNC)
+Society of Teachers of the Alexander Technique (STAT)
+Interactive Teaching Method Association (ITM)
+Professional Association of Alexander Teachers (PAAT)
+Alexander Technique International (ATI)
+Of these, only the CHNC has been accredited by the Professional Standards Authority.
+Risks and limitations
+For most people, Alexander technique lessons are safe and pose no health risks. No manipulation of your body is involved, just gentle touch.
+However, the technique may not be suitable for certain people, such as those with specific spinal problems like an injury or slipped disc. These problems will need specialist medical treatment.
+It's important to remember that most teachers of the Alexander technique aren't medical professionals. They should not diagnose, offer advice on or treat conditions that should be managed by a suitably qualified mainstream healthcare professional.
+Page last reviewed: 06 September 2021
+Next review due: 06 September 2024
+Support links
+Home
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+Mental health
+Care and support
+Pregnancy
+NHS services
+Coronavirus (COVID-19)
+NHS App
+Find my NHS number
+Your health records
+About the NHS
+Healthcare abroad
+Contact us
+Other NHS websites
+Profile editor login
+About us
+Accessibility statement
+Our policies
+Cookies
+© Crown copyright

integrations/haystack/nhs-search/data/www.nhs.uk_conditions_alkaptonuria_.txt

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+Cookies on the NHS website
+We've put some small files called cookies on your device to make our site work.
+We'd also like to use analytics cookies. These send information about how our site is used to services called Adobe Analytics, Hotjar and Google Analytics. We use this information to improve our site.
+Let us know if this is OK. We'll use a cookie to save your choice. You can read more about our cookies before you choose.
+I'm OK with analytics cookies Do not use analytics cookies
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+Get the latest advice about COVID-19
+Home Health A to Z
+Alkaptonuria
+Alkaptonuria, or black urine disease, is a very rare inherited disorder that prevents the body fully breaking down two protein building blocks (amino acids) called tyrosine and phenylalanine.
+It results in a build-up of a chemical called homogentisic acid in the body.
+This can turn urine and parts of the body a dark colour and lead to a range of health problems over time.
+Amino acids are usually broken down in a series of chemical reactions. But in alkaptonuria a substance produced along the way, homogentisic acid, cannot be broken down any further.
+This is because the enzyme that normally breaks it down does not work properly. Enzymes are proteins that make chemical reactions happen.
+One of the earliest signs of the condition is dark-stained nappies, as homogentisic acid causes urine to turn black when exposed to air for a few hours.
+If this sign is missed or overlooked in a baby or child, the disorder may go unnoticed until adulthood, as there are usually no other noticeable symptoms until the person reaches their late 20s to early 30s.
+Signs and symptoms in adults
+Over the course of many years, homogentisic acid slowly builds up in tissues throughout the body.
+It can build up in almost any area of the body, including the cartilage, tendons, bones, nails, ears and heart. It stains the tissues dark and causes a wide range of problems.
+Joints and bones
+When a person with alkaptonuria reaches their 30s, they may start to experience joint problems.
+Typically, they'll have lower back pain and stiffness, followed by knee, hip and shoulder pain. These are the early symptoms of osteoarthritis. 
+Eventually, cartilage – a tough, flexible tissue found throughout the body – may become brittle and break, leading to joint and spinal damage. Joint replacement operations may be needed.
+Eyes and ears
+Many people develop brown or grey spots on the whites of their eyes.
+Another sign in many adults with alkaptonuria is thickening of ear cartilage. The cartilage may also look blue, grey or black. This is called ochronosis.
+The earwax may be black or reddish-brown.
+Alkaptonuria can cause dark spots in the whites of the eyes
+Alkaptonuria can thicken the ear cartilage and make it look blue-black
+Skin and nails
+Alkaptonuria can result in discoloured sweat, which can stain clothes and cause some people to have blue or black speckled areas of skin. Nails may also turn a bluish or brownish colour.
+The skin colour changes are most obvious on areas exposed to the sun and where sweat glands are found – the cheeks, forehead, armpits and genital area.
+Breathing difficulties
+If the bones and muscles around the lungs become stiff, it can prevent the chest expanding and lead to shortness of breath or difficulty breathing.
+Heart, kidney and prostate problems
+Deposits of homogentisic acid around heart valves can cause them to harden and turn brittle and black. Blood vessels can also become stiff and weaken.
+This can lead to heart disease and may require heart valve replacements.
+The deposits can also lead to kidney stones, bladder stones and prostate stones.
+How alkaptonuria is inherited
+Each cell in the body contains 23 pairs of chromosomes. These carry the genes you inherit from your parents.
+One of each pair of chromosomes is inherited from each parent, which means (with the exception of the sex chromosomes) there are two copies of each gene in each cell.
+The gene involved in alkaptonuria is the HGD gene. This provides instructions for making an enzyme called homogentisate oxidase, which is needed to break down homogentisic acid.
+You need to inherit two copies of the faulty HGD gene (one from each parent) to develop alkaptonuria. The chances of this are slim, which is why the condition is very rare.
+The parents of a person with alkaptonuria will often only carry one copy of the faulty gene themselves, which means they will not have any signs or symptoms of the condition.
+How alkaptonuria is managed
+Alkaptonuria is a lifelong condition – there's currently no specific treatment or cure.
+However, a medicine called nitisinone has shown some promise, and painkillers and lifestyle changes may help you cope with the symptoms.
+Nitisinone
+Nitisinone is not licensed for alkaptonuria – it's offered "off label" at the National Alkaptonuria Centre, the treatment centre for all alkaptonuria patients, based at Royal Liverpool University Hospital.
+Nitisinone reduces the level of homogentisic acid in the body. Research into its effectiveness for alkaptonuria is ongoing and there have been some promising results so far.
+Find out about the National Alkaptonuria Centre and nitisinone treatment on the Alkaptonuria Society website
+Diet
+If the condition is diagnosed in childhood, it may be possible to slow its progression by restricting protein in the diet, as this may reduce levels of tyrosine and phenylalanine in your body.
+A low-protein diet can also be useful in reducing the risk of potential side effects when taking nitisinone for alkaptonuria during adulthood. Your doctor or dietitian can advise you about this.
+Exercise
+If alkaptonuria causes pain and stiffness, you may think exercise will make your symptoms worse. But regular gentle exercise can actually help by building muscle and strengthening your joints.
+Exercise is also good for relieving stress, losing weight and improving your posture, all of which can ease your symptoms.
+The AKU Society recommends avoiding exercise that puts additional strain on the joints, such as boxing, football and rugby, and trying gentle exercise such as yoga, swimming and pilates instead.
+Your GP or a physiotherapist can help you come up with a suitable exercise plan to follow at home. It's important to follow this plan as there's a risk the wrong sort of exercise may damage your joints.
+Pain relief
+Speak to a doctor about painkillers and other techniques to manage pain.
+Find tips for managing your pain levels about with 10 ways to reduce pain.
+Emotional support
+A diagnosis of alkaptonuria can be confusing and overwhelming at first. Like many people with a long-term health condition, those who find out they have alkaptonuria may feel anxious or depressed.
+But there are people you can talk to who can help. Talk to your GP if you feel you need support to cope with your illness. You could also visit the AKU Society website, a charity offering support to patients, their families and carers.
+Surgery
+Sometimes surgery may be necessary if joints are damaged and need replacing, or if heart valves or vessels have hardened.
+Your doctor may recommend:
+hip replacement
+knee replacement
+aortic valve replacement
+Outlook
+People with alkaptonuria have a normal life expectancy. However, they will usually experience severe symptoms, such as pain and loss of movement in the joints, which considerably affect quality of life.
+Working and carrying out strenuous physical activity will usually become very difficult, and eventually you may need mobility aids such as a wheelchair to get around.
+Visit the AKU Society website for more information and support.
+Sharing your information
+If you or your child have alkaptonuria, your clinical team will pass relevant patient information on to the National Congenital Anomaly and Rare Disease 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 NCARDRS register on GOV.UK
+Page last reviewed: 10 March 2022
+Next review due: 10 March 2025
+Support links
+Home
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+Contact us
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+About us
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+Our policies
+Cookies
+© Crown copyright

integrations/haystack/nhs-search/data/www.nhs.uk_conditions_allergic-rhinitis_.txt

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+Cookies on the NHS website
+We've put some small files called cookies on your device to make our site work.
+We'd also like to use analytics cookies. These send information about how our site is used to services called Adobe Analytics, Hotjar and Google Analytics. We use this information to improve our site.
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+Overview
+-
+Allergic rhinitis
+Contents
+Overview
+Causes
+Diagnosis
+Treatment
+Complications
+Prevention
+Allergic rhinitis is inflammation of the inside of the nose caused by an allergen, such as pollen, dust, mould or flakes of skin from certain animals.
+It's a very common condition, estimated to affect around 1 in every 5 people in the UK.
+Symptoms of allergic rhinitis
+Allergic rhinitis typically causes cold-like symptoms, such as sneezing, itchiness and a blocked or runny nose.
+These symptoms usually start soon after being exposed to an allergen.
+Some people only get allergic rhinitis for a few months at a time because they're sensitive to seasonal allergens, such as tree or grass pollen. Other people get allergic rhinitis all year round.
+Most people with allergic rhinitis have mild symptoms that can be easily and effectively treated.
+But for some people symptoms can be severe and persistent, causing sleep problems and interfering with everyday life.
+The symptoms of allergic rhinitis occasionally improve with time, but this can take many years and it's unlikely that the condition will disappear completely.
+When to see a GP
+Visit a GP if the symptoms of allergic rhinitis are disrupting your sleep, preventing you carrying out everyday activities, or adversely affecting your performance at work or school.
+A diagnosis of allergic rhinitis will usually be based on your symptoms and any possible triggers you may have noticed.
+If the cause of your condition is uncertain, you may be referred for allergy testing.
+Find out more about diagnosing allergic rhinitis
+What causes allergic rhinitis
+Allergic rhinitis is caused by the immune system reacting to an allergen as if it were harmful.
+This results in cells releasing a number of chemicals that cause the inside layer of your nose (the mucous membrane) to become swollen and too much mucus to be produced.
+Common allergens that cause allergic rhinitis include pollen (this type of allergic rhinitis is known as hay fever), as well as mould spores, house dust mites, and flakes of skin or droplets of urine or saliva from certain animals.
+Find out more about the causes of allergic rhinitis
+Treating and preventing allergic rhinitis
+It's difficult to completely avoid potential allergens, but you can take steps to reduce exposure to a particular allergen you know or suspect is triggering your allergic rhinitis. This will help improve your symptoms.
+If your condition is mild, you can also help reduce the symptoms by taking over-the-counter medications, such as non-sedating antihistamines, and by regularly rinsing your nasal passages with a salt water solution to keep your nose free of irritants.
+See a GP for advice if you have tried taking these steps and they have not helped.
+They may prescribe a stronger medication, such as a nasal spray containing corticosteroids.
+Further problems
+Allergic rhinitis can lead to complications in some cases.
+These include:
+nasal polyps – abnormal but non-cancerous (benign) sacs of fluid that grow inside the nasal passages and sinuses
+sinusitis – an infection caused by nasal inflammation and swelling that prevents mucus draining from the sinuses
+middle ear infections – infection of part of the ear located directly behind the eardrum
+These problems can often be treated with medication, although surgery is sometimes needed in severe or long-term cases.
+Find out more about the complications of allergic rhinitis
+Non-allergic rhinitis
+Not all cases of rhinitis are caused by an allergic reaction.
+Some cases are the result of:
+an infection, such as the common cold
+oversensitive blood vessels in the nose
+overuse of nasal decongestants
+This type of rhinitis is known as non-allergic rhinitis.
+Page last reviewed: 29 April 2019
+Next review due: 29 April 2022
+Next
+:
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integrations/haystack/nhs-search/data/www.nhs.uk_conditions_allergies_.txt

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+Cookies on the NHS website
+We've put some small files called cookies on your device to make our site work.
+We'd also like to use analytics cookies. These send information about how our site is used to services called Adobe Analytics, Hotjar and Google Analytics. We use this information to improve our site.
+Let us know if this is OK. We'll use a cookie to save your choice. You can read more about our cookies before you choose.
+I'm OK with analytics cookies Do not use analytics cookies
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+Overview
+-
+Allergies
+Contents
+Overview
+Symptoms
+Diagnosis
+Treatment
+Prevention
+An allergy is a reaction the body has to a particular food or substance.
+Allergies are very common. They're thought to affect more than 1 in 4 people in the UK at some point in their lives.
+They're particularly common in children. Some allergies go away as a child gets older, although many are lifelong.
+Adults can develop allergies to things they were not previously allergic to.
+Having an allergy can be a nuisance and affect your everyday activities, but most allergic reactions are mild and can be largely kept under control.
+Severe reactions can occasionally occur, but these are uncommon.
+Common allergies
+Substances that cause allergic reactions are called allergens. 
+The more common allergens include:
+grass and tree pollen – an allergy to these is known as hay fever (allergic rhinitis)
+dust mites
+animal dander, tiny flakes of skin or hair
+food – particularly nuts, fruit, shellfish, eggs and cows' milk
+insect bites and stings
+medicines – including ibuprofen, aspirin and certain antibiotics
+latex – used to make some gloves and condoms
+mould – these can release small particles into the air that you can breathe in
+household chemicals – including those in detergents and hair dyes
+Most of these allergens are generally harmless to people who are not allergic to them.
+Symptoms of an allergic reaction
+Allergic reactions usually happen quickly within a few minutes of exposure to an allergen.
+They can cause:
+sneezing
+a runny or blocked nose
+red, itchy, watery eyes
+wheezing and coughing
+a red, itchy rash
+worsening of asthma or eczema symptoms
+Most allergic reactions are mild, but occasionally a severe reaction called anaphylaxis or anaphylactic shock can occur.
+This is a medical emergency and needs urgent treatment.
+Getting help for allergies
+See a GP if you think you or your child might have had an allergic reaction to something.
+The symptoms of an allergic reaction can also be caused by other conditions.
+A GP can help determine whether it's likely you have an allergy.
+If they think you might have a mild allergy, they can offer advice and treatment to help manage the condition.
+If your allergy is particularly severe or it's not clear what you're allergic to, they may refer you to an allergy specialist for testing and advice about treatment.
+Find out more about allergy testing
+How to manage an allergy
+In many cases, the most effective way of managing an allergy is to avoid the allergen that causes the reaction whenever possible.
+For example, if you have a food allergy, you should check a food's ingredients list for allergens before eating it.
+There are also several medicines available to help control symptoms of allergic reactions, including:
+antihistamines – these can be taken when you notice the symptoms of a reaction, or before being exposed to an allergen, to stop a reaction occurring
+decongestants – tablets, capsules, nasal sprays or liquids that can be used as a short-term treatment for a blocked nose
+lotions and creams, such as moisturising creams (emollients) – these can reduce skin redness and itchiness
+steroid medicines – sprays, drops, creams, inhalers and tablets that can help reduce redness and swelling caused by an allergic reaction
+For some people with very severe allergies, a treatment called immunotherapy may be recommended.
+This involves being exposed to the allergen in a controlled way over a number of years so your body gets used to it and does not react to it so severely.
+What causes allergies?
+Allergies occur when the body's immune system reacts to a particular substance as though it's harmful.
+It's not clear why this happens, but most people affected have a family history of allergies or have closely related conditions, such as asthma or eczema.
+The number of people with allergies is increasing every year.
+The reasons for this are not understood, but 1 of the main theories is it's the result of living in a cleaner, germ-free environment, which reduces the number of germs our immune system has to deal with.
+It's thought this may cause it to overreact when it comes into contact with harmless substances.
+Is it an allergy, sensitivity or intolerance?
+Allergy
+A reaction produced by the body's immune system when exposed to a normally harmless substance.
+Sensitivity
+The exaggeration of the normal effects of a substance. For example, the caffeine in a cup of coffee may cause extreme symptoms, such as palpitations and trembling.
+Intolerance
+Where a substance causes unpleasant symptoms, such as diarrhoea, but does not involve the immune system.
+People with an intolerance to certain foods can typically eat a small amount without having any problems.
+Page last reviewed: 22 November 2018
+Next review due: 22 November 2021
+Next
+:
+Symptoms
+Support links
+Home
+Health A to Z
+Live Well
+Mental health
+Care and support
+Pregnancy
+NHS services
+Coronavirus (COVID-19)
+NHS App
+Find my NHS number
+Your health records
+About the NHS
+Healthcare abroad
+Contact us
+Other NHS websites
+Profile editor login
+About us
+Accessibility statement
+Our policies
+Cookies
+© Crown copyright

integrations/haystack/nhs-search/data/www.nhs.uk_conditions_altitude-sickness_.txt

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+Cookies on the NHS website
+We've put some small files called cookies on your device to make our site work.
+We'd also like to use analytics cookies. These send information about how our site is used to services called Adobe Analytics, Hotjar and Google Analytics. We use this information to improve our site.
+Let us know if this is OK. We'll use a cookie to save your choice. You can read more about our cookies before you choose.
+I'm OK with analytics cookies Do not use analytics cookies
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+Search
+My account
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+Home Health A to Z
+Altitude sickness
+You can get altitude sickness if you travel to a high altitude too quickly.
+Breathing becomes difficult because you're not able to take in as much oxygen.
+Altitude sickness, also called acute mountain sickness (AMS), can become a medical emergency if ignored.
+Your age, sex or physical fitness do not affect your likelihood of getting altitude sickness.
+Also, just because you may not have had it before, this does not mean you will not get it on another trip.
+Symptoms of altitude sickness
+Symptoms of altitude sickness usually develop between 6 and 24 hours after reaching altitudes more than 2,500m above sea level.
+Symptoms are similar to those of a bad hangover and include:
+headache
+feeling and being sick
+dizziness
+tiredness
+loss of appetite
+shortness of breath
+The symptoms are usually worse at night.
+Altitude sickness does not only affect mountain climbers. Tourists travelling to cities that are 2,500m above sea level or higher, such as La Paz in Bolivia or Bogotá in Colombia, can also get altitude sickness.
+It's not possible to get altitude sickness in the UK because the highest mountain, Ben Nevis in Scotland, is only 1,345m.
+Preventing altitude sickness
+The best way to prevent getting altitude sickness is to travel to altitudes above 2,500m slowly.
+It usually takes a few days for your body to get used to a change in altitude.
+You should also:
+avoid flying directly to areas of high altitude, if possible
+take 2 to 3 days to get used to high altitudes before going above 2,500m
+avoid climbing more than 300m to 500m a day
+have a rest day every 600m to 900m you go up, or rest every 3 to 4 days
+make sure you're drinking enough water
+avoid smoking and alcohol
+avoid strenuous exercise for the first 24 hours
+eat a light but high-calorie diet
+Medicines
+Consider travelling with these medicines for altitude sickness:
+acetazolamide to prevent and treat high-altitude sickness
+ibuprofen and paracetamol for headaches
+anti-sickness medicine, such as promethazine, for nausea
+In the UK, acetazolamide is not licensed to treat altitude sickness. But it's available from most travel clinics and some GPs may prescribe it.
+Promethazine is available from pharmacies. You do not need a prescription to buy it.
+Begin taking acetazolamide 1 to 2 days before you start to go up in altitude and continue to take it while going up.
+You should still go up gradually and follow the prevention advice, including taking time to acclimatise, having regular rest days and drinking plenty of water.
+If you get symptoms of altitude sickness while taking acetazolamide, rest or go down until you feel better before going up again.
+Treating altitude sickness
+If you think you have altitude sickness:
+stop and rest where you are
+do not go any higher for at least 24 to 48 hours
+if you have a headache, take ibuprofen or paracetamol
+if you feel sick, take an anti-sickness medicine, such as promethazine
+make sure you're drinking enough water
+do not smoke, drink alcohol, or exercise
+Acetazolamide can be used to reduce the severity of your symptoms, but it will not completely get rid of them.
+Tell your travel companions how you feel, even if your symptoms are mild – there's a danger your judgement may not be clear.
+You can continue going up with care once you feel you have fully recovered.
+If you do not feel any better after 24 hours, go down by at least 500m (about 1,600 feet).
+Do not attempt to climb again until your symptoms have completely disappeared.
+After 2 to 3 days, your body should have adjusted to the altitude and your symptoms should disappear.
+See a doctor if your symptoms do not improve or get worse.
+Complications
+If the symptoms of altitude sickness are ignored, they can lead to life-threatening conditions affecting the brain or lungs.
+High altitude cerebral oedema (HACE)
+High altitude cerebral oedema (HACE) is swelling of the brain caused by a lack of oxygen.
+Symptoms of HACE include:
+headache
+weakness
+feeling and being sick
+loss of coordination
+feeling confused
+hallucinations (seeing and hearing things that are not there)
+A person with HACE will often not realise they're ill. They may insist they're OK and want to be left alone.
+HACE can develop quickly over a few hours. It can be fatal if it's not treated immediately.
+Treating HACE:
+move down to a lower altitude immediately
+take dexamethasone
+give bottled oxygen, if available
+Dexamethasone is a steroid medicine that reduces swelling of the brain. It's often carried by professional mountain climbers as part of their medical supplies.
+If you cannot go down immediately, dexamethasone can help relieve symptoms until it's safe to do so.
+You should go to hospital as soon as possible for follow-up treatment.
+High altitude pulmonary oedema (HAPE)
+High altitude pulmonary oedema (HAPE) is a build-up of fluid in the lungs.
+Symptoms of HAPE:
+blue tinge to the skin or lips (cyanosis)
+breathing difficulties, even when resting
+tightness in the chest
+a persistent cough, bringing up pink or white frothy liquid (sputum)
+tiredness and weakness
+The symptoms of HAPE can start to appear a few days after arrival at high altitude. It can be fatal if it's not treated immediately.
+Treating HAPE:
+move down to a lower altitude immediately
+take nifedipine
+give bottled oxygen, if available
+Nifedipine is a medicine that helps to reduce chest tightness and make breathing easier. It's also often part of an expedition's medical supplies
+You should go to hospital as soon as possible for follow-up treatment.
+If you've had HAPE, you can register with the International HAPE Database to help develop new treatments for the condition.
+Page last reviewed: 13 March 2020
+Next review due: 13 March 2023
+Support links
+Home
+Health A to Z
+Live Well
+Mental health
+Care and support
+Pregnancy
+NHS services
+Coronavirus (COVID-19)
+NHS App
+Find my NHS number
+Your health records
+About the NHS
+Healthcare abroad
+Contact us
+Other NHS websites
+Profile editor login
+About us
+Accessibility statement
+Our policies
+Cookies
+© Crown copyright

integrations/haystack/nhs-search/data/www.nhs.uk_conditions_alzheimers-disease_.txt

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+Cookies on the NHS website
+We've put some small files called cookies on your device to make our site work.
+We'd also like to use analytics cookies. These send information about how our site is used to services called Adobe Analytics, Hotjar and Google Analytics. We use this information to improve our site.
+Let us know if this is OK. We'll use a cookie to save your choice. You can read more about our cookies before you choose.
+I'm OK with analytics cookies Do not use analytics cookies
+Search the NHS website
+Search
+My account
+Health A-Z
+Live Well
+Mental health
+Care and support
+Pregnancy
+Browse
+More
+Home Health A to Z
+Overview
+-
+Alzheimer's disease
+Contents
+Overview
+Symptoms
+Causes
+Diagnosis
+Treatment
+Prevention
+Alzheimer's disease is the most common cause of dementia in the UK.
+Dementia is the name for a group of symptoms associated with an ongoing decline of brain functioning. It can affect memory, thinking skills and other mental abilities.
+The exact cause of Alzheimer's disease is not yet fully understood, although a number of things are thought to increase your risk of developing the condition.
+These include:
+increasing age
+a family history of the condition
+untreated depression, although depression can also be one of the symptoms of Alzheimer's disease
+lifestyle factors and conditions associated with cardiovascular disease
+Read more about the causes of Alzheimer's disease.
+Information:
+Coronavirus (COVID-19) advice
+Get advice about COVID-19 and dementia:
+Alzheimer's Society: COVID-19 information for people affected by dementia
+Dementia UK: COVID-19 questions and answers
+Signs and symptoms of Alzheimer's disease
+Alzheimer's disease is a progressive condition, which means the symptoms develop gradually over many years and eventually become more severe. It affects multiple brain functions.
+The first sign of Alzheimer's disease is usually minor memory problems.
+For example, this could be forgetting about recent conversations or events, and forgetting the names of places and objects.
+As the condition develops, memory problems become more severe and further symptoms can develop, such as:
+confusion, disorientation and getting lost in familiar places
+difficulty planning or making decisions
+problems with speech and language
+problems moving around without assistance or performing self-care tasks
+personality changes, such as becoming aggressive, demanding and suspicious of others
+hallucinations (seeing or hearing things that are not there) and delusions (believing things that are untrue)
+low mood or anxiety
+Read more about the symptoms of Alzheimer's disease.
+Who is affected?
+Alzheimer's disease is most common in people over the age of 65.
+The risk of Alzheimer's disease and other types of dementia increases with age, affecting an estimated 1 in 14 people over the age of 65 and 1 in every 6 people over the age of 80.
+But around 1 in every 20 people with Alzheimer's disease are under the age of 65. This is called early- or young-onset Alzheimer's disease.
+Getting a diagnosis
+As the symptoms of Alzheimer's disease progress slowly, it can be difficult to recognise that there's a problem. Many people feel that memory problems are simply a part of getting older.
+Also, the disease process itself may (but not always) prevent people recognising changes in their memory. But Alzheimer's disease is not a "normal" part of the ageing process.
+An accurate and timely diagnosis of Alzheimer's disease can give you the best chance to prepare and plan for the future, as well as receive any treatment or support that may help.
+If you're worried about your memory or think you may have dementia, it's a good idea to see a GP.
+If possible, someone who knows you well should be with you as they can help describe any changes or problems they have noticed.
+If you're worried about someone else, encourage them to make an appointment and perhaps suggest that you go along with them.
+There's no single test that can be used to diagnose Alzheimer's disease. And it's important to remember that memory problems do not necessarily mean you have Alzheimer's disease.
+A GP will ask questions about any problems you're experiencing and may do some tests to rule out other conditions.
+If Alzheimer's disease is suspected, you may be referred to a specialist service to:
+assess your symptoms in more detail
+organise further testing, such as brain scans if necessary
+create a treatment and care plan
+Read more about diagnosing Alzheimer's disease.
+How Alzheimer's disease is treated
+There's currently no cure for Alzheimer's disease, but medicines are available that can help relieve some of the symptoms.
+Various other types of support are also available to help people with Alzheimer's live as independently as possible, such as making changes to your home environment so it's easier to move around and remember daily tasks.
+Psychological treatments such as cognitive stimulation therapy may also be offered to help support your memory, problem solving skills and language ability.
+Read more about treating Alzheimer's disease.
+Outlook
+People with Alzheimer's disease can live for several years after they start to develop symptoms. But this can vary considerably from person to person.
+Alzheimer's disease is a life-limiting illness, although many people diagnosed with the condition will die from another cause.
+As Alzheimer's disease is a progressive neurological condition, it can cause problems with swallowing.
+This can lead to aspiration (food being inhaled into the lungs), which can cause frequent chest infections.
+It's also common for people with Alzheimer's disease to eventually have difficulty eating and have a reduced appetite.
+There's increasing awareness that people with Alzheimer's disease need palliative care.
+This includes support for families, as well as the person with Alzheimer's.
+Can Alzheimer's disease be prevented?
+As the exact cause of Alzheimer's disease is not clear, there's no known way to prevent the condition.
+But there are things you can do that may reduce your risk or delay the onset of dementia, such as:
+stopping smoking and cutting down on alcohol
+eating a healthy, balanced diet and maintaining a healthy weight
+staying physically fit and mentally active
+These measures have other health benefits, such as lowering your risk of cardiovascular disease and improving your overall mental health.
+Read more about preventing Alzheimer's disease.
+Dementia research
+There are dozens of dementia research projects going on around the world, many of which are based in the UK.
+If you have a diagnosis of dementia or are worried about memory problems, you can help scientists better understand the disease by taking part in research.
+If you're a carer for someone with dementia, you can also take part in research.
+You can sign up to take part in trials on the NHS Join Dementia Research website.
+More information
+Dementia can affect all aspects of a person's life, as well as their family's.
+If you have been diagnosed with dementia, or you're caring for someone with the condition, remember that advice and support is available to help you live well.
+Read more about:
+Staying independent with dementia
+Living well with dementia
+Communicating with someone with dementia
+Looking after someone with dementia
+Coping with dementia behaviour changes
+Help and support for people with dementia
+Dementia, social services and the NHS
+Information:
+Social care and support guide
+If you:
+need help with day-to-day living because of illness or disability
+care for someone regularly because they're ill, elderly or disabled - including family members
+Our guide to care and support explains your options and where you can get support.
+Page last reviewed: 05 July 2021
+Next review due: 05 July 2024
+Next
+:
+Symptoms
+Support links
+Home
+Health A to Z
+Live Well
+Mental health
+Care and support
+Pregnancy
+NHS services
+Coronavirus (COVID-19)
+NHS App
+Find my NHS number
+Your health records
+About the NHS
+Healthcare abroad
+Contact us
+Other NHS websites
+Profile editor login
+About us
+Accessibility statement
+Our policies
+Cookies
+© Crown copyright

integrations/haystack/nhs-search/data/www.nhs.uk_conditions_amniocentesis_.txt

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+Cookies on the NHS website
+We've put some small files called cookies on your device to make our site work.
+We'd also like to use analytics cookies. These send information about how our site is used to services called Adobe Analytics, Hotjar and Google Analytics. We use this information to improve our site.
+Let us know if this is OK. We'll use a cookie to save your choice. You can read more about our cookies before you choose.
+I'm OK with analytics cookies Do not use analytics cookies
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+More
+Home Health A to Z
+Overview
+-
+Amniocentesis
+Contents
+Overview
+Why it's offered
+What happens
+Results
+Risks
+Amniocentesis is a test you may be offered during pregnancy to check if your baby has a genetic or chromosomal condition, such as Down's syndrome, Edwards' syndrome or Patau's syndrome.
+It involves removing and testing a small sample of cells from amniotic fluid, the fluid that surrounds the unborn baby in the womb (uterus).
+When amniocentesis is offered
+Amniocentesis is not offered to all pregnant women. It's only offered if there's a higher chance your baby could have a genetic condition.
+This could be because:
+an antenatal screening test has suggested your baby may be born with a condition, such as Down's syndrome, Edwards' syndrome or Patau's syndrome
+you have had a previous pregnancy that was affected by a genetic condition
+you have a family history of a genetic condition, such as sickle cell disease, thalassaemia, cystic fibrosis or muscular dystrophy.
+It's important to remember that you do not have to have amniocentesis if it's offered. It's up to you to decide whether you want it.
+A midwife or doctor will speak to you about what the test involves and let you know what the possible benefits and risks are to help you make a decision.
+Find out about why amniocentesis is offered and deciding whether to have it
+How amniocentesis is performed
+Amniocentesis is usually carried out between the 15th and 20th weeks of pregnancy, but you can have it later if necessary.
+It can be performed earlier, but this may increase the risk of complications of amniocentesis and is usually avoided.
+During the test, a long, thin needle is inserted through your abdominal wall, guided by an ultrasound image.
+The needle is passed into the amniotic sac that surrounds the foetus and a small sample of amniotic fluid is removed for analysis.
+The test itself usually takes about 10 minutes, although the whole consultation may take about 30 minutes.
+Amniocentesis is usually described as being uncomfortable rather than painful.
+Some women describe experiencing a pain similar to period pain or feeling pressure when the needle is taken out.
+Find out more about what happens during amniocentesis
+Getting your results
+The first results of the test should be available within 3 working days and will tell you whether Down's syndrome, Edwards' syndrome or Patau's syndrome has been discovered.
+If rarer conditions are also being tested for, it can take 3 weeks or more for the results to come back.
+If your test shows that your baby has a genetic or chromosomal condition, the implications will be fully discussed with you.
+There's no cure for most of the conditions amniocentesis finds, so you'll need to consider your options carefully.
+You may choose to continue with your pregnancy, while gathering information about the condition so you're fully prepared.
+Find out more about having a baby that may be born with a genetic condition
+Or you may consider ending your pregnancy (having a termination).
+Find out more about the results of amniocentesis
+What are the risks of amniocentesis?
+Before you decide to have amniocentesis, the risks and possible complications will be discussed with you.
+One of the main risks associated with amniocentesis is miscarriage, which is the loss of the pregnancy in the first 23 weeks.
+This is estimated to occur in up to 1 out of every 100 women who have amniocentesis.
+There are also some other risks, such as infection or needing to have the procedure again because it was not possible to accurately test the first sample.
+The risk of amniocentesis causing complications is higher if it's carried out before the 15th week of pregnancy, which is why the test is only done after this point.
+Find out more about the possible complications of amniocentesis
+What are the alternatives?
+An alternative to amniocentesis is a test called chorionic villus sampling (CVS).
+This is where a small sample of cells from the placenta, the organ that links the mother's blood supply with her unborn baby's, is removed for testing.
+It's usually carried out between the 11th and 14th weeks of pregnancy, although it can be performed later than this if necessary.
+With CVS, the risk of miscarriage is similar to the risk of miscarriage for amniocentesis (up to 1 out of every 100).
+As the test can be carried out earlier, you'll have more time to consider the results.
+If you're offered tests to look for a genetic or chromosomal condition in your baby, a specialist involved in carrying out the test will be able to discuss the different options with you and help you make a decision.
+Page last reviewed: 17 April 2019
+Next review due: 17 April 2022
+Next
+:
+Why it's offered
+Support links
+Home
+Health A to Z
+Live Well
+Mental health
+Care and support
+Pregnancy
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+Coronavirus (COVID-19)
+NHS App
+Find my NHS number
+Your health records
+About the NHS
+Healthcare abroad
+Contact us
+Other NHS websites
+Profile editor login
+About us
+Accessibility statement
+Our policies
+Cookies
+© Crown copyright

integrations/haystack/nhs-search/data/www.nhs.uk_conditions_amputation_.txt

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+Cookies on the NHS website
+We've put some small files called cookies on your device to make our site work.
+We'd also like to use analytics cookies. These send information about how our site is used to services called Adobe Analytics, Hotjar and Google Analytics. We use this information to improve our site.
+Let us know if this is OK. We'll use a cookie to save your choice. You can read more about our cookies before you choose.
+I'm OK with analytics cookies Do not use analytics cookies
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+Home Health A to Z
+Amputation
+An amputation is the surgical removal of part of the body, such as an arm or leg.
+This topic may be helpful if you, a friend, or a member of your family, recently had or are planning to have an amputation.
+Why amputation may be needed
+An amputation may be needed if:
+you have a severe infection in your limb
+your limb has been affected by gangrene (often as a result of peripheral arterial disease)
+there's serious trauma to your limb, such as a crush or blast wound
+your limb is deformed and has limited movement and function
+Assessment before surgery
+Unless you need to have an emergency amputation, you'll be fully assessed before surgery to identify the most suitable type of amputation and any factors that may affect your rehabilitation.
+The assessment is likely to include a thorough medical examination to check your physical condition, such as your nutritional status, bowel and bladder function, cardiovascular system (heart, blood and blood vessels) and your respiratory system (lungs and airways).
+The doctor will also check the condition and function of your healthy limb. Removing one limb can place extra strain on the remaining limb, so it's important to look after the healthy limb.
+It may also inlude a psychological assessment to determine how well you'll cope with the psychological and emotional impact of amputation, and whether you'll need additional support.
+There may be an assessment of your home, work and social environments to check if any changes will need to be made to help you cope.
+You'll also be introduced to a physiotherapist, who will be involved in your post-operative care. A prosthetist (a specialist in prosthetic limbs) will advise you about the type and function of prosthetic limbs or other devices available.
+If you're having a planned amputation, you might find it reassuring to talk to someone who's had a similar type of amputation. A member of your care team may be able to arrange this.
+How amputations are done
+Amputations can be done under general anaesthetic (where you're unconscious) or using either an epidural anaesthetic or spinal anaesthetic (both of which numb the lower half of the body). The choice of anaesthetic can depend on what part of your body is being amputated.
+Most amputations involve removing a section of a limb rather than the entire limb.
+Once the section of the limb has been amputated, additional techniques can be used to help improve the function of the remaining part of the limb and reduce the risk of complications.
+These include shortening and smoothing the bone in the remaining section of the limb so it's covered by an adequate amount of soft tissue and muscle. The surgeon then stitches the muscle to the bones to help strengthen the remaining section (a technique known as myodesis).
+After the amputation, your wound will be sealed with stitches or surgical staples. It will be covered with a bandage and a tube may be placed under your skin to drain any excess fluid. The bandage will usually need to be kept in place for a few days to reduce the risk of infection.
+Recovering after an amputation
+After surgery, you'll usually be given oxygen through a mask and fluids through a drip for the first few days while you recover in a ward.
+A small flexible tube (urinary catheter)) may be placed in your bladder during surgery to drain urine. This means you will not need to get out of bed to go to the toilet for the first few days after the operation. You may be given a commode or bedpan so you can also poo without having to get up to use the toilet.
+The site of the operation may be painful, so you'll be given painkillers if you need them. Tell a member of your care team if the painkillers are not working, as you may need a larger dose or a stronger painkiller. A small tube may be used to deliver local anaesthetic to the nerves in the stump to help reduce pain.
+Your physiotherapist will teach you some exercises to help prevent blood clots and improve your blood supply while you're recovering in hospital.
+Compression garments
+You'll notice swelling (oedema) of the stump after surgery. This is normal and it may continue after you've been discharged.
+Using a compression garment will help with swelling and the shape of the stump. It may also reduce phantom pain (pain that seems to be coming from your missing limb) and help support the limb.
+You'll be fitted with a compression garment once your wound has healed. It should be worn every day, but taken off at bedtime. You should be given at least 2 garments, which should be washed regularly.
+Rehabilitation
+Physical rehabilitation is an important part of the recovery process. It can be a long, difficult and frustrating process, but it's important to persevere. After rehabilitation, you may be able to return to work and other activities.
+Your rehabilitation programme will be tailored to your individual needs and will aim to allow you to do as many of your normal activities as possible.
+You'll work closely with physiotherapists and occupational therapists who will discuss with you what you'd like to achieve from rehabilitation so that some realistic goals can be set.
+Your rehabilitation programme will usually start a few days after your operation. It may begin with simple exercises you can do while lying down or sitting. If you've had a leg amputation, you'll be encouraged to move around as soon as possible using a wheelchair.
+You'll also be taught "transfer techniques" to help you move around more easily, such as how to get into a wheelchair from your bed.
+Once your wound has started to heal, you may start working on an exercise programme with a physiotherapist in the hospital to help you maintain your mobility and muscle strength.
+If you have a prosthetic limb fitted, your physiotherapist will teach you how to use it. For example, how to walk on a prosthetic leg or grip with a prosthetic hand.
+Going home and follow-up
+The length of time it will take before you're ready to go home will depend on the type of amputation you've had and your general state of health.
+Before you're discharged from hospital, an occupational therapist may arrange to visit you at home to see if your home needs to be adapted to make it more accessible.
+For example, you may need a wheelchair ramp or a stairlift. If these types of modifications are needed, the issue can be referred to your local social care and support services. Find out more about walking aids, wheelchairs and scooters and assessing your care and support needs.
+It can take several months before you're fitted with a prosthetic limb (if you're suitable for a prosthesis), so you may be given a wheelchair to help you get around if you've had an amputation of a lower limb.
+You'll probably need to attend a follow-up appointment a few weeks after you leave hospital, to discuss how you're coping at home and whether you need additional help, support or equipment.
+At your appointment, you may also be given details of your nearest amputee support group, made up of both healthcare professionals and people living with an amputation.
+Prosthetic limbs
+After an amputation, you may be able to have a prosthetic limb fitted.
+Prosthetic limbs are not suitable for everyone who's had an amputation because an extensive course of physiotherapy and rehabilitation is required.
+Adjusting to life with a prosthetic limb takes a considerable amount of energy because you have to compensate for the loss of muscle and bone in the amputated limb.
+This is why frail people or those with a serious health condition, such as heart disease, may not be suitable for a prosthetic limb.
+If you're able to have a prosthetic limb, the type of limb that's recommended for you will depend on:
+the type of amputation you had
+the amount of muscle strength in the remaining section of the limb
+your general health
+tasks the prosthetic limb will be expected to perform
+whether you want the limb to look as real as possible or you're more concerned with function
+If it's thought that you would find it difficult to withstand the strain of using a prosthetic limb, a cosmetic limb may be recommended. This is a limb that looks like a real limb, but it cannot be used like a prosthetic limb.
+It's possible to have a prosthetic limb that's both physically realistic and functional, but there may have to be an element of compromise between the different types.
+Preparing to have a prosthetic limb fitted
+If a prosthetic limb is suitable for you, you'll begin a programme of activities while still in hospital to prepare for the prosthesis.
+Before a prosthetic limb is fitted, the skin covering your stump may be made less sensitive (known as desensitisation). This will make the prosthesis more comfortable to wear.
+Skin desensitisation involves:
+gently tapping the skin with a face cloth
+using compression bandages to help reduce swelling and prevent a build-up of fluid inside and around the stump
+rubbing and pulling the skin around your bone to prevent excessive scarring
+Your physiotherapist will teach you exercises to strengthen the muscles in your remaining limb and improve your general energy levels, so you're able to cope better with the demands of an artificial limb.
+Depending on what's available in your local area, it can be several months before you get your first appointment with a prosthetist.
+Stump care
+It's very important to keep the skin on the surface of your stump clean to reduce the risk of it becoming irritated or infected.
+Gently wash your stump at least once a day (more frequently in hot weather) with mild unscented soap and warm water, and dry it carefully.
+If you have a prosthetic limb, you should also regularly clean the socket using soap and warm water.
+When taking a bath, avoid leaving your stump submerged in water for long periods because the water will soften the skin on your stump, making it more vulnerable to injury.
+If your skin becomes dry, use a moisturising cream before bedtime or when you're not wearing your prosthesis.
+Some people find wearing one or more socks around their stump helps absorb sweat and reduces skin irritation. The size of your stump may change as the swelling goes down, so the number of socks you need to use may vary. You should change the socks every day.
+Check your stump carefully every day for signs of infection, such as:
+warm, red and tender skin
+discharge of fluid or pus
+increasing swelling
+Contact your care team for advice if you think you may be developing a skin infection.
+Caring for your remaining limb
+After having a leg or foot amputated, it's very important to avoid injuring your remaining "good" leg and foot, particularly if your amputation was needed because of diabetes. Your remaining leg and foot may also be at risk.
+Avoid wearing poorly fitting footwear and ensure that an appropriately trained healthcare professional, such as a podiatrist, is involved in the care of your remaining foot. You should also be offered a regular review of your foot by a foot care team.
+Find out more about diabetes and foot care.
+Complications
+Like any type of operation, an amputation carries a risk of complications. It also carries a risk of additional problems directly related to the loss of a limb.
+There are a number of factors that influence the risk of complications from amputation, such as your age, the type of amputation you've had, and your general health.
+The risk of serious complications is lower in planned amputations than in emergency amputations.
+Complications associated with having an amputation include:
+heart problems such as heart attack
+deep vein thrombosis (DVT)
+slow wound healing and wound infection
+pneumonia
+stump and "phantom limb" pain
+In some cases, further surgery may be needed to correct problems that develop or to help relieve pain. For example, if neuromas (thickened nerve tissue) are thought to be causing pain, the affected cluster of nerves may need to be removed.
+Stump and "phantom limb" pain
+Many people who have an amputation experience some degree of stump pain or "phantom limb" pain.
+Stump pain can have many different causes, including rubbing or sores where the stump touches a prosthetic limb, nerve damage during surgery and the development of neuromas.
+Phantom limb sensations are sensations that seem to be coming from the amputated limb. Occasionally, these can be painful (phantom limb pain).
+The term "phantom" does not mean the sensations are imaginary. Phantom limb pain is a real phenomenon, which has been confirmed using brain imaging scans to study how nerve signals are transmitted to the brain.
+The symptoms of phantom limb pain can range from mild to severe. Some people have described brief "flashes" of mild pain, similar to an electric shock, that last for a few seconds. Others have described constant severe pain.
+Treating stump and phantom limb pain
+Stump and phantom limb pain will usually improve over time, but treatments are available to help relieve the symptoms.
+Medicines
+Medicines that may be used to help relieve pain include:
+non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen
+anticonvulsants such as carbamazepine or gabapentin
+antidepressants such as amitriptyline, or nortriptyline, which are useful in treating nerve pain
+opioids such as codeine or morphine
+corticosteroid or local anaesthetic injections
+Self-help measures and complementary therapy
+There are several non-invasive techniques that may help relieve pain in some people. They include: 
+adjusting the way your prosthesis fits to make it more comfortable.
+applying heat or cold to your limb, such as using heat or ice packs, rubs and creams.
+massage to increase circulation and stimulate muscles.
+acupuncture is thought to stimulate the nervous system and relieve pain.
+transcutaneous electrical nerve stimulation (TENS), which uses a small, battery-operated device to deliver electrical impulses to the affected area of your body, to block or reduce pain signals.
+Mental imagery
+Research has shown that people who spend 40 minutes a day imagining using the part of their limb that was amputated, such as stretching out their "fingers" or bunching up their "toes", experience a reduction in pain symptoms.
+This may be related to the central theory of phantom limb pain. Researchers think the brain looks to receive feedback from an amputated limb, and these mental exercises may provide an effective substitute for this missing feedback.
+Another technique, known as mirror visual feedback, involves using a mirror to create a reflection of the other limb. Some people find that exercising and moving their other limb can help relieve phantom pain.
+Psychological impact of amputation
+The loss of a limb can have a considerable psychological impact. Many people who've had an amputation report emotions such as grief and bereavement, similar to experiencing the death of a loved one.
+Coming to terms with the psychological impact of an amputation is therefore often as important as coping with the physical demands.
+Having an amputation can have a considerable psychological impact for three main reasons:
+you have to cope with the loss of sensation from your amputated limb.
+you have to cope with the loss of function from your amputated limb.
+your sense of body image, and other people's perception of your body image, has changed.
+Negative thoughts and emotions are common after an amputation. This is particularly true in people who've had an emergency amputation because they don't have time to mentally prepare for the effects of surgery.
+Common emotions and thoughts experienced by people after an amputation include:
+depression
+anxiety
+denial (refusing to accept they need to make changes, such as having physiotherapy, to adapt to life after an amputation)
+grief
+feeling suicidal
+People who've had an amputation as a result of trauma (particularly members of the armed forces) also have an increased risk of developing post-traumatic stress disorder (PTSD).
+Talk to your care team about your thoughts and feelings, particularly if you're feeling depressed or suicidal. You may need additional treatment, such as antidepressants or counselling, to improve your ability to cope after having an amputation.
+Help and support
+Being told you need to have a limb amputated can be a devastating and frightening experience. Adjusting to life after an amputation can be challenging, but many people enjoy a good quality of life once they have managed to adapt.
+There are a number of charities that can provide advice and support for people living with amputations, which include:
+The Limbless Association
+Douglas Bader Foundation
+Steel Bones
+Amputation Foundation
+Page last reviewed: 12 August 2019
+Next review due: 09 August 2022
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integrations/haystack/nhs-search/data/www.nhs.uk_conditions_amyloidosis_.txt

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+Cookies on the NHS website
+We've put some small files called cookies on your device to make our site work.
+We'd also like to use analytics cookies. These send information about how our site is used to services called Adobe Analytics, Hotjar and Google Analytics. We use this information to improve our site.
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+Amyloidosis
+Amyloidosis is the name for a group of rare, serious conditions caused by a build-up of an abnormal protein called amyloid in organs and tissues throughout the body.
+The build-up of amyloid proteins (deposits) can make it difficult for the organs and tissues to work properly. Without treatment, this can lead to organ failure.
+This page focuses on AL amyloidosis, which is the most common type, and on ATTR amyloidosis, which often runs in families.
+For information on other types of amyloidosis, visit the UCL National Amyloidosis Centre Patient Information Site.
+Symptoms of AL amyloidosis
+The symptoms of AL amyloidosis depend on which tissues and organs are affected.
+Kidney failure
+Most people with AL amyloidosis have a build-up of amyloid proteins in their kidneys, and are at risk of kidney failure.
+Symptoms of kidney failure include:
+swelling, often in the legs, caused by fluid retention (oedema)
+tiredness
+weakness
+loss of appetite
+Heart failure
+Deposits of amyloid in the heart can cause the muscles to become stiffer, making it more difficult to pump blood around the body. This may result in heart failure, which can cause:
+shortness of breath
+oedema
+an abnormal heartbeat (arrhythmia)
+Other symptoms
+Amyloid proteins can also build up in other areas, like the liver, spleen, nerves or digestive system. Symptoms can include:
+feeling lightheaded or fainting, particularly after standing or sitting up
+numbness or a tingling feeling in the hands and feet (peripheral neuropathy)
+nausea, diarrhoea or constipation
+numbness, tingling and pain in the wrist, hand and fingers (carpal tunnel syndrome)
+easy bruising
+AL amyloidosis does not affect the brain, so it does not cause any problems with memory or thinking, for example.
+See a GP if you have any of the above symptoms and are worried. The GP can prescribe treatments to help with these symptoms.
+In some cases, AL amyloidosis can be linked to a type of bone cancer called multiple myeloma.
+The charity Myeloma UK has more information on multiple myeloma and its link with AL amyloidosis.
+Cause of AL amyloidosis
+AL amyloidosis is caused by an abnormality in certain cells found in the bone marrow, called plasma cells.
+The abnormal plasma cells produce abnormal forms of light chain proteins, which enter the bloodstream and can form amyloid deposits.
+Healthy people have normal light chain proteins in their blood that are part of their natural antibody proteins. These help protect the body from infection.
+The abnormal light chains in patients with AL amyloidosis clump together into thread-like strings (amyloid fibrils) that the body cannot clear away easily.
+Over time, amyloid fibrils build up as AL amyloid deposits in tissues and organs. This gradually stops them functioning properly, causing the many symptoms of AL amyloidosis.
+Unlike some other types of amyloidosis, AL amyloidosis is not inherited, so a person with the condition cannot pass it on to their children.
+Treating AL amyloidosis
+There is not currently a cure for amyloidosis. The amyloid deposits cannot be directly removed.
+But there are treatments to stop more of the abnormal proteins being produced and treat your symptoms.
+These treatments can give your body time to gradually clear the deposits before they build up again. This can help prevent organ damage.
+In most cases, the treatment will involve having chemotherapy. Chemotherapy damages abnormal bone marrow cells and stops them producing the abnormal proteins that form amyloid deposits.
+Steroids are usually given together with chemotherapy to boost the effect of the chemotherapy drugs. They may also lessen your chances of having a bad reaction to chemotherapy.
+Your doctor may also discuss using other treatments, such as a stem cell transplant.
+You may also need special medicine if you have heart failure or kidney failure. 
+Your doctors and nurses will need to carefully control the amount of salt you have and how much you drink. You may also need dialysis if you have end-stage kidney failure.
+Some people with kidney failure may be suitable for a kidney transplant. But the underlying problem with your bone marrow will still need to be treated using chemotherapy as this will prevent a build-up of amyloid in the new kidney.
+After chemotherapy, you'll need regular check-ups every 6 to 12 months to look for signs of the AL amyloidosis returning. If it does return, you may need to start chemotherapy again.
+Diagnosing AL amyloidosis
+Diagnosing AL amyloidosis can be hard, as the symptoms are often vague.
+A small tissue sample (a biopsy) can be taken from the affected part of your body. Your doctor will talk to you about how this will be done.
+The biopsy will be examined under a microscope in a laboratory to see if there are any amyloid deposits in it.
+Other tests
+You may also have other tests to assess how the amyloid deposits have affected your individual organs.
+For example:
+taking a sample of your bone marrow
+a heart ultrasound scan (an echocardiogram) to check the condition of your heart
+various different blood tests to look for damage to your heart, kidneys or other organs
+a CT scan or MRI scan to check the health of different organs in your body
+The NHS National Amyloidosis Centre at the Royal Free Hospital in London also offers a type of body scan called an SAP scan.
+This involves being injected with a small amount of a radio-labelled blood protein called serum amyloid P component (SAP). You are then scanned with a special camera that detects the radioactivity.
+The radio-labelled protein sticks to any amyloid deposits in your body, so you can see the areas of your body that are affected.
+ATTR amyloidosis
+ATTR amyloidosis is a very rare condition caused by amyloid deposits from abnormal versions of a blood protein called transthyretin (TTR).
+ATTR amyloidosis can run in families and is known as hereditary ATTR amyloidosis. People with hereditary ATTR amyloidosis carry mutations in the TTR gene.
+This means their bodies produce abnormal TTR proteins throughout their lives, which can form amyloid deposits. These usually affect the nerves or the heart, or both.
+Another type of ATTR amyloidosis is not hereditary. This is called wild-type ATTR amyloidosis, or senile systemic amyloidosis.
+In this condition, the amyloid deposits mainly affect the heart and can also cause carpal tunnel syndrome in some people.
+Hereditary ATTR amyloidosis may cause symptoms at any age from about 30 years old. The symptoms of wild-type ATTR amyloidosis usually only appear after around the age of 65.
+ATTR amyloidosis can be diagnosed by:
+taking a sample of the affected tissues (tissue biopsy)
+genetic testing
+heart scans – such as an echocardiogram, a cardiac MRI or a special type of scan called a DPD
+Treatment for ATTR amyloidosis
+Medicines used to treat ATTR include:
+patisiran (Onpattro) – evidence shows that it reduces disability and improves quality of life. It may also stop and potentially reverse the disease
+inotersen (Tegsedi) – evidence shows that it slows down progression of the illness
+Some types of inherited ATTR amyloidosis can be treated with a liver transplant.
+Heart failure can be treated by carefully controlling the amount of salt you have and how much you drink, and by taking drugs for heart failure. Heart transplantation may very rarely be an option.
+Information about you
+If you have amyloidosis, your clinical team will pass information about you on to the National Congenital Anomaly and Rare Disease 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
+Page last reviewed: 17 September 2020
+Next review due: 17 September 2023
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integrations/haystack/nhs-search/data/www.nhs.uk_conditions_anabolic-steroid-misuse_.txt

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+Cookies on the NHS website
+We've put some small files called cookies on your device to make our site work.
+We'd also like to use analytics cookies. These send information about how our site is used to services called Adobe Analytics, Hotjar and Google Analytics. We use this information to improve our site.
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+Anabolic steroid misuse
+Anabolic steroids are prescription-only medicines that are sometimes taken without medical advice to increase muscle mass and improve athletic performance.
+If used in this way, they can cause serious side effects and addiction. 
+Anabolic steroids are manufactured drugs that mimic the effects of the male hormone testosterone. They have limited medical uses and aren't to be confused with corticosteroids, a different type of steroid drug that's commonly prescribed for a variety of conditions.
+This page explains the dangers of misusing anabolic steroids, and aims to advise and support those who are addicted to the drugs.
+Are anabolic steroids illegal?
+Anabolic steroids are class C drugs, which can only be sold by pharmacists with a prescription.
+It's legal to have anabolic steroids for personal use. They can also be imported or exported, as long as this is carried out in person. This means they can't be posted or delivered by a courier or freight service.
+However, it's illegal to possess, import or export anabolic steroids if it's believed you're supplying or selling them. This includes giving them to friends. The penalty is an unlimited fine, or even a prison sentence of up to 14 years.
+In professional sport, most organisations ban anabolic steroid use and test competitors for banned steroids.
+Why people misuse anabolic steroids
+Anabolic steroids can be used as performance-enhancing drugs that increase muscle mass and decrease fat, as well as causing many undesirable effects. Some athletes, weightlifters and bodybuilders take them regularly to improve their physical performance and build up their bodies.
+However, people of all ages have been known to misuse these drugs, including adolescent boys who suffer from body dysmorphic disorder. This is a mental health condition where a person spends a lot of time worrying about flaws in their appearance. These flaws are often unnoticeable to others.
+Boys and men who have body dysmorphic disorder may take anabolic steroids because they don't see themselves as being physically big enough or strong enough.
+Some people believe taking anabolic steroids will help them become fit and healthy. This isn't true: taking anabolic steroids is a dangerous drug habit.
+How anabolic steroids are taken
+Anabolic steroids are usually injected into the muscle or taken by mouth as tablets, but they also come as creams or gels that are applied to the skin.
+Many people who use anabolic steroids are aware of the dangers of taking them, and believe that by taking the drugs in certain ways they can avoid side effects.
+Users might:
+Take the drugs for a period of time and then stop for a rest period before starting again. This is known as "cycling".
+Taking more than 1 type of anabolic steroid at a time, known as "stacking" – which they believe makes them work better.
+Do a combination of both stacking and cycling known as "pyramiding" – where they start off taking a low dose of 1 or more anabolic steroids, and then increase the dose over time up to a maximum dose. They then stop taking them for a rest period to give the body a break before starting the cycle again.
+But there is no evidence that any of these methods actually reduce side effects from taking anabolic steroids.
+Users tend to exercise more when they're taking high doses to make the most of their improved performance during this time.
+Side effects of anabolic steroids
+Regularly taking anabolic steroids can lead to physical and psychological changes in both men and women, as well as potentially dangerous medical conditions.
+Physical effects
+Effects of anabolic steroids in men can include:
+reduced sperm count
+infertility
+shrunken testicles
+erectile dysfunction
+baldness
+breast development
+increased risk of prostate cancer
+severe acne
+stomach pain
+In women, anabolic steroids can cause:
+facial hair growth and body hair
+loss of breasts
+swelling of the clitoris
+a deepened voice
+an increased sex drive
+problems with periods
+hair loss
+severe acne
+In addition, both men and women who take anabolic steroids can develop any of the following medical conditions:
+heart attack or stroke
+liver or kidney problems or failure
+high blood pressure (hypertension)
+blood clots
+fluid retention
+high cholesterol
+Psychological effects
+Misusing anabolic steroids can also cause the following psychological or emotional effects:
+aggressive behaviour
+mood swings
+paranoia
+manic behaviour
+hallucinations and delusions
+Stunted growth in adolescents
+Anabolic steroids accelerate bone growth, so if they're misused by adolescents who haven't yet had the growth spurt associated with puberty, the drugs can cause premature ageing of the bones and restricted growth.
+Sharing needles
+As anabolic steroids are often injected, there are risks associated with sharing needles. These are the same risks associated with recreational drug use, and include:
+damage to veins, leading to ulcers or gangrene
+hepatitis B infection
+hepatitis C infection
+HIV transmission
+Addiction
+Like many other substances, anabolic steroids are addictive. This means you can crave the drug, require more to get the same effect, and have withdrawal symptoms if you suddenly stop taking them.
+A person who is addicted to anabolic steroids will want to keep using them despite experiencing unpleasant physical side effects.
+When doctors prescribe steroid medication, they always advise coming off the medication slowly by gradually reducing the dose. Coming off anabolic steroids suddenly can result in withdrawal symptoms that include:
+depression and apathy
+feelings of anxiety
+difficulty concentrating
+insomnia
+anorexia
+decreased sex drive
+extreme tiredness (fatigue)
+headaches
+muscle and joint pain
+Getting help 
+You should see your GP if you think you're addicted to anabolic steroids. Treatment for an addiction to anabolic steroids will be similar to that of other types of addiction.
+Your GP may refer you to a specially trained drugs counsellor. They'll discuss your addiction with you, how to safely stop taking steroids, and any obstacles you may face when trying to stop, plus strategies for dealing with those obstacles.
+For more information and advice, see:
+Drug addiction: getting help
+Find drug addiction support services
+FRANK (friendly, confidential drugs advice)
+Page last reviewed: 30 August 2018
+Next review due: 30 August 2021
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+Anaesthesia
+Anaesthesia means "loss of sensation". Medicines that cause anaesthesia are called anaesthetics.
+Anaesthetics are used during tests and surgical operations to numb sensation in certain areas of the body or induce sleep.
+This prevents pain and discomfort, and enables a wide range of medical procedures to be carried out.
+Local anaesthetics and general anaesthetics are 2 commonly used types of anaesthetics:
+local anaesthesia is where a small area of the body is numbed and you remain fully conscious – often used during minor procedures
+general anaesthesia is where you're totally unconscious and unaware of the procedure – often used for more serious operations
+Types of anaesthesia
+As well as local and general anaesthetic, there are a number of other types of anaesthesia.
+Unlike general anaesthetic, these do not make you unconscious – they just stop you feeling pain in a particular area of your body.
+The different types of anaesthetic are:
+regional anaesthetic – a local anaesthetic given to a specific region of your body, leading to numbness or pain relief for deeper operations where more extensive numbness is needed
+epidural anaesthetic – a type of regional anaesthetic usually used to numb the lower half of the body; for example, as pain relief during labour and childbirth
+spinal anaesthetic – a type of regional anaesthetic used to give total numbness, lasting about 3 hours, to the lower parts of the body, such as in the base of your spine or in your lower back, so surgery can be safely carried out in this area
+sedation – medicine that makes you feel sleepy and relaxes you both physically and mentally; it's sometimes used to keep you calm during minor, painful or unpleasant procedures
+Different types of anaesthesia can be used in combination. For example, a regional anaesthetic can be used with a general anaesthetic to relieve pain after an operation.
+A sedative is also sometimes used with a regional anaesthetic to help you feel relaxed and calm, as well as pain-free, during an operation.
+How anaesthetics are given
+An anaesthetic can be given in a number of ways:
+as an ointment, spray or drops
+as an injection into a vein
+as a gas you breathe in
+Anaesthetists
+Anaesthetists are doctors who have received specialist training in anaesthesia. They'll give you your anaesthetic and be responsible for your safety and wellbeing during your procedure.
+Before the procedure, your anaesthetist will discuss a number of things with you, including:
+the types of anaesthetic appropriate for the procedure you're having
+any risks or side effects associated with different types of anaesthetic
+They'll plan your anaesthetic and pain control with you, taking into account any preferences you have for a particular type of anaesthetic. You should ask your anaesthetist to clarify anything you're unsure about.
+If you have a general anaesthetic, your anaesthetist will carefully monitor you throughout your operation and make sure you wake up comfortably afterwards. They may also help with any pain relief you might need after the procedure.
+Side effects
+Anaesthetics consist of a number of medicines that can cause side effects in some people. Your anaesthetist will tell you about any side effects you may experience after having a specific type of anaesthetic and measures that will be taken to reduce these.
+Some common side effects that can occur after a general anaesthetic or some regional anaesthetics include:
+feeling or being sick
+dizziness and feeling faint
+feeling cold or shivering
+headaches
+itchiness
+bruising and soreness
+difficulty peeing
+aches and pains
+The side effects of anaesthetic usually do not last very long and, if necessary, some of them can be treated.
+Tell the healthcare professionals treating you if you experience any of the above side effects, or if you're in pain after your procedure.
+Risks and complications
+In recent years, having anaesthesia has become very safe. Advances in equipment, medicine and training mean serious problems are rare.
+However, as with any type of surgery or medical procedure, there's a potential risk of complications.
+The benefits and risks of surgery and anaesthesia will be carefully weighed up and explained to you before you have any operation.
+The complications of anaesthesia listed below are very rare.
+Permanent nerve damage
+This can cause numbness or paralysis (inability to move a part of the body), although this may be a result of the surgery itself.
+If the damage is slight, you may get better in a few days to a few weeks. Permanent damage to the peripheral nerves, which run between the spinal cord and the rest of the body, occurs in around 1 in 1,000 people having a general anaesthetic.
+An allergic reaction to an anaesthetic medicine
+Although an allergic reaction (anaphylaxis) can be severe, appropriate treatment is on hand to enable the best chance of dealing with this immediately and effectively.
+It's not clear exactly how often anaesthetics cause anaphylaxis, but the best estimate is that a life-threatening allergic reaction occurs in 1 in 10,000 anaesthetics. More than 95 per cent of these will survive and generally recover well.
+Death
+If you're a healthy patient having non-emergency surgery, death is very rare at around 1 in 100,000 people having general anaesthetic. However, this may increase depending on certain factors.
+Factors affecting risk of complications
+Your risk of developing complications will depend on a number of factors, including:
+your medical history – for example, whether you have any other serious medical conditions or illnesses
+personal factors – for example, whether you smoke or are overweight; if you smoke, stopping several weeks before your operation will reduce your risk of having breathing problems, and losing weight will also help reduce your risk
+the type of procedure – for example, whether it's a planned or an emergency procedure, or whether it's a major or minor procedure
+the type of anaesthetic – local anaesthesia can have advantages over general anaesthesia in the right circumstances
+Before your procedure, your anaesthetist will explain if there are any particular risks of developing possible complications.
+In most cases, the benefits outweigh the risks. Any concerns you have should be discussed with your anaesthetist before surgery.
+More information
+You can find out more about specific types of anaesthesia:
+local anaesthesia
+general anaesthesia
+epidural
+Also see the Royal College of Anaesthetists' patient information.
+Page last reviewed: 23 September 2021
+Next review due: 23 September 2024
+Support links
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integrations/haystack/nhs-search/data/www.nhs.uk_conditions_anal-cancer_.txt

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+Cookies on the NHS website
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+-
+Anal cancer
+Contents
+Overview
+Symptoms
+Causes
+Tests and next steps
+Treatment
+Where to find help and support
+Anal cancer is a rare type of cancer that affects the anus.
+The anus is where your bowel connects to the outside of your body (the bottom).
+Anal cancer can start in any part of the anus.
+How serious anal cancer is depends on where it starts, how big it is, if it spreads and your general health.
+Get your symptoms checked
+It's important to get any symptoms of anal cancer checked as soon as possible. Finding it early can make it more treatable.
+Information:
+Coronavirus advice
+Get advice about coronavirus and cancer:
+Macmillan: Coronavirus guidance for people with cancer
+Cancer Research UK: Coronavirus and cancer
+Page last reviewed: 08 March 2021
+Next review due: 08 March 2024
+Next
+:
+Symptoms
+Support links
+Home
+Health A to Z
+Live Well
+Mental health
+Care and support
+Pregnancy
+NHS services
+Coronavirus (COVID-19)
+NHS App
+Find my NHS number
+Your health records
+About the NHS
+Healthcare abroad
+Contact us
+Other NHS websites
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+Our policies
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integrations/haystack/nhs-search/data/www.nhs.uk_conditions_anal-fissure_.txt

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+Cookies on the NHS website
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+We'd also like to use analytics cookies. These send information about how our site is used to services called Adobe Analytics, Hotjar and Google Analytics. We use this information to improve our site.
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+Overview
+-
+Anal fissure
+Contents
+Overview
+Treatment
+An anal fissure is a tear or open sore (ulcer) that develops in the lining of the large intestine, near the anus.
+Anal fissure symptoms
+The most common symptoms of anal fissures are:
+a sharp pain when you poo, often followed by a deep burning pain that may last several hours
+bleeding when you poo – most people notice a small amount of bright red blood either in their poo or on the toilet paper
+When to see a GP
+See a GP if you think you have an anal fissure.
+Do not let embarrassment stop you seeking help. Anal fissures are a common problem GPs are used to dealing with.
+Most anal fissures get better without treatment, but a GP will want to rule out other conditions with similar symptoms, such as piles (haemorrhoids).
+They can also tell you about self-help measures and treatments that can relieve your symptoms and reduce the risk of fissures coming back.
+Diagnosing anal fissures
+The GP will ask you about your symptoms and the type of pain you have been experiencing. They may also ask about your toilet habits.
+They'll usually be able to see the fissure by gently parting your buttocks.
+A digital rectal examination, where a GP inserts a lubricated, gloved finger into your bottom to feel for abnormalities, is not usually used to diagnose anal fissures as it's likely to be painful.
+The GP may refer you for specialist assessment if they think something serious may be causing your fissure.
+This may include a more thorough examination of your bottom carried out using anaesthetic to minimise pain.
+Occasionally, a measurement of anal sphincter pressure may be taken for fissures that have not responded to simple treatments.
+The anal sphincter is the ring of muscles that open and close the anus.
+What causes anal fissures?
+Anal fissures are most commonly caused by damage to the lining of the anus or anal canal, the last part of the large intestine.
+Most cases occur in people who have constipation, when a particularly hard or large poo tears the lining of the anal canal.
+Other possible causes of anal fissures include:
+persistent diarrhoea
+inflammatory bowel disease (IBD), such as Crohn's disease and ulcerative colitis
+pregnancy and childbirth
+occasionally, a sexually transmitted infection (STI), such as syphilis or herpes, which can infect and damage the anal canal
+having unusually tight anal sphincter muscles, which can increase the tension in your anal canal, making it more susceptible to tearing
+In many cases, no clear cause can be identified.
+Treatment for anal fissure from a GP
+A GP can prescribe medicine to help relieve your symptoms and speed up the healing process.
+This can include laxatives to help you poo more easily and painkilling ointment that you put directly on your anus.
+Surgery may be recommended in persistent cases of anal fissure where self-help measures and medicine have not helped.
+Surgery is often very effective at treating anal fissures, but it does carry a small risk of complications, such as temporary or permanent loss of bowel control (bowel incontinence).
+Anal fissures usually heal within a few weeks without the need for treatment.
+But they can easily come back if they're caused by constipation that remains untreated.
+In some people, symptoms from anal fissures last 6 weeks or more (chronic anal fissures).
+How to ease symptoms of anal fissure
+Adopting some simple self-help measures can make going to the toilet easier.
+This will allow existing fissures to heal, as well as reduce your chances of developing new fissures in the future.
+Self-help measures for avoiding constipation include:
+plenty of fibre in your diet, such as fruit and vegetables and wholemeal bread, pasta and rice – adults should aim to eat at least 30g of fibre a day
+staying well hydrated by drinking plenty of fluids
+not ignoring the urge to poo – this can cause your poo to dry out and become harder to pass
+exercising regularly – you should aim to do at least 150 minutes of physical activity every week
+You can help soothe the pain by taking simple painkillers, such as paracetamol or ibuprofen, or by soaking your bottom in a warm bath several times a day, particularly after a bowel movement.
+Who's affected
+Anal fissures are quite common, with around 1 in every 10 people affected at some point in their life.
+They affect both sexes equally and people of all ages can get them.
+But children and young adults between 15 and 40 years of age are more likely to get anal fissures.
+Page last reviewed: 09 November 2021
+Next review due: 09 November 2024
+Next
+:
+Treatment
+Support links
+Home
+Health A to Z
+Live Well
+Mental health
+Care and support
+Pregnancy
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+Coronavirus (COVID-19)
+NHS App
+Find my NHS number
+Your health records
+About the NHS
+Healthcare abroad
+Contact us
+Other NHS websites
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+Accessibility statement
+Our policies
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+© Crown copyright

integrations/haystack/nhs-search/data/www.nhs.uk_conditions_anal-fistula_.txt

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+Cookies on the NHS website
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+We'd also like to use analytics cookies. These send information about how our site is used to services called Adobe Analytics, Hotjar and Google Analytics. We use this information to improve our site.
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+Overview
+-
+Anal fistula
+Contents
+Overview
+Treatment
+An anal fistula is a small tunnel that develops between the end of the bowel and the skin near the anus (where poo leaves the body).
+They're usually the result of an infection near the anus causing a collection of pus (abscess) in the nearby tissue.
+When the pus drains away, it can leave a small channel behind.
+Anal fistulas can cause unpleasant symptoms, such as discomfort and skin irritation, and will not usually get better on their own.
+Surgery is recommended in most cases.
+Symptoms of an anal fistula
+Symptoms of an anal fistula can include:
+skin irritation around the anus
+a constant, throbbing pain that may be worse when you sit down, move around, poo or cough
+smelly discharge from near your anus 
+passing pus or blood when you poo
+swelling and redness around your anus and a high temperature (fever) if you also have an abscess
+difficulty controlling bowel movements (bowel incontinence) in some cases
+The end of the fistula might be visible as a hole in the skin near your anus, although this may be difficult for you to see yourself.
+When to get medical advice
+See a GP if you have persistent symptoms of an anal fistula. They'll ask about your symptoms and whether you have any bowel conditions.
+They may also ask to examine your anus and gently insert a finger inside it (rectal examination) to check for signs of a fistula.
+If the GP thinks you might have a fistula, they can refer you to a specialist called a colorectal surgeon for further tests to confirm the diagnosis and determine the most suitable treatment.
+These may include:
+a further physical and rectal examination
+a proctoscopy, where a special telescope with a light on the end is used to look inside your anus
+an ultrasound scan, MRI scan or CT scan
+Causes of anal fistulas
+Most anal fistulas develop after an anal abscess. You can get one if the abscess does not heal properly after the pus has drained away.
+Less common causes of anal fistulas include:
+Crohn's disease – a long-term condition in which the digestive system becomes inflamed
+diverticulitis – infection of the small pouches that can stick out of the side of the large intestine (colon)
+hidradenitis suppurativa – a long-term skin condition that causes abscesses and scarring
+infection with tuberculosis (TB) or HIV
+a complication of surgery near the anus
+Treatments for an anal fistula
+Anal fistulas usually require surgery as they rarely heal if left untreated.
+The main options include:
+a fistulotomy – a procedure that involves cutting open the whole length of the fistula so it heals into a flat scar
+seton procedures – where a piece of surgical thread called a seton is placed in the fistula and left there for several weeks to help it heal before a further procedure is carried out to treat it
+All the procedures have different benefits and risks. You can discuss this with the surgeon.
+Many people do not need to stay in hospital overnight after surgery, although some may need to stay in hospital for a few days.
+Find out more about treating an anal fistula
+Page last reviewed: 18 June 2019
+Next review due: 18 June 2022
+Next
+:
+Treatment
+Support links
+Home
+Health A to Z
+Live Well
+Mental health
+Care and support
+Pregnancy
+NHS services
+Coronavirus (COVID-19)
+NHS App
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+Your health records
+About the NHS
+Healthcare abroad
+Contact us
+Other NHS websites
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+About us
+Accessibility statement
+Our policies
+Cookies
+© Crown copyright

integrations/haystack/nhs-search/data/www.nhs.uk_conditions_anal-pain_.txt

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+Cookies on the NHS website
+We've put some small files called cookies on your device to make our site work.
+We'd also like to use analytics cookies. These send information about how our site is used to services called Adobe Analytics, Hotjar and Google Analytics. We use this information to improve our site.
+Let us know if this is OK. We'll use a cookie to save your choice. You can read more about our cookies before you choose.
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+Anal pain
+Anal pain (pain in the bottom) is common. There are things you can do to ease it, but see a GP if you're in a lot of pain or it does not get better.
+Common causes of anal pain
+Anal pain has many different causes.
+Your symptoms might give you an idea of what is causing anal pain. Do not self-diagnose, see a GP if you're worried.
+Common causes of anal pain and related symptoms.
+Symptoms Possible cause
+Pooing less than normal for you and pain when pooing Constipation
+Itchy anus, feeling a lump around the anus, blood on the paper after wiping Piles (haemorrhoids)
+Sharp pain when pooing, burning pain after doing a poo and blood on the paper after wiping Anal fissures
+Constant throbbing pain, pus and blood on the paper after wiping, high temperature Anal fistulas and abscesses
+Less often, anal pain can be caused by something else like a sexually transmitted infection (STI) or fungal infection. Rarely, it can be a sign of something serious like anal cancer.
+How you can ease or prevent anal pain
+Do
+drink lots of fluid and eat plenty of fibre to keep your poo soft
+exercise regularly
+wipe your bottom with damp toilet paper
+take paracetamol
+take a warm bath to ease itching and pain
+put an ice pack (or bag of frozen peas) in a towel on the painful area for up to 20 minutes every 2 to 3 hours
+Don’t
+do not scratch around your anus
+do not ignore the urge to poo
+do not push too hard when pooing
+do not use fragranced products, such as shower gels or soaps around your anus
+do not eat spicy food or drink alcohol and caffeine
+do not lift or carry anything heavy
+do not take ibuprofen if your anus is bleeding
+A pharmacist can help with anal pain
+A pharmacist can recommend medicines to reduce constipation and anal pain such as:
+painkillers like ibuprofen or paracetamol
+creams or suppositories (medicines you put into your bottom) to ease itching, pain and swelling
+medicines that help make it easier to poo (laxatives)
+Many pharmacies have private areas if you do not want to be overheard.
+Find a pharmacy
+Non-urgent advice:
+See a GP if:
+anal pain is severe
+the pain does not improve after a few days
+you've had blood in your poo or bleeding from your bottom for 3 weeks
+Do not feel embarrassed to see a GP. Anal pain is a common problem that they're used to treating.
+What we mean by severe pain
+Information:
+Coronavirus (COVID-19) update: how to contact a GP
+It's still important to get help from a GP if you need it. To contact your GP surgery:
+visit their website
+use the NHS App
+call them
+Find out about using the NHS during COVID-19
+Urgent advice:
+Ask for an urgent GP appointment or get help from NHS 111 if:
+you have severe anal pain and you have a high temperature or feel hot and shivery
+your poo is black or dark red
+You can call 111 or get help from 111 online.
+What we mean by severe pain
+Immediate action required:
+Go to A&E or call 999 if:
+you're bleeding non-stop from your bottom
+there's a lot of blood coming from your bottom – for example, the toilet water turns red or you see large blood clots
+Find your nearest A&E
+Treatment for anal pain
+Treatment for anal pain depends on what's causing it.
+A GP will examine you and may prescribe:
+a cream or ointment to ease your pain
+laxatives to help you poo more easily
+antibiotics if you have an infection
+The GP may also recommend changes to your diet or arrange for tests to look for a cause of the anal pain.
+Sometimes surgery or other treatments may be needed if the pain is caused by severe anal fissures, piles or fistulas.
+Page last reviewed: 15 March 2022
+Next review due: 15 March 2025
+Support links
+Home
+Health A to Z
+Live Well
+Mental health
+Care and support
+Pregnancy
+NHS services
+Coronavirus (COVID-19)
+NHS App
+Find my NHS number
+Your health records
+About the NHS
+Healthcare abroad
+Contact us
+Other NHS websites
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+Our policies
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+© Crown copyright

integrations/haystack/nhs-search/data/www.nhs.uk_conditions_anaphylaxis_.txt

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+Cookies on the NHS website
+We've put some small files called cookies on your device to make our site work.
+We'd also like to use analytics cookies. These send information about how our site is used to services called Adobe Analytics, Hotjar and Google Analytics. We use this information to improve our site.
+Let us know if this is OK. We'll use a cookie to save your choice. You can read more about our cookies before you choose.
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+Overview
+-
+Anaphylaxis
+Contents
+Overview
+Treatment
+Prevention
+Anaphylaxis is a severe and potentially life-threatening reaction to a trigger such as an allergy.
+Important:
+Coronavirus (COVID-19)
+At the moment it can be hard to know what to do if you're unwell.
+It's still important to get medical help if you need it.
+Do not delay if you feel very unwell or think there's something seriously wrong. Call 999.
+Symptoms of anaphylaxis
+Anaphylaxis usually develops suddenly and gets worse very quickly.
+The symptoms include:
+feeling lightheaded or faint
+breathing difficulties – such as fast, shallow breathing
+wheezing
+a fast heartbeat
+clammy skin
+confusion and anxiety
+collapsing or losing consciousness
+There may also be other allergy symptoms, including an itchy, raised rash (hives); feeling or being sick; swelling (angioedema) or stomach pain.
+What to do if someone has anaphylaxis
+Anaphylaxis is a medical emergency. It can be very serious if not treated quickly.
+If someone has symptoms of anaphylaxis:
+Use an adrenaline auto-injector if the person has one – but make sure you know how to use it correctly first.
+Call 999 for an ambulance immediately (even if they start to feel better) – mention that you think the person has anaphylaxis.
+Remove any trigger if possible – for example, carefully remove any stinger stuck in the skin.
+Lie the person down and raise their legs – unless they're having breathing difficulties and need to sit up to help them breathe. If they're pregnant, lie them down on their left side.
+Give another injection after 5 minutes if the symptoms do not improve and a second auto-injector is available.
+If you're having an anaphylactic reaction, you can follow these steps yourself if you feel able to.
+Read about how to treat anaphylaxis for more advice about using auto-injectors and correct positioning.
+Triggers of anaphylaxis
+Anaphylaxis is the result of the immune system, the body's natural defence system, overreacting to a trigger.
+This is often something you're allergic to, but not always.
+Common anaphylaxis triggers include:
+foods – including nuts, milk, fish, shellfish, eggs and some fruits
+medicines – including some antibiotics and non-steroidal anti-inflammatory drugs (NSAIDs) like aspirin
+insect stings – particularly wasp and bee stings
+general anaesthetic
+contrast agents – dyes used in some medical tests to help certain areas of your body show up better on scans
+latex – a type of rubber found in some rubber gloves and condoms
+In some cases, there's no obvious trigger. This is known as idiopathic anaphylaxis.
+Preventing anaphylaxis
+If you have a serious allergy or have experienced anaphylaxis before, it's important to try to prevent future episodes.
+The following can help reduce your risk:
+identify any triggers – you may be referred to an allergy clinic for allergy tests to check for anything that could trigger anaphylaxis
+avoid triggers whenever possible – for example, be careful when food shopping or eating out if you have a food allergy
+carry 2 in-date adrenaline auto-injectors at all times – give yourself an injection whenever you think you may be experiencing anaphylaxis, even if you're not completely sure
+Read more about preventing anaphylaxis
+Page last reviewed: 29 November 2019
+Next review due: 29 November 2022
+Next
+:
+Treatment
+Support links
+Home
+Health A to Z
+Live Well
+Mental health
+Care and support
+Pregnancy
+NHS services
+Coronavirus (COVID-19)
+NHS App
+Find my NHS number
+Your health records
+About the NHS
+Healthcare abroad
+Contact us
+Other NHS websites
+Profile editor login
+About us
+Accessibility statement
+Our policies
+Cookies
+© Crown copyright

integrations/haystack/nhs-search/data/www.nhs.uk_conditions_androgen-insensitivity-syndrome_.txt

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+Cookies on the NHS website
+We've put some small files called cookies on your device to make our site work.
+We'd also like to use analytics cookies. These send information about how our site is used to services called Adobe Analytics, Hotjar and Google Analytics. We use this information to improve our site.
+Let us know if this is OK. We'll use a cookie to save your choice. You can read more about our cookies before you choose.
+I'm OK with analytics cookies Do not use analytics cookies
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+Overview
+-
+Androgen insensitivity syndrome
+Contents
+Overview
+Symptoms
+Causes
+Diagnosis
+Living with
+Androgen insensitivity syndrome (AIS) affects the development of a person's genitals and reproductive organs.
+The 2 types of AIS are called complete androgen insensitivity syndrome (CAIS) and partial androgen insensitivity syndrome (PAIS).
+The genitals of a person with CAIS appear female.
+The genitals of a person with PAIS may appear as female or male. Sometimes PAIS is discovered because a baby's genitals are not as expected for a baby boy or baby girl.
+There are specialist healthcare psychologists who can help people with AIS understand their bodies and sex development.
+The sex development of people with AIS means they will not be able to become pregnant or make their partner pregnant. However, there is help and advice on other ways to become parents if that is wanted.
+What causes AIS?
+AIS is caused by a genetic alteration that is passed along the female line to the child.
+Although people with AIS have XY (usual male pattern) chromosomes, the body does not respond to testosterone (the sex hormone) fully or at all. This prevents the sex development of a typical male.
+A penis does not form or is underdeveloped. This means the child's genitals may develop as female, or are underdeveloped as male.
+The child may have have fully or partially undescended testicles. But there will be no womb or ovaries.
+Women who carry the genetic alteration will not have AIS themselves, but there's a 1 in 4 chance each child they have will be born with AIS.
+Read more about the causes of AIS.
+Types of AIS
+There are 2 main types of AIS, which are determined by how much the body is able to use testosterone.
+These are:
+complete androgen insensitivity syndrome (CAIS) – where testosterone has no effect on sex development, so the genitals are entirely female
+partial androgen insensitivity syndrome (PAIS) – where testosterone has some effect on sex development, so the genitals are often not as expected for boys or girls
+PAIS is usually noticed at birth because the genitals appear different.
+CAIS can be more difficult to spot, as the genitals usually look like those of any other girl. It's often not diagnosed until puberty, when periods do not start and pubic and underarm hair does not develop.
+Read more about the symptoms of AIS and diagnosing AIS.
+Living with AIS
+Children with AIS and their parents are supported by a team of specialists, who will offer ongoing care.
+The team will help you understand your child's sex development. In the case of PAIS, they will talk to you about why they recommend raising your child as a boy or a girl.
+Children with PAIS will be brought up either as girls or boys, depending mostly on the extent to which their body responds to hormones (androgens), including testosterone.
+You and the specialist team will decide together what you think is in the best interests of your child.
+Most children with CAIS are raised as girls.
+Once you have learned about your child's sex development, and understand how their body will grow and develop, the specialist team can explain the treatment options your child might have in the future.
+Read more about how AIS is treated.
+Support and advice
+You and your child will be offered psychological support to help you understand and cope with the diagnosis of AIS.
+Children may not need psychological support while they're very young. But they will need to grow up understanding their body and how it works.
+You'll be given advice about talking to your child about AIS at all ages.
+You may also find it helpful to get in touch with a support group, such as DSD Families.
+Gender identity and gender dysphoria
+Most children with AIS continue to feel they are the gender they grew up with.
+In a few cases, older children and adults with AIS feel their gender identity does not match the gender they've been raised as. This is known as gender dysphoria.
+People with gender dysphoria often have a desire to live as a member of the opposite sex or as non-binary.
+They may want treatment to make their physical appearance more consistent with their gender identity or how they choose to identify.
+If your child is diagnosed with AIS, you should be told about issues of gender identity.
+National Congenital Anomaly and Rare Disease Registration Service
+If your child has AIS, your clinical team will pass information about them on to the National Congenital Anomaly and Rare Disease Registration Service (NCARDRS).
+The NCARDRS helps scientists look for better ways to prevent and treat AIS. You can opt out of the register at any time.
+Page last reviewed: 17 March 2021
+Next review due: 17 March 2024
+Next
+:
+Symptoms
+Support links
+Home
+Health A to Z
+Live Well
+Mental health
+Care and support
+Pregnancy
+NHS services
+Coronavirus (COVID-19)
+NHS App
+Find my NHS number
+Your health records
+About the NHS
+Healthcare abroad
+Contact us
+Other NHS websites
+Profile editor login
+About us
+Accessibility statement
+Our policies
+Cookies
+© Crown copyright

integrations/haystack/nhs-search/data/www.nhs.uk_conditions_angelman-syndrome_.txt

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+Cookies on the NHS website
+We've put some small files called cookies on your device to make our site work.
+We'd also like to use analytics cookies. These send information about how our site is used to services called Adobe Analytics, Hotjar and Google Analytics. We use this information to improve our site.
+Let us know if this is OK. We'll use a cookie to save your choice. You can read more about our cookies before you choose.
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+Angelman syndrome
+Angelman syndrome is a genetic condition that affects the nervous system and causes severe physical and learning disabilities.
+A person with Angelman syndrome will have a near-normal life expectancy, but they will need support throughout their life.
+Characteristics of Angelman syndrome
+A child with Angelman syndrome will begin to show signs of delayed development at around 6 to 12 months of age, such as being unable to sit unsupported or make babbling noises.
+Later, they may not speak at all or may only be able to say a few words. However, most children with Angelman syndrome will be able to communicate using gestures, signs or other systems.
+The movement of a child with Angelman syndrome will also be affected. They may have difficulty walking because of issues with balance and co-ordination (ataxia). Their arms may tremble or make jerky movements, and their legs may be stiff.
+Several distinctive behaviours are associated with Angelman syndrome. These include:
+frequent laughter and smiling, often with little stimulus
+being easily excitable, often flapping the hands
+being restless (hyperactive)
+having a short attention span
+trouble sleeping and needing less sleep than other children
+a particular fascination with water
+By around 2 years of age, a small head which is flat at the back (microbrachycephaly) may be noticeable in some children with Angelman syndrome. Children with Angelman syndrome may also start to have seizures or fits around this age.
+Other possible features of the syndrome include:
+tendency to stick the tongue out
+crossed eyes (strabismus)
+skin, hair and eyes that are paler than other family members
+a wide mouth with widely spaced teeth
+a side-to-side curvature of the spine (scoliosis)
+walking with arms in the air
+Some young babies with Angelman syndrome may have difficulties feeding because they're unable to co-ordinate sucking and swallowing. In such cases, a high-calorie formula may be recommended to help the baby gain weight. Babies with Angelman syndrome may need to be treated for reflux.
+Causes of Angelman syndrome
+In most cases of Angelman syndrome, the child's parents do not have the condition and the genetic difference responsible for the syndrome happens by chance around the time of conception.
+Angelman syndrome usually happens when the gene known as UBE3A is either missing or not working properly. A gene is a single unit of genetic material (DNA) that acts as an instruction for the way an individual is made and develops.
+Most cases of Angelman syndrome are caused by the child not getting a copy of the UBE3A gene from its mother, or the gene not working. This means there's no active copy of the gene in the child's brain.
+In a small number of cases, Angelman syndrome happens when a child gets 2 copies of the gene from their father, rather than 1 from each parent.
+Sometimes the cause of Angelman syndrome is unknown. Most children in these unexplained cases have different conditions involving other genes or chromosomes.
+Diagnosing Angelman syndrome
+Angelman syndrome may be suspected if a child's development is delayed and they have the syndrome's distinctive characteristics.
+A blood test is used to confirm the diagnosis. Several genetic tests will be done on the blood sample. These tests look for:
+any chromosomes or pieces of chromosomes that are missing
+changes in the mother's or father's UBE3A gene that they may have passed on
+changes in the child's UBE3A gene that would stop it from working
+For each child with Angelman syndrome, it's important to know the genetic change that caused the condition. This helps to determine whether there's a chance you might have another child with Angelman syndrome.
+Most children with Angelman syndrome are diagnosed between the ages of 9 months to 6 years, when physical and behavioural symptoms become apparent.
+If your child is diagnosed with Angelman syndrome, you will be able to talk to a genetic doctor about what support they might need.
+Managing Angelman syndrome
+Your child may benefit from some of the following treatments and aids:
+anti-epileptic medicine to control seizures
+physiotherapy may improve posture, balance and walking ability; it's also important to prevent permanent stiffening of the joints as people with Angelman syndrome get older
+communication therapy may help them develop non-verbal language skills, such as sign language and using visual aids; using iPad applications and similar tablet devices may also help
+behavioural therapy may be recommended to help overcome behaviours you find hard to manage, such as hyperactivity and a short attention span
+In later childhood, the seizures usually improve, although they may return in adulthood. With age, people with Angelman syndrome become less hyperactive and may sleep better.
+Most people with the syndrome will have learning disability and limited speech throughout their life. In adults, some mobility may be lost and joints may stiffen.
+People with Angelman syndrome usually have good general health and are often able to improve their communication and acquire new skills.
+While there's currently no cure for Angelman syndrome, research into treatments is being done in other countries. There are also clinical trials looking at treatment for some of the symptoms associated with Angelman syndrome, such as seizures.
+Find out more about:
+Caring for a disabled child
+Carers' wellbeing
+Help and support
+AngelmanUK is a charity providing information and support for parents and carers of people with Angelman syndrome.
+You can call their helpline (0300 999 0102) to speak with parents of people with Angelman syndrome, who can offer you advice and support.
+The Foundation for Angelman Syndrome Therapeutics (FAST) is a charity that provides information about Angelman syndrome.
+The website includes a section for parents who have a child who has recently been diagnosed with Angelman syndrome.
+National Congenital Anomaly and Rare Disease Registration Service
+If your child has Angelman syndrome, your clinical team will pass information about them on to the National Congenital Anomaly and Rare Disease Registration Service (NCARDRS).
+The NCARDRS helps scientists look for better ways to prevent and treat this condition. You can opt out of the register at any time.
+Page last reviewed: 30 September 2019
+Next review due: 30 September 2022
+Support links
+Home
+Health A to Z
+Live Well
+Mental health
+Care and support
+Pregnancy
+NHS services
+Coronavirus (COVID-19)
+NHS App
+Find my NHS number
+Your health records
+About the NHS
+Healthcare abroad
+Contact us
+Other NHS websites
+Profile editor login
+About us
+Accessibility statement
+Our policies
+Cookies
+© Crown copyright

integrations/haystack/nhs-search/data/www.nhs.uk_conditions_angina_.txt

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+Cookies on the NHS website
+We've put some small files called cookies on your device to make our site work.
+We'd also like to use analytics cookies. These send information about how our site is used to services called Adobe Analytics, Hotjar and Google Analytics. We use this information to improve our site.
+Let us know if this is OK. We'll use a cookie to save your choice. You can read more about our cookies before you choose.
+I'm OK with analytics cookies Do not use analytics cookies
+Search the NHS website
+Search
+My account
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+More
+Coronavirus (COVID-19)
+Get the latest advice about COVID-19
+Home Health A to Z
+Overview
+-
+Angina
+Contents
+Overview
+Symptoms
+Diagnosis
+Treatment
+Living with
+Angina is chest pain caused by reduced blood flow to the heart muscles. It's not usually life threatening, but it's a warning sign that you could be at risk of a heart attack or stroke.
+With treatment and healthy lifestyle changes, it's possible to control angina and reduce the risk of these more serious problems.
+Symptoms of angina
+The main symptom of angina is chest pain.
+Chest pain caused by angina usually:
+feels tight, dull or heavy – it may spread to your arms, neck, jaw or back
+is triggered by physical exertion or stress
+stops within a few minutes of resting
+Sometimes there might be other symptoms, like feeling sick or breathless.
+When to get medical help
+If you have not been diagnosed with angina, get an urgent GP appointment if you have an attack of chest pain that stops within a few minutes of resting.
+They can check if it might be a heart problem and refer you to a hospital for tests.
+Find out more about how angina is diagnosed
+Call 999 for an ambulance if you have chest pain that does not stop after a few minutes. This could be a heart attack.
+Types
+There are 2 main types of angina you can be diagnosed with:
+stable angina (more common) – attacks have a trigger (such as stress or exercise) and stop within a few minutes of resting
+unstable angina (more serious) – attacks are more unpredictable (they may not have a trigger) and can continue despite resting
+Some people develop unstable angina after having stable angina.
+Treatment for angina
+You'll probably need to take several different medicines for the rest of your life.
+You may be given medicine to:
+treat attacks when they happen (only taken when needed)
+prevent further attacks
+reduce the risk of heart attacks and strokes
+If medicines are not suitable or do not help, an operation to improve blood flow to your heart muscles may be recommended.
+Living with angina
+If it's well controlled, there's no reason why you cannot have a largely normal life with angina.
+You can usually continue to do most of your normal activities.
+One of the most important things you'll need to do is to make healthy lifestyle changes, such as:
+having a balanced diet
+cutting down on alcohol
+stopping smoking if you smoke
+losing weight if you're overweight
+exercising regularly – gentle exercises are usually safe
+This can help reduce your risk of heart attacks and strokes.
+Causes of angina
+Angina is usually caused by the arteries supplying blood to the heart muscles becoming narrowed by a build-up of fatty substances.
+This is called atherosclerosis.
+Things that can increase your risk of atherosclerosis include:
+an unhealthy diet
+a lack of exercise
+smoking
+increasing age
+a family history of atherosclerosis or heart problems
+Video: Angina
+In this video an expert describes the symptoms, stages and treatment of angina.
+Play Video
+Media last reviewed: 1 September 2021
+Media review due: 1 September 2024
+Page last reviewed: 22 April 2021
+Next review due: 22 April 2024
+Next
+:
+Symptoms
+Support links
+Home
+Health A to Z
+Live Well
+Mental health
+Care and support
+Pregnancy
+NHS services
+Coronavirus (COVID-19)
+NHS App
+Find my NHS number
+Your health records
+About the NHS
+Healthcare abroad
+Contact us
+Other NHS websites
+Profile editor login
+About us
+Accessibility statement
+Our policies
+Cookies
+© Crown copyright

integrations/haystack/nhs-search/data/www.nhs.uk_conditions_angioedema_.txt

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+Cookies on the NHS website
+We've put some small files called cookies on your device to make our site work.
+We'd also like to use analytics cookies. These send information about how our site is used to services called Adobe Analytics, Hotjar and Google Analytics. We use this information to improve our site.
+Let us know if this is OK. We'll use a cookie to save your choice. You can read more about our cookies before you choose.
+I'm OK with analytics cookies Do not use analytics cookies
+Search the NHS website
+Search
+Health A-Z
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+Mental health
+Care and support
+Pregnancy
+Browse
+More
+Home Health A to Z
+Overview
+-
+Angioedema
+Contents
+Overview
+Symptoms
+Causes
+Diagnosis
+Treatment
+Angioedema is swelling underneath the skin. It's usually a reaction to a trigger, such as a medicine or something you're allergic to.
+It is not normally serious, but it can be a recurring problem for some people and can very occasionally be life-threatening if it affects breathing.
+Treatment can usually help keep the swelling under control.
+Symptoms of angioedema
+The swelling most often affects the:
+hands
+feet
+area around the eyes
+lips and tongue
+genitals
+Many people also have a raised, itchy rash called urticaria (hives).
+In more serious cases, angioedema can also cause breathing difficulties, tummy (abdominal) pain and dizziness.
+Read more about the symptoms of angioedema.
+When to get medical advice
+See your GP if you have episodes of swelling that affect your skin or lips and you're not certain of the cause.
+You may need to have some tests to determine the cause. Read more about tests for angioedema.
+Dial 999 for an ambulance if you, or someone with you, has swelling and:
+sudden or worsening breathing problems 
+feels faint or dizzy
+passes out or collapses 
+These are signs of a serious allergic reaction (anaphylaxis). If you, or the person who's ill, have been prescribed an adrenaline auto-injector for this, use it while waiting for the ambulance to arrive.
+Causes of angioedema
+There are several different types of angioedema, each of which has a different cause.
+It can be caused by:
+an allergic reaction, such as a food allergy – this is known as allergic angioedema
+a medicine, such as angiotensin-converting enzyme (ACE) inhibitors for high blood pressure – this is known as drug-induced angioedema
+a genetic fault that you inherit from your parents – this is a rare, lifelong condition that usually starts in childhood called hereditary angioedema
+But in many cases, it's not clear what causes angioedema. This is known as idiopathic angioedema.
+Read more about the causes of angioedema.
+Treatments for angioedema
+The swelling will usually get better by itself in a few days, but there are treatments that can help it settle faster and reduce the risk of it happening again.
+The treatments recommended depend on the type of angioedema you have. For example:
+allergic and idiopathic angioedema are usually treated with antihistamines or, occasionally, steroid medicine to reduce the swelling
+drug-induced angioedema will usually resolve if you change to a different medicine – your doctor will advise you about this
+hereditary angioedema cannot be cured, but medicines can help prevent swelling and quickly treat swelling when it occurs
+Angioedema can usually be treated at home, although treatment in hospital may be necessary in serious cases.
+Read more about how angioedema is treated.
+Page last reviewed: 28 August 2019
+Next review due: 28 August 2022
+Next
+:
+Symptoms
+Support links
+Home
+Health A to Z
+Live Well
+Mental health
+Care and support
+Pregnancy
+NHS services
+Coronavirus (COVID-19)
+NHS App
+Find my NHS number
+Your health records
+About the NHS
+Healthcare abroad
+Contact us
+Other NHS websites
+Profile editor login
+About us
+Accessibility statement
+Our policies
+Cookies
+© Crown copyright

integrations/haystack/nhs-search/data/www.nhs.uk_conditions_angiography_.txt

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+Cookies on the NHS website
+We've put some small files called cookies on your device to make our site work.
+We'd also like to use analytics cookies. These send information about how our site is used to services called Adobe Analytics, Hotjar and Google Analytics. We use this information to improve our site.
+Let us know if this is OK. We'll use a cookie to save your choice. You can read more about our cookies before you choose.
+I'm OK with analytics cookies Do not use analytics cookies
+Search the NHS website
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+Mental health
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+More
+Home Health A to Z
+Overview
+-
+Angiography
+Contents
+Overview
+What happens
+Risks
+Angiography is a type of X-ray used to check blood vessels.
+Blood vessels do not show clearly on a normal X-ray, so a special dye needs to be injected into your blood first.
+This highlights your blood vessels, allowing your doctor to see any problems.
+The X-ray images created during angiography are called angiograms.
+Why angiography is used
+Angiography is used to check the health of your blood vessels and how blood flows through them.
+It can help to diagnose or investigate several problems affecting blood vessels, including:
+atherosclerosis – narrowing of the arteries, which could mean you're at risk of having a stroke or heart attack
+peripheral arterial disease – reduced blood supply to the leg muscles
+a brain aneurysm – a bulge in a blood vessel in your brain
+angina – chest pain caused by reduced blood flow to the heart muscles
+blood clots or a pulmonary embolism – a blockage in the artery supplying your lungs
+a blockage in the blood supply to your kidneys
+Angiography may also be used to help plan treatment for some of these conditions.
+What happens during angiography
+Angiography is done in a hospital X-ray or radiology department.
+For the test:
+you'll usually be awake, but may be given a medicine called a sedative to help you relax
+you lie on an X-ray table and a small cut (incision) is made over 1 of your arteries, usually near your groin or wrist – local anaesthetic is used to numb the area where the cut is made
+a very thin flexible tube (catheter) is inserted into the artery
+the catheter is carefully guided to the area that's being examined (such as the heart)
+a dye (contrast medium) is injected into the catheter
+a series of X-rays are taken as the dye flows through your blood vessels
+The test can take between 30 minutes and 2 hours. You'll usually be able to go home a few hours afterwards.
+Read more about what happens before, during and after angiography.
+Risks of angiography
+Angiography is generally a safe and painless procedure.
+But for a few days or weeks afterwards it's common to have:
+bruising
+soreness
+a very small lump or collection of blood near where the cut was made
+There's also a very small risk of more serious complications, such as an allergic reaction to the dye, a stroke or a heart attack.
+Read more about the risks of angiography.
+Types of angiography
+There are several different types of angiography, depending on which part of the body is being looked at.
+Common types include:
+coronary angiography – to check the heart and nearby blood vessels
+cerebral angiography – to check the blood vessels in and around the brain
+pulmonary angiography – to check the blood vessels supplying the lungs
+renal angiography – to check the blood vessels supplying the kidneys
+Occasionally, angiography may be done using scans instead of X-rays. These are called CT angiography or MRI angiography.
+There's also a type of angiography that's used to check the eyes, called fluorescein angiography. It's different to the other types of angiography and is not covered in this topic.
+Page last reviewed: 16 January 2020
+Next review due: 16 January 2023
+Next
+:
+What happens
+Support links
+Home
+Health A to Z
+Live Well
+Mental health
+Care and support
+Pregnancy
+NHS services
+Coronavirus (COVID-19)
+NHS App
+Find my NHS number
+Your health records
+About the NHS
+Healthcare abroad
+Contact us
+Other NHS websites
+Profile editor login
+About us
+Accessibility statement
+Our policies
+Cookies
+© Crown copyright

integrations/haystack/nhs-search/data/www.nhs.uk_conditions_animal-and-human-bites_.txt

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+Cookies on the NHS website
+We've put some small files called cookies on your device to make our site work.
+We'd also like to use analytics cookies. These send information about how our site is used to services called Adobe Analytics, Hotjar and Google Analytics. We use this information to improve our site.
+Let us know if this is OK. We'll use a cookie to save your choice. You can read more about our cookies before you choose.
+I'm OK with analytics cookies Do not use analytics cookies
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+Search
+My account
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+Mental health
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+More
+Home Health A to Z
+Animal and human bites
+Serious animal and human bites can get infected if they're not checked and treated quickly.
+Always seek medical advice if you have been bitten by an animal or person and the bite has broken the skin.
+People and animals have a lot of bacteria in their mouths, which can cause an infection if a bite breaks the skin.
+These infections are rarely serious if treated quickly, but occasionally they can spread to the blood or other parts of the body.
+Serious infections such as tetanus and rabies are extremely rare in the UK, but it's important to get serious bites looked at as treatment to prevent these infections may be recommended.
+The following information is about bites by people and animals such as dogs and cats.
+There are separate pages on insect bites and snake bites.
+What to do if you have been bitten
+If you have been bitten by an animal or another person:
+clean the wound immediately by running warm tap water over it for a couple of minutes – it's a good idea to do this even if the skin does not appear to be broken
+remove any objects from the bite, such as teeth, hair or dirt
+encourage the wound to bleed slightly by gently squeezing it, unless it's already bleeding freely
+if the wound is bleeding heavily, put a clean pad or sterile dressing over it and apply pressure
+dry the wound and cover it with a clean dressing or plaster
+take painkillers if you're in pain, such as paracetamol or ibuprofen – children under 16 years old should not take aspirin
+seek medical advice, unless the wound is very minor
+If the bite has severed a body part like a finger or ear, wash it with tap water, wrap it in clean tissue, and store it in a plastic bag surrounded by ice so it can be transported to hospital.
+It may be possible to surgically reattach the body part later on.
+When to seek medical advice
+If the bite has broken the skin, you should seek immediate medical attention after cleaning the wound.
+Do not delay seeking help until symptoms of infection appear.
+Minor bites can be treated at your GP surgery, or by staff at your local walk-in centre or minor injuries unit.
+For particularly severe bites, visit your local A&E department.
+The healthcare professional treating you may:
+clean the wound and remove any damaged tissue
+prescribe a course of antibiotics to prevent infection
+recommend specific treatment to prevent infections such as tetanus if you're felt to be at risk
+close the wound with stitches if the risk of infection is thought to be low – high-risk wounds will usually be left open as this means they're easier to keep clean
+arrange blood tests to check for infection, or an X-ray to check for any damage to your bones and see if there's anything embedded in your wound, such as a tooth
+refer you for an assessment by a specialist if the bite penetrated a joint or there's severe damage, such as damage to bones or nerves – surgery may be needed in these cases
+if you're bitten by a person with hepatitis or HIV, there's a tiny chance of the infection spreading if the bite is contaminated with blood, so you may be offered treatment to stop you becoming infected
+When you return home, watch out for signs of a possible infection.
+Signs a bite may be infected
+Symptoms that suggest a wound has become infected include:
+redness and swelling around the wound
+the wound feels warm and increasingly painful
+liquid or pus leaks from the wound
+a fever of 38C or above
+sweats and chills
+swollen glands under the chin or in the neck, armpits or groin
+red streaks extending along the skin from the wound
+Get medical help as soon as possible if you think your wound is infected.
+When do bites happen?
+Although you may be more worried about bites from wild and stray animals, any animal has the potential to bite.
+Many bites are actually caused by a person's own pet or an animal belonging to a friend or neighbour.
+Animals can act unpredictably and bites are not always provoked. But an animal is more likely to bite if it's been disturbed, feels threatened or gets overexcited.
+Most human bites occur when one person punches another person in the mouth.
+They can also happen during contact sports, vigorous sex, domestic violence or sexual assault, and fits (seizures).
+How to avoid animal bites
+Most animal bites are caused by dogs. The advice below may help reduce the chances of being bitten:
+never leave a young child unsupervised with a dog – regardless of what type of dog it is and its previous behaviour (the Blue Dog website provides educational resources aimed to help children estabilish a safe relationship with dogs)
+treat dogs with respect – do not approach them suddenly, run around screaming in their presence, or interrupt them when they're eating or sleeping
+avoid stroking or petting unfamiliar dogs – when greeting a dog for the first time, let it sniff you before petting it
+It's also a good idea to avoid contact with any wild or stray animals, particularly while travelling abroad, as they can be aggressive and there's a chance they could carry serious infections, such as rabies.
+Page last reviewed: 11 January 2019
+Next review due: 11 January 2022
+Support links
+Home
+Health A to Z
+Live Well
+Mental health
+Care and support
+Pregnancy
+NHS services
+Coronavirus (COVID-19)
+NHS App
+Find my NHS number
+Your health records
+About the NHS
+Healthcare abroad
+Contact us
+Other NHS websites
+Profile editor login
+About us
+Accessibility statement
+Our policies
+Cookies
+© Crown copyright

integrations/haystack/nhs-search/data/www.nhs.uk_conditions_ankylosing-spondylitis_.txt

@@ -0,0 +1,103 @@
+Cookies on the NHS website
+We've put some small files called cookies on your device to make our site work.
+We'd also like to use analytics cookies. These send information about how our site is used to services called Adobe Analytics, Hotjar and Google Analytics. We use this information to improve our site.
+Let us know if this is OK. We'll use a cookie to save your choice. You can read more about our cookies before you choose.
+I'm OK with analytics cookies Do not use analytics cookies
+Search the NHS website
+Search
+Health A-Z
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+Coronavirus (COVID-19)
+Get the latest advice about COVID-19
+Home Health A to Z
+Overview
+-
+Ankylosing spondylitis
+Contents
+Overview
+Symptoms
+Causes
+Diagnosis
+Treatment
+Complications
+Ankylosing spondylitis (AS) is a long-term condition in which the spine and other areas of the body become inflamed.
+AS tends to first develop in teenagers and young adults. It's also around 2 times more common in men than in women.
+Information:
+Coronavirus (COVID-19) advice
+Get advice about COVID-19 and ankylosing spondylitis from the National Axial Spondyloarthritis Society
+Symptoms of ankylosing spondylitis
+The symptoms of AS can vary, but usually involve:
+back pain and stiffness
+pain and swelling in other parts of the body – caused by inflammation of the joints (arthritis) and inflammation where a tendon joins a bone (enthesitis)
+extreme tiredness (fatigue)
+These symptoms tend to develop gradually, usually over several months or years, and may come and go over time.
+In some people the condition gets better with time, but for others it can get slowly worse.
+Read about symptoms of ankylosing spondylitis.
+When to seek medical advice
+You should see your GP if you have persistent symptoms of AS.
+If your GP thinks you may have the condition, they should refer you to a specialist in conditions affecting muscles and joints (rheumatologist) for further tests and any necessary treatment.
+Further tests may include blood tests and imaging tests.
+Read about diagnosing ankylosing spondylitis.
+Causes of ankylosing spondylitis
+It's not known what causes the condition, but there's thought to be a link with a particular gene known as HLA-B27.
+Read about the causes of ankylosing spondylitis.
+Treating ankylosing spondylitis
+There's no cure for AS and it's not possible to reverse the damage caused by the condition. However, treatment is available to relieve the symptoms and help prevent or delay its progression.
+In most cases treatment involves a combination of:
+exercises carried out individually or in groups to reduce pain and stiffness
+physiotherapy – where physical methods, such as massage and manipulation, are used to improve comfort and spinal flexibility
+medicine to help relieve pain and reduce inflammation– such as painkillers, anti-tumour necrosis factor (TNF) medication and other forms of biological therapy
+Surgery is sometimes needed to repair significantly damaged joints or correct severe bends in the spine, but this is uncommon.
+Read about treating ankylosing spondylitis.
+Complications of ankylosing spondylitis
+The outlook for AS is highly variable. For some people the condition improves after an initial period of inflammation, whereas for others it can get progressively worse over time.
+Some people with AS are able to remain fully independent or minimally disabled in the long-term.
+However, some people eventually become severely disabled as a result of the bones in their spine fusing in a fixed position and damage to other joints, such as the hips or knees.
+With modern treatments, AS does not normally affect life expectancy significantly, although the condition is associated with an increased risk of other potentially life-threatening problems.
+For example, AS can lead to:
+weakening of the bones (osteoporosis)
+spinal fractures
+cardiovascular disease – a group of conditions affecting the heart and blood vessels
+chest infections
+rarely, kidney disease
+Read about the complications of ankylosing spondylitis.
+Living with AS
+The National Axial Spondyloarthritis Society (NASS) has information on living with ankylosing spondylitis, including advice on working, travelling and driving.
+Video: back stretches
+In this video, a physiotherapist shows some simple back stretches to help prevent aches and pains.
+Play Video
+Media last reviewed: 16 November 2020
+Media review due: 16 November 2023
+See exercise video safety information
+Page last reviewed: 11 July 2019
+Next review due: 11 July 2022
+Next
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+Symptoms
+Support links
+Home
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+Care and support
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+Coronavirus (COVID-19)
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integrations/haystack/nhs-search/data/www.nhs.uk_conditions_anosmia_.txt

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+Cookies on the NHS website
+We've put some small files called cookies on your device to make our site work.
+We'd also like to use analytics cookies. These send information about how our site is used to services called Adobe Analytics, Hotjar and Google Analytics. We use this information to improve our site.
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+Lost or changed sense of smell
+A change in your sense of smell can be unpleasant and affect how things taste. But it is not usually serious and may get better in a few weeks or months.
+Important:
+Could it be coronavirus (COVID-19)?
+A loss or change to your sense of smell or taste could be COVID-19.
+Get advice about symptoms of COVID-19 and what to do
+Causes of lost or changed sense of smell
+Changes in sense of smell are most often caused by:
+a cold or flu
+sinusitis (sinus infection)
+an allergy, like hay fever
+growths in your nose (nasal polyps)
+These can cause:
+loss of smell (anosmia)
+smelling things that are not there (phantosmia), like smoke or burnt toast
+reduced sense of smell (hyposmia)
+the smell of things to change (parosmia)
+Information:
+It's also common to lose some of your sense of smell as you get older.
+Cleaning inside your nose can help
+Rinsing the inside of your nose with a saltwater solution may help if your sense of smell is affected by an infection or allergy.
+You can make a saltwater solution at home.
+How to clean your nose with a saltwater solution
+Some pharmacies sell sachets you can use to make a saltwater solution and devices to help you rinse your nose.
+Information:
+Call a pharmacy or contact them online before going in person. You can get medicines delivered or ask someone to collect them.
+Find a pharmacy
+Non-urgent advice:
+See a GP if your sense of smell does not go back to normal in a few weeks
+They'll check for any obvious causes, such as sinusitis or nasal polyps.
+They may refer you to a specialist for tests if they're not sure what the problem is.
+Information:
+Coronavirus (COVID-19) update: how to contact a GP
+It's still important to get help from a GP if you need it. To contact your GP surgery:
+visit their website
+use the NHS App
+call them
+Find out about using the NHS during COVID-19
+Treatment for lost or changed sense of smell
+Your sense of smell may go back to normal in a few weeks or months.
+Treating the cause might help. For example, steroid nasal sprays or drops might help if you have sinusitis or nasal polyps.
+A treatment called smell training can also help some people. To find out more about smell training, see:
+AbScent: smell training
+Fifth Sense: smell testing and training
+Sometimes changes in sense of smell cannot be treated and may be permanent.
+Important
+If you have lost your sense of smell, you may not be able to smell things like gas leaks, fires and food that's gone off.
+Fifth Sense has some safety advice if you have anosmia
+Page last reviewed: 11 December 2020
+Next review due: 11 December 2023
+Support links
+Home
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integrations/haystack/nhs-search/data/www.nhs.uk_conditions_antacids_.txt

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+Cookies on the NHS website
+We've put some small files called cookies on your device to make our site work.
+We'd also like to use analytics cookies. These send information about how our site is used to services called Adobe Analytics, Hotjar and Google Analytics. We use this information to improve our site.
+Let us know if this is OK. We'll use a cookie to save your choice. You can read more about our cookies before you choose.
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+Antacids
+Antacids are medicines that counteract (neutralise) the acid in your stomach to relieve indigestion and heartburn.
+They come as a liquid or chewable tablets and can be bought from pharmacies and shops without a prescription.
+When antacids are used
+Antacids may help if you have:
+indigestion
+heartburn or acid reflux – also known as gastro-oesophageal reflux disease (GORD)
+a stomach ulcer
+gastritis (inflammation of the stomach lining)
+They can quickly relieve your symptoms for a few hours. But they do not treat the underlying cause and long-term use is not recommended.
+Speak to a GP if you find you need to take antacids regularly.
+Common types of antacids
+Many different types of antacid are available. Some are sold under a brand name and others are named after their main ingredient. Brands include Gaviscon (alginic acid) and Pepto-Bismol (bismuth subsalicylate).
+Ingredients to look for include:
+aluminium hydroxide
+magnesium carbonate
+magnesium trisilicate
+magnesium hydroxide
+calcium carbonate
+sodium bicarbonate
+Some antacids also contain other medicines, such as an alginate (which coats your gullet with a protective layer) and simeticone (which reduces flatulence).
+How and when to take antacids
+Check the instructions on the packet or leaflet to see how much antacid to take and how often. This depends on the exact medicine you're taking.
+Antacids should be used when you have symptoms or think you will get them soon – for most people, the best time to take them is with or soon after meals, and just before going to bed.
+Remember that doses for children may be lower than for adults.
+Contact a GP or pharmacist, or call NHS 111, if you take too much of the medicine and start to feel unwell.
+Taking antacids with food, alcohol and other medicines
+It's best to take antacids with food or soon after eating because this is when you're most likely to get indigestion or heartburn.
+The effect of the medicine may also last longer if taken with food.
+Antacids can affect how well other medicines work, so do not take other medicines within 2 to 4 hours of taking an antacid.
+You can drink alcohol while taking antacids, but alcohol can irritate your stomach and make your symptoms worse.
+Side effects of antacids
+Antacids do not usually have many side effects if they're only taken occasionally and at the recommended dose.
+But sometimes they can cause:
+diarrhoea or constipation
+flatulence (wind)
+stomach cramps
+feeling sick or vomiting
+These should pass once you stop taking the medicine.
+Speak to a pharmacist or a GP if side effects do not improve or are troublesome. You may need to switch to another medicine.
+Who may not be able to take antacids
+Antacids are safe for most people to take, but they're not suitable for everyone.
+Speak to a pharmacist or a GP for advice first if you:
+are pregnant or breastfeeding – most antacids are considered safe to take while pregnant or breastfeeding, but always get advice first
+are looking for a medicine for a child under 12 years of age – some antacids are not recommended for children
+have liver disease, kidney disease or heart failure – some antacids may not be safe if you have one of these problems
+have an illness that means you need to control how much salt (sodium) is in your diet, such as high blood pressure or cirrhosis – some antacids contain high levels of sodium, which could make you unwell
+are taking other medicines – antacids can interfere with other medicines and may need be avoided or taken at a different time
+Page last reviewed: 13 November 2019
+Next review due: 13 November 2022
+Support links
+Home
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integrations/haystack/nhs-search/data/www.nhs.uk_conditions_antibiotics_.txt

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+Cookies on the NHS website
+We've put some small files called cookies on your device to make our site work.
+We'd also like to use analytics cookies. These send information about how our site is used to services called Adobe Analytics, Hotjar and Google Analytics. We use this information to improve our site.
+Let us know if this is OK. We'll use a cookie to save your choice. You can read more about our cookies before you choose.
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+Overview
+-
+Antibiotics
+Contents
+Overview
+Uses
+Considerations
+Side effects
+Interactions
+Antibiotic resistance
+Antibiotics are used to treat or prevent some types of bacterial infection. They work by killing bacteria or preventing them from spreading. But they do not work for everything.
+Many mild bacterial infections get better on their own without using antibiotics.
+Antibiotics do not work for viral infections such as colds and flu, and most coughs and sore throats.
+Antibiotics are no longer routinely used to treat:
+chest infections
+ear infections in children
+sore throats
+When it comes to antibiotics, take your doctor's advice on whether you need them or not. Antibiotic resistance is a big problem – taking antibiotics when you do not need them can mean they will not work for you in the future.
+When antibiotics are needed
+Antibiotics may be used to treat bacterial infections that:
+are unlikely to clear up without antibiotics
+could infect others
+could take too long to clear without treatment
+carry a risk of more serious complications
+People at a high risk of infection may also be given antibiotics as a precaution, known as antibiotic prophylaxis.
+Read more about when antibiotics are used and why they are not routinely used to treat infections.
+How to take antibiotics?
+Take antibiotics as directed on the packet or the patient information leaflet that comes with the medicine, or as instructed by your GP or pharmacist.
+Antibiotics can come as:
+tablets, capsules or a liquid that you drink – these can be used to treat most types of mild to moderate infections in the body
+creams, lotions, sprays and drops – these are often used to treat skin infections and eye or ear infections
+injections – these can be given as an injection or through a drip directly into the blood or muscle, and are used for more serious infections
+Missing a dose of antibiotics
+If you forget to take a dose of your antibiotics, take that dose as soon as you remember and then continue to take your course of antibiotics as normal.
+But if it's almost time for the next dose, skip the missed dose and continue your regular dosing schedule. Do not take a double dose to make up for a missed one.
+Accidentally taking an extra dose
+There's an increased risk of side effects if you take 2 doses closer together than recommended.
+Accidentally taking 1 extra dose of your antibiotic is unlikely to cause you any serious harm.
+But it will increase your chances of getting side effects, such as pain in your stomach, diarrhoea, and feeling or being sick.
+If you accidentally take more than 1 extra dose of your antibiotic, are worried or you get severe side effects, speak to your GP or call NHS 111 as soon as possible.
+Side effects of antibiotics
+As with any medicine, antibiotics can cause side effects. Most antibiotics do not cause problems if they're used properly and serious side effects are rare.
+The common side effects include:
+being sick
+feeling sick
+bloating and indigestion
+diarrhoea
+Some people may have an allergic reaction to antibiotics, especially penicillin and a type called cephalosporins. In very rare cases, this can lead to a serious allergic reaction (anaphylaxis), which is a medical emergency.
+Read more about the side effects of antibiotics.
+Considerations and interactions
+Some antibiotics are not suitable for people with certain medical problems, or women who are pregnant or breastfeeding. Only ever take antibiotics prescribed for you – never "borrow" them from a friend or family member.
+Some antibiotics do not mix well with other medicines, such as the contraceptive pill and alcohol.
+Read the information leaflet that comes with your medicine carefully and discuss any concerns with your pharmacist or GP.
+Read more about:
+things to consider before taking antibiotics
+how antibiotics interact with other medicines
+Types of antibiotics
+There are hundreds of different types of antibiotics, but most of them can be classified into 6 groups.
+Penicillins (such as penicillin, amoxicillin, co-amoxiclav, flucloxacillin and phenoxymethylpenicillin) – widely used to treat a variety of infections, including skin infections, chest infections and urinary tract infections
+Cephalosporins (such as cefalexin) – used to treat a wide range of infections, but some are also effective for treating more serious infections, such as septicaemia and meningitis
+Aminoglycosides (such as gentamicin and tobramycin) – tend to only be used in hospital to treat very serious illnesses such as septicaemia, as they can cause serious side effects, including hearing loss and kidney damage; they're usually given by injection, but may be given as drops for some ear or eye infections
+Tetracyclines (such as tetracycline, doxycycline and lymecycline) – can be used to treat a wide range of infections, but are commonly used to treat acne and a skin condition called rosacea
+Macrolides (such as azithromycin, erythromycin and clarithromycin) – can be particularly useful for treating lung and chest infections, or as an alternative for people with a penicillin allergy, or to treat penicillin-resistant strains of bacteria
+Fluoroquinolones (such as ciprofloxacin and levofloxacin) – are broad-spectrum antibiotics that were once used to treat a wide range of infections, especially respiratory and urinary tract infections. These antibiotics are no longer used routinely because of the risk of serious side effects
+Other antibiotics include chloramphenicol (used for eye and ear infections), fusidic acid (used for skin and eye infections), and nitrofurantoin and trimethoprim (used for urinary tract infections).
+Help us improve our website
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+Page last reviewed: 23 May 2019
+Next review due: 23 May 2022
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integrations/haystack/nhs-search/data/www.nhs.uk_conditions_anticoagulants_.txt

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+Cookies on the NHS website
+We've put some small files called cookies on your device to make our site work.
+We'd also like to use analytics cookies. These send information about how our site is used to services called Adobe Analytics, Hotjar and Google Analytics. We use this information to improve our site.
+Let us know if this is OK. We'll use a cookie to save your choice. You can read more about our cookies before you choose.
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+Overview
+-
+Anticoagulant medicines
+Contents
+Overview
+Uses
+Dosage
+Considerations
+Side effects
+Anticoagulants are medicines that help prevent blood clots. They're given to people at a high risk of getting clots, to reduce their chances of developing serious conditions such as strokes and heart attacks.
+A blood clot is a seal created by the blood to stop bleeding from wounds. While they're useful in stopping bleeding, they can block blood vessels and stop blood flowing to organs such as the brain, heart or lungs if they form in the wrong place.
+Anticoagulants work by interrupting the process involved in the formation of blood clots. They're sometimes called "blood-thinning" medicines, although they don't actually make the blood thinner.
+Although they're used for similar purposes, anticoagulants are different to antiplatelet medicines, such as low-dose aspirin and clopidogrel.
+Types of anticoagulants
+The most commonly prescribed anticoagulant is warfarin.
+Newer types of anticoagulants are also available and are becoming increasingly common. These include:
+rivaroxaban (Xarelto)
+dabigatran (Pradaxa)
+apixaban (Eliquis)
+edoxaban (Lixiana)
+Warfarin and the newer alternatives are taken as tablets or capsules. There's also an anticoagulant called heparin that can be given by injection. Read more about heparin on the Electronic Medicines Compendium (EMC) website.
+When anticoagulants are used
+If a blood clot blocks the flow of blood through a blood vessel, the affected part of the body will become starved of oxygen and will stop working properly.
+Depending on where the clot forms, this can lead to serious problems such as:
+strokes or transient ischaemic attacks ("mini-strokes")
+heart attacks
+deep vein thrombosis (DVT)
+pulmonary embolism
+Treatment with anticoagulants may be recommended if your doctor feels you're at an increased risk of developing one of these problems. This may be because you've had blood clots in the past or you've been diagnosed with a condition such as atrial fibrillation that can cause blood clots to form.
+You may also be prescribed an anticoagulant if you've recently had surgery, as the period of rest and inactivity you need during your recovery can increase your risk of developing a blood clot.
+Read more about when anticoagulants are used.
+How to take anticoagulants
+Your doctor or nurse should tell you how much of your anticoagulant medicine to take and when to take it. 
+Most people need to take their tablets or capsules once or twice a day with water or food.
+The length of time you need to keep taking your medicine for depends on why it's been prescribed. In many cases, treatment will be lifelong.
+If you're unsure how to take your medicine, or are worried that you missed a dose or have taken too much, check the patient information leaflet that comes with it or ask your GP, anticoagulant clinic or pharmacist what to do. You can also call NHS 111 for advice.
+Read more about anticoagulant dosage.
+Things to consider when taking anticoagulants
+There are several things you need to be aware of when taking anticoagulant medicines.
+If you're going to have surgery or a test such as an endoscopy, make sure your doctor or surgeon is aware that you're taking anticoagulants, as you may have to stop taking them for a short time.
+Speak to your GP, anticoagulant clinic or pharmacist before taking any other medicines, including prescription and over-the-counter medicines, as some medicines can affect how your anticoagulant works.
+If you're taking warfarin, you'll also need to avoid making significant changes to what you normally eat and drink, as this can affect your medicine.
+Most anticoagulant medicines aren't suitable for pregnant women. Speak to your GP or anticoagulant clinic if you become pregnant or are planning to try for a baby while taking anticoagulants.
+Read more about things to consider when taking anticoagulants.
+Side effects of anticoagulants
+Like all medicines, there's a risk of experiencing side effects while taking anticoagulants.
+The main side effect is that you can bleed too easily, which can cause problems such as:
+passing blood in your urine
+passing blood when you poo or having black poo
+severe bruising
+prolonged nosebleeds
+bleeding gums
+vomiting blood or coughing up blood
+heavy periods in women
+For most people, the benefits of taking anticoagulants will outweigh the risk of excessive bleeding.
+Read more about the side effects of anticoagulants.
+Page last reviewed: 26 July 2021
+Next review due: 26 July 2024
+Next
+:
+Uses
+Support links
+Home
+Health A to Z
+Live Well
+Mental health
+Care and support
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+NHS App
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+Your health records
+About the NHS
+Healthcare abroad
+Contact us
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+Our policies
+Cookies
+© Crown copyright

integrations/haystack/nhs-search/data/www.nhs.uk_conditions_antidepressants_.txt

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+Cookies on the NHS website
+We've put some small files called cookies on your device to make our site work.
+We'd also like to use analytics cookies. These send information about how our site is used to services called Adobe Analytics, Hotjar and Google Analytics. We use this information to improve our site.
+Let us know if this is OK. We'll use a cookie to save your choice. You can read more about our cookies before you choose.
+I'm OK with analytics cookies Do not use analytics cookies
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+Home Mental health Talking therapies, medicine and psychiatry Medicines and psychiatry Antidepressants
+Overview - Antidepressants
+Antidepressants are a type of medicine used to treat clinical depression.
+They can also be used to treat a number of other conditions, including:
+obsessive compulsive disorder (OCD)
+generalised anxiety disorder
+post-traumatic stress disorder (PTSD)
+Antidepressants are also sometimes used to treat people with long-term (chronic) pain.
+Read more about when antidepressants are used.
+How antidepressants work
+It's not known exactly how antidepressants work.
+It's thought they work by increasing levels of chemicals in the brain called neurotransmitters. Certain neurotransmitters, such as serotonin and noradrenaline, are linked to mood and emotion.
+Neurotransmitters may also affect pain signals sent by nerves, which may explain why some antidepressants can help relieve long-term pain.
+While antidepressants can treat the symptoms of depression, they do not always address its causes. This is why they're usually used in combination with therapy to treat more severe depression or other mental health conditions.
+How effective are antidepressants?
+Research suggests that antidepressants can be helpful for people with moderate or severe depression.
+They're not usually recommended for mild depression, unless other treatments like talking therapy have not helped.
+Doses and duration of treatment
+Antidepressants are usually taken in tablet form. When they're prescribed, you'll start on the lowest possible dose thought necessary to improve your symptoms.
+Antidepressants usually need to be taken for 1 or 2 weeks (without missing a dose) before the benefit starts to be felt. It's important not to stop taking them if you get some mild side effects early on, as these effects usually wear off quickly.
+If you take an antidepressant for 4 weeks without feeling any benefit, speak to your GP or mental health specialist. They may recommend increasing your dose or trying a different medicine.
+A course of treatment usually lasts for at least 6 months after you start to feel better. Some people with recurrent depression may be advised to take them indefinitely.
+Read more about antidepressant dosages.
+Side effects
+Different antidepressants can have a range of different side effects. Always check the information leaflet that comes with your medicine to see what the possible side effects are.
+The most common side effects of antidepressants are usually mild. Side effects should improve within a few days or weeks of treatment, as the body gets used to the medicine.
+Read more about:
+possible side effects of antidepressants
+cautions and interactions of antidepressants
+Coming off antidepressants
+Talk to your doctor before you stop taking antidepressants. It's important that you do not stop taking antidepressants suddenly.
+Once you're ready to come off antidepressants, your doctor will probably recommend reducing your dose gradually over several weeks – or longer, if you have been taking them for a long time.
+This is to help prevent any withdrawal symptoms you might get as a reaction to coming off the medicine.
+Read more about stopping or coming off antidepressants.
+Types of antidepressants
+There are several different types of antidepressants.
+Selective serotonin reuptake inhibitors (SSRIs)
+SSRIs are the most widely prescribed type of antidepressants. They're usually preferred over other antidepressants, as they cause fewer side effects. An overdose is also less likely to be serious.
+Fluoxetine is probably the best known SSRI (sold under the brand name Prozac). Other SSRIs include citalopram (Cipramil), escitalopram (Cipralex), paroxetine (Seroxat) and sertraline (Lustral).
+Serotonin-noradrenaline reuptake inhibitors (SNRIs)
+SNRIs are similar to SSRIs. They were designed to be a more effective antidepressant than SSRIs. However, the evidence that SNRIs are more effective in treating depression is uncertain. It seems that some people respond better to SSRIs, while others respond better to SNRIs.
+Examples of SNRIs include duloxetine (Cymbalta and Yentreve) and venlafaxine (Efexor).
+Noradrenaline and specific serotonergic antidepressants (NASSAs)
+NASSAs may be effective for some people who are unable to take SSRIs. The side effects of NASSAs are similar to those of SSRIs, but they're thought to cause fewer sexual problems. However, they may also cause more drowsiness at first.
+The main NASSA prescribed in the UK is mirtazapine (Zispin).
+Tricyclic antidepressants (TCAs)
+TCAs are an older type of antidepressant. They're no longer usually recommended as the first treatment for depression because they can be more dangerous if an overdose is taken. They also cause more unpleasant side effects than SSRIs and SNRIs.
+Exceptions are sometimes made for people with severe depression that fail to respond to other treatments. TCAs may also be recommended for other mental health conditions, such as OCD and bipolar disorder.
+Examples of TCAs include amitriptyline, clomipramine, dosulepin, imipramine, lofepramine and nortriptyline.
+Some types of TCAs, such as amitriptyline, can also be used to treat chronic nerve pain.
+Serotonin antagonists and reuptake inhibitors (SARIs)
+SARIs are not usually the first choice of antidepressant, but they may be prescribed if other antidepressants have not worked or have caused side effects.
+The main SARI prescribed in the UK is trazodone (Molipaxin).
+Monoamine oxidase inhibitors (MAOIs)
+MAOIs are an older type of antidepressant that are rarely used nowadays.
+They can cause potentially serious side effects so should only be prescribed by a specialist doctor.
+Examples of MAOIs include tranylcypromine, phenelzine and isocarboxazid.
+Other treatments for depression
+Other treatments for depression include talking therapies such as cognitive behavioural therapy (CBT).
+People with moderate to severe depression are usually treated using a combination of antidepressants and CBT. Antidepressants work quickly in reducing symptoms, whereas CBT takes time to deal with causes of depression and ways of overcoming it.
+Regular exercise has also been shown to be useful for those with mild depression.
+Read more about alternatives to antidepressants.
+Yellow Card Scheme
+The Yellow Card Scheme allows you to report suspected side effects from any type of medicine you're taking. It's run by a medicines safety watchdog called the Medicines and Healthcare products Regulatory Agency (MHRA).
+See the Yellow Card Scheme website for more information.
+More in Antidepressants
+Overview - Antidepressants
+Uses - Antidepressants
+Cautions - Antidepressants
+Dosage - Antidepressants
+Side effects - Antidepressants
+Alternatives - Antidepressants
+Page last reviewed: 4 November 2021
+Next review due: 4 November 2024
+Support links
+Home
+Health A to Z
+Live Well
+Mental health
+Care and support
+Pregnancy
+NHS services
+Coronavirus (COVID-19)
+NHS App
+Find my NHS number
+Your health records
+About the NHS
+Healthcare abroad
+Contact us
+Other NHS websites
+Profile editor login
+About us
+Accessibility statement
+Our policies
+Cookies
+© Crown copyright

integrations/haystack/nhs-search/data/www.nhs.uk_conditions_antifungal-medicines_.txt

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+Cookies on the NHS website
+We've put some small files called cookies on your device to make our site work.
+We'd also like to use analytics cookies. These send information about how our site is used to services called Adobe Analytics, Hotjar and Google Analytics. We use this information to improve our site.
+Let us know if this is OK. We'll use a cookie to save your choice. You can read more about our cookies before you choose.
+I'm OK with analytics cookies Do not use analytics cookies
+Search the NHS website
+Search
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+Home Health A to Z
+Antifungal medicines
+Antifungal medicines are used to treat fungal infections, which most commonly affect your skin, hair and nails.
+You can get some antifungal medicines from a pharmacy without needing a GP prescription.
+Infections antifungals can treat
+Fungal infections commonly treated with antifungals include:
+ringworm
+athlete's foot
+fungal nail infection
+vaginal thrush
+some types of severe dandruff
+Some fungal infections can grow inside the body and need to be treated in hospital.
+Examples include:
+aspergillosis, which affects the lungs
+fungal meningitis, which affects the brain
+You're more at risk of getting one of these more serious fungal infections if you have a weakened immune system – for example, if you're taking medicines to suppress your immune system.
+Types of antifungal medicines
+You can get antifungal medicines as:
+a cream, gel, ointment or spray
+a capsule, tablet or liquid
+an injection
+a pessary: a small and soft tablet you put inside the vagina
+Common names for antifungal medicines include:
+clotrimazole (Canesten)
+econazole
+miconazole
+terbinafine (Lamisil)
+fluconazole (Diflucan)
+ketoconazole (Daktarin)
+nystatin (Nystan)
+amphotericin
+How antifungal medicines work
+Antifungal medicines work by either:
+killing the fungus
+preventing the fungus from growing
+When to see a pharmacist or GP
+See a pharmacist or GP if you think you have a fungal infection. They can advise you on which antifungal medicine is best for you.
+If you take too much antifungal medicine, call 111 or speak to a pharmacist or GP.
+If you're advised to go to hospital, take the medicine's packaging with you so the healthcare professionals who treat you know what you've taken.
+Things to consider when using antifungal medicines
+Before taking antifungal medicines, speak to a pharmacist or GP about:
+any existing conditions or allergies that may affect your treatment for fungal infection
+the possible side effects of antifungal medicines
+whether the antifungal medicine may interact with other medicines you may already be taking
+whether your antifungal medicine is suitable to take during pregnancy or while breastfeeding – many are not suitable
+You can also check the patient information leaflet that comes with your antifungal medicine for more information.
+Side effects of antifungal medicines
+Antifungal medicines may cause side effects. These are usually mild and do not last long.
+They can include:
+itching or burning
+redness
+feeling sick
+tummy (abdominal) pain
+diarrhoea
+a rash
+Occasionally, antifungal medicines may cause a more severe reaction, such as:
+an allergic reaction – your face, neck or tongue may swell and you may have difficulty breathing
+a severe skin reaction – such as peeling or blistering skin
+liver damage (very rarely) – you may have loss of appetite, vomiting, nausea, jaundice, dark pee or pale poo, tiredness or weakness
+Stop using the medicine if you have these severe side effects, and see a GP or pharmacist to find an alternative.
+If you're having difficulty breathing, go to A&E or call 999.
+Reporting side effects
+If you think a medicine has made you unwell, you can report this side effect through the Yellow Card Scheme.
+Antifungal medicines for children
+Some antifungal medicines can be used to treat children and babies – for example, miconazole oral gel can be used for oral thrush in babies.
+But different doses are usually needed for children of different ages. Speak to a pharmacist or GP for more advice.
+Page last reviewed: 27 July 2020
+Next review due: 27 July 2023
+Support links
+Home
+Health A to Z
+Live Well
+Mental health
+Care and support
+Pregnancy
+NHS services
+Coronavirus (COVID-19)
+NHS App
+Find my NHS number
+Your health records
+About the NHS
+Healthcare abroad
+Contact us
+Other NHS websites
+Profile editor login
+About us
+Accessibility statement
+Our policies
+Cookies
+© Crown copyright

integrations/haystack/nhs-search/data/www.nhs.uk_conditions_antihistamines_.txt

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+Cookies on the NHS website
+We've put some small files called cookies on your device to make our site work.
+We'd also like to use analytics cookies. These send information about how our site is used to services called Adobe Analytics, Hotjar and Google Analytics. We use this information to improve our site.
+Let us know if this is OK. We'll use a cookie to save your choice. You can read more about our cookies before you choose.
+I'm OK with analytics cookies Do not use analytics cookies
+Search the NHS website
+Search
+Health A-Z
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+Mental health
+Care and support
+Pregnancy
+Browse
+More
+Coronavirus (COVID-19)
+Get the latest advice about COVID-19
+Home Health A to Z
+Antihistamines
+Antihistamines are medicines often used to relieve symptoms of allergies, such as hay fever, hives, conjunctivitis and reactions to insect bites or stings.
+They're also sometimes used to prevent motion sickness and as a short-term treatment for insomnia.
+Most antihistamines can be bought from pharmacies and shops, but some are only available on prescription.
+Types of antihistamine
+There are many types of antihistamine.
+They're usually divided into 2 main groups:
+antihistamines that make you feel sleepy – such as chlorphenamine (Piriton), cinnarizine, diphenhydramine, hydroxyzine and promethazine
+non-drowsy antihistamines that are less likely to make you feel sleepy – such as acrivastine, cetirizine, fexofenadine and loratadine
+They also come in several different forms – including tablets, capsules, liquids, syrups, creams, lotions, gels, eyedrops and nasal sprays.
+Which type is best?
+There's not much evidence to suggest any particular antihistamine is better than any other at relieving allergy symptoms.
+Some people find certain types work well for them and others do not. You may need to try several types to find one that works for you.
+Non-drowsy antihistamines are generally the best option, as they're less likely to make you feel sleepy. But types that make you feel sleepy may be better if your symptoms stop you sleeping.
+Ask a pharmacist for advice if you're unsure which medicine to try as not all antihistamines are suitable for everyone.
+How to take antihistamines
+Take your medicine as advised by the pharmacist or doctor, or as described in the leaflet that comes with it.
+Before taking an antihistamine, you should know:
+how to take it – including whether it needs to be taken with water or food, or how to use it correctly (if eyedrops or a nasal spray)
+how much to take (the dose) – this can vary depending on things such as your age and weight
+when to take it – including how many times a day you can take it and when to take it (some types should be taken before bedtime)
+how long to take it for – some types can be used for a long time, but some are only recommended for a few days
+what to do if you miss a dose or take too much (overdose)
+The advice varies depending on the exact medicine you're taking. If you're not sure how to take your medicine, ask a pharmacist.
+Side effects of antihistamines
+Like all medicines, antihistamines can cause side effects.
+Side effects of antihistamines that make you drowsy can include:
+sleepiness (drowsiness) and reduced co-ordination, reaction speed and judgement – do not drive or use machinery after taking these antihistamines
+dry mouth
+blurred vision
+difficulty peeing
+Side effects of non-drowsy antihistamines can include:
+headache
+dry mouth
+feeling sick
+drowsiness – although this is less common than with older types of antihistamines
+Check the leaflet that comes with your medicine for a full list of possible side effects and advice about when to get medical help.
+If you think your medicine has caused an unwanted side effect, you can report it through the Yellow Card Scheme.
+Taking antihistamines with other medicines, food or alcohol
+Speak to a pharmacist or GP before taking antihistamines if you're already taking other medicines.
+There may be a risk the medicines do not mix, which could stop either from working properly or increase the risk of side effects.
+Examples of medicines that could cause problems if taken with antihistamines include some types of:
+antidepressants
+stomach ulcer or indigestion medicines
+cough and cold remedies that also contain an antihistamine
+Try not to drink alcohol while taking an antihistamine, particularly if it's a type that makes you drowsy, as it can increase the chances of it making you feel sleepy.
+Food and other drinks do not affect most antihistamines, but check the leaflet that comes with your medicine to make sure.
+Who can take antihistamines
+Most people can safely take antihistamines.
+But speak to a pharmacist or GP for advice if you:
+are pregnant or breastfeeding
+are looking for a medicine for a young child
+are taking other medicines 
+have an underlying health condition, such as heart disease, liver disease, kidney disease or epilepsy
+Some antihistamines may not be suitable in these cases. A pharmacist or doctor can recommend one that's best for you.
+Loratadine is usually recommended if you need to take an antihistamine in pregnancy. Loratadine or cetirizine are usually OK to take while breastfeeding.
+Always check the leaflet that comes with your medicine to see if it's safe for you before taking it or giving it to your child.
+How antihistamines work
+Antihistamines block the effects of a substance called histamine in your body.
+Histamine is normally released when your body detects something harmful, such as an infection. It causes blood vessels to expand and the skin to swell, which helps protect the body.
+But in people with allergies, the body mistakes something harmless – such as pollen, animal hair or house dust – for a threat and produces histamine. The histamine causes an allergic reaction with unpleasant symptoms including itchy, watering eyes, a running or blocked nose, sneezing and skin rashes.
+Antihistamines help stop this happening if you take them before you come into contact with the substance you're allergic to. Or they can reduce the severity of symptoms if you take them afterwards.
+Find out more about your medicine
+The leaflet that comes in the packet with your medicine will have detailed information about it, including how to take it and what side effects you might get.
+If you no longer have the leaflet that came with your medicine, you can search for an online version of it using our medicines guide.
+You may also find information on individual antihistamines on these websites:
+Medicines and Healthcare products Regulatory Agency (MHRA): patient information leaflets
+Electronic Medicines Compendium
+Page last reviewed: 28 February 2020
+Next review due: 28 February 2023
+Support links
+Home
+Health A to Z
+Live Well
+Mental health
+Care and support
+Pregnancy
+NHS services
+Coronavirus (COVID-19)
+NHS App
+Find my NHS number
+Your health records
+About the NHS
+Healthcare abroad
+Contact us
+Other NHS websites
+Profile editor login
+About us
+Accessibility statement
+Our policies
+Cookies
+© Crown copyright

integrations/haystack/nhs-search/data/www.nhs.uk_conditions_antiphospholipid-syndrome_.txt

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+Cookies on the NHS website
+We've put some small files called cookies on your device to make our site work.
+We'd also like to use analytics cookies. These send information about how our site is used to services called Adobe Analytics, Hotjar and Google Analytics. We use this information to improve our site.
+Let us know if this is OK. We'll use a cookie to save your choice. You can read more about our cookies before you choose.
+I'm OK with analytics cookies Do not use analytics cookies
+Search the NHS website
+Search
+My account
+Health A-Z
+Live Well
+Mental health
+Care and support
+Pregnancy
+Browse
+More
+Home Health A to Z
+Overview
+-
+Antiphospholipid syndrome (APS)
+Contents
+Overview
+Symptoms
+Causes
+Diagnosis
+Treatment
+Complications
+Antiphospholipid syndrome (APS), sometimes known as Hughes syndrome, is a disorder of the immune system that causes an increased risk of blood clots.
+This means people with APS are at greater risk of developing conditions such as:
+deep vein thrombosis (DVT), a blood clot that usually develops in the leg
+arterial thrombosis (a clot in an artery), which can cause a stroke or heart attack
+blood clots in the brain, leading to problems with balance, mobility, vision, speech and memory
+Pregnant women with APS also have an increased risk of having a miscarriage, although the exact reasons for this are uncertain.
+APS doesn't always cause noticeable problems, but some people have general symptoms that can be similar to those of multiple sclerosis (a common condition affecting the central nervous system).
+Find out more about signs and symptoms of APS
+What causes antiphospholipid syndrome?
+APS is an autoimmune condition. This means the immune system, which usually protects the body from infection and illness, attacks healthy tissue by mistake.
+In APS, the immune system produces abnormal antibodies called antiphospholipid antibodies.
+These target proteins attached to fat molecules (phospholipids), which makes the blood more likely to clot.
+It's not known what causes the immune system to produce abnormal antibodies.
+As with other autoimmune conditions, genetic, hormonal and environmental factors are thought to play a part.
+Find out more about the causes of APS
+Who's affected
+APS can affect people of all ages, including children and babies.
+But most people are diagnosed with APS between 20 and 50 years of age, and it affects 3 to 5 times as many women as men.
+It's not clear how many people in the UK have the condition.
+Diagnosing APS
+Diagnosing APS can sometimes be tricky, as some of the symptoms are similar to multiple sclerosis.
+This means blood tests to identify the antibodies responsible for APS are essential in diagnosing the condition.
+Find out more about diagnosing APS
+How antiphospholipid syndrome is treated
+Although there's no cure for APS, the risk of developing blood clots can be greatly reduced if it's correctly diagnosed.
+An anticoagulant medicine, such as warfarin, or an antiplatelet, such as low-dose aspirin, is usually prescribed.
+These reduce the likelihood of unnecessary blood clots forming, but still allow clots to form when you cut yourself.
+Treatment with these medications can also improve a pregnant woman's chance of having a successful pregnancy.
+With treatment, it's estimated there's about an 80% chance of having a successful pregnancy.
+Most people respond well to treatment and can lead normal, healthy lives.
+But a small number of people with APS continue to experience blood clots despite extensive treatment.
+Find out more about treating APS
+Catastrophic antiphospholipid syndrome
+In very rare cases, blood clots can suddenly form throughout the body, resulting in multiple organ failure. This is known as catastrophic antiphospholipid syndrome (CAPS).
+CAPS requires immediate emergency treatment in hospital with high-dose anticoagulants.
+Find out more about catastrophic antiphospholipid syndrome (CAPS)
+Page last reviewed: 21 August 2018
+Next review due: 21 August 2021
+Next
+:
+Symptoms
+Support links
+Home
+Health A to Z
+Live Well
+Mental health
+Care and support
+Pregnancy
+NHS services
+Coronavirus (COVID-19)
+NHS App
+Find my NHS number
+Your health records
+About the NHS
+Healthcare abroad
+Contact us
+Other NHS websites
+Profile editor login
+About us
+Accessibility statement
+Our policies
+Cookies
+© Crown copyright

integrations/haystack/nhs-search/data/www.nhs.uk_conditions_anxiety-disorders-in-children_.txt

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+Cookies on the NHS website
+We've put some small files called cookies on your device to make our site work.
+We'd also like to use analytics cookies. These send information about how our site is used to services called Adobe Analytics, Hotjar and Google Analytics. We use this information to improve our site.
+Let us know if this is OK. We'll use a cookie to save your choice. You can read more about our cookies before you choose.
+I'm OK with analytics cookies Do not use analytics cookies
+Search the NHS website
+Search
+My account
+Health A-Z
+Live Well
+Mental health
+Care and support
+Pregnancy
+Browse
+More
+Home Mental health Mental health for children, teenagers and young adults Advice for parents
+Anxiety disorders in children
+It's normal for children to feel worried or anxious from time to time – such as when they're starting school or nursery, or moving to a new area.
+But for some children, anxiety affects their behaviour and thoughts every day, interfering with their school, home and social life.
+This is when you may need professional help to tackle it.
+Symptoms of anxiety in children
+Signs to look out for in your child are:
+finding it hard to concentrate
+not sleeping, or waking in the night with bad dreams
+not eating properly
+quickly getting angry or irritable, and being out of control during outbursts
+constantly worrying or having negative thoughts
+feeling tense and fidgety, or using the toilet often
+always crying
+being clingy
+complaining of tummy aches and feeling unwell
+Separation anxiety is common in younger children, whereas older children and teenagers tend to worry more about school or have social anxiety.
+How to help your anxious child
+If your child is having problems with anxiety, there's plenty you can do to help.
+Above all, it's important to talk to your child about their anxiety or worries.
+Read more about how to help an anxious child, including self-help tips for parents of anxious children.
+Many children at different ages may have anxieties that will go away after a while, with your reassurance.
+However, it's a good idea to seek professional help or reassurance yourself if your child is constantly anxious and:
+it's not getting better, or is getting worse
+self-help is not working
+it's affecting their school or family life, or their friendships
+Where to get help for anxiety
+An appointment with a GP is a good place to start.
+You can talk to the GP on your own or with your child, or your child might be able to have an appointment without you.
+If the GP thinks your child could have an anxiety disorder, they may refer them for an assessment with your local children and young people's mental health services (CYPMHS).
+Specialist CYPMHS are NHS mental health services that focus on the needs of children and young people. CYPMHS workers are trained to help young people with a wide range of problems, including anxiety.
+If your child does not want to see a doctor, they may be able to get help directly from a local youth counselling service. For more information, visit Youth Access.
+Treatments for anxiety disorders in children
+The type of treatment offered will depend on your child's age and the cause of their anxiety.
+Counselling can help your child understand what's making them anxious and allow them to work through the situation.
+Cognitive behavioural therapy (CBT) is a talking therapy that can help your child manage their anxiety by changing the way they think and behave. Learn more about CBT.
+Anxiety medicines may be offered to your child if their anxiety is severe or does not get better with talking therapies. They're usually only prescribed by doctors who specialise in children and young people's mental health.
+What causes anxiety disorders in children
+Some children are simply born more anxious and less able to cope with stress than others.
+Children can also pick up anxious behaviour from being around anxious people.
+Some children develop anxiety after stressful events, such as:
+frequently moving house or school
+parents fighting or arguing
+the death of a close relative or friend
+becoming seriously ill or getting injured in an accident
+school-related issues like exams or bullying
+being abused or neglected
+Children with attention deficit hyperactivity disorder (ADHD) and autistic spectrum disorders are more likely to have problems with anxiety.
+More information and support
+For you
+Mental Health Foundation: The Anxious Child – a booklet for parents and carers
+Royal College of Psychiatrists: worries and anxieties – helping children to cope
+YoungMinds Parents Helpline – call 0808 802 5544 (Monday to Friday 9.30am to 4pm, free for mobiles and landlines)
+For your child
+YoungMinds: anxiety
+Childline: managing your anxiety
+More in Advice for parents
+Children and bereavement
+Helping your child with anger issues
+Anxiety disorders in children
+Anxiety in children
+Depression in children and young people
+Talking to your child about feelings
+Teen aggression and arguments
+Coping with your teenager
+Worried about your teenager?
+Help your child beat exam stress
+Talking to your teenager
+Page last reviewed: 1 December 2020
+Next review due: 1 December 2023
+Support links
+Home
+Health A to Z
+Live Well
+Mental health
+Care and support
+Pregnancy
+NHS services
+Coronavirus (COVID-19)
+NHS App
+Find my NHS number
+Your health records
+About the NHS
+Healthcare abroad
+Contact us
+Other NHS websites
+Profile editor login
+About us
+Accessibility statement
+Our policies
+Cookies
+© Crown copyright

integrations/haystack/nhs-search/data/www.nhs.uk_conditions_aortic-valve-replacement_.txt

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+Cookies on the NHS website
+We've put some small files called cookies on your device to make our site work.
+We'd also like to use analytics cookies. These send information about how our site is used to services called Adobe Analytics, Hotjar and Google Analytics. We use this information to improve our site.
+Let us know if this is OK. We'll use a cookie to save your choice. You can read more about our cookies before you choose.
+I'm OK with analytics cookies Do not use analytics cookies
+Search the NHS website
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+My account
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+Mental health
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+More
+Home Health A to Z
+Overview
+-
+Aortic valve replacement
+Contents
+Overview
+Why it's done
+What happens
+Recovery
+Risks
+Alternatives
+An aortic valve replacement is a type of open heart surgery used to treat problems with the heart's aortic valve.
+The aortic valve controls the flow of blood out from the heart to the rest of the body.
+An aortic valve replacement involves removing a faulty or damaged valve and replacing it with a new valve made from synthetic materials or animal tissue.
+It's a major operation that isn't suitable for everyone and can take a long time to recover from.
+When is it necessary to replace the aortic valve?
+The aortic valve may need to be replaced for 2 reasons:
+the valve has become narrowed (aortic stenosis) – the opening of the valve becomes smaller, obstructing the flow of blood out of the heart
+the valve is leaky (aortic regurgitation) – the valve allows blood to flow back through into the heart
+The problems can get worse over time and in severe cases can lead to life-threatening problems such as heart failure if left untreated.
+There are no medicines to treat aortic valve problems, so replacing the valve will be recommended if you're at risk of serious complications but are otherwise well enough to have surgery. 
+Find out more about why aortic valve replacements are carried out
+How is an aortic valve replacement carried out?
+An aortic valve replacement is carried out under general anaesthetic.
+This means you'll be asleep during the operation and won't feel any pain while it's carried out.
+During the procedure:
+a large cut (incision) about 25cm long is made in your chest to access your heart – although sometimes a smaller cut may be made
+your heart is stopped and a heart-lung (bypass) machine is used to take over the job of your heart during the operation
+the damaged or faulty valve is removed and replaced with the new one
+your heart is restarted and the opening in your chest is closed
+The operation usually takes a few hours.
+You'll have a discussion with your doctor or surgeon before the procedure to decide whether a synthetic or animal tissue replacement valve is most suitable for you.
+Find out what happens during an aortic valve replacement
+Recovering from an aortic valve replacement
+You'll usually need to stay in hospital for about a week after an aortic valve replacement, although it may be 2 to 3 months before you fully recover.
+You should take things easy when you first get home, but you can start to gradually return to your normal activities over the next few weeks.
+You'll be given specific advice about any side effects you can expect while you recover and any activities you should avoid.
+You won't usually be able to drive for around 6 weeks and you'll probably need 6 to 12 weeks off work, depending on your job.
+Read more about recovering from an aortic valve replacement.
+Risks of an aortic valve replacement
+An aortic valve replacement is a big operation and, like any type of surgery, carries a risk of complications.
+Some of the main risks of an aortic valve replacement include:
+wound, lung, bladder or heart valve infections
+blood clots
+strokes
+a temporarily irregular heartbeat (arrhythmia)
+reduced kidney function for a few days
+The risk of dying from an aortic valve replacement is around 2%, although this risk is much smaller than that of leaving severe aortic valve problems untreated.
+Most people who survive surgery have a life expectancy close to normal.
+Read more about the risks of aortic valve replacement.
+Alternatives to an aortic valve replacement
+An aortic valve replacement is the most effective treatment for aortic valve conditions. 
+Alternative procedures are usually only used if open heart surgery is too risky.
+Possible alternatives include:
+transcatheter aortic valve implantation (TAVI) – the replacement valve is guided into place through the blood vessels, rather than through a large incision in the chest
+aortic valve balloon valvuloplasty – the valve is widened using a balloon
+sutureless aortic valve replacement – the valve is not secured using stitches (sutures) to minimise the time spent on a heart-lung machine
+Read more about the alternatives to an aortic valve replacement.
+Page last reviewed: 23 December 2021
+Next review due: 23 December 2024
+Next
+:
+Why it's done
+Support links
+Home
+Health A to Z
+Live Well
+Mental health
+Care and support
+Pregnancy
+NHS services
+Coronavirus (COVID-19)
+NHS App
+Find my NHS number
+Your health records
+About the NHS
+Healthcare abroad
+Contact us
+Other NHS websites
+Profile editor login
+About us
+Accessibility statement
+Our policies
+Cookies
+© Crown copyright

integrations/haystack/nhs-search/data/www.nhs.uk_conditions_aphasia_.txt

@@ -0,0 +1,105 @@
+Cookies on the NHS website
+We've put some small files called cookies on your device to make our site work.
+We'd also like to use analytics cookies. These send information about how our site is used to services called Adobe Analytics, Hotjar and Google Analytics. We use this information to improve our site.
+Let us know if this is OK. We'll use a cookie to save your choice. You can read more about our cookies before you choose.
+I'm OK with analytics cookies Do not use analytics cookies
+Search the NHS website
+Search
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+Health A-Z
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+Mental health
+Care and support
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+More
+Home Health A to Z
+Overview
+-
+Aphasia
+Contents
+Overview
+Symptoms
+Treatment
+Aphasia is when a person has difficulty with their language or speech. It's usually caused by damage to the left side of the brain (for example, after a stroke).
+Symptoms of aphasia
+People with aphasia often have trouble with the 4 main ways people understand and use language.
+These are:
+reading
+listening
+speaking
+typing or writing
+Speaking problems are perhaps the most obvious, and people with aphasia may make mistakes with the words they use.
+This could be sometimes using the wrong sounds in a word, choosing the wrong word, or putting words together incorrectly.
+Although aphasia affects a person's ability to communicate, it doesn't affect their intelligence.
+Aphasia can occur by itself or alongside other disorders, such as visual difficulties, mobility problems, limb weakness, and problems with memory or thinking skills.
+Types of aphasia
+Aphasia is often classified as "expressive" or "receptive", depending on whether there are difficulties with understanding or expressing language, or both.
+But most people with aphasia have some trouble with their speaking, and will have a mixture of problems with writing, reading and perhaps listening.
+Symptoms can range widely from getting a few words mixed up to having difficulty with all forms of communication.
+Some people are unaware that their speech makes no sense and get frustrated when others don't understand them.
+Read more about the different types of aphasia.
+Causes of aphasia
+Aphasia is caused by damage to parts of the brain responsible for understanding and producing language.
+Common causes include:
+stroke – the most common cause of aphasia
+severe head injury
+a brain tumour
+progressive neurological conditions – conditions that cause the brain and nervous system to become damaged over time, such as dementia
+Aphasia can affect people of all ages, but it's most common in people over the age of 65. This is because strokes and progressive neurological conditions tend to affect older adults.
+Diagnosing aphasia
+Aphasia is usually diagnosed after tests carried out by a clinician – either a speech and language therapist or a doctor. They can also help arrange treatment if necessary.
+These tests often involve simple exercises, such as asking a person to name objects in the room, repeat words and sentences, and read and write.
+The aim of these tests is to understand a person's ability to:
+understand basic speech and grammar
+express words, phrases and sentences
+socially communicate – for example, hold a conversation or understand a joke
+read and write letters, words and sentences
+Imaging techniques such as a CT scan or MRI scan can be used to assess brain damage.
+Treating aphasia
+Speech and language therapy is the main type of treatment for people with aphasia.
+This aims to help restore some of your ability to communicate, as well as help you develop alternative ways of communicating, if necessary.
+You may receive speech and language therapy on an individual basis or in a group, depending on your needs and the service provided.
+An increasing number of computer-based applications are available to support people with aphasia.
+But it's important to start using these with the assistance of a speech and language therapist.
+How successful treatment is differs from person to person. Most people with aphasia make some degree of recovery, and some recover fully.
+If the aphasia is caused by a one-off event, like a stroke, most patients recover to some degree with therapy. There's no evidence to suggest that recovery stops at a specific time after stroke.
+But the chance of recovery is poorer for people with aphasia resulting from a progressive neurological condition.
+Some people can still respond to therapy, but there are currently no good ways of reversing the ongoing injury to the brain.
+When aphasia is caused by a progressive condition, treatment focuses on making the most of what people can still do and developing other ways of communicating to prepare for a time when speaking will be more difficult.
+Read more about treating aphasia.
+Complications of aphasia
+The challenges of living with aphasia can impact how a person feels and interacts with others.
+In some cases, it can lead to:
+isolation
+anxiety
+depression
+If you're concerned about someone with aphasia, encourage them to discuss any problems with their GP or a member of their care team to access the relevant support.
+If the person is unable to do this themselves, they may require someone to communicate on their behalf.
+Page last reviewed: 23 March 2021
+Next review due: 23 March 2024
+Next
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+Support links
+Home
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integrations/haystack/nhs-search/data/www.nhs.uk_conditions_appendicitis_.txt

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+Cookies on the NHS website
+We've put some small files called cookies on your device to make our site work.
+We'd also like to use analytics cookies. These send information about how our site is used to services called Adobe Analytics, Hotjar and Google Analytics. We use this information to improve our site.
+Let us know if this is OK. We'll use a cookie to save your choice. You can read more about our cookies before you choose.
+I'm OK with analytics cookies Do not use analytics cookies
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+Overview
+-
+Appendicitis
+Contents
+Overview
+Symptoms
+Diagnosis
+Treatment
+Complications
+Appendicitis is a painful swelling of the appendix. The appendix is a small, thin pouch about 5 to 10cm (2 to 4 inches) long. It's connected to the large intestine, where poo forms.
+Nobody knows exactly what the appendix does, but removing it is not harmful.
+Symptoms of appendicitis
+Appendicitis typically starts with a pain in the middle of your tummy (abdomen) that may come and go.
+Within hours, the pain travels to the lower right-hand side, where the appendix usually lies, and becomes constant and severe.
+Pressing on this area, coughing or walking may make the pain worse.
+You may lose your appetite, feel sick and have constipation or diarrhoea.
+When to get medical help
+If you have abdominal pain that's gradually getting worse, contact a GP or your local out-of-hours service immediately.
+If these options are not available, call NHS 111 for advice.
+Call 999 to ask for an ambulance if you have pain that suddenly gets worse and spreads across your abdomen, or if your pain temporarily improves before getting worse again.
+If your pain eases for a while but then gets worse, your appendix may have burst, which can lead to life-threatening complications.
+Read more about diagnosing appendicitis and complications of appendicitis.
+How appendicitis is treated
+If you have appendicitis, it's likely your appendix will need to be removed as soon as possible.
+Removal of the appendix, known as an appendicectomy or appendectomy, is 1 of the most common operations in the UK and its success rate is excellent.
+It's most commonly carried out as keyhole surgery (laparoscopy).
+Several small cuts are made in the abdomen, allowing special surgical instruments to be inserted.
+Open surgery, where a larger, single cut is made in the abdomen, is usually used if the appendix has burst or access is more difficult.
+It usually takes a couple of weeks to make a full recovery after your appendix has been removed.
+But strenuous activities may need to be avoided for up to 6 weeks after having open surgery.
+What causes appendicitis?
+It's not clear what causes appendicitis. In many cases it may be that something blocks the entrance of the appendix.
+For example, it could become blocked by a small piece of poo, or an upper respiratory tract infection could cause the lymph node within the wall of the bowel to become swollen.
+If the obstruction causes inflammation and swelling, it could lead to increased pressure within the appendix, which may then burst.
+As the causes of appendicitis are not fully understood, there's no guaranteed way of preventing it.
+Who's affected
+Appendicitis is a common condition. In England, around 50,000 people are admitted to hospital with appendicitis each year.
+You can get appendicitis at any age, but it usually affects young people aged between 10 and 20 years.
+Video: what is appendicitis?
+Watch this animation to learn about what causes appendicitis and how it's treated.
+Play Video
+Media last reviewed: 1 May 2021
+Media review due: 1 May 2024
+Page last reviewed: 18 February 2019
+Next review due: 18 February 2022
+Next
+:
+Symptoms
+Support links
+Home
+Health A to Z
+Live Well
+Mental health
+Care and support
+Pregnancy
+NHS services
+Coronavirus (COVID-19)
+NHS App
+Find my NHS number
+Your health records
+About the NHS
+Healthcare abroad
+Contact us
+Other NHS websites
+Profile editor login
+About us
+Accessibility statement
+Our policies
+Cookies
+© Crown copyright

integrations/haystack/nhs-search/data/www.nhs.uk_conditions_arrhythmia_.txt

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+Cookies on the NHS website
+We've put some small files called cookies on your device to make our site work.
+We'd also like to use analytics cookies. These send information about how our site is used to services called Adobe Analytics, Hotjar and Google Analytics. We use this information to improve our site.
+Let us know if this is OK. We'll use a cookie to save your choice. You can read more about our cookies before you choose.
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+Home Health A to Z
+Arrhythmia
+Arrhythmias or heart rhythm problems are experienced by more than 2 million people in the UK. Most people with an abnormal heart rhythm can lead a normal life if it is properly diagnosed.
+The main types of arrhythmia are:
+atrial fibrillation (AF) – this is the most common type, where the heart beats irregularly and faster than normal
+supraventricular tachycardia – episodes of abnormally fast heart rate at rest
+bradycardia – the heart beats more slowly than normal
+heart block – the heart beats more slowly than normal and can cause people to collapse
+ventricular fibrillation – a rare, rapid and disorganised rhythm of heartbeats that rapidly leads to loss of consciousness and sudden death if not treated immediately
+Arrhythmias can affect all age groups, but atrial fibrillation is more common in older people. Drinking alcohol in excess or being overweight increases your likelihood of developing atrial fibrillation.
+You may also be at risk of developing an arrhythmia if your heart tissue is damaged because of an illness – for example, if you have had a heart attack or have heart failure, or if you have had severe coronavirus (COVID-19).
+Atrial fibrillation is a common cause of stroke. Having atrial fibrillation means your risk of stroke is 5 times higher than for someone whose heart rhythm is normal.
+Certain types of arrhythmia occur in people with severe heart conditions, and can cause sudden cardiac death. This kills 100,000 people in the UK every year. Some of these deaths could be avoided if the arrhythmias were diagnosed earlier.
+Common triggers for an arrhythmia are viral illnesses, alcohol, tobacco, changes in posture, exercise, drinks containing caffeine, certain over-the-counter and prescribed medicines, and illegal recreational drugs.
+Information:
+Coronavirus (COVID-19) advice
+Get advice about coronavirus (COVID-19) and arrhythmia from the British Heart Foundation
+Preventing arrhythmias
+It is not always possible to prevent an arrhythmia developing, although a healthy lifestyle can lower your risk of developing a heart condition.
+Treatment aims to prevent future episodes. You can also make lifestyle changes so you avoid some of the triggers for your heart rhythm problem.
+Your heart's electrical system
+The heart's rhythm is controlled by electrical signals. An arrhythmia is an abnormality of the heart's rhythm. It may beat too slowly, too quickly, or irregularly.
+These abnormalities range from a minor inconvenience or discomfort to a potentially fatal problem.
+Symptoms of arrhythmias
+Symptoms of arrhythmias include palpitations, feeling dizzy, fainting and being short of breath, although having these symptoms does not always mean you have a heart rhythm problem.
+Arrhythmia Alliance's heart rhythm checklists can help you gather information to discuss with your GP if you have any of these symptoms.
+Diagnosing arrhythmias
+If your symptoms persist or there's a history of unexplained sudden death in your family, it's important for your GP to refer you to a heart specialist (a cardiologist or electrophysiologist who specialises in heart rhythm disorders).
+The most effective way to diagnose an arrhythmia is with an electrical recording of your heart rhythm called an electrocardiogram (ECG). If the ECG doesn't find a problem, you may need further monitoring of your heart.
+This may involve wearing a small portable ECG recording device for 24 hours or longer. This is called a Holter monitor or ambulatory ECG monitoring. Some people might be asked to wear an ECG monitor for up to 14 days.
+If your symptoms seem to be triggered by exercise, an exercise ECG may be needed to record your heart rhythm while you are using a treadmill or exercise bike.
+You should request a copy of your ECG. Take it with you to see the cardiologist or heart rhythm specialist and always keep a copy for future use.
+Other tests used in diagnosing arrhythmias include:
+cardiac event recorder – a device to record occasional symptoms over a period of time whenever you have them
+electrophysiological (EP) study – a test to locate problems with the electrical signals in your heart by passing soft wires up a vein in your leg and into your heart while you are sedated
+echocardiogram (echo) – an ultrasound scan of your heart
+Treatment for arrhythmias
+How your arrhythmia will be treated will depend on whether it is a fast or slow arrhythmia or heart block. Any underlying causes of your arrhythmia, such as heart failure, will need to be treated as well.
+The treatments used for arrhythmias include:
+medicine – to stop or prevent an arrhythmia or control the rate of an arrhythmia
+electrical cardioversion – a treatment that uses electricity to shock the heart back into a normal rhythm while you are anaesthetised or sedated
+catheter ablation – a keyhole treatment under local or general anaesthetic that carefully destroys the diseased tissue in your heart that causes the arrhythmia
+pacemaker – a small device containing its own battery that is implanted in your chest under local anaesthetic; it produces electrical signals to do the work of the natural pacemaker in your heart to help it beat at a normal rate
+implantable cardioverter defibrillator (ICD) – a device similar to a pacemaker that monitors your heart rhythm and shocks your heart back into a normal rhythm whenever this is needed
+Staying safe with an arrhythmia
+If you have an arrhythmia that affects your driving, you must tell the Driver and Vehicle Licensing Agency (DVLA).
+If your job involves working at height or with machinery that could be dangerous, you will need to stop work at least until your arrhythmia is diagnosed or you get treatment for your underlying condition. Get advice from your GP or cardiologist.
+Support services
+Find heart disease information and support services
+Find atrial fibrillation services
+Find pacemaker implantation services
+Other heart rhythm pages
+See the list below for information about specific heart rhythm problems.
+Atrial fibrillation
+Brugada syndrome
+Heart block
+Heart palpitations
+Long QT syndrome
+Supraventricular tachycardia
+Wolff-Parkinson-White syndrome
+Page last reviewed: 14 September 2021
+Next review due: 14 September 2024
+Support links
+Home
+Health A to Z
+Live Well
+Mental health
+Care and support
+Pregnancy
+NHS services
+Coronavirus (COVID-19)
+NHS App
+Find my NHS number
+Your health records
+About the NHS
+Healthcare abroad
+Contact us
+Other NHS websites
+Profile editor login
+About us
+Accessibility statement
+Our policies
+Cookies
+© Crown copyright

integrations/haystack/nhs-search/data/www.nhs.uk_conditions_arterial-thrombosis_.txt

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+Cookies on the NHS website
+We've put some small files called cookies on your device to make our site work.
+We'd also like to use analytics cookies. These send information about how our site is used to services called Adobe Analytics, Hotjar and Google Analytics. We use this information to improve our site.
+Let us know if this is OK. We'll use a cookie to save your choice. You can read more about our cookies before you choose.
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+Arterial thrombosis
+Arterial thrombosis is a blood clot in an artery, which can be very serious because it can stop blood reaching important organs.
+Arteries are blood vessels that carry blood from the heart to the rest of the body and the heart muscle.
+Symptoms and risks of arterial thrombosis
+A blood clot does not usually have any symptoms until it blocks the flow of blood to part of the body.
+This can cause several serious problems, including:
+a heart attack, when blood flow to the heart muscle is suddenly blocked, causing chest pain, shortness of breath and dizziness
+a stroke, when blood flow to the brain is cut off; the main symptoms are one side of the face dropping, weakness in one side of the body and slurred speech
+a transient ischaemic attack (TIA) or "mini-stroke", when blood flow to the brain is temporarily blocked, causing short-lived stroke symptoms
+critical limb ischaemia (a complication of peripheral arterial disease), when the blood supply to a limb is blocked, causing it to become painful, discoloured (either pale or blue) and cold
+These conditions are all medical emergencies. Get medical help straight away by calling 999 if you or someone in your care is experiencing these symptoms.
+Causes of arterial thrombosis
+Arterial thrombosis usually affects people whose arteries are clogged with fatty deposits. This is known as atherosclerosis.
+These deposits cause the arteries to harden and narrow over time and increase the risk of blood clots.
+The following can increase your risk of developing atherosclerosis:
+getting older
+smoking
+an unhealthy diet
+a lack of exercise
+being overweight or obese
+regularly drinking excessive amounts of alcohol
+other health conditions, including high blood pressure, high cholesterol and diabetes
+a family history of atherosclerosis
+being of south Asian, African or African-Caribbean descent
+Sometimes arterial thrombosis can be due to a condition that makes your blood more likely to clot, such as atrial fibrillation or antiphospholipid syndrome.
+Reduce your risk of arterial thrombosis
+It's not possible to prevent blood clots entirely, but you can reduce your risk by lowering your risk of atherosclerosis.
+The main things you can do are:
+stop smoking
+eat a healthy, balanced diet
+exercise regularly
+maintain a healthy weight – find advice about losing weight
+cut down on your alcohol consumption
+If you're at a high risk of getting a blood clot, your doctor may also recommend taking medicines such as:
+statins to manage high cholesterol
+medicines for high blood pressure
+medicines to reduce the risk of your blood clotting. For example, an anticoagulant such as warfarin and an antiplatelet such as low-dose aspirin or clopidogrel
+Treatments for arterial thrombosis
+If you develop arterial thrombosis, it may need to be treated with medicine or surgery.
+Treatments include:
+injections of a medicine called a thrombolytic which can dissolve some blood clots
+an operation to remove the clot (embolectomy)
+an operation to widen the affected artery – for example, an angioplasty (where a hollow tube is placed inside the artery to hold it open)
+surgery to divert blood around the blocked artery – for example, a coronary artery bypass graft (where a blood vessel taken from another part of the body is used to bypass a blockage in the artery that supplies the heart muscle)
+Other types of blood clot
+As well as arterial thrombosis, there are several other types of blood clot, including:
+venous thromboembolism (VTE) – a blood clot in a vein
+DVT (deep vein thrombosis) – a blood clot in one of the deep veins in the body, usually in the leg
+embolism – where the blood flow in an artery is blocked by a foreign body; this can be a blood clot or something else such as an air bubble
+pulmonary embolism – a blood clot in the pulmonary artery, which transports blood from the heart to the lungs
+Page last reviewed: 09 January 2020
+Next review due: 09 January 2023
+Support links
+Home
+Health A to Z
+Live Well
+Mental health
+Care and support
+Pregnancy
+NHS services
+Coronavirus (COVID-19)
+NHS App
+Find my NHS number
+Your health records
+About the NHS
+Healthcare abroad
+Contact us
+Other NHS websites
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+Our policies
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+© Crown copyright

integrations/haystack/nhs-search/data/www.nhs.uk_conditions_arthritis_.txt

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+Cookies on the NHS website
+We've put some small files called cookies on your device to make our site work.
+We'd also like to use analytics cookies. These send information about how our site is used to services called Adobe Analytics, Hotjar and Google Analytics. We use this information to improve our site.
+Let us know if this is OK. We'll use a cookie to save your choice. You can read more about our cookies before you choose.
+I'm OK with analytics cookies Do not use analytics cookies
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+Search
+My account
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+More
+Coronavirus (COVID-19)
+Get the latest advice about COVID-19
+Home Health A to Z
+Overview
+-
+Arthritis
+Contents
+Overview
+Living with arthritis
+Arthritis is a common condition that causes pain and inflammation in a joint.
+In the UK, more than 10 million people have arthritis or other, similar conditions that affect the joints.
+Arthritis affects people of all ages, including children.
+Information:
+Coronavirus advice
+If you have arthritis and you're worried about coronavirus, you can get advice about coronavirus and arthritis from Versus Arthritis.
+Types of arthritis
+Osteoarthritis and rheumatoid arthritis are the 2 most common types of arthritis.
+Osteoarthritis
+Osteoarthritis is the most common type of arthritis in the UK, affecting nearly 9 million people.
+It most often develops in people in their mid-40s or older.
+It's also more common in women and people with a family history of the condition. 
+But it can occur at any age as a result of an injury or be associated with other joint-related conditions, such as gout or rheumatoid arthritis.
+Osteoarthritis initially affects the smooth cartilage lining of the joint. This makes movement more difficult than usual, leading to pain and stiffness.
+Once the cartilage lining starts to roughen and thin out, the tendons and ligaments have to work harder.
+This can cause swelling and the formation of bony spurs called osteophytes.
+Severe loss of cartilage can lead to bone rubbing on bone, altering the shape of the joint and forcing the bones out of their normal position.
+The most commonly affected joints are those in the:
+hands
+spine
+knees
+hips
+Find out more about osteoarthritis
+Rheumatoid arthritis
+In the UK, rheumatoid arthritis affects more than 400,000 people.
+It often starts when a person is between 40 and 50 years old. Women are 3 times more likely to be affected than men.
+In rheumatoid arthritis, the body's immune system targets affected joints, which leads to pain and swelling. 
+The outer covering (synovium) of the joint is the first place affected.
+This can then spread across the joint, leading to further swelling and a change in the joint's shape. This may cause the bone and cartilage to break down.
+People with rheumatoid arthritis can also develop problems with other tissues and organs in their body.
+Find out more about rheumatoid arthritis
+Other types of arthritis and related conditions
+ankylosing spondylitis – a long-term inflammatory condition that mainly affects the bones, muscles and ligaments of the spine, leading to stiffness and joints fusing together. Other problems can include the swelling of tendons, eyes and large joints
+cervical spondylosis – also known as degenerative osteoarthritis, cervical spondylitis affects the joints and bones in the neck, which can lead to pain and stiffness
+fibromyalgia – causes pain in the body's muscles, ligaments and tendons
+lupus – an autoimmune condition that can affect many different organs and the body's tissues
+gout – a type of arthritis caused by too much uric acid in the body. This can be left in joints (usually affecting the big toe), but can develop in any joint. It causes intense pain, redness and swelling
+psoriatic arthritis – an inflammatory joint condition that can affect people with psoriasis
+enteropathic arthritis – a form of chronic inflammatory arthritis associated with inflammatory bowel disease (IBD), the 2 main types being ulcerative colitis and Crohn's disease. About 1 in 5 people with Crohn's disease or ulcerative colitis will develop enteropathic arthritis. The most common areas affected by inflammation are the peripheral (limb) joints and the spine
+reactive arthritis – this can cause inflammation of the joints, eyes and the tube that urine passes through (urethra). It develops shortly after an infection of the bowel, genital tract or, less frequently, after a throat infection
+secondary arthritis – a type of arthritis that can develop after a joint injury and sometimes occurs many years afterwards
+polymyalgia rheumatica – a condition that almost always affects people over 50 years of age, where the immune system causes muscle pain and stiffness, usually across the shoulders and tops of the legs. It can also cause joint inflammation
+Symptoms of arthritis
+There are lots of different types of arthritis.
+The symptoms you experience will vary depending on the type you have.
+This is why it's important to have an accurate diagnosis if you have:
+joint pain, tenderness and stiffness
+inflammation in and around the joints
+restricted movement of the joints
+warm red skin over the affected joint
+weakness and muscle wasting
+Arthritis and children
+Arthritis is often associated with older people, but it can also affect children.
+In the UK, about 15,000 children and young people are affected by arthritis.
+Most types of childhood arthritis are known as juvenile idiopathic arthritis (JIA).
+JIA causes pain and inflammation in 1 or more joints for at least 6 weeks.
+Although the exact cause of JIA is unknown, the symptoms often improve as a child gets older, meaning they can lead a normal life.
+The main types of JIA are:
+Oligo-articular JIA
+Oligo-articular JIA is the most common type of JIA. It affects up to 4 joints in the body, most commonly in the knees, ankles and wrists.
+Oligo-articular JIA often goes away without causing long-term joint damage.
+But there's a risk that children with the condition may develop eye problems, so regular eye tests with an eyecare specialist called an ophthalmologist are recommended.
+Polyarticular JIA (polyarthritis)
+Polyarticular JIA, or polyarthritis, is the second most common type of JIA and affects 5 or more joints.
+It can affect a child of any age and may come on suddenly or develop gradually.
+The symptoms of polyarticular JIA are similar to the symptoms of adult rheumatoid arthritis.
+A child with the condition may also feel unwell and may occasionally have a high temperature of 38C or above.
+Systemic onset JIA
+Systemic onset JIA begins with symptoms such as a fever, rash, a lack of energy and enlarged glands. Later on, joints can become swollen and inflamed.
+Like polyarticular JIA, systemic onset JIA can affect children of any age.
+Enthesitis-related arthritis
+Enthesitis-related arthritis is a type of juvenile arthritis that often affects the joints of the leg and spine, causing inflammation where the tendons attach to the bone.
+It can cause stiffness in the neck and lower back in the teenage years.
+It's also linked to a painful eye condition called acute uveitis.
+Versus Arthritis has more information about the different types of juvenile idiopathic arthritis.
+Treating arthritis
+There's no cure for arthritis, but there are many treatments that can help slow it down.
+Osteoarthritis treatments include lifestyle changes, medicines and surgery.
+Treatment for rheumatoid arthritis aims to slow the condition's progress and minimise joint inflammation. This helps prevent joint damage.
+Treatments include medication, physiotherapy and surgery.
+Further information, help and support
+Versus Arthritis provides help and support for people in the UK with arthritis, plus their families and friends.
+They have a free helpline you can call for further information and support on 0800 5200 520, Monday to Friday, 9am to 8pm.
+You can also look up arthritis services near where you live.
+Find out more about living with arthritis
+Information:
+Social care and support guide
+If you:
+need help with day-to-day living because of illness or disability
+care for someone regularly because they're ill, elderly or disabled, including family members
+Our guide to care and support explains your options and where you can get support.
+Help us improve our website
+If you've finished what you're doing, can you answer some questions about your visit today?
+Take our survey
+Page last reviewed: 14 December 2018
+Next review due: 14 December 2021
+Next
+:
+Living with arthritis
+Support links
+Home
+Health A to Z
+Live Well
+Mental health
+Care and support
+Pregnancy
+NHS services
+Coronavirus (COVID-19)
+NHS App
+Find my NHS number
+Your health records
+About the NHS
+Healthcare abroad
+Contact us
+Other NHS websites
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+Accessibility statement
+Our policies
+Cookies
+© Crown copyright

integrations/haystack/nhs-search/data/www.nhs.uk_conditions_arthroscopy_.txt

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+Cookies on the NHS website
+We've put some small files called cookies on your device to make our site work.
+We'd also like to use analytics cookies. These send information about how our site is used to services called Adobe Analytics, Hotjar and Google Analytics. We use this information to improve our site.
+Let us know if this is OK. We'll use a cookie to save your choice. You can read more about our cookies before you choose.
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+Overview
+-
+Arthroscopy
+Contents
+Overview
+Recovery
+An arthroscopy is a type of keyhole surgery used to diagnose and treat problems with joints.
+It's most commonly used on the knees, ankles, shoulders, elbows, wrists and hips.
+Arthroscopy equipment is very small, so only small cuts in the skin are needed. This means it has some advantages over "open" surgery, including:
+less pain after the operation
+faster healing time
+lower risk of infection
+you can often go home the same day
+you may be able to return to normal activities more quickly
+When an arthroscopy is used
+You might need an arthroscopy if you have problems such as persistent joint pain, swelling or stiffness, and scans have not been able to find the cause.
+An arthroscopy can be used to assess the level of joint damage resulting from an injury, such as a sports injury, or from underlying conditions that can cause joint damage, such as osteoarthritis.
+The procedure can also be used to treat a range of joint problems and conditions, including:
+repairing damaged cartilage
+removing fragments of loose bone or cartilage
+draining away any excess fluid
+treating arthritis, frozen shoulder, a torn anterior cruciate ligament (ACL), carpal tunnel syndrome or temporomandibular disorder (TMD)
+How an arthroscopy is carried out
+Preparing for surgery
+Before having an arthroscopy, you'll usually need to attend a pre-admission clinic.
+During the appointment, your general health will be assessed to make sure you're ready for surgery. You'll also be given information about issues such as:
+what and when you can eat and drink on the day of surgery
+whether you should stop or start any medicines before surgery
+how long it will take for you to recover from surgery
+whether you'll need to do rehabilitation exercises after surgery
+Your surgical team will explain the benefits and risks of having an arthroscopy. You'll also be asked to sign a consent form to confirm you agree to have the operation and that you understand what's involved, including the potential risks. 
+The procedure
+An arthroscopy is usually carried out under general anaesthetic, although sometimes a spinal or local anaesthetic is used.
+Your anaesthetist will explain which type of anaesthetic is most suitable for you. Sometimes, you may be able to say which you would prefer.
+If you have a local anaesthetic, your joint will be numbed so you do not feel any pain. You may still feel some sensations during the procedure, such as a slight tugging, as the surgeon works on the joint.
+Antibacterial fluid is used to clean the skin over the affected joint and a small cut, a few millimetres long, is made in the skin next to the joint so that an arthroscope (a thin, metal tube with a light and camera at one end) can be inserted.
+One or more additional incisions will also be made so that an examining probe or other fine surgical instruments can be inserted.
+The joint is sometimes filled with a sterile fluid to expand it and make it easier for the surgeon to view. The arthroscope sends images to a video screen or eyepiece, allowing the surgeon to see inside your joint.
+As well as examining the inside of your joint, if necessary, your surgeon will be able to remove any unwanted tissue or repair damaged areas using tiny surgical instruments inserted through the additional incisions.
+After the procedure, the arthroscope and any attachments are removed, along with any excess fluid from the joint. The incisions are usually closed using special tape or stitches and covered with a sterile dressing.
+An arthroscopy usually takes 30 minutes to 2 hours, depending on the type of procedure carried out. You'll be able to go home on the same day as the surgery or the following morning.
+Recovering from an arthroscopy
+How long it takes to recover from an arthroscopy depends on the joint involved and the specific procedure you had.
+It may be possible to return to work within 7 days if your job involves sitting at a desk, but if it's more physical, you may need to stay off work for up to 2 weeks.
+You may not be able to do more demanding physical activities, such as lifting and sport, for several months.
+Your surgeon or care team will let you know how long it's likely to take to recover and what activities to avoid until you've fully recovered.
+While recovering, contact your GP or surgical team for advice if you think you may have a complication, such as an infection or blood clot.
+Read more about recovering from an arthroscopy.
+Complications of arthroscopy
+An arthroscopy is generally considered to be a safe procedure, but like all types of surgery there's a risk of complications.
+It's normal to have shortlived problems such as swelling, bruising, stiffness and discomfort after an arthroscopy. These usually improve in the days and weeks after the procedure.
+More serious problems are much less common (less than 1 in 100) and include:
+a blood clot that develops in a limb – known as deep vein thrombosis (DVT), it can cause pain and swelling in the affected limb
+infection inside the joint – known as septic arthritis, it can cause fever, pain and swelling in the joint
+bleeding inside the joint – which often causes severe pain and swelling
+accidental damage to the nerves near the joint – which can lead to temporary or permanent numbness and some loss of sensation
+Speak to your surgeon about the possible risks before agreeing to have an arthroscopy.
+Page last reviewed: 21 July 2020
+Next review due: 21 July 2023
+Next
+:
+Recovery
+Support links
+Home
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+Live Well
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+NHS App
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+Our policies
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+© Crown copyright

integrations/haystack/nhs-search/data/www.nhs.uk_conditions_artificial-insemination_.txt

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+Cookies on the NHS website
+We've put some small files called cookies on your device to make our site work.
+We'd also like to use analytics cookies. These send information about how our site is used to services called Adobe Analytics, Hotjar and Google Analytics. We use this information to improve our site.
+Let us know if this is OK. We'll use a cookie to save your choice. You can read more about our cookies before you choose.
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+Home Health A to Z
+Intrauterine insemination (IUI)
+Intrauterine insemination (IUI) is a fertility treatment that involves directly inserting sperm into a woman's womb.
+Accessing IUI on the NHS
+See your GP if you are considering having IUI on the NHS.
+You may be offered IUI if:
+you're unable to have vaginal sex – for example, because of a physical disability or psychosexual problem
+you have a condition that means you need specific help to conceive. For example, if 1 of you has HIV and it's not safe to have unprotected sex
+you're in a same-sex relationship and have not become pregnant after up to 6 cycles of IUI using donor sperm from a licensed fertility unit (the Stonewall website has more information about IUI for same-sex couples)
+Bear in mind that the waiting list for IUI treatment on the NHS can be very long in some areas.
+The criteria you must meet to be eligible for IUI can also vary. Check with your GP or local CCG to find out what the rules are where you live.
+Paying for IUI privately
+IUI is also available from some private fertility clinics. The Human Fertilisation and Embryology Authority (HFEA) has a fertility clinic finder.
+Costs range from about £700 to £1,600 for each cycle of IUI treatment.
+The Human Fertilisation & Embryology Authority (HFEA) website has more information on costs and funding for fertility treatments.
+Fertility tests before IUI
+Before IUI is done, you and your partner's fertility will need to be assessed to find out why you are having difficulty conceiving and to see whether IUI is suitable for you.
+Read more about diagnosing infertility.
+For a woman to have IUI, her fallopian tubes (the tubes connecting the ovaries to the womb) must be open and healthy.
+You and your partner will not usually be offered IUI if you have:
+unexplained infertility
+a low sperm count or poor‑quality sperm
+mild endometriosis
+This is because there is some evidence to suggest that IUI will not increase your chances of getting pregnant in these circumstances, compared with trying to get pregnant naturally.
+Timing your IUI treatment
+You may be offered IUI in a natural (unstimulated) cycle or in a stimulated cycle.
+To increase your chances of success, a cycle of IUI should be done just after ovulation. Ovulation usually happens 12 to 16 days before your next period. This can vary if you have an irregular menstrual cycle.
+You may be given an ovulation prediction kit (OPK) to help you work out the date of ovulation. An OPK device detects hormones released during ovulation in urine or saliva.
+Otherwise, blood tests may be used to find out when you are about to ovulate.
+Stimulated IUI
+Sometimes, fertility medicines are used to stimulate ovulation before IUI. In this case, vaginal ultrasound scans are used to track the development of your eggs. As soon as an egg is mature, you'll be given a hormone injection to stimulate its release.
+IUI using a partner's sperm
+If a couple decides to have IUI using their own sperm, the man will be asked to provide a sperm sample at the fertility clinic by masturbating into a specimen cup. This usually happens on the same day that IUI takes place.
+The sperm sample will be "washed" and filtered to produce a concentrated sample of healthy sperm.
+An instrument called a speculum is inserted into the woman's vagina to keep it open. A thin, flexible tube called a catheter is then placed inside the vagina and guided into the womb. The sperm sample is then passed through the catheter and into the womb.
+This process is mostly painless, although some women experience mild cramping for a short time.
+The process usually takes no more than 10 minutes. You should be able to go home after a short rest.
+IUI using donor sperm
+Frozen sperm from a donor can also be used for IUI, regardless of whether you are single or in a partnership, gay or straight.
+All licensed fertility clinics in the UK are required to screen donor sperm for infections and inherited diseases.
+Some infections take a while to show, so the sperm will be frozen for 6 months to allow time for infections, such as HIV, to be detected.
+The sperm is frozen whether it's from someone you know, or from a registered and licensed sperm bank.
+Choosing to use donated sperm can be a difficult decision, and you should be offered counselling before you go ahead.
+The Human Fertilisation and Embryology Authority (HFEA) has more information about using a sperm donor.
+Your chances of success with IUI
+This depends on lots of different things, including:
+the cause of infertility
+the woman's age
+the man's sperm count and sperm quality (using fresh sperm leads to higher conception rates than using frozen sperm)
+whether fertility medicines are used to stimulate ovulation (this can increase your chances of success)
+There are many different factors involved, so it's best to talk to your fertility team about your individual chances of success.
+Are there any risks?
+Some women have mild cramps similar to period pains, but otherwise the risks involved with IUI are minimal.
+If you have fertility medicine to stimulate ovulation, there is a small risk of developing ovarian hyperstimulation syndrome. Read more about this condition on our page about the risks of IVF. There's also a chance that you will have more than 1 baby, which has additional risks for both you and your babies.
+Page last reviewed: 10 March 2020
+Next review due: 10 March 2023
+Support links
+Home
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+Live Well
+Mental health
+Care and support
+Pregnancy
+NHS services
+Coronavirus (COVID-19)
+NHS App
+Find my NHS number
+Your health records
+About the NHS
+Healthcare abroad
+Contact us
+Other NHS websites
+Profile editor login
+About us
+Accessibility statement
+Our policies
+Cookies
+© Crown copyright

integrations/haystack/nhs-search/data/www.nhs.uk_conditions_asbestosis_.txt

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+Cookies on the NHS website
+We've put some small files called cookies on your device to make our site work.
+We'd also like to use analytics cookies. These send information about how our site is used to services called Adobe Analytics, Hotjar and Google Analytics. We use this information to improve our site.
+Let us know if this is OK. We'll use a cookie to save your choice. You can read more about our cookies before you choose.
+I'm OK with analytics cookies Do not use analytics cookies
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+Home Health A to Z
+Asbestosis
+Asbestosis is a serious lung condition caused by long-term exposure to asbestos.
+Asbestos is a fibre-like material that was once used in buildings for insulation, flooring and roofing. Its use has been fully banned in the UK since 1999.
+While asbestos can be dangerous, it's not harmful if left alone. But if material containing asbestos is damaged, it can release a fine dust that contains asbestos fibres.
+When the dust is breathed in, the asbestos fibres enter the lungs and can gradually damage them over time.
+But you would need long-term exposure to asbestos fibres, usually over many years, before you develop asbestosis.
+Am I at risk?
+You may have been exposed to asbestos if you worked in an industry such as building or construction, particularly from the 1970s to the 1990s.
+Nowadays, you’re only likely to come into contact with asbestos if your work puts you at risk of damaging any asbestos remaining in old buildings. Examples include:
+heating and ventilation engineers
+demolition workers
+plumbers
+construction workers
+electricians
+For more information on who could be at risk, read Health and Safety Executive (HSE): am I at risk?
+Symptoms of asbestosis
+Breathing in asbestos fibres over many years eventually causes scarring of the lungs. Symptoms include:
+shortness of breath
+persistent cough
+wheezing
+extreme tiredness (fatigue)
+pain in your chest or shoulder
+in more advanced cases, clubbed (swollen) fingertips
+It can take 20 to 30 years before symptoms appear.
+When to see a GP
+You should see a GP if you have symptoms of asbestosis and think you may have been exposed to asbestos.
+The GP will listen to your lungs and ask about your work history.
+They may refer you to a specialist in lung diseases for more tests if asbestosis is suspected.
+Tests may include:
+a chest X-ray
+a CT scan of the lungs
+lung function tests to see how well your lungs are working
+Treatment for asbestosis
+There's no cure for asbestosis once it has developed, as it's not possible to reverse the damage to the lungs.
+But some treatments can help, such as:
+pulmonary rehabilitation – a programme of exercises and education to help manage your symptoms
+oxygen therapy – breathing in oxygen-rich air from a machine or tank to help improve breathlessness if your blood oxygen levels are low
+inhaler to ease breathing (if your symptoms are mild)
+It's also important that you:
+stop smoking if you smoke – symptoms can be worse in those who smoke, and smoking increases the risk of lung cancer
+see a GP to have the flu vaccination and the pneumococcal vaccination – your lungs will be more vulnerable to infections like flu and pneumonia
+Complications of asbestosis
+People with asbestosis also have a higher risk of developing other serious conditions, such as:
+pleural disease – thickening of the lining covering the lungs (pleura)
+mesothelioma – cancer that affects the lining of the lungs, tummy, heart or testicles
+lung cancer
+Can I get compensation?
+If you've been diagnosed with asbestosis, you may be able to claim compensation through:
+industrial injuries disablement benefit
+a civil claim for compensation against previous employers
+a claim for governmental compensation under the Pneumoconiosis etc. (Workers' Compensation) Act 1979
+Find out about industrial injuries disablement benefit on GOV.UK. You can also get advice on benefits and compensation on the British Lung Foundation website.
+Support for people with asbestosis
+Asbestosis can have a big impact on your life, but help is available. Support services include:
+Asbestos Victims Support Groups Forum 
+British Lung Foundation – helpline 03000 030 555
+Cancer Research UK: mesothelioma – helpline 0808 800 4040
+Mesothelioma UK – helpline 0800 169 2409
+Page last reviewed: 04 August 2020
+Next review due: 04 August 2023
+Support links
+Home
+Health A to Z
+Live Well
+Mental health
+Care and support
+Pregnancy
+NHS services
+Coronavirus (COVID-19)
+NHS App
+Find my NHS number
+Your health records
+About the NHS
+Healthcare abroad
+Contact us
+Other NHS websites
+Profile editor login
+About us
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+Our policies
+Cookies
+© Crown copyright

integrations/haystack/nhs-search/data/www.nhs.uk_conditions_aspergillosis_.txt

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+Cookies on the NHS website
+We've put some small files called cookies on your device to make our site work.
+We'd also like to use analytics cookies. These send information about how our site is used to services called Adobe Analytics, Hotjar and Google Analytics. We use this information to improve our site.
+Let us know if this is OK. We'll use a cookie to save your choice. You can read more about our cookies before you choose.
+I'm OK with analytics cookies Do not use analytics cookies
+Search the NHS website
+Search
+My account
+Health A-Z
+Live Well
+Mental health
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+More
+Home Health A to Z
+Aspergillosis
+Aspergillosis is a condition caused by aspergillus mould. There are several different types of aspergillosis. Most affect the lungs and cause breathing difficulties.
+How you get aspergillosis
+Aspergillosis is usually caused by inhaling tiny bits of mould. The mould is found in lots of places, including:
+soil, compost and rotting leaves
+plants, trees and crops
+dust
+damp buildings
+air conditioning systems
+You cannot catch aspergillosis from someone else or from animals.
+Information:
+Most people who breathe in the mould do not get ill.
+Aspergillosis is rare in healthy people
+You're usually only at risk of aspergillosis if you have:
+a lung condition – such as asthma, cystic fibrosis or chronic obstructive pulmonary disease (COPD)
+a weakened immune system – for example, if you have had an organ transplant or are having chemotherapy
+had tuberculosis (TB) in the past
+severe flu or coronavirus (COVID-19) and need artificial ventilation
+Symptoms of aspergillosis
+Symptoms of aspergillosis include:
+shortness of breath
+a cough – you may cough up blood or lumps of mucus
+wheezing (a whistling sound when breathing)
+a high temperature of 38C or above
+weight loss
+If you already have a lung condition, your existing symptoms may get worse.
+Non-urgent advice:
+See a GP if you have:
+a cough for more than 3 weeks
+a lung condition that's getting worse or harder to control with your usual treatment
+a weakened immune system and symptoms of aspergillosis
+Get an urgent GP appointment if you cough up blood. Call 111 if you cannot see your GP.
+Information:
+Coronavirus (COVID-19) update: how to contact a GP
+It's still important to get help from a GP if you need it. To contact your GP surgery:
+visit their website
+use the NHS App
+call them
+Find out about using the NHS during COVID-19
+What happens at your appointment
+Your GP will check for an obvious cause of your symptoms, like a chest infection or asthma.
+If they're not sure what the problem is, they may refer you to a specialist for tests such as:
+X-rays and scans
+blood tests or tests on a sample of mucus
+allergy tests
+a bronchoscopy – where a thin, flexible tube with a camera at the end is used to look inside your lungs
+Treatment for aspergillosis depends on the type
+Treatment usually helps control the symptoms. If it's not treated or well controlled, there's a risk it could damage your lungs.
+Treatments for common types of aspergillosis
+Common types Treatment
+Allergic bronchopulmonary aspergillosis (ABPA) – an allergy to aspergillus mould steroid tablets and antifungal tablets for a few months (possibly longer)
+Chronic pulmonary aspergillosis (CPA) – a long-term lung infection long-term (possibly lifelong) treatment with antifungal tablets
+Aspergilloma – a ball of mould in the lungs, often linked to CPA surgery to remove the ball if it's causing symptoms, often after antifungal treatment
+Invasive pulmonary aspergillus (IPA) – a life-threatening infection in people with a weakened immune system antifungal medicine given directly into a vein in hospital
+You cannot always prevent aspergillosis
+It's almost impossible to completely avoid aspergillus mould.
+But there are things you can do to reduce your risk of aspergillosis if you have a lung condition or weakened immune system.
+Do
+try to avoid places where aspergillus mould is often found, such as compost heaps and piles of dead leaves
+close your windows if there's construction work or digging outside
+wear a face mask in dusty places
+consider using an air purifier at home – devices with HEPA filters are best
+Don’t
+do not dry your laundry in your bedroom or living areas, if possible – ideally dry it outside or in a tumble dryer
+Information:
+You can find out more about aspergillosis on the Aspergillosis Patients and Carers website.
+Page last reviewed: 11 March 2021
+Next review due: 11 March 2024
+Support links
+Home
+Health A to Z
+Live Well
+Mental health
+Care and support
+Pregnancy
+NHS services
+Coronavirus (COVID-19)
+NHS App
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+Your health records
+About the NHS
+Healthcare abroad
+Contact us
+Other NHS websites
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+About us
+Accessibility statement
+Our policies
+Cookies
+© Crown copyright

integrations/haystack/nhs-search/data/www.nhs.uk_conditions_aspirin_.txt

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+Cookies on the NHS website
+We've put some small files called cookies on your device to make our site work.
+We'd also like to use analytics cookies. These send information about how our site is used to services called Adobe Analytics, Hotjar and Google Analytics. We use this information to improve our site.
+Let us know if this is OK. We'll use a cookie to save your choice. You can read more about our cookies before you choose.
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+Home Medicines A to Z
+Aspirin for pain relief
+Brand names: Anadin, Bonjela gel. Find out more about how aspirin is used for pain relief, and how to take or use it.
+About aspirin for pain
+Who can and cannot take it
+How and when to take it
+Side effects
+Pregnancy, breastfeeding and fertility
+Taking aspirin with other medicines
+Common questions
+Related conditions
+Common cold
+Headaches
+Period pain
+Toothache
+Related conditions
+HealthUnlocked: aspirin for pain forum
+healthunlocked.com
+British Pain Society
+www.britishpainsociety.org
+Which painkiller?
+Support links
+Home
+Health A to Z
+Live Well
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+Contact us
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+Our policies
+Cookies
+© Crown copyright

integrations/haystack/nhs-search/data/www.nhs.uk_conditions_asthma_.txt

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+Cookies on the NHS website
+We've put some small files called cookies on your device to make our site work.
+We'd also like to use analytics cookies. These send information about how our site is used to services called Adobe Analytics, Hotjar and Google Analytics. We use this information to improve our site.
+Let us know if this is OK. We'll use a cookie to save your choice. You can read more about our cookies before you choose.
+I'm OK with analytics cookies Do not use analytics cookies
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+Coronavirus (COVID-19)
+Get the latest advice about COVID-19
+Home Health A to Z
+Overview
+-
+Asthma
+Contents
+Overview
+Symptoms
+Causes
+Diagnosis
+Treatment
+Living with
+Asthma attacks
+Asthma is a common lung condition that causes occasional breathing difficulties.
+It affects people of all ages and often starts in childhood, although it can also develop for the first time in adults.
+There's currently no cure, but there are simple treatments that can help keep the symptoms under control so it does not have a big impact on your life.
+Information:
+Coronavirus (COVID-19) advice
+Get advice about COVID-19 and asthma from Asthma UK
+Symptoms of asthma
+The main symptoms of asthma are:
+a whistling sound when breathing (wheezing)
+breathlessness
+a tight chest, which may feel like a band is tightening around it
+coughing
+The symptoms can sometimes get temporarily worse. This is known as an asthma attack.
+When to see a GP
+See a GP if you think you or your child may have asthma.
+Several conditions can cause similar symptoms, so it's important to get a proper diagnosis and correct treatment.
+The GP will usually be able to diagnose asthma by asking about symptoms and carrying out some simple tests.
+Find out more about how asthma is diagnosed.
+Treatments for asthma
+Asthma is usually treated by using an inhaler, a small device that lets you breathe in medicines.
+The main types are:
+reliever inhalers – used when needed to quickly relieve asthma symptoms for a short time
+preventer inhalers – used every day to prevent asthma symptoms happening
+Some people also need to take tablets.
+Causes and triggers of asthma
+Asthma is caused by swelling (inflammation) of the breathing tubes that carry air in and out of the lungs. This makes the tubes highly sensitive, so they temporarily narrow.
+It may happen randomly or after exposure to a trigger.
+Common asthma triggers include:
+allergies (to house dust mites, animal fur or pollen, for example)
+smoke, pollution and cold air
+exercise
+infections like colds or flu
+Identifying and avoiding your asthma triggers can help you keep your symptoms under control.
+How long asthma lasts for
+Asthma is a long-term condition for many people, particularly if it first develops when you're an adult.
+In children, it sometimes goes away or improves during the teenage years, but can come back later in life.
+The symptoms can usually be controlled with treatment. Most people will have normal, active lives, although some people with more severe asthma may have ongoing problems.
+Complications of asthma
+Although asthma can normally be kept under control, it's still a serious condition that can cause a number of problems.
+This is why it's important to follow your treatment plan and not ignore your symptoms if they're getting worse.
+Badly controlled asthma can cause problems such as:
+feeling tired all the time
+underperformance at, or absence from, work or school
+stress, anxiety or depression
+disruption of your work and leisure because of unplanned visits to a GP or hospital
+lung infections (pneumonia)
+delays in growth or puberty in children
+There's also a risk of severe asthma attacks, which can be life threatening.
+Video: Asthma
+Animated video about asthma, which is a chronic condition affecting the lungs.
+Play Video
+Media last reviewed: 1 May 2021
+Media review due: 1 May 2024
+Page last reviewed: 19 April 2021
+Next review due: 19 April 2024
+Next
+:
+Symptoms
+Support links
+Home
+Health A to Z
+Live Well
+Mental health
+Care and support
+Pregnancy
+NHS services
+Coronavirus (COVID-19)
+NHS App
+Find my NHS number
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+About the NHS
+Healthcare abroad
+Contact us
+Other NHS websites
+Profile editor login
+About us
+Accessibility statement
+Our policies
+Cookies
+© Crown copyright

integrations/haystack/nhs-search/data/www.nhs.uk_conditions_astigmatism_.txt

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+Cookies on the NHS website
+We've put some small files called cookies on your device to make our site work.
+We'd also like to use analytics cookies. These send information about how our site is used to services called Adobe Analytics, Hotjar and Google Analytics. We use this information to improve our site.
+Let us know if this is OK. We'll use a cookie to save your choice. You can read more about our cookies before you choose.
+I'm OK with analytics cookies Do not use analytics cookies
+Search the NHS website
+Search
+Health A-Z
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+More
+Home Health A to Z
+Astigmatism
+Astigmatism, along with short-sightedness and long-sightedness, is a common cause of blurry vision. It's usually corrected with glasses or contact lenses.
+What is astigmatism?
+Astigmatism means your eye is shaped more like a rugby ball than a football, so light is focused at more than 1 place in the eye.
+This can cause:
+blurred vision
+headaches
+eye strain (you may notice this after concentrating for a long time – on a computer, for example)
+Astigmatism normally happens alongside short-sightedness or long-sightedness.
+Astigmatism in 1 eye may cause lazy eye (where the vision does not develop properly). It's important this is spotted early so it can be treated.
+Regular eye tests for children
+Take your child for regular eye tests. Astigmatism, as well as short-sightedness or long-sightedness, may affect their reading or concentration.
+Find an optician
+Teenagers with astigmatism should also have regular eye tests to check for an eye condition called keratoconus. This causes the cornea to change shape.
+Treatments for astigmatism
+If astigmatism is affecting your eyesight, there are ways to correct it.
+Table showing the pros and cons of treatments for astigmatism
+Treatment Pros Cons
+Glasses
+the cheapest option
+may be available free or discounted on the NHS
+could get lost or broken
+Contact lenses
+choice of soft or hard lenses
+can be a good choice if you're active
+may be free or discounted on the NHS
+may not be suitable for everyone
+risk of eye infection through poor contact lens hygiene
+Laser eye or lens surgery
+may be permanent
+may be better for people with more severe vision problems
+risk of complications during or after surgery
+not available on the NHS
+can be expensive
+some side effects
+Page last reviewed: 08 December 2020
+Next review due: 08 December 2023
+Support links
+Home
+Health A to Z
+Live Well
+Mental health
+Care and support
+Pregnancy
+NHS services
+Coronavirus (COVID-19)
+NHS App
+Find my NHS number
+Your health records
+About the NHS
+Healthcare abroad
+Contact us
+Other NHS websites
+Profile editor login
+About us
+Accessibility statement
+Our policies
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+© Crown copyright

integrations/haystack/nhs-search/data/www.nhs.uk_conditions_ataxia_.txt

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+Cookies on the NHS website
+We've put some small files called cookies on your device to make our site work.
+We'd also like to use analytics cookies. These send information about how our site is used to services called Adobe Analytics, Hotjar and Google Analytics. We use this information to improve our site.
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+Overview
+-
+Ataxia
+Contents
+Overview
+Types
+Causes
+Diagnosis
+Treatment
+Ataxia is a term for a group of disorders that affect co-ordination, balance and speech.
+Any part of the body can be affected, but people with ataxia often have difficulties with:
+balance and walking
+speaking
+swallowing
+tasks that require a high degree of control, such as writing and eating
+vision
+The exact symptoms and their severity vary depending on the type of ataxia a person has.
+Types of ataxia
+There are many different types of ataxia, which can be divided into three broad categories:
+acquired ataxia – where symptoms develop as the result of trauma, a stroke, multiple sclerosis (MS), a brain tumour, nutritional deficiencies, or other problems that damage the brain or nervous system
+hereditary ataxia – where symptoms develop slowly over many years and are caused by faulty genes that a person inherits from their parents; the most common type is Friedreich's ataxia
+idiopathic late-onset cerebellar ataxia (ILOCA) – where the brain is progressively damaged over time for reasons that are unclear
+Read more about the main types of ataxia.
+What causes ataxia?
+Ataxia usually results from damage to a part of the brain called the cerebellum, but it can also be caused by damage to other parts of the nervous system.
+This damage can be part of an underlying condition such as MS, or can be caused by a head injury, lack of oxygen to the brain, or long-term, excessive alcohol consumption.
+Hereditary ataxia is caused by a faulty gene passed on by family members, who may or may not be affected.
+Read more about the causes of ataxia.
+How ataxia is treated
+In most cases, there's no cure for ataxia and supportive treatment to control the symptoms is necessary.
+This may include:
+speech and language therapy to help with speech and swallowing problems
+physiotherapy to help with movement problems
+occupational therapy to help you cope with the day-to-day problems
+medication to control muscle, bladder, heart and eye problems
+In a few cases, it's possible to improve ataxia or stop it getting worse by treating the underlying cause.
+Read more about treating ataxia.
+Outlook
+The outlook for ataxia can vary considerably and largely depends on the type of ataxia you have. Some types may remain relatively stable or even improve with time, but most will get progressively worse over many years.
+Life expectancy is generally shorter than normal for people with hereditary ataxia, although some people can live well into their 50s, 60s or beyond. In more severe cases, the condition can be fatal in childhood or early adulthood.
+For acquired ataxia, the outlook depends on the underlying cause. Some cases may improve or stay the same, while other cases may get gradually worse over time and reduce life expectancy.
+Page last reviewed: 16 April 2021
+Next review due: 16 April 2024
+Next
+:
+Types
+Support links
+Home
+Health A to Z
+Live Well
+Mental health
+Care and support
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+NHS App
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+Our policies
+Cookies
+© Crown copyright

integrations/haystack/nhs-search/data/www.nhs.uk_conditions_atherosclerosis_.txt

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+Cookies on the NHS website
+We've put some small files called cookies on your device to make our site work.
+We'd also like to use analytics cookies. These send information about how our site is used to services called Adobe Analytics, Hotjar and Google Analytics. We use this information to improve our site.
+Let us know if this is OK. We'll use a cookie to save your choice. You can read more about our cookies before you choose.
+I'm OK with analytics cookies Do not use analytics cookies
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+Search
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+Home Health A to Z
+Atherosclerosis (arteriosclerosis)
+Atherosclerosis is a potentially serious condition where arteries become clogged with fatty substances called plaques, or atheroma.
+These plaques cause the arteries to harden and narrow, restricting the blood flow and oxygen supply to vital organs, and increasing the risk of blood clots that could potentially block the flow of blood to the heart or brain.
+Atherosclerosis does not tend to have any symptoms at first and many people may be unaware they have it, but it can eventually cause life-threatening problems, such as heart attacks and strokes, if it gets worse.
+But the condition is largely preventable with a healthy lifestyle, and treatment can help reduce the risk of serious problems happening.
+Health risks of atherosclerosis
+If left to get worse, atherosclerosis can potentially lead to a number of serious conditions known as cardiovascular disease (CVD). There will not usually be any symptoms until CVD develops.
+Types of CVD include:
+coronary heart disease – the main arteries that supply your heart (the coronary arteries) become clogged with plaques
+angina – short periods of tight, dull or heavy chest pain caused by coronary heart disease, which may precede a heart attack
+heart attacks – where the blood supply to your heart is blocked, causing sudden crushing or indigestion-like chest pain that can radiate to nearby areas, as well as shortness of breath and dizziness
+strokes – where the blood supply to your brain is interrupted, causing the face to droop to 1 side, weakness on 1 side of the body, and slurred speech
+transient ischaemic attacks (TIAs) – where there are temporary symptoms of a stroke
+peripheral arterial disease – where the blood supply to your legs is blocked, causing leg pain when walking
+Who's at risk of atherosclerosis
+Exactly why and how arteries become clogged is unclear.
+It can happen to anyone, although the following things can increase your risk:
+increasing age
+smoking
+an unhealthy, high-fat diet
+lack of exercise
+being overweight or obese
+regularly drinking excessive amounts of alcohol
+other conditions, including high blood pressure, high cholesterol and diabetes
+a family history of atherosclerosis and CVD
+being of south Asian, African or African-Caribbean descent
+You cannot do anything about some of these factors, but by tackling things like an unhealthy diet and a lack of exercise you can help reduce your risk of atherosclerosis and CVD.
+Find out more about the risk factors for CVD
+Testing for atherosclerosis
+Speak to your GP if you're worried you may be at a high risk of atherosclerosis.
+If you're between the ages of 40 and 74, you should have an NHS Health Check every 5 years, which will include tests to find out if you're at risk of atherosclerosis and CVD.
+Your GP or practice nurse can work out your level of risk by taking into account factors such as:
+your age, gender and ethnic group
+your weight and height
+if you smoke or have previously smoked
+if you have a family history of CVD
+your blood pressure and cholesterol levels
+if you have certain long-term conditions
+Depending on your result, you may be advised to make lifestyle changes, consider taking medication or have further tests to check for atherosclerosis and CVD.
+Reduce your risk of atherosclerosis
+Making healthy lifestyle changes can reduce your risk of developing atherosclerosis and may help stop it getting worse.
+The main ways you can reduce your risk are:
+stop smoking – you can call the NHS Smokefree helpline for advice on 0300 123 1044 or ask your GP about stop smoking treatments; read more advice about stopping smoking
+have a healthy diet – avoid foods that are high in saturated fats, salt or sugar, and aim to eat 5 portions of fruit and vegetables a day; read more healthy diet advice
+exercise regularly – aim for at least 150 minutes of moderate aerobic activity such as cycling or fast walking every week, and strength exercises on at least 2 days a week
+maintain a healthy weight – aim for a body mass index (BMI) of 18.5 to 24.9; use the BMI healthy weight calculator to work out your BMI and read advice about losing weight
+moderate your alcohol consumption – men and women are advised not to regularly drink more than 14 alcohol units a week; get tips on cutting down on alcohol
+Read more specific advice about preventing CVD
+Treatments for atherosclerosis
+There are not currently any treatments that can reverse atherosclerosis, but the healthy lifestyle changes suggested above may help stop it getting worse.
+Sometimes additional treatment to reduce the risk of problems like heart attacks and strokes may also be recommended, such as:
+statins for high cholesterol – read more about treating high cholesterol
+medicines for high blood pressure – read more about treating high blood pressure
+medicines to reduce the risk of blood clots – such as low-dose aspirin or clopidogrel
+dietary changes and medication for diabetes – read more about type 1 diabetes and treating type 2 diabetes
+a procedure to widen or bypass an affected artery – such as a coronary angioplasty, a coronary artery bypass graft or a carotid endarterectomy
+Page last reviewed: 02 May 2019
+Next review due: 02 May 2022
+Support links
+Home
+Health A to Z
+Live Well
+Mental health
+Care and support
+Pregnancy
+NHS services
+Coronavirus (COVID-19)
+NHS App
+Find my NHS number
+Your health records
+About the NHS
+Healthcare abroad
+Contact us
+Other NHS websites
+Profile editor login
+About us
+Accessibility statement
+Our policies
+Cookies
+© Crown copyright

integrations/haystack/nhs-search/data/www.nhs.uk_conditions_athletes-foot_.txt

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+Cookies on the NHS website
+We've put some small files called cookies on your device to make our site work.
+We'd also like to use analytics cookies. These send information about how our site is used to services called Adobe Analytics, Hotjar and Google Analytics. We use this information to improve our site.
+Let us know if this is OK. We'll use a cookie to save your choice. You can read more about our cookies before you choose.
+I'm OK with analytics cookies Do not use analytics cookies
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+Coronavirus (COVID-19)
+Get the latest advice about COVID-19
+Home Health A to Z
+Athlete's foot
+Athlete's foot is a common fungal infection that affects the feet. You can usually treat it with creams, sprays or powders from a pharmacy, but it can keep coming back.
+Symptoms of athlete's foot
+One of the main symptoms of Athlete's foot is itchy white patches between your toes.
+Credit:
+Credit:
+It can also cause sore and flaky patches on your feet.
+The skin can look red, but this may be less noticeable on brown or black skin.
+Credit:
+Credit:
+Sometimes the skin on your feet may become cracked or bleed.
+Credit:
+Other symptoms
+Athlete's foot can also affect your soles or sides of your feet. It sometimes causes fluid-filled blisters.
+If it's not treated, the infection can spread to your toenails and cause a fungal nail infection.
+A pharmacist can help with athlete's foot
+Athlete's foot is unlikely to get better on its own, but you can buy antifungal medicines for it from a pharmacy. They usually take a few weeks to work.
+Athlete's foot treatments are available as:
+creams
+sprays
+powders
+They're not all suitable for everyone – for example, some are only for adults. Always check the packet or ask a pharmacist.
+You might need to try a few treatments to find one that works best for you.
+Find a pharmacy
+How to treat and prevent athlete's foot yourself
+You can keep using some pharmacy treatments to stop athlete's foot coming back.
+It's also important to keep your feet clean and dry. You do not need to stay off work or school.
+Do
+dry your feet after washing them, particularly between your toes – dab them dry rather than rubbing them
+use a separate towel for your feet and wash it regularly
+take your shoes off when at home
+wear clean socks every day – cotton socks are best
+Don’t
+do not scratch affected skin – this can spread it to other parts of your body
+do not walk around barefoot – wear flip-flops in places like changing rooms and showers
+do not share towels, socks or shoes with other people
+do not wear the same pair of shoes for more than 2 days in a row
+do not wear shoes that make your feet hot and sweaty
+Important
+Keep following this advice after finishing treatment to help stop athlete's foot coming back.
+Non-urgent advice:
+See a GP if:
+treatments from a pharmacy do not work
+you're in a lot of discomfort
+your foot or leg is hot, painful and red (the redness may be less noticeable on brown or black skin) – this could be a more serious infection
+the infection spreads to other parts of your body such as your hands
+you have diabetes – foot problems can be more serious if you have diabetes
+you have a weakened immune system – for example, you have had an organ transplant or are having chemotherapy
+Information:
+Coronavirus (COVID-19) update: how to contact a GP
+It's still important to get help from a GP if you need it. To contact your GP surgery:
+visit their website
+use the NHS App
+call them
+Find out about using the NHS during COVID-19
+Treatment for athlete's foot from a GP
+The GP may:
+send a small scraping of skin from your feet to a laboratory to check you have athlete's foot
+prescribe a steroid cream to use alongside antifungal cream
+prescribe antifungal tablets – you might need to take these for several weeks
+refer you to a skin specialist (dermatologist) for more tests and treatment if needed
+How you get athlete's foot
+You can catch athlete's foot from other people with the infection.
+You can get it by:
+walking barefoot in places where someone else has athlete's foot – especially changing rooms and showers
+touching the affected skin of someone with athlete's foot
+You're more likely to get it if you have wet or sweaty feet, or if the skin on your feet is damaged.
+Page last reviewed: 08 June 2021
+Next review due: 08 June 2024
+Support links
+Home
+Health A to Z
+Live Well
+Mental health
+Care and support
+Pregnancy
+NHS services
+Coronavirus (COVID-19)
+NHS App
+Find my NHS number
+Your health records
+About the NHS
+Healthcare abroad
+Contact us
+Other NHS websites
+Profile editor login
+About us
+Accessibility statement
+Our policies
+Cookies
+© Crown copyright

integrations/haystack/nhs-search/data/www.nhs.uk_conditions_atopic-eczema_.txt

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+Cookies on the NHS website
+We've put some small files called cookies on your device to make our site work.
+We'd also like to use analytics cookies. These send information about how our site is used to services called Adobe Analytics, Hotjar and Google Analytics. We use this information to improve our site.
+Let us know if this is OK. We'll use a cookie to save your choice. You can read more about our cookies before you choose.
+I'm OK with analytics cookies Do not use analytics cookies
+Search the NHS website
+Search
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+Overview
+-
+Atopic eczema
+Contents
+Overview
+Symptoms
+Causes
+Treatment
+Complications
+Atopic eczema (atopic dermatitis) is the most common form of eczema, a condition that causes the skin to become itchy, dry and cracked.
+Atopic eczema is more common in children, often developing before their first birthday. But it may also develop for the first time in adults.
+It's usually a long-term (chronic) condition, although it can improve significantly, or even clear completely, in some children as they get older.
+Information:
+Coronavirus advice
+Get advice about coronavirus and eczema from the National Eczema Society
+Symptoms of atopic eczema
+Atopic eczema causes the skin to become itchy, dry, cracked and sore.
+Some people only have small patches of dry skin, but others may experience widespread inflamed skin all over the body.
+Inflamed skin can become red on lighter skin, and darker brown, purple or grey on darker skin. This can also be more difficult to see on darker skin.
+Although atopic eczema can affect any part of the body, it most often affects the hands, insides of the elbows, backs of the knees and the face and scalp in children.
+People with atopic eczema usually have periods when symptoms are less noticeable, as well as periods when symptoms become more severe (flare-ups).
+When to seek medical advice
+See a GP if you have symptoms of atopic eczema. They'll usually be able to diagnose atopic eczema by looking at your skin and asking questions, such as:
+whether the rash is itchy and where it appears
+when the symptoms first began
+whether it comes and goes over time
+whether there's a history of atopic eczema in your family
+whether you have any other conditions, such as allergies or asthma
+whether something in your diet or lifestyle may be contributing to your symptoms
+Typically, to be diagnosed with atopic eczema you should have had an itchy skin condition in the last 12 months and 3 or more of the following:
+visibly irritated red skin in the creases of your skin – such as the insides of your elbows or behind your knees (or on the cheeks, outsides of elbows, or fronts of the knees in children aged 18 months or under) at the time of examination by a health professional
+a history of skin irritation occurring in the same areas mentioned above
+generally dry skin in the last 12 months
+a history of asthma or hay fever – children under 4 must have an immediate relative, such as a parent, brother or sister, who has 1 of these conditions
+the condition started before the age of 2 (this does not apply to children under the age of 4)
+Causes of atopic eczema
+The exact cause of atopic eczema is unknown, but it's clear it is not down to one single thing.
+Atopic eczema often occurs in people who get allergies. "Atopic" means sensitivity to allergens.
+It can run in families, and often develops alongside other conditions, such as asthma and hay fever.
+The symptoms of atopic eczema often have certain triggers, such as soaps, detergents, stress and the weather. 
+Sometimes food allergies can play a part, especially in young children with severe eczema.
+You may be asked to keep a food diary to try to determine whether a specific food makes your symptoms worse.
+Allergy tests are not usually needed, although they're sometimes helpful in identifying whether a food allergy may be triggering symptoms.
+Treating atopic eczema
+Treatment for atopic eczema can help to relieve the symptoms and many cases improve over time.
+But there's currently no cure and severe eczema often has a significant impact on daily life, which may be difficult to cope with physically and mentally.
+There's also an increased risk of skin infections. 
+Many different treatments can be used to control symptoms and manage eczema, including:
+self-care techniques, such as reducing scratching and avoiding triggers
+emollients (moisturising treatments) – used on a daily basis for dry skin
+topical corticosteroids – used to reduce swelling, redness and itching during flare-ups
+Other types of eczema
+Eczema is the name for a group of skin conditions that cause dry, irritated skin.
+Other types of eczema include:
+discoid eczema – a type of eczema that occurs in circular or oval patches on the skin
+contact dermatitis – a type of eczema that occurs when the body comes into contact with a particular substance
+varicose eczema – a type of eczema that most often affects the lower legs and is caused by problems with the flow of blood through the leg veins
+seborrhoeic eczema – a type of eczema where red, scaly patches develop on the sides of the nose, eyebrows, ears and scalp
+dyshidrotic eczema (pompholyx) – a type of eczema that causes tiny blisters to erupt across the palms of the hands
+Page last reviewed: 05 December 2019
+Next review due: 05 December 2022
+Next
+:
+Symptoms
+Support links
+Home
+Health A to Z
+Live Well
+Mental health
+Care and support
+Pregnancy
+NHS services
+Coronavirus (COVID-19)
+NHS App
+Find my NHS number
+Your health records
+About the NHS
+Healthcare abroad
+Contact us
+Other NHS websites
+Profile editor login
+About us
+Accessibility statement
+Our policies
+Cookies
+© Crown copyright

integrations/haystack/nhs-search/data/www.nhs.uk_conditions_atrial-fibrillation_.txt

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+Cookies on the NHS website
+We've put some small files called cookies on your device to make our site work.
+We'd also like to use analytics cookies. These send information about how our site is used to services called Adobe Analytics, Hotjar and Google Analytics. We use this information to improve our site.
+Let us know if this is OK. We'll use a cookie to save your choice. You can read more about our cookies before you choose.
+I'm OK with analytics cookies Do not use analytics cookies
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+More
+Home Health A to Z
+Overview
+-
+Atrial fibrillation
+Contents
+Overview
+Symptoms
+Causes
+Diagnosis
+Treatment
+Complications
+Atrial fibrillation is a heart condition that causes an irregular and often abnormally fast heart rate.
+A normal heart rate should be regular and between 60 and 100 beats a minute when you're resting.
+You can measure your heart rate by checking your pulse in your wrist or neck.
+Information:
+Coronavirus (COVID-19) advice
+Get advice about coronavirus (COVID-19) and atrial fibrillation from the British Heart Foundation
+Symptoms of atrial fibrillation
+In atrial fibrillation, the heart rate is irregular and can sometimes be very fast. In some cases, it can be considerably higher than 100 beats a minute.
+This can cause problems including dizziness, shortness of breath and tiredness.
+You may be aware of noticeable heart palpitations, where your heart feels like it's pounding, fluttering or beating irregularly, often for a few seconds or, in some cases, a few minutes.
+Sometimes atrial fibrillation does not cause any symptoms and a person who has it is completely unaware that their heart rate is irregular.
+When to see a GP
+See a GP or call 111 if:
+you have chest pain that comes and goes
+you have chest pain that goes away quickly but you're still worried
+you notice a sudden change in your heartbeat
+your heart rate is consistently lower than 60 or above 100 (particularly if you're experiencing other symptoms of atrial fibrillation, such as dizziness and shortness of breath)
+It's important to get medical advice to make sure it's nothing serious.
+Urgent advice:
+Call 999 if:
+You have sudden chest pain that:
+spreads to your arms, back, neck or jaw
+makes your chest feel tight or heavy
+also started with shortness of breath, sweating and feeling or being sick
+lasts more than 15 minutes
+You could be having a heart attack. Call 999 immediately as you need immediate treatment in hospital.
+What causes atrial fibrillation?
+When the heart beats normally, its muscular walls tighten and squeeze (contract) to force blood out and around the body.
+They then relax so the heart can fill with blood again. This process is repeated every time the heart beats.
+In atrial fibrillation, the heart's upper chambers (atria) contract randomly and sometimes so fast that the heart muscle cannot relax properly between contractions. This reduces the heart's efficiency and performance.
+Atrial fibrillation happens when abnormal electrical impulses suddenly start firing in the atria.
+These impulses override the heart's natural pacemaker, which can no longer control the rhythm of the heart. This causes you to have a highly irregular pulse rate.
+The cause is not fully understood, but it tends to affect certain groups of people, such as older people and people living with long-term (chronic) conditions such as heart disease, high blood pressure or obesity.
+It may be triggered by certain situations, such as drinking too much alcohol or smoking.
+Atrial fibrillation can be defined in various ways, depending on the degree to which it affects you.
+For example:
+paroxysmal atrial fibrillation – episodes come and go, and usually stop within 48 hours without any treatment
+persistent atrial fibrillation – each episode lasts for longer than 7 days (or less when it's treated)
+permanent atrial fibrillation – when it's present all the time
+long-standing atrial fibrillation – where you've had atrial fibrillation usually for over a year
+Who's affected
+Atrial fibrillation is the most common heart rhythm disturbance, affecting around 1.4 million people in the UK.
+It can affect adults of any age, but it's more common in older people.
+More men than women have atrial fibrillation. 
+Atrial fibrillation is more likely to occur in people with other conditions, such as high blood pressure (hypertension), atherosclerosis or a heart valve problem.
+Information:
+Social care and support guide
+If you:
+need help with day-to-day living because of illness or disability
+care for someone regularly because they're ill, elderly or disabled (including family members)
+Our guide to care and support explains your options and where you can get support.
+Treating atrial fibrillation
+Atrial fibrillation is not usually life threatening, but it can be uncomfortable and often requires treatment.
+Treatment may involve: 
+medicines to prevent a stroke (people with atrial fibrillation are more at risk of having a stroke)
+medicines to control the heart rate or rhythm
+cardioversion – where the heart is given a controlled electric shock to restore normal rhythm
+catheter ablation – where the area inside the heart that's causing the abnormal heart rhythm is destroyed using radiofrequency energy; afterwards you may then need to have a pacemaker fitted to help your heart beat regularly
+Atrial flutter
+Atrial flutter is less common than atrial fibrillation, but shares the same symptoms, causes and possible complications.
+Some people with atrial flutter also have atrial fibrillation.
+Atrial flutter is similar to atrial fibrillation, but the rhythm in the atria is more organised and less chaotic than the abnormal patterns caused by atrial fibrillation.
+Treatment for atrial flutter is also slightly different. Catheter ablation is considered to be the best treatment for atrial flutter, whereas medicine is often the first treatment used for atrial fibrillation.
+Page last reviewed: 17 May 2021
+Next review due: 17 May 2024
+Next
+:
+Symptoms
+Support links
+Home
+Health A to Z
+Live Well
+Mental health
+Care and support
+Pregnancy
+NHS services
+Coronavirus (COVID-19)
+NHS App
+Find my NHS number
+Your health records
+About the NHS
+Healthcare abroad
+Contact us
+Other NHS websites
+Profile editor login
+About us
+Accessibility statement
+Our policies
+Cookies
+© Crown copyright

integrations/haystack/nhs-search/data/www.nhs.uk_conditions_attention-deficit-hyperactivity-disorder-adhd_.txt

@@ -0,0 +1,95 @@
+Cookies on the NHS website
+We've put some small files called cookies on your device to make our site work.
+We'd also like to use analytics cookies. These send information about how our site is used to services called Adobe Analytics, Hotjar and Google Analytics. We use this information to improve our site.
+Let us know if this is OK. We'll use a cookie to save your choice. You can read more about our cookies before you choose.
+I'm OK with analytics cookies Do not use analytics cookies
+Search the NHS website
+Search
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+More
+Home Health A to Z
+Overview
+-
+Attention deficit hyperactivity disorder (ADHD)
+Contents
+Overview
+Symptoms
+Causes
+Diagnosis
+Treatment
+Living with
+Attention deficit hyperactivity disorder (ADHD) is a condition that affects people's behaviour. People with ADHD can seem restless, may have trouble concentrating and may act on impulse.
+Symptoms of ADHD tend to be noticed at an early age and may become more noticeable when a child's circumstances change, such as when they start school.
+Most cases are diagnosed when children are 3 to 7 years old, but sometimes it's diagnosed later in childhood.
+Sometimes ADHD was not recognised when someone was a child, and they are diagnosed later as an adult.
+The symptoms of ADHD usually improve with age, but many adults who were diagnosed with the condition at a young age continue to experience problems.
+People with ADHD may also have additional problems, such as sleep and anxiety disorders.
+Getting help
+Many children go through phases where they're restless or inattentive. This is often completely normal and does not necessarily mean they have ADHD.
+But you should discuss your concerns with your child's teacher, their school's special educational needs co-ordinator (SENCO) or a GP if you think their behaviour may be different from most children their age.
+It's also a good idea to speak to a GP if you're an adult and think you may have ADHD, but were not diagnosed with the condition as a child.
+What causes attention deficit hyperactivity disorder (ADHD)?
+The exact cause of ADHD is unknown, but the condition has been shown to run in families.
+Research has also identified a number of possible differences in the brains of people with ADHD when compared with those without the condition.
+Other factors suggested as potentially having a role in ADHD include:
+being born prematurely (before the 37th week of pregnancy)
+having a low birthweight
+smoking or alcohol or drug abuse during pregnancy
+ADHD can occur in people of any intellectual ability, although it's more common in people with learning difficulties.
+How attention deficit hyperactivity disorder (ADHD) is treated
+For children with ADHD, although there's no cure, it can be managed with appropriate educational support, advice and support for parents and affected children, alongside medicine, if necessary.
+For adults with ADHD, medicine is often the first treatment offered, although psychological therapies such as cognitive behavioural therapy (CBT) may also help.
+Living with attention deficit hyperactivity disorder (ADHD)
+Parents of children with ADHD
+Looking after a child with ADHD can be challenging, but it's important to remember that they cannot help their behaviour.
+Some day-to-day activities might be more difficult for you and your child, including:
+getting your child to sleep at night
+getting ready for school on time
+listening to and carrying out instructions
+being organised
+social occasions
+shopping
+Adults with ADHD
+Adults with ADHD may find they have problems with:
+organisation and time management
+following instructions
+focusing and completing tasks
+coping with stress
+feeling restless or impatient
+impulsiveness and risk taking
+Some adults may also have issues with relationships or social interaction.
+Help us improve our website
+If you've finished what you're doing, can you answer some questions about your visit today?
+Take our survey
+Page last reviewed: 24 December 2021
+Next review due: 24 December 2024
+Next
+:
+Symptoms
+Support links
+Home
+Health A to Z
+Live Well
+Mental health
+Care and support
+Pregnancy
+NHS services
+Coronavirus (COVID-19)
+NHS App
+Find my NHS number
+Your health records
+About the NHS
+Healthcare abroad
+Contact us
+Other NHS websites
+Profile editor login
+About us
+Accessibility statement
+Our policies
+Cookies
+© Crown copyright

integrations/haystack/nhs-search/data/www.nhs.uk_conditions_auditory-processing-disorder_.txt

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+Cookies on the NHS website
+We've put some small files called cookies on your device to make our site work.
+We'd also like to use analytics cookies. These send information about how our site is used to services called Adobe Analytics, Hotjar and Google Analytics. We use this information to improve our site.
+Let us know if this is OK. We'll use a cookie to save your choice. You can read more about our cookies before you choose.
+I'm OK with analytics cookies Do not use analytics cookies
+Search the NHS website
+Search
+My account
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+Mental health
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+Home Health A to Z
+Auditory processing disorder (APD)
+Auditory processing disorder (APD) is where you have difficulty understanding sounds, including spoken words. There are things you can do that can help.
+Symptoms of auditory processing disorder (APD)
+APD often starts in childhood but some people develop it later.
+If you or your child have APD, you may find it difficult to understand:
+people speaking in noisy places
+people with strong accents or fast talkers
+similar sounding words
+spoken instructions
+APD is not a hearing problem. People with the condition usually have normal hearing.
+Non-urgent advice:
+See a GP if:
+you or your child find it hard to hear or understand speech
+The GP may refer you to a hearing specialist.
+Information:
+Coronavirus (COVID-19) update: how to contact a GP
+It's still important to get help from a GP if you need it. To contact your GP surgery:
+visit their website
+use the NHS App
+call them
+Find out about using the NHS during COVID-19
+Tests for auditory processing disorder (APD)
+To test for APD you may be asked to:
+listen to speech with background noise
+spot small changes in sounds
+fill in missing parts of words
+Other tests may include:
+having electrodes on your head to measure how your brain reacts to sound
+speech and language tests
+memory, problem-solving and concentration tests
+Testing for APD is not usually done on children under 7 years old.
+Treating auditory processing disorder (APD)
+There is no cure for APD but there are things that can help.
+Treatment usually involves activities to improve listening and concentration. This is called auditory training. You can do it with a hearing specialist or in your own time online.
+To reduce background noise, school children with APD may be advised to wear a wireless earpiece that connects to a tiny microphone worn by their teacher.
+Things you can do to help with auditory processing disorder (APD)
+There are things that you and other people can do to help with your APD.
+Do
+talk face to face
+use pictures and text
+repeat or rephrase things if necessary
+use carpet and soft furnishings to reduce room noise
+Don’t
+do not cover your mouth when talking
+do not talk in long complicated sentences
+do not speak too fast or too slow
+do not have background noise, like TV and radio
+Causes of auditory processing disorder (APD)
+It's not always clear what causes APD.
+Possible causes include:
+regular ear infections
+a faulty gene
+head injury
+complications at birth
+APD is often found in people with attention, language and learning difficulties, such as dyslexia and ADHD.
+Page last reviewed: 21 September 2020
+Next review due: 21 September 2023
+Support links
+Home
+Health A to Z
+Live Well
+Mental health
+Care and support
+Pregnancy
+NHS services
+Coronavirus (COVID-19)
+NHS App
+Find my NHS number
+Your health records
+About the NHS
+Healthcare abroad
+Contact us
+Other NHS websites
+Profile editor login
+About us
+Accessibility statement
+Our policies
+Cookies
+© Crown copyright

integrations/haystack/nhs-search/data/www.nhs.uk_conditions_autism_.txt

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+Cookies on the NHS website
+We've put some small files called cookies on your device to make our site work.
+We'd also like to use analytics cookies. These send information about how our site is used to services called Adobe Analytics, Hotjar and Google Analytics. We use this information to improve our site.
+Let us know if this is OK. We'll use a cookie to save your choice. You can read more about our cookies before you choose.
+I'm OK with analytics cookies Do not use analytics cookies
+Search the NHS website
+Search
+Health A-Z
+Live Well
+Mental health
+Care and support
+Pregnancy
+Browse
+More
+Home Health A to Z
+Autism
+This guide can help if you or someone you care about is autistic or might be autistic.
+Signs of autism
+How to get diagnosed
+What is autism?
+An introduction to what autism is and how it affects people.
+Getting diagnosed
+Information and advice about how to get diagnosed with autism and how a diagnosis can help.
+Autism and everyday life
+Information and advice if you care for an autistic child.
+Newly diagnosed: things to help
+Information and advice if you or your child have recently been diagnosed with autism
+Where to get support
+Find out where to get support if you or your child are autistic, such as charities and your council
+Easy read information and videos
+Information about autism in an easy read format or video if you have a learning disability
+Other conditions that affect autistic people
+Find out which conditions often affect people with autism, what the symptoms are and when to get help
+Support links
+Home
+Health A to Z
+Live Well
+Mental health
+Care and support
+Pregnancy
+NHS services
+Coronavirus (COVID-19)
+NHS App
+Find my NHS number
+Your health records
+About the NHS
+Healthcare abroad
+Contact us
+Other NHS websites
+Profile editor login
+About us
+Accessibility statement
+Our policies
+Cookies
+© Crown copyright

integrations/haystack/nhs-search/data/www.nhs.uk_conditions_autosomal-dominant-polycystic-kidney-disease-adpkd_.txt

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+Cookies on the NHS website
+We've put some small files called cookies on your device to make our site work.
+We'd also like to use analytics cookies. These send information about how our site is used to services called Adobe Analytics, Hotjar and Google Analytics. We use this information to improve our site.
+Let us know if this is OK. We'll use a cookie to save your choice. You can read more about our cookies before you choose.
+I'm OK with analytics cookies Do not use analytics cookies
+Search the NHS website
+Search
+My account
+Health A-Z
+Live Well
+Mental health
+Care and support
+Pregnancy
+Browse
+More
+Coronavirus (COVID-19)
+Get the latest advice about COVID-19
+Home Health A to Z
+Overview
+-
+Autosomal dominant polycystic kidney disease
+Contents
+Overview
+Symptoms
+Diagnosis
+Treatment
+Complications
+Autosomal dominant polycystic kidney disease (ADPKD) is an inherited condition that causes small fluid-filled sacs called cysts to develop in the kidneys.
+Although children affected by ADPKD are born with the condition, it rarely causes any noticeable problems until the cysts grow large enough to affect the kidneys' functions.
+In most cases, this does not occur until a person is between 30 and 60 years of age. 
+Less commonly, children or older people may have noticeable symptoms as a result of ADPKD.
+When ADPKD reaches this stage, it can cause a wide range of problems, including:
+tummy (abdominal) pain
+high blood pressure (hypertension)
+blood in the urine (haematuria), which may not always be noticeable to the naked eye
+potentially serious upper urinary tract infections (UTIs)
+kidney stones
+Kidney function will gradually deteriorate until so much is lost that kidney failure occurs.
+Read more about the symptoms of ADPKD and diagnosing ADPKD.
+Information:
+Coronavirus advice
+Get advice about coronavirus and kidney disease from Kidney Care UK
+What causes ADPKD
+ADPKD is caused by a genetic fault that disrupts the normal development of some of the cells in the kidneys and causes cysts to grow.
+Faults in 1 of 2 different genes are known to cause ADPKD.
+The affected genes are:
+PKD1, which accounts for 85% of cases
+PKD2, which accounts for 15% of cases
+Both types of ADPKD have the same symptoms, but they tend to be more severe in PKD1.
+A child has a 1 in 2 (50%) chance of developing ADPKD if one of their parents has the faulty PKD1 or PKD2 gene.
+Autosomal recessive polycystic kidney disease (ARPKD) is a rarer type of kidney disease that can only be inherited if both parents carry the faulty gene. In this type problems usually start much earlier, during childhood.
+Non-inherited ADPKD
+In around 1 in 4 (25%) cases, a person develops ADPKD without having a known family history of the condition.
+This could be because the condition was never diagnosed in a relative, or a relative with the condition may have died before their symptoms were recognised.
+In around 1 in 10 cases of ADPKD, the mutation develops for the first time in the affected person. It's not known what causes this to happen.
+The affected person can pass the faulty gene on to their children in the same way as someone who's inherited it from a parent.
+Who's affected
+ADPKD is the most common inherited condition to affect the kidneys, although it's still relatively uncommon.
+Only around 1 or 2 in every 1,000 people are born with ADPKD, which means there are currently around 60,000 people in the UK with the condition.
+Treating ADPKD
+There's currently no cure for ADPKD, but various treatments are available to manage problems caused by the condition.
+Most problems, such as high blood pressure, pain and UTIs, can be treated with medication, although you may need to have an operation to remove any large kidney stones that develop.
+If the condition reaches a point where the kidneys are not able to function properly, there are 2 main treatment options:
+dialysis, where a machine is used to replicate kidney functions
+a kidney transplant, where a healthy kidney is removed from a living or recently deceased donor and implanted into someone with kidney failure
+In some cases of ADPKD in adults, where chronic kidney disease is advanced and progressing rapidly, a medication called tolvaptan can be used to slow down the formation of cysts and protect kidney function.
+Find out more about treating ADPKD
+Outlook
+The outlook for ADPKD is highly variable. Some people experience kidney failure soon after the condition is diagnosed, whereas others may live the rest of their life with their kidneys working relatively well.
+On average, around half of people with ADPKD require treatment for kidney failure by the time they're 60.
+As well as kidney failure, ADPKD can also cause a number of other potentially serious problems, such as heart attacks and strokes caused by high blood pressure, or bleeding on the brain (subarachnoid haemorrhage) caused by a bulge in the wall of a blood vessel in the brain (brain aneurysm).
+Find out more about the complications of ADPKD
+Information about you
+If you have ADPKD, 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
+The kidneys
+The kidneys are 2 bean-shaped organs located on either side of the back of the body, just underneath the ribcage.
+The main role of the kidneys is to filter out waste products from the blood and pass them out of the body in urine.
+The kidneys also play an important role in:
+helping to maintain blood pressure at a healthy level
+keeping salt and water in balance
+making hormones needed for the production of blood and bone
+Page last reviewed: 11 April 2019
+Next review due: 11 April 2022
+Next
+:
+Symptoms
+Support links
+Home
+Health A to Z
+Live Well
+Mental health
+Care and support
+Pregnancy
+NHS services
+Coronavirus (COVID-19)
+NHS App
+Find my NHS number
+Your health records
+About the NHS
+Healthcare abroad
+Contact us
+Other NHS websites
+Profile editor login
+About us
+Accessibility statement
+Our policies
+Cookies
+© Crown copyright

integrations/haystack/nhs-search/data/www.nhs.uk_conditions_autosomal-recessive-polycystic-kidney-disease-arpkd_.txt

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+Cookies on the NHS website
+We've put some small files called cookies on your device to make our site work.
+We'd also like to use analytics cookies. These send information about how our site is used to services called Adobe Analytics, Hotjar and Google Analytics. We use this information to improve our site.
+Let us know if this is OK. We'll use a cookie to save your choice. You can read more about our cookies before you choose.
+I'm OK with analytics cookies Do not use analytics cookies
+Search the NHS website
+Search
+Health A-Z
+Live Well
+Mental health
+Care and support
+Pregnancy
+Browse
+More
+Home Health A to Z
+Overview
+-
+Autosomal recessive polycystic kidney disease
+Contents
+Overview
+Symptoms
+Causes
+Diagnosis
+Treatment
+Autosomal recessive polycystic kidney disease (ARPKD) is a rare inherited childhood condition where the development of the kidneys and liver is abnormal. Over time, either one of these organs may fail.
+The condition often causes serious problems soon after birth, although less severe cases may not become obvious until a child is older.
+ARPKD can cause a wide range of problems, including:
+underdeveloped lungs, which can cause severe breathing difficulties soon after birth
+high blood pressure (hypertension)
+excessive peeing and thirst
+problems with blood flow through the liver, which can lead to serious internal bleeding
+a progressive loss of kidney function, known as chronic kidney disease (CKD) 
+When these problems develop and how severe they are can vary considerably, even between family members with the condition.
+Read more about the symptoms of ARPKD and diagnosing ARPKD.
+Even though ARPKD is rare, it's one of the most common kidney problems to affect young children.
+It's estimated around 1 in 20,000 babies is born with the condition. Both boys and girls are affected equally.
+The kidneys
+The kidneys are 2 bean-shaped organs located on either side of the body, just beneath the rib cage.
+The main role of the kidneys is to filter out waste products from the blood before passing them out of the body as urine.
+The kidneys also help maintain blood pressure at a healthy level.
+What causes ARPKD?
+ARPKD is caused by a genetic fault that disrupts normal development of the kidneys and liver.
+In particular, the growth and development of the small tubes that make up the kidneys is affected, causing bulges and cysts (fluid-filled sacs) to develop within them.
+Over time, the cysts cause the kidneys to become enlarged and scarred (fibrosis), resulting in the deterioration of overall kidney function.
+Similar problems also affect the small tubes (bile ducts) that allow a digestive fluid called bile to flow out of the liver.
+The bile ducts may develop abnormally and cysts may grow inside them. The liver can also become scarred over time.
+ARPKD is caused by a genetic alteration in the gene PKHD1, which in most cases is passed on to a child by their parents.
+If both parents carry a faulty version of this gene, there's a 1 in 4 chance of each child they have developing ARPKD.
+The way ARPKD is inherited is different from a more common type of kidney disease called autosomal dominant polycystic kidney disease (ADPKD), which usually does not cause significantly reduced kidney function until adulthood.
+ADPKD can be inherited if only 1 parent carries one of the genetic faults responsible for the condition.
+Find out more about the causes of ARPKD
+Treating ARPKD
+There's currently no cure for ARPKD, but various treatments can help manage the wide range of problems it can cause.
+Treatment for ARPKD may include:
+breathing assistance with a machine that moves air in and out of the lungs (a ventilator) for children with severe breathing difficulties
+medication to treat high blood pressure
+procedures to stop any internal bleeding that may occur
+medications to control problems associated with the loss of kidney function, such as iron supplements for anaemia.
+More than half of all children who survive the early stages of ARPKD will eventually experience kidney failure by the time they're 15 to 20 years old.
+If kidney failure does occur, there are 2 main treatment options:
+dialysis, where a machine is used to replicate many functions of the kidney
+a kidney transplant, where a healthy kidney is removed from a living or recently deceased donor and implanted into someone with kidney failure
+Find out more about how ARPKD is treated
+Outlook
+The outlook for children with ARPKD can vary considerably depending on the severity of the condition.
+If routine scans pick up kidney problems during pregnancy, the baby will usually have a poorer outlook than a child who's diagnosed at a later stage.
+But in general, ARPKD is a severe condition and around 1 in 3 babies will die from severe breathing difficulties during the first 4 weeks after birth.
+About 8 or 9 out of 10 babies with ARPKD who survive the first month of life will live until they're at least 5 years old.
+It's difficult to predict exactly how long a child with ARPKD will live because there's very little data showing long-term survival rates.
+But with advances in treatments and a better understanding of the condition, increasing numbers of children with ARPKD are living well into adulthood.
+Information about you
+If you have ARPKD, 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
+Page last reviewed: 01 March 2019
+Next review due: 01 March 2022
+Next
+:
+Symptoms
+Support links
+Home
+Health A to Z
+Live Well
+Mental health
+Care and support
+Pregnancy
+NHS services
+Coronavirus (COVID-19)
+NHS App
+Find my NHS number
+Your health records
+About the NHS
+Healthcare abroad
+Contact us
+Other NHS websites
+Profile editor login
+About us
+Accessibility statement
+Our policies
+Cookies
+© Crown copyright

integrations/haystack/nhs-search/data/www.nhs.uk_conditions_back-pain_.txt

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+Cookies on the NHS website
+We've put some small files called cookies on your device to make our site work.
+We'd also like to use analytics cookies. These send information about how our site is used to services called Adobe Analytics, Hotjar and Google Analytics. We use this information to improve our site.
+Let us know if this is OK. We'll use a cookie to save your choice. You can read more about our cookies before you choose.
+I'm OK with analytics cookies Do not use analytics cookies
+Search the NHS website
+Search
+My account
+Health A-Z
+Live Well
+Mental health
+Care and support
+Pregnancy
+Browse
+More
+Home Health A to Z
+Overview
+-
+Back pain
+Contents
+Overview
+Causes
+Treatment
+Back pain is very common and usually improves within a few weeks or months.
+Pain in the lower back (lumbago) is particularly common, although it can be felt anywhere along the spine, from the neck down to the hips.
+In most cases the pain is not caused by anything serious and will usually get better over time.
+There are things you can do to help relieve it. But sometimes the pain can last a long time or keep coming back.
+How to relieve back pain
+The following tips may help reduce your back pain and speed up your recovery:
+stay as active as possible and try to continue your daily activities – this is 1 of the most important things you can do, as resting for long periods is likely to make the pain worse
+try exercises and stretches for back pain; other activities such as walking, swimming, yoga and pilates may also be helpful
+take anti-inflammatory painkillers, such as ibuprofen – remember to check the medicine is safe for you to take and ask a pharmacist if you're not sure
+use hot or cold compression packs for short-term relief – you can buy these from a pharmacy, or a hot water bottle or a bag of frozen vegetables wrapped in a cloth or towel will work just as well
+Although it can be difficult, it helps if you stay optimistic and recognise that your pain should get better. People who manage to stay positive despite their pain tend to recover quicker.
+Back pain usually gets better on its own within a few weeks or months and you may not need to see a doctor or other healthcare professional.
+But it's a good idea to get help if:
+the pain does not start to improve within a few weeks
+the pain stops you doing your day-to-day activities
+the pain is very severe or gets worse over time
+you're worried about the pain or struggling to cope
+If you see a GP they will ask about your symptoms, examine your back and discuss possible treatments. 
+They may refer you to a specialist doctor or a physiotherapist for further help.
+Alternatively, you may want to consider contacting a physiotherapist directly. Some NHS physiotherapists accept appointments without a doctor's referral, or you could choose to pay for private treatment.
+Read more about how to get access to physiotherapy.
+Treatments for back pain from a specialist
+A GP, specialist or physiotherapist may recommend extra treatments if they do not think your pain will improve with self-help measures alone.
+These may include:
+group exercise classes where you're taught exercises to strengthen your muscles and improve your posture
+manual therapy treatments, such as manipulating the spine and massage, which are usually done by a physiotherapist, chiropractor or osteopath
+psychological support, such as cognitive behavioural therapy (CBT), which can be a useful part of treatment if you're struggling to cope with pain
+Some people choose to see a therapist for manual therapy without seeing a GP first. If you want to do this, you'll usually need to pay for private treatment.
+Surgery is generally only considered in the small number of cases where back pain is caused by a specific medical condition.
+Causes of back pain
+It's often not possible to identify the cause of back pain. Doctors call this non-specific back pain.
+Sometimes the pain may be from an injury such as a sprain or strain, but often it happens for no apparent reason. It's very rarely caused by anything serious.
+Occasionally back pain can be caused by a medical condition such as:
+a slipped (prolapsed) disc – where a disc of cartilage in the spine presses on a nearby nerve
+sciatica – irritation of the nerve that runs from the pelvis to the feet
+These conditions tend to cause additional symptoms, such as numbness, weakness or a tingling sensation, and they're treated differently from non-specific back pain.
+Preventing back pain
+It's difficult to prevent back pain, but the following tips may help reduce your risk:
+do regular back exercises and stretches – a GP or physiotherapist may be able to advise you about exercises to try
+stay active – doing regular exercise can help keep your back strong; adults are advised to do at least 150 minutes of exercise a week
+avoid sitting for long periods
+take care when lifting – read some safe lifting tips
+check your posture when sitting, using computers or tablets and watching television – find out how to sit correctly and get tips for laptop users
+ensure the mattress on your bed supports you properly
+lose weight through a combination of a healthy diet and regular exercise if you're overweight – being overweight can increase your risk of developing back pain
+When to get immediate medical advice
+You should contact a GP or NHS 111 immediately if you have back pain and:
+numbness or tingling around your genitals or buttocks
+difficulty peeing
+loss of bladder or bowel control – peeing or pooing yourself
+chest pain
+a high temperature
+unintentional weight loss
+a swelling or a deformity in your back
+it does not improve after resting or is worse at night
+it started after a serious accident, such as after a car accident
+the pain is so bad you're having problems sleeping
+pain is made worse when sneezing, coughing or pooing
+the pain is coming from the top of your back, between your shoulders, rather than your lower back
+These problems could be a sign of something more serious and need to be checked urgently.
+Help us improve our website
+If you've finished what you're doing, can you answer some questions about your visit today?
+Take our survey
+Page last reviewed: 14 January 2020
+Next review due: 14 January 2023
+Next
+:
+Causes
+Support links
+Home
+Health A to Z
+Live Well
+Mental health
+Care and support
+Pregnancy
+NHS services
+Coronavirus (COVID-19)
+NHS App
+Find my NHS number
+Your health records
+About the NHS
+Healthcare abroad
+Contact us
+Other NHS websites
+Profile editor login
+About us
+Accessibility statement
+Our policies
+Cookies
+© Crown copyright

integrations/haystack/nhs-search/data/www.nhs.uk_conditions_bacterial-vaginosis_.txt

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+Cookies on the NHS website
+We've put some small files called cookies on your device to make our site work.
+We'd also like to use analytics cookies. These send information about how our site is used to services called Adobe Analytics, Hotjar and Google Analytics. We use this information to improve our site.
+Let us know if this is OK. We'll use a cookie to save your choice. You can read more about our cookies before you choose.
+I'm OK with analytics cookies Do not use analytics cookies
+Search the NHS website
+Search
+Health A-Z
+Live Well
+Mental health
+Care and support
+Pregnancy
+Browse
+More
+Home Health A to Z
+Bacterial vaginosis
+Bacterial vaginosis (BV) is a common cause of unusual vaginal discharge. BV is not a sexually transmitted infection (STI), but it can increase your risk of getting an STI such as chlamydia.
+Check if you have bacterial vaginosis
+The most common symptom of bacterial vaginosis is unusual vaginal discharge that has a strong fishy smell, particularly after sex.
+You may notice a change to the colour and consistency of your discharge, such as becoming greyish-white and thin and watery.
+But 50% of women with bacterial vaginosis do not have any symptoms.
+Bacterial vaginosis does not usually cause any soreness or itching.
+If you're unsure it's BV, check for other causes of unusual vaginal discharge.
+Non-urgent advice:
+See a GP or go to a sexual health clinic if you think you have BV
+The condition is not usually serious, but you'll need to be treated with antibiotics if you do have BV.
+It's also important to seek treatment if you're pregnant as there's a small chance that BV can cause complications with pregnancy.
+Information:
+Sexual health clinics can help with bacterial vaginosis
+Sexual health clinics treat problems with the genitals and urinary system.
+Many sexual health clinics offer a walk-in service, where you do not need an appointment.
+They'll often get test results quicker than GP practices.
+During coronavirus, call a sexual health clinic if you need help or advice. Only go to a clinic if you've been told to.
+Find a sexual health clinic
+What happens at your appointment
+Your GP or sexual health clinic will want to confirm it's BV and rule out an STI.
+You'll be asked about your symptoms, and a doctor or nurse may look at your vagina.
+A cotton bud may be wiped over the discharge inside your vagina to test for BV and other infections.
+Treatment for bacterial vaginosis
+Bacterial vaginosis is usually treated with antibiotic tablets or gels or creams.
+These are prescribed by a GP or sexual health clinic.
+If you have a same-sex partner, they may also need treatment.
+Recurring bacterial vaginosis
+It's common for BV to come back, usually within 3 months.
+You'll need to take treatment for longer (up to 6 months) if you keep getting BV (you get it more than twice in 6 months).
+A GP or sexual health clinic will recommend how long you need to treat it.
+They can also help identify if something is triggering your BV, such as sex or your period.
+Things you can do yourself
+To help relieve symptoms and prevent bacterial vaginosis returning:
+Do
+use water and plain soap to wash your genital area
+have showers instead of baths
+Don’t
+do not use perfumed soaps, bubble bath, shampoo or shower gel in the bath
+do not use vaginal deodorants, washes or douches
+do not put antiseptic liquids in the bath
+do not use strong detergents to wash your underwear
+do not smoke
+What causes bacterial vaginosis
+Bacterial vaginosis is caused by a change in the natural balance of bacteria in your vagina.
+What causes this to happen is not fully known, but you're more likely to get it if:
+you're sexually active (but women who have not had sex can also get BV)
+you have had a change of partner
+you have an IUD (contraception device)
+you use perfumed products in or around your vagina
+BV is not an STI, even though it can be triggered by sex.
+A woman can pass it to another woman during sex.
+You're more likely to get an STI if you have BV. This may be because BV makes your vagina less acidic and reduces your natural defences against infection.
+Bacterial vaginosis in pregnancy
+If you develop bacterial vaginosis in pregnancy, there's a small chance of complications, such as premature birth or miscarriage.
+But BV causes no problems in the majority of pregnancies.
+Speak to a GP or your midwife if you're pregnant and your vaginal discharge changes.
+Help us improve our website
+If you've finished what you're doing, can you answer some questions about your visit today?
+Take our survey
+Page last reviewed: 22 November 2018
+Next review due: 22 November 2021
+Support links
+Home
+Health A to Z
+Live Well
+Mental health
+Care and support
+Pregnancy
+NHS services
+Coronavirus (COVID-19)
+NHS App
+Find my NHS number
+Your health records
+About the NHS
+Healthcare abroad
+Contact us
+Other NHS websites
+Profile editor login
+About us
+Accessibility statement
+Our policies
+Cookies
+© Crown copyright

integrations/haystack/nhs-search/data/www.nhs.uk_conditions_bad-breath_.txt

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+Cookies on the NHS website
+We've put some small files called cookies on your device to make our site work.
+We'd also like to use analytics cookies. These send information about how our site is used to services called Adobe Analytics, Hotjar and Google Analytics. We use this information to improve our site.
+Let us know if this is OK. We'll use a cookie to save your choice. You can read more about our cookies before you choose.
+I'm OK with analytics cookies Do not use analytics cookies
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+Search
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+More
+Home Health A to Z
+Bad breath
+Bad breath (sometimes called halitosis) is very common. You can usually treat it yourself.
+How to treat bad breath yourself
+The best way of making sure you do not have bad breath is to keep your teeth, tongue and mouth clean.
+Do
+gently brush your teeth and gums at least twice a day for 2 minutes
+use a fluoride toothpaste
+gently clean your tongue once a day using a tongue scraper or cleaner
+clean between your teeth with interdental brushes or floss at least once a day
+get regular dental check-ups
+keep dentures clean and remove them at night
+use sugar-free mints or chewing gum after having strong-smelling food and drinks
+try using an antibacterial mouthwash or toothpaste
+Don’t
+do not smoke
+do not rinse your mouth with water straight after brushing your teeth
+do not have lots of sugary foods and drinks
+do not brush so hard your gums or tongue bleed
+Causes of bad breath
+Causes of bad breath include:
+eating or drinking strong-smelling or spicy foods and drinks
+problems with your teeth or gums, such as gum disease, holes in your teeth or an infection
+crash dieting
+some medical conditions, like dry mouth, tonsillitis and acid reflux
+smoking
+Non-urgent advice:
+See a dentist if you have:
+bad breath that does not go away after treating it yourself for a few weeks
+painful, bleeding or swollen gums
+toothache or wobbly adult teeth
+problems with your dentures
+Information:
+Coronavirus (COVID-19) update: how to contact a GP
+It's still important to get help from a GP if you need it. To contact your GP surgery:
+visit their website
+use the NHS App
+call them
+Find out about using the NHS during COVID-19
+Page last reviewed: 07 December 2021
+Next review due: 07 December 2024
+Support links
+Home
+Health A to Z
+Live Well
+Mental health
+Care and support
+Pregnancy
+NHS services
+Coronavirus (COVID-19)
+NHS App
+Find my NHS number
+Your health records
+About the NHS
+Healthcare abroad
+Contact us
+Other NHS websites
+Profile editor login
+About us
+Accessibility statement
+Our policies
+Cookies
+© Crown copyright

integrations/haystack/nhs-search/data/www.nhs.uk_conditions_bakers-cyst_.txt

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+Cookies on the NHS website
+We've put some small files called cookies on your device to make our site work.
+We'd also like to use analytics cookies. These send information about how our site is used to services called Adobe Analytics, Hotjar and Google Analytics. We use this information to improve our site.
+Let us know if this is OK. We'll use a cookie to save your choice. You can read more about our cookies before you choose.
+I'm OK with analytics cookies Do not use analytics cookies
+Search the NHS website
+Search
+Health A-Z
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+Coronavirus (COVID-19)
+Get the latest advice about COVID-19
+Home Health A to Z
+Overview
+-
+Baker's cyst
+Contents
+Overview
+Treatment
+A Baker's cyst, also called a popliteal cyst, is a fluid-filled swelling that develops at the back of the knee.
+A Baker's cyst on a leg
+Credit:
+It's caused when the tissue behind the knee joint becomes swollen and inflamed. The swelling and inflammation can cause:
+pain in the knee and calf
+a build-up of fluid around the knee
+occasional locking or clicking in the knee joint
+However, sometimes a Baker's cyst may not cause any symptoms other than the fluid-filled swelling at the back of the knee.
+A Baker's cyst can sometimes burst (rupture), resulting in fluid leaking down into your calf. This can cause sharp pain, swelling and redness in your calf, but redness can be harder to see on brown and black skin.
+What causes a Baker's cyst?
+Knee damage caused by a sports injury or a blow to the knee can lead to a Baker's cyst developing.
+A Baker's cyst can also sometimes occur if you have a health condition such as:
+osteoarthritis – usually caused by age-related "wear and tear" of joints; it particularly affects the knees, hips, hands and big toe
+inflammatory arthritis – including rheumatoid arthritis, which is a less common type of arthritis and is caused by the immune system attacking the joints
+gout – a type of arthritis that usually affects the big toe and is caused by a build-up of the waste product uric acid in the blood
+Baker's cysts usually develop in people aged 30 to 70, although they can affect people of any age, including children.
+When to see your GP
+See your GP if you have a lump behind your knee that's causing problems and does not clear up on its own. They'll usually be able to diagnose a Baker's cyst by examining the back of your knee and asking about your symptoms.
+Your GP will ask you whether you have any associated health conditions, such as arthritis.
+Tests may be recommended to rule out other more serious conditions, such as a tumour, an aneurysm (bulge in a section of a blood vessel) or DVT (deep vein thrombosis) (a blood clot in one of the deep veins of the body). You may need an ultrasound scan or a MRI scan.
+Treating a Baker's cyst
+Treatment will not usually be necessary if you have a Baker's cyst that is not causing any symptoms.
+Painkillers such as paracetamol and ibuprofen can be used to reduce the swelling and relieve any pain. A knee support or an ice pack may also help. A bag of frozen peas wrapped in a tea towel works well as an ice pack.
+If you have an underlying condition that's causing your cyst, it's important that the condition is properly managed. The cyst may disappear when the condition causing it has been treated.
+In some cases, it may be possible to drain the cyst. Surgery may also be needed to repair any significant damage around the knee joint.
+Read more about treating a Baker's cyst.
+Page last reviewed: 04 October 2021
+Next review due: 04 October 2024
+Next
+:
+Treatment
+Support links
+Home
+Health A to Z
+Live Well
+Mental health
+Care and support
+Pregnancy
+NHS services
+Coronavirus (COVID-19)
+NHS App
+Find my NHS number
+Your health records
+About the NHS
+Healthcare abroad
+Contact us
+Other NHS websites
+Profile editor login
+About us
+Accessibility statement
+Our policies
+Cookies
+© Crown copyright

integrations/haystack/nhs-search/data/www.nhs.uk_conditions_balanitis_.txt

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+Cookies on the NHS website
+We've put some small files called cookies on your device to make our site work.
+We'd also like to use analytics cookies. These send information about how our site is used to services called Adobe Analytics, Hotjar and Google Analytics. We use this information to improve our site.
+Let us know if this is OK. We'll use a cookie to save your choice. You can read more about our cookies before you choose.
+I'm OK with analytics cookies Do not use analytics cookies
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+My account
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+Home Health A to Z
+Balanitis
+Balanitis is when the head of the penis is swollen and sore.
+Balanitis is not usually serious but it's important to see a GP to find out what's causing it.
+Check if you have balanitis
+With balanitis, the head of your penis is usually:
+red, swollen, itchy and sore
+Other symptoms can include:
+pain when peeing
+a thick discharge that comes from under your foreskin
+bleeding around your foreskin
+an unpleasant smell
+difficulty pulling back your foreskin – though in young children it's normal to have a tight foreskin
+Non-urgent advice:
+See a GP if:
+you or your child have symptoms of balanitis
+treatment has not worked
+Adults can also go to a sexual health clinic for assessment.
+Information:
+Coronavirus (COVID-19) update: how to contact a GP
+It's still important to get help from a GP if you need it. To contact your GP surgery:
+visit their website
+use the NHS App
+call them
+Find out about using the NHS during COVID-19
+Sexual health clinics can help with balanitis
+Sexual health clinics treat problems with the genitals.
+Many sexual health clinics offer a walk-in service, where you do not need an appointment.
+They'll often get test results quicker than GP practices.
+During coronavirus, call a sexual health clinic if you need help or advice. Only go to a clinic if you've been told to.
+Find a sexual health clinic
+What happens at your appointment
+A doctor or nurse will look at your penis and ask you a few questions. They may also wipe a cotton bud over the head of your penis to test for infections.
+If any treatment they prescribe does not work, the cause is unknown, or the infection is severe and thrush is present, a blood test may be suggested to check if you have diabetes.
+Treatment for balanitis
+Treatment for balanitis depends on what's causing it.
+A GP may prescribe:
+a mild steroid cream or ointment
+an antifungal cream or ointment
+antibiotics
+If you or your child keeps getting balanitis and medicine has not helped, circumcision (surgery to remove the foreskin) may be considered.
+Things you can do if you have balanitis
+Do
+wash your penis every day
+gently pull back your foreskin and wash the area with warm water
+dry gently after washing
+if you use condoms, choose condoms for sensitive skin
+wash your hands before peeing or touching your penis
+Don’t
+do not use soap or shower gel but you could use an emollient (moisturising treatment)
+Things you can do if your child has balanitis
+Do
+gently wash your child's penis every day
+use warm water and then dry it gently
+if they wear nappies, change your child's nappies often
+Don’t
+do not use soap, bubble bath or baby wipes
+do not pull your child's foreskin back if it is fixed in place
+Causes of balanitis
+Causes of balanitis include:
+not washing your penis properly
+some young boys have a very tight foreskin (phimosis), which means they cannot pull it back to clean under it
+thrush
+a sexually transmitted infection (STI) such as gonorrhoea or chlamydia – if a STI is suspected you may be referred to a sexual health clinic
+substances such as soap, shower gels or condoms may irritate the skin
+diabetes – high levels of sugar in your pee can cause thrush
+Page last reviewed: 08 July 2020
+Next review due: 08 July 2023
+Support links
+Home
+Health A to Z
+Live Well
+Mental health
+Care and support
+Pregnancy
+NHS services
+Coronavirus (COVID-19)
+NHS App
+Find my NHS number
+Your health records
+About the NHS
+Healthcare abroad
+Contact us
+Other NHS websites
+Profile editor login
+About us
+Accessibility statement
+Our policies
+Cookies
+© Crown copyright

integrations/haystack/nhs-search/data/www.nhs.uk_conditions_barium-enema_.txt

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+Cookies on the NHS website
+We've put some small files called cookies on your device to make our site work.
+We'd also like to use analytics cookies. These send information about how our site is used to services called Adobe Analytics, Hotjar and Google Analytics. We use this information to improve our site.
+Let us know if this is OK. We'll use a cookie to save your choice. You can read more about our cookies before you choose.
+I'm OK with analytics cookies Do not use analytics cookies
+Search the NHS website
+Search
+Health A-Z
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+Mental health
+Care and support
+Pregnancy
+Browse
+More
+Home Health A to Z
+Barium enema
+A barium enema is a test that helps to highlight the large bowel so it can be clearly seen on an X-ray.
+During the test, a white liquid called barium is passed into your bowel through your bottom.
+A barium enema may be requested by any doctor who thinks you might have a problem with your bowel, including your GP.
+The test will usually be carried out at a hospital radiology department by a radiologist or radiographer.
+When barium enemas are used
+Nowadays, barium enemas aren't carried out very often, as alternative tests such as a colonoscopy or CT scan are usually preferred.
+But a barium enema can sometimes be a useful way of finding the cause of problems like blood in your stools or a constant change in your bowel habits.
+Conditions that can be detected during a barium enema include:
+bowel cancer
+growths in the bowel (bowel polyps)
+inflammation of the bowel (ulcerative colitis) or Crohn's disease
+pouches in the bowel (diverticular disease)
+Preparing for a barium enema
+To ensure the X-ray images taken during a barium enema are clear, your bowel must be empty before the test.
+The hospital should send you instructions on what you need to do to prepare.
+You'll normally be asked to:
+eat a light diet – for a few days leading up to the test, only eat low-fibre foods such as clear soup, white bread and lean meat
+take laxative medication – you'll be given medication that makes you empty your bowels frequently to take from the day before the test
+drink plenty of fluids – this will help to replace the fluids you lose each time you empty your bowels
+It's usually a good idea to stay at home the day before the test, as the laxative medication will make you go to the toilet frequently.
+Contact the hospital as soon as you receive your appointment letter if you have diabetes or are pregnant (or think you could be pregnant).
+Barium enemas aren't done during pregnancy because the X-rays may harm the baby.
+If you have diabetes, you'll need to follow special instructions to ensure your blood sugar level is kept under control.
+Having a barium enema
+When you arrive at hospital, you'll be asked to change into a hospital gown.
+You can take someone with you to the hospital, but they're not usually allowed into the X-ray room.
+During the test:
+you'll be asked to lie on your side on an X-ray table, and an injection of a medication called Buscopan may be given into your arm or hand to prevent involuntary bowel movements
+a small, soft tube will be gently inserted a few centimetres into your bottom, where it will remain throughout the test
+the barium is passed through the tube and into your bowel – try to keep the muscles in your bottom tight to prevent it coming back out, but don't worry if some leaks out 
+you may be asked to move around a bit to help the barium spread along your bowel, and air may be pumped into your bowel to expand it and help push the barium around
+several X-rays will be taken with you in different positions
+The whole process usually takes around 30 to 45 minutes.
+What happens after a barium enema
+When the test is finished, the tube will be removed from your bottom and you can go to the toilet to empty your bowels.
+You should be able to go home shortly afterwards, although it's a good idea to take things easy for a few hours before returning to your normal activities.
+If you had a Buscopan injection, your vision may be blurry for 30 to 60 minutes, so you won't be able to drive during this time. It's best to arrange for someone to drive you home.
+When you get home:
+stay close to a toilet for the next few hours, as you may find you need to empty your bowels quite often at first
+your poo may be a whitish colour for a few days – this is normal and is just the remaining barium passing out of your body
+you can eat and drink as normal – drink plenty of fluids and eat high-fibre foods for the first few days to help stop the barium causing constipation
+The X-ray images taken during the test will be analysed by a specialist. A report will be sent to the doctor who referred you for the test and you can discuss the results at your next appointment.
+Does a barium enema hurt?
+Having a barium enema may be a bit embarrassing and unpleasant, but it shouldn't be painful.
+You'll probably feel uncomfortable when the air is pumped into your bowel during the test, similar to the feeling of having trapped wind.
+You may have some bloating, wind or stomach cramps for a short while afterwards.
+Are there any risks or side effects?
+A barium enema is generally a very safe procedure, although there a few risks and side effects that you should be aware of.
+These include:
+laxative side effects – side effects such as feeling sick, a mild headache and bloating are common, but shouldn't last long
+barium side effects – barium is usually harmless, but it can cause an upset stomach or constipation, and can cause an allergic reaction in very rare cases
+radiation exposure – you'll be exposed to a small amount of radiation during the test; this is about the equivalent to what you would receive naturally from the environment over 3 years (for more information, see GOV.UK: patient dose information)
+bowel perforation – there's a risk of a small hole developing in your bowel as a result of the procedure, but this is very rare
+Your doctor can help you weigh up the risks of the procedure against the benefits of identifying any problem in your bowel.
+Page last reviewed: 16 August 2018
+Next review due: 16 August 2021
+Support links
+Home
+Health A to Z
+Live Well
+Mental health
+Care and support
+Pregnancy
+NHS services
+Coronavirus (COVID-19)
+NHS App
+Find my NHS number
+Your health records
+About the NHS
+Healthcare abroad
+Contact us
+Other NHS websites
+Profile editor login
+About us
+Accessibility statement
+Our policies
+Cookies
+© Crown copyright

integrations/haystack/nhs-search/data/www.nhs.uk_conditions_bartholins-cyst_.txt

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+Cookies on the NHS website
+We've put some small files called cookies on your device to make our site work.
+We'd also like to use analytics cookies. These send information about how our site is used to services called Adobe Analytics, Hotjar and Google Analytics. We use this information to improve our site.
+Let us know if this is OK. We'll use a cookie to save your choice. You can read more about our cookies before you choose.
+I'm OK with analytics cookies Do not use analytics cookies
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+More
+Home Health A to Z
+Overview
+-
+Bartholin's cyst
+Contents
+Overview
+Treatment
+A Bartholin's cyst, also called a Bartholin's duct cyst, is a small fluid-filled sac just inside the opening of the vagina.
+Symptoms of a Bartholin's cyst
+You may feel a soft, painless lump. This does not usually cause any problems.
+But if the cyst grows very large, it can become noticeable and uncomfortable. You may feel pain in the skin surrounding the vagina (vulva) when you walk, sit down or have sex.
+The cyst can sometimes affect the outer pair of lips surrounding the vagina (labia majora). One side may look swollen or bigger than usual.
+If the cyst becomes infected, it can cause a painful collection of pus (abscess) to develop in one of the Bartholin's glands.
+Signs of an abscess include the affected area becoming red, swollen, tender and hot. It can also cause a high temperature.
+When to see a GP
+Small Bartholin's cysts are sometimes only found during a routine cervical screening test or an examination carried out for another reason.
+Always see a GP if you develop a lump in the area around your vagina so they can confirm a diagnosis and rule out more serious conditions.
+If they think the cyst or one of your Bartholin's glands may be infected, they may use a swab to remove a sample of discharge for analysis to identify the bacteria responsible.
+Sometimes, a GP may recommend you have a biopsy. A small sample of cyst tissue will be removed and examined under a microscope to check for signs of a rare type of vulval cancer called Bartholin's gland cancer.
+What causes Bartholin's cysts?
+The Bartholin's glands are a pair of pea-sized glands found just behind and either side of the lips that surround the entrance to the vagina.
+The glands are not usually noticeable because they're rarely larger than 1cm (0.4 inches) across.
+The Bartholin's glands secrete fluid that acts as a lubricant during sex. The fluid travels down tiny tubes called ducts into the vagina.
+If the ducts become blocked, they can fill with fluid and expand to form a cyst.
+It's often not known why the ducts become blocked, but sometimes it's linked to sexually transmitted bacterial infections (STIs), such as gonorrhoea or chlamydia, or other bacterial infections, such as Escherichia coli (E. coli).
+How Bartholin's cysts are treated
+If you do not have any noticeable symptoms, it's unlikely you'll need treatment.
+If the cyst is painful, a GP may recommend some simple self-care measures, such as soaking the cyst in warm water several times a day for 3 or 4 days and taking painkillers you can buy from a pharmacy or supermarket.
+If these do not work, several treatments are available to treat the pain and any infection. If necessary, the cyst can be drained. Most of these treatments involve a minor surgical procedure.
+A Bartholin's cyst can sometimes return after treatment.
+Who's affected
+A Bartholin's cyst usually affects sexually active women aged 20 to 30.
+Bartholin's cysts do not usually affect children because the Bartholin's glands do not start functioning until puberty. 
+The cysts are also uncommon after the menopause as this usually causes the Bartholin's glands to shrink.
+Preventing Bartholin's cysts
+It's not clear exactly why Bartholin's cysts develop, so it's not usually possible to prevent them.
+But as some are thought to be linked to STIs, practising safe sex (using a condom every time you have sex) can help reduce your chances of developing Bartholin's cysts .
+Get more advice about STIs
+Page last reviewed: 26 October 2021
+Next review due: 26 October 2024
+Next
+:
+Treatment
+Support links
+Home
+Health A to Z
+Live Well
+Mental health
+Care and support
+Pregnancy
+NHS services
+Coronavirus (COVID-19)
+NHS App
+Find my NHS number
+Your health records
+About the NHS
+Healthcare abroad
+Contact us
+Other NHS websites
+Profile editor login
+About us
+Accessibility statement
+Our policies
+Cookies
+© Crown copyright

integrations/haystack/nhs-search/data/www.nhs.uk_conditions_bedbugs_.txt

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+Cookies on the NHS website
+We've put some small files called cookies on your device to make our site work.
+We'd also like to use analytics cookies. These send information about how our site is used to services called Adobe Analytics, Hotjar and Google Analytics. We use this information to improve our site.
+Let us know if this is OK. We'll use a cookie to save your choice. You can read more about our cookies before you choose.
+I'm OK with analytics cookies Do not use analytics cookies
+Search the NHS website
+Search
+Health A-Z
+Live Well
+Mental health
+Care and support
+Pregnancy
+Browse
+More
+Coronavirus (COVID-19)
+Get the latest advice about COVID-19
+Home Health A to Z
+Bedbugs
+Bedbugs are small insects that often live on furniture or bedding. Their bites can be itchy, but do not usually cause other health problems.
+Check if it's bedbugs
+Bedbugs can be dark yellow, red or brown. Adults are around 5mm long.
+Credit:
+Bedbugs can hide in many places, including on bed frames, mattresses, clothing, furniture, behind pictures and under loose wallpaper.
+Signs of bedbugs include:
+bites – often on areas exposed while sleeping, like the face, neck and arms
+spots of blood on your bedding – from the bites or from squashing a bedbug
+small brown spots on bedding or furniture (bedbug poo)
+Bedbug bites can be red and itchy. They're often in a line or cluster.
+Credit:
+Some people have a reaction to the bites. They can be very itchy and there may be painful swelling.
+A severe allergic reaction (anaphylaxis) is also possible but rare.
+How you can treat bedbug bites
+Bedbug bites usually clear up on their own in a week or so.
+Things you can do include:
+putting something cool, like a clean, damp cloth, on the affected area to help with the itching and any swelling
+keeping the affected area clean
+not scratching the bites to avoid getting an infection
+You can ask a pharmacist about:
+using a mild steroid cream like hydrocortisone cream to ease bedbug bites (children under 10 and pregnant women should get advice from a doctor before using hydrocortisone cream)
+antihistamines – these may help if the bites are very itchy and you're unable to sleep
+Find a pharmacy
+Non-urgent advice:
+See a GP if:
+the bites are still very painful, swollen or itchy after trying treatments from a pharmacist
+the redness around the bites is spreading
+You may have an infection and need treatment with antibiotics.
+Information:
+Coronavirus (COVID-19) update: how to contact a GP
+It's still important to get help from a GP if you need it. To contact your GP surgery:
+visit their website
+use the NHS App
+call them
+Find out about using the NHS during COVID-19
+How to get rid of bedbugs
+Do
+contact your local council on GOV.UK or local pest control service – it's unlikely you'll be able to get rid of bedbugs yourself because they can be resistant to some insecticides
+wash affected bedding and clothing – use a hot wash (60C) or tumble dry on a hot setting for at least 30 minutes
+put affected clothing and bedding in a plastic bag and put it in the freezer (-16C) for 4 days (alternative to hot washing)
+clean and vacuum regularly – bedbugs are found in both clean and dirty places, but regular cleaning will help you spot them early
+Don’t
+do not keep clutter around your bed
+do not bring secondhand furniture indoors without carefully checking it first
+do not take luggage or clothing indoors without checking it carefully if you have come from somewhere where you know there were bedbugs
+Page last reviewed: 21 January 2019
+Next review due: 21 January 2022
+Support links
+Home
+Health A to Z
+Live Well
+Mental health
+Care and support
+Pregnancy
+NHS services
+Coronavirus (COVID-19)
+NHS App
+Find my NHS number
+Your health records
+About the NHS
+Healthcare abroad
+Contact us
+Other NHS websites
+Profile editor login
+About us
+Accessibility statement
+Our policies
+Cookies
+© Crown copyright

integrations/haystack/nhs-search/data/www.nhs.uk_conditions_bedwetting_.txt

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+Cookies on the NHS website
+We've put some small files called cookies on your device to make our site work.
+We'd also like to use analytics cookies. These send information about how our site is used to services called Adobe Analytics, Hotjar and Google Analytics. We use this information to improve our site.
+Let us know if this is OK. We'll use a cookie to save your choice. You can read more about our cookies before you choose.
+I'm OK with analytics cookies Do not use analytics cookies
+Search the NHS website
+Search
+My account
+Health A-Z
+Live Well
+Mental health
+Care and support
+Pregnancy
+Browse
+More
+Home Health A to Z
+Bedwetting in children
+Bedwetting is common and often runs in families. It can be upsetting, but most children and young people will grow out of it. See a GP or school nurse for advice.
+Things you can do at home to help with bedwetting
+Do
+give your child enough water to drink during the day
+make sure your child goes to the toilet regularly, around 4 to 7 times a day, including just before bedtime
+agree with your child on rewards for positive actions, such as a sticker for every time they use the toilet before bed
+use waterproof covers on their mattress and duvet
+make sure they have easy access to a toilet at night
+Don’t
+do not punish your child – it is not their fault and can make bedwetting worse
+do not give your child drinks containing caffeine, such as cola, tea and coffee – this can make them pee more
+do not regularly wake or carry your child in the night to use the toilet – this will not help in the long term
+Bedwetting in young children is normal
+Many children under the age of 5 wet the bed.
+It can take some time for a child to learn to stay dry throughout the night.
+Non-urgent advice:
+See a GP if:
+you've tried things you can do at home and your child keeps wetting the bed
+your child has started wetting the bed again after being dry for more than 6 months
+Information:
+Coronavirus (COVID-19) update: how to contact a GP
+It's still important to get help from a GP if you need it. To contact your GP surgery:
+visit their website
+use the NHS App
+call them
+Find out about using the NHS during COVID-19
+Treatments from a GP
+The GP will be able to suggest other options such as:
+a bedwetting alarm
+medicine to reduce how much pee your child makes at night
+The GP will check if treatment is helping. They'll also be able to offer support if you are finding it hard to cope.
+If these treatments do not work, your child may be referred to a specialist.
+Causes of bedwetting
+There are many reasons why a child might wet the bed. Causes include:
+not feeling the need to pee while sleeping
+making too much pee at night
+stress at home or at school
+Bedwetting may also be caused by an underlying health condition such as diabetes or constipation.
+More information and advice on bedwetting
+Bladder & Bowel UK: Resources for children and young people
+ERIC: Bedwetting
+Page last reviewed: 27 April 2020
+Next review due: 27 April 2023
+Support links
+Home
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+Live Well
+Mental health
+Care and support
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+Coronavirus (COVID-19)
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+About the NHS
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+Contact us
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+Our policies
+Cookies
+© Crown copyright

integrations/haystack/nhs-search/data/www.nhs.uk_conditions_behcets-disease_.txt

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+Cookies on the NHS website
+We've put some small files called cookies on your device to make our site work.
+We'd also like to use analytics cookies. These send information about how our site is used to services called Adobe Analytics, Hotjar and Google Analytics. We use this information to improve our site.
+Let us know if this is OK. We'll use a cookie to save your choice. You can read more about our cookies before you choose.
+I'm OK with analytics cookies Do not use analytics cookies
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+Overview
+-
+Behçet's disease
+Contents
+Overview
+Symptoms
+Treatment
+Behçet's disease, or Behçet's syndrome, is a rare and poorly understood condition that results in inflammation of the blood vessels and tissues.
+Confirming a diagnosis of Behçet's disease can be difficult because the symptoms are so wide-ranging and general (they can be shared with a number of other conditions).
+Symptoms of Behçet's disease
+The main symptoms of Behçet's disease include:
+genital and mouth ulcers
+red, painful eyes and blurred vision
+acne-like spots
+headaches
+painful, stiff and swollen joints
+In severe cases, there's also a risk of serious and potentially life-threatening problems, such as permanent vision loss and strokes.
+Most people with the condition experience episodes where their symptoms are severe (flare-ups or relapses), followed by periods where the symptoms disappear (remission).
+Over time, some of the symptoms can settle down and become less troublesome, although they may never resolve completely.
+Read about the symptoms of Behçet's disease
+Diagnosing Behçet's disease
+There's no definitive test that can be used to diagnose Behçet's disease.
+Several tests may be necessary to check for signs of the condition, or to help rule out other causes, including:
+blood tests
+urine tests
+scans, such as X-rays, a CT scan or an MRI scan
+a skin biopsy
+a pathergy test – which involves pricking your skin with a needle to see if a particular red spot appears within the next day or two; people with Behçet's disease often have particularly sensitive skin
+Current guidelines state a diagnosis of Behçet's disease can usually be confidently made if you've experienced at least 3 episodes of mouth ulcers over the past 12 months and you have at least 2 of the following symptoms:
+genital ulcers
+eye inflammation
+skin lesions (any unusual growths or abnormalities that develop on the skin)
+pathergy (hypersensitive skin)
+Other potential causes also need to be ruled out before the diagnosis is made.
+Causes of Behçet's disease
+The cause of Behçet's disease is unknown, although most experts believe it's an autoinflammatory condition.
+An autoinflammatory condition is where the immune system – the body's natural defence against infection and illness – mistakenly attacks healthy tissue.
+In cases of Behçet's disease, it's thought the immune system mistakenly attacks the blood vessels.
+It's not clear what triggers this problem with the immune system, but 2 things are thought to play a role:
+genes – Behçet's disease tends to be much more common in certain ethnic groups where the genes that are linked to the condition may be more common
+environmental factors – although a specific environmental factor has not been identified, rates of Behçet's disease are lower in people from an at-risk ethnic group who live outside their native country
+Behçet's disease is more common in the Far East, the Middle East and Mediterranean countries such as Turkey and Israel.
+People of Mediterranean, Middle Eastern and Asian origin are thought to be most likely to develop the condition, although it can affect all ethnic groups.
+Treating Behçet's disease
+There's no cure for Behçet's disease, but it's often possible to control the symptoms with medicines that reduce inflammation in the affected parts of the body.
+These medicines include:
+steroids – powerful anti-inflammatory medicines
+immunosuppressants – medicines that reduce the activity of the immune system
+biological therapies – medicines that target the biological processes involved in the process of inflammation
+Your healthcare team will create a specific treatment plan for you depending on your symptoms.
+Read about treating Behçet's disease
+Specialist Behçet's disease centres
+There are 3 NHS Centres of Excellence that have been set up to help diagnose and treat people with Behçet's disease in England.
+These are located in London, Birmingham and Liverpool.
+You may be referred to one of these centres so a diagnosis can be confirmed. Staff at these centres may also liaise with specialists at other centres to help with a person's management and treatment, even if they're not seen directly.
+You can find out more about these centres on the Behçet's Syndrome Centres of Excellence website.
+If you have Behçet's disease, your clinical team will pass information about you on to the National Congenital Anomaly and Rare Disease 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.
+Further information about Behçet's disease
+A natural response to receiving a diagnosis of a complex condition such as Behçet's disease is to find out as much as possible about the condition.
+However, in the UK this may be difficult because Behçet's disease is so rare that many healthcare professionals know little about it.
+A good place to start to learn more about Behçet's disease is from Behçet's UK – the UK's main patient support group for people with Behçet's disease.
+Its website has a range of information about different aspects of Behçet's disease, a members' forum, blogs and links to other useful resources.
+Page last reviewed: 20 November 2019
+Next review due: 20 November 2022
+Next
+:
+Symptoms
+Support links
+Home
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+Live Well
+Mental health
+Care and support
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+Coronavirus (COVID-19)
+NHS App
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+Your health records
+About the NHS
+Healthcare abroad
+Contact us
+Other NHS websites
+Profile editor login
+About us
+Accessibility statement
+Our policies
+Cookies
+© Crown copyright

integrations/haystack/nhs-search/data/www.nhs.uk_conditions_bells-palsy_.txt

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+Cookies on the NHS website
+We've put some small files called cookies on your device to make our site work.
+We'd also like to use analytics cookies. These send information about how our site is used to services called Adobe Analytics, Hotjar and Google Analytics. We use this information to improve our site.
+Let us know if this is OK. We'll use a cookie to save your choice. You can read more about our cookies before you choose.
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+Bell's palsy
+Bell's palsy is temporary weakness or lack of movement affecting 1 side of the face. Most people get better within 9 months.
+Unlike a stroke, the facial weakness develops gradually.
+Immediate action required:
+Call 999 if:
+somebody's face droops on 1 side (the mouth or eye may have drooped)
+a person cannot lift up both arms and keep them there
+a person has difficulty speaking (speech may be slurred or garbled)
+These can be signs of a stroke, which is a medical emergency.
+Unlike Bell's palsy, the symptoms of a stroke usually come on suddenly.
+Non-urgent advice:
+See a GP if you have:
+weakness or total paralysis on 1 side of your face that develops quickly within 72 hours
+a drooping eyelid or corner of the mouth
+drooling
+a dry mouth
+a loss of taste
+eye irritation, such as dryness or more tears
+These are symptoms of Bell's palsy.
+It's important to see a GP as soon as possible after developing these symptoms.
+
+This is because treatment for Bell's palsy is more effective if started early (within 72 hours).
+
+You may also have a problem closing one of your eyes. If this is the case you may need additional treatment to prevent damage to your vision.
+Information:
+Coronavirus (COVID-19) update: how to contact a GP
+It's still important to get help from a GP if you need it. To contact your GP surgery:
+visit their website
+use the NHS App
+call them
+Find out about using the NHS during COVID-19
+Treatment from a GP
+Treatments for Bell's palsy include:
+a 10-day course of steroid medicine
+eyedrops and eye ointment to stop the affected eye drying out
+surgical tape to keep the eye closed at bedtime
+The GP might prescribe a type of steroid called prednisolone. Treatment with prednisolone should begin within 3 days (72 hours) of the symptoms starting.
+Bell's palsy is rare in children, and most children who are affected make a full recovery without treatment.
+How long Bell's palsy lasts
+Most people make a full recovery within 9 months, but it can take longer. In a small number of cases, the facial weakness can be permanent.
+Go back to see a GP if there are no signs of improvement after 3 weeks. Some cases might need to be treated with surgery.
+Living with Bell's palsy can make you feel depressed, stressed or anxious. Speak to a GP if it's affecting your mental health.
+You cannot prevent Bell's palsy
+Because it's probably caused by an infection, Bell's palsy cannot usually be prevented. It may be linked to the herpes virus.
+You'll usually only get Bell's palsy once, but it can sometimes come back. This is more likely if you have a family history of the condition.
+Page last reviewed: 11 September 2020
+Next review due: 11 September 2023
+Support links
+Home
+Health A to Z
+Live Well
+Mental health
+Care and support
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+Coronavirus (COVID-19)
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+About the NHS
+Healthcare abroad
+Contact us
+Other NHS websites
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+About us
+Accessibility statement
+Our policies
+Cookies
+© Crown copyright

integrations/haystack/nhs-search/data/www.nhs.uk_conditions_benign-brain-tumour_.txt

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+Cookies on the NHS website
+We've put some small files called cookies on your device to make our site work.
+We'd also like to use analytics cookies. These send information about how our site is used to services called Adobe Analytics, Hotjar and Google Analytics. We use this information to improve our site.
+Let us know if this is OK. We'll use a cookie to save your choice. You can read more about our cookies before you choose.
+I'm OK with analytics cookies Do not use analytics cookies
+Search the NHS website
+Search
+Health A-Z
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+Get the latest advice about COVID-19
+Home Health A to Z
+Overview
+-
+Benign brain tumour (non-cancerous)
+Contents
+Overview
+Symptoms
+Diagnosis
+Treatment
+Recovery
+A benign (non-cancerous) brain tumour is a mass of cells that grows relatively slowly in the brain.
+Non-cancerous brain tumours tend to stay in one place and do not spread. It will not usually come back if all of the tumour can be safely removed during surgery.
+If the tumour cannot be completely removed, there's a risk it could grow back. In this case it'll be closely monitored using scans or treated with radiotherapy.
+Read about malignant brain tumour (brain cancer).
+Types and grades of non-cancerous brain tumour
+There are many different types of non-cancerous brain tumours, which are related to the type of brain cells affected.
+Examples include:
+gliomas – tumours of the glial tissue, which hold and support nerve cells and fibres
+meningiomas – tumours of the membranes that cover the brain
+acoustic neuromas – tumours of the acoustic nerve (also known as vestibular schwannomas)
+craniopharyngiomas – tumours near the base of the brain that are most often diagnosed in children, teenagers and young adults
+haemangioblastomas – tumours of the brain's blood vessels
+pituitary adenomas – tumours of the pituitary gland, a pea-sized gland on the under surface of the brain
+The Cancer Research UK website has more information about the different types of brain tumours.
+Brain tumours are graded from 1 to 4 according to how fast they grow and spread, and how likely they are to grow back after treatment.
+Non-cancerous brain tumours are grades 1 or 2 because they tend to be slow growing and unlikely to spread.
+They are not cancerous and can often be successfully treated, but they're still serious and can be life threatening.
+Symptoms of non-cancerous brain tumours
+The symptoms of a non-cancerous brain tumour depend on how big it is and where it is in the brain. Some slow-growing tumours may not cause any symptoms at first.
+Common symptoms include:
+new, persistent headaches
+seizures (epileptic fits)
+feeling sick all the time, being sick, and drowsiness
+mental or behavioural changes, such as changes in personality
+weakness or paralysis, vision problems, or speech problems
+When to see a GP
+See a GP if you have symptoms of a brain tumour. While it's unlikely to be a tumour, these symptoms need to be assessed by a doctor.
+The GP will examine you and ask about your symptoms. They may also test your nervous system.
+If the GP thinks you may have a brain tumour, or they're not sure what's causing your symptoms, they'll refer you to a brain and nerve specialist called a neurologist.
+Causes of non-cancerous brain tumours
+The cause of most non-cancerous brain tumours is unknown, but you're more likely to develop one if:
+you're over the age of 50
+you have a family history of brain tumours
+you have a genetic condition that increases your risk of developing a non-cancerous brain tumour – such as neurofibromatosis type 1, neurofibromatosis type 2, tuberous sclerosis, Turcot syndrome, Li-Fraumeni cancer syndrome, von Hippel-Lindau syndrome, and Gorlin syndrome
+you've had radiotherapy
+Treating non-cancerous brain tumours
+Treatment for a non-cancerous brain tumour depends on the type and location of the tumour.
+Surgery is used to remove most non-cancerous brain tumours, and they do not usually come back after being removed. But sometimes tumours do grow back or become cancerous.
+If all of the tumour cannot be removed, other treatments, such as radiotherapy and chemotherapy, may be needed to control the growth of the remaining abnormal cells.
+Recovering from treatment for a non-cancerous brain tumour
+After treatment, you may have persistent problems, such as seizures and difficulties with speech and walking. You may need supportive treatment to help you recover from, or adapt to, these problems.
+Many people are eventually able to resume their normal activities, including work and sport, but it can take time.
+You may find it useful to speak to a counsellor if you want to talk about the emotional aspects of your diagnosis and treatment.
+The Brain Tumour Charity has links to support groups in the UK, and Brain Tumour Research also has details of helplines you can contact.
+Video: benign brain tumour - Debbie's story
+In this video, Debbie describes her diagnosis and treatment for a benign brain tumour.
+Play Video
+Media last reviewed: 2 March 2021
+Media review due: 2 March 2024
+Page last reviewed: 21 April 2020
+Next review due: 21 April 2023
+Next
+:
+Symptoms
+Support links
+Home
+Health A to Z
+Live Well
+Mental health
+Care and support
+Pregnancy
+NHS services
+Coronavirus (COVID-19)
+NHS App
+Find my NHS number
+Your health records
+About the NHS
+Healthcare abroad
+Contact us
+Other NHS websites
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+About us
+Accessibility statement
+Our policies
+Cookies
+© Crown copyright

integrations/haystack/nhs-search/data/www.nhs.uk_conditions_beta-blockers_.txt

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+Cookies on the NHS website
+We've put some small files called cookies on your device to make our site work.
+We'd also like to use analytics cookies. These send information about how our site is used to services called Adobe Analytics, Hotjar and Google Analytics. We use this information to improve our site.
+Let us know if this is OK. We'll use a cookie to save your choice. You can read more about our cookies before you choose.
+I'm OK with analytics cookies Do not use analytics cookies
+Search the NHS website
+Search
+My account
+Health A-Z
+Live Well
+Mental health
+Care and support
+Pregnancy
+Browse
+More
+Home Health A to Z
+Beta blockers
+Beta blockers work mainly by slowing down the heart. They do this by blocking the action of hormones like adrenaline.
+Beta blockers usually come as tablets.
+They are prescription-only medicines, which means they can only be prescribed by a GP or another suitably qualified healthcare professional.
+Commonly used beta blockers include:
+atenolol (also called Tenormin)
+bisoprolol (also called Cardicor or Emcor)
+carvedilol
+labetalol (also called Trandate)
+metoprolol (also called Betaloc or Lopresor)
+propranolol (also called Inderal or Angilol)
+sotalol
+Uses for beta blockers
+Beta blockers may be used to treat:
+angina – chest pain caused by narrowing of the arteries supplying the heart
+heart failure – failure of the heart to pump enough blood around the body
+atrial fibrillation – irregular heartbeat
+heart attack – an emergency where the blood supply to the heart is suddenly blocked
+high blood pressure – when other medicines have been tried, or in addition to other medicines
+Less commonly, beta blockers are used to prevent migraine or treat:
+an overactive thyroid (hyperthyroidism)
+anxiety 
+tremor
+glaucoma – as eyedrops
+There are several types of beta blocker, and each one has its own characteristics. The type prescribed for you will depend on your health condition.
+Who can take beta blockers
+Beta blockers are not suitable for everyone. To make sure they are safe for you, tell your doctor before starting a beta blocker if you have:
+had an allergic reaction to a beta blocker or any other medicine in the past
+low blood pressure or a slow heart rate
+serious blood circulation problems in your limbs (such as Raynaud's phenomenon, which may make your fingers and toes tingle or turn pale or blue)
+metabolic acidosis – when there's too much acid in your blood
+lung disease or asthma
+Tell your doctor if you're trying to get pregnant, are already pregnant or breastfeeding.
+It's important not to stop taking beta blockers without seeking your doctor's advice. In some cases suddenly stopping the medicine may make your health condition worse.
+Cautions with other medicines
+There are some medicines that may interfere with the way that beta blockers, including beta blocker eyedrops, work.
+Tell your doctor if you're taking:
+other medicines for high blood pressure. The combination with beta blockers can sometimes lower your blood pressure too much. This may make you feel dizzy or faint
+other medicines for an irregular heartbeat such as amiodarone or flecainide
+other medicines that can lower your blood pressure. These include some antidepressants, nitrates (for chest pain), baclofen (a muscle relaxant), medicines for an enlarged prostate gland like tamsulosin, or Parkinson's disease medicines such as levodopa
+medicines for asthma or chronic obstructive pulmonary disease (COPD)
+medicines for diabetes, particularly insulin – beta blockers may make it more difficult to recognise the warning signs of low blood sugar
+medicines to treat nose or sinus congestion, or other cold remedies (including those you can buy in the pharmacy)
+medicines for allergies, such as ephedrine, noradrenaline or adrenaline
+non-steroidal anti-inflammatory medicines (NSAIDs), such as ibuprofen. These medicines may increase your blood pressure, so it's best to keep them to a minimum
+Side effects of beta blockers
+Most people taking beta blockers have either no or very mild side effects that become less troublesome with time.
+Contact your GP if you're having symptoms that bother you or last more than a few days.
+Side effects commonly reported by people taking beta blockers include:
+feeling tired, dizzy or lightheaded (these can be signs of a slow heart rate)
+cold fingers or toes (beta blockers may affect the blood supply to your hands and feet)
+difficulties sleeping or nightmares
+feeling sick
+It happens rarely, but some people have serious side effects when taking beta blockers.
+Tell a doctor straight away if you have:
+shortness of breath with a cough that gets worse when you exercise (like walking up stairs), swollen ankles or legs, chest pain, or an irregular heartbeat – these are signs of heart problems
+shortness of breath, wheezing and tightening of your chest – these can be signs of lung problems
+yellow skin or the whites of your eyes turn yellow – these can be signs of liver problems
+These are not all the side effects of beta blockers. For a full list, see the leaflet inside your medicine packet.
+You can report suspected side effects using the Yellow Card Scheme.
+For more information on the side effects of beta blockers, read about the specific medicine you take in our Medicines A to Z.
+Missed or extra doses
+Most beta blockers are taken once a day, apart from certain beta blockers that are used during pregnancy and Sotalol, which is given 2 or 3 times a day.
+What if I forget to take it?
+If you forget to take a dose of your beta blocker, take it as soon as you remember, unless it is nearly time for your next dose. In this case, just leave out the missed dose and take your next dose as normal.
+Never take 2 doses at the same time. Never take an extra dose to make up for a forgotten one.
+If you often forget doses, it may help to set an alarm to remind you. You could also ask your pharmacist for advice on other ways to help you remember to take your medicine.
+What if I take too much?
+An overdose of beta blockers can slow down your heart rate and make it difficult to breathe. It can also cause dizziness and trembling.
+The amount of beta blocker that can lead to an overdose varies from person to person.
+Call your doctor or go to A&E straight away if you take too much of your beta blocker.
+Page last reviewed: 16 July 2019
+Next review due: 16 July 2022
+Support links
+Home
+Health A to Z
+Live Well
+Mental health
+Care and support
+Pregnancy
+NHS services
+Coronavirus (COVID-19)
+NHS App
+Find my NHS number
+Your health records
+About the NHS
+Healthcare abroad
+Contact us
+Other NHS websites
+Profile editor login
+About us
+Accessibility statement
+Our policies
+Cookies
+© Crown copyright

integrations/haystack/nhs-search/data/www.nhs.uk_conditions_bile-duct-cancer_.txt

@@ -0,0 +1,66 @@
+Cookies on the NHS website
+We've put some small files called cookies on your device to make our site work.
+We'd also like to use analytics cookies. These send information about how our site is used to services called Adobe Analytics, Hotjar and Google Analytics. We use this information to improve our site.
+Let us know if this is OK. We'll use a cookie to save your choice. You can read more about our cookies before you choose.
+I'm OK with analytics cookies Do not use analytics cookies
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+Get the latest advice about COVID-19
+Home Health A to Z
+What is bile duct cancer?
+-
+Bile duct cancer (cholangiocarcinoma)
+Contents
+What is bile duct cancer?
+Symptoms
+Causes
+Tests and next steps
+Treatment
+Where to find help and support
+Credit:
+Bile duct cancer, also called cholangiocarcinoma, is a cancer that's found anywhere in the bile ducts.
+The bile ducts are small tubes that connect different organs. They are part of the digestive system.
+How serious bile duct cancer is depends on where it is in the bile ducts, how big it is, if it has spread and your general health.
+Important
+It's important to get any symptoms of bile duct cancer checked as soon as possible.
+Information:
+Coronavirus advice
+Get advice about coronavirus and cancer:
+Macmillan: Coronavirus guidance for people with cancer
+Cancer Research UK: Coronavirus and cancer
+Page last reviewed: 05 May 2020
+Next review due: 05 May 2023
+Next
+:
+Symptoms
+Support links
+Home
+Health A to Z
+Live Well
+Mental health
+Care and support
+Pregnancy
+NHS services
+Coronavirus (COVID-19)
+NHS App
+Find my NHS number
+Your health records
+About the NHS
+Healthcare abroad
+Contact us
+Other NHS websites
+Profile editor login
+About us
+Accessibility statement
+Our policies
+Cookies
+© Crown copyright