BG Clinic & Medical Centre

 Fainting is a temporary loss of consciousness that happens when the brain does not receive enough oxygen. It comes on suddenly, only lasts for a short time and you recover fully within a short time. It is also often called a blackout. The medical term is syncope. It isn't the same thing as a seizure which usually causes jerking. It is important to seek medical attention if you experience faints. Faints may be caused by a serious problem. However, this is very unusual unless you are aged over 40 or they have happened while you were lying down or during exercise. The most common causes are mentioned below.

​

What are faints?

When you faint, you become unconscious for a few seconds. It is also called passing out or blacking out. The medical term for this is syncope. You may feel sick and sweaty first or pass out with no warning at all. When you pass out, you fall to the ground. It isn't the same thing as a seizure which usually makes you jerk. You come round after a few seconds and feel back to normal. Some people feel very tired after they've come round. Usually, fainting happens for a reason, like when you're in pain or have been standing for a long time in a hot place. Fainting happens because the brain needs a constant supply of oxygen. If that supply falls below a certain level, we fall to the ground, which makes it easier for the more oxygen-rich blood to reach the brain.

​

How common is fainting?

Fainting is common at all ages and affects up to 4 in 10 people at least once in their lives. Most people never get medical help. Most people (95%) have their first attack of syncope before they're 40 years old. If you have it for the first time after 40, it is more likely to be due to a serious underlying problem. The most common cause is a common faint, also called neurally mediated syncope (NMS). Common faints usually happen for the first time in teenage years and affect girls more than boys. In older people, fainting is more likely to be due to an underlying heart problem, low blood pressure or as a side-effect of medication.

​

What problems can cause fainting?

Here are some of the more common causes of faints:

Common faint (NMS): this is also known as vasovagal syncope. It is the most common cause of fainting. NMS can occur in various situations. These include:

• Fear.

• Severe pain or emotional distress.

• After extreme exercise.

• After prolonged standing, especially in hot places (which is why soldiers on parade may faint).

• When wearing tight collars that constrict the neck.

During attacks, you may look pale and feel sweaty. Your eyes will usually stay open.

Orthostatic hypotension: this is a fall in blood pressure on standing up, which can cause fainting. It can occur:

• Due to medication prescribed to lower blood pressure.

• During being sick (vomiting) or experiencing runny stools (diarrhoea) and other reasons for having a lack of fluid in the body (being dehydrated).

• As a result of neurological diseases such as Parkinson's disease and peripheral neuropathy.

• After a big meal.

Cardiac syncope: this occurs due to an underlying heart problem. There may be a family history of sudden death. The faint may be preceded by chest pain or the sensation of having a 'thumping heart' (palpitations) and may happen during exercise.

​

What investigations might be advised?

The doctor will want to know more about what you were doing when you blacked out. You will be asked whether you've recently started new medication. Try to remember whether you had any warning before you blacked out. Did anyone see you fall? (If so, ask them to speak to the doctor if possible). How did you feel when you came round? These details will help the doctor to make a diagnosis. Your doctor will examine you. He or she will check your heart, including your blood pressure when sitting and standing and your pulse. You may be asked to have a heart tracing (an electrocardiogram, or ECG). You may have blood tests for anaemia and diabetes. Further tests of your heart and nervous system may be necessary.

​

What else could it be?

The most common cause of blacking out is fainting. Other causes include epileptic seizures, syncope due to anxiety (psychogenic pseudosyncope) and other rare causes of faints. Other causes of blacking out may be due to low blood sugar (hypoglycaemia) and lack of oxygen (hypoxia) from a variety of causes. It may be due to over-breathing (hyperventilation) but this is rare.

You may also black out after a fall or blow to the head or due to excess alcohol or street drugs.

Strokes and mini strokes (transient ischaemic attacks) can also result in a blackout.

Prolonged blackout, confusion after the event, incomplete recovery and tongue biting all suggest that the cause is not a simple faint.

​

What treatments may be offered?

Treatment will depend on the likely cause of your blackout. You may be asked to keep a diary of your faints, including what you were doing when each happened. Most people will only need to see their GP but you may be referred for further investigation and treatment at a hospital.

​

What can you do if you feel like you're going to faint?

• Lie down flat with your legs up on a chair or against a wall or sit down on the ground with your head between your knees. Do not just sit on a chair.

• Squatting down on your heels can be very effective and is less noticeable in public.

• When feeling better, get up carefully. If symptoms return, resume the position.

If you faint again:

• Discuss with your doctor stopping any medication that may be responsible.

• Avoid alcohol.

• Drink more fluids such as water or soft drinks.

• Wear support stockings.

• Do leg crossing and arm tensing exercises.

 

What should you do next?

You should call an ambulance if you:

• Have a blackout while exercising or lying down.

• Have a family history of sudden and unexplained deaths

• Experience chest pain or the sensation of a 'thumping heart' (palpitations).

If the attack happens again or you do not feel completely back to normal, you should also seek urgent medical attention. In all other cases, you should see your GP. If you have lots of attacks, or you hurt yourself because of the faints, your GP may want you to see a specialist. He or she may also want you to see a specialist if your faints could affect your driving.

​

How can I avoid faints?

You will need to find the underlying cause and try to address it if possible. Common faints are by far the most common cause. Many people who faint know when it tends to happen and how to avoid attacks.

​

What is the outlook (prognosis)?

This depends on the underlying cause but is generally very good. In young people, when the blackouts are not associated with any heart or nervous system problem, there is nothing to worry about. In older people, there may be a risk to your health but this is due to the underlying condition and the risks from falling.

​

(Source: patient.co.uk, Edited)

 

​

​

​

Headache

 

Headaches are common, and many people treat themselves with simple painkillers, drinking extra water, having a rest, or simply by waiting for the headache to go away. A headache is one of the most common reasons for attending a doctor's surgery or a neurology clinic.

Almost everyone will experience headaches at some time. Most headaches are not caused by serious or sinister conditions. However, people understandably worry if headaches seem different (either particularly severe, particularly frequent or unusual in any other way). The most common worry is that the headache is a symptom of a brain tumour.

​

What are the different types of headache?

Headaches can be primary, or they can be secondary which means they are a side-effect of a separate illness or injury.

Your doctor can generally tell the likely cause of your headache from talking to you and examining you. Once he or she has discovered the cause then you will be able to decide how to reduce or stop the headaches. This may involve taking medication only when you get the headaches, taking daily medication to prevent them or, sometimes, stopping medication you are already taking.

Very occasionally, headaches need further investigation to rule out more serious underlying causes.

 

Primary headaches

The most common types of headache, by a very long way, are tension-type headaches (previously just called tension headaches) and migraines.

Tension-type headaches

Tension-type headaches are usually felt as a band or across the forehead. They can last for several days. They can be uncomfortable and tiring, but they do not usually disturb sleep. Most people can carry on working with a tension-type headache. They are not usually made worse by physical activity, although it's not unusual to be a bit sensitive to bright light or noise.

​

Tension-type headaches tend to worsen as the day goes on and are often mildest in the morning. (An exception to this would be a headache caused by sleeping in an awkward position causing a sore neck, or an ache in the face and jaw due to tooth grinding.) Tension-type headaches are usually felt on both sides of the head (referred to as symmetrical pains) - most often the front. They are sometimes called pressure headaches. They can interrupt concentration but are usually not bad enough to send you to bed. Most people can work through a tension-type headache if they really need to.

Tension-type headaches are thought to be caused by tightness in the muscles at the back of the neck and over the scalp. The underlying causes include anything which makes those muscles tense. This includes both physical and mental tension. Tiredness, stress, anxiety and an awkward sleeping position can make them worse. Working long hours bent over a computer may trigger them. Some people get tension-type headaches if they drink too much caffeine or alcohol, if they don't drink enough water or if they go for a long time between meals and become tired and hungry.

 

What is the treatment for tension-type headaches?
Tension-type headaches usually respond to simple painkillers, often with a large glass of water. However, the best approach is to treat the underlying reason (if you can work out what it is). Changes in lifestyle can help - such as having less caffeine and drinking more water. So, too, can a sensible diet. in which you eat regularly and have a good balance of slow-release energy foods rather than lots of sugars. Reducing the number of pillows you sleep on can sometimes help, particularly if you sleep on more than two pillows. Sleeping on your side on high pillows means your neck is bending sideways during the night, and this may trigger muscle tension and hence headaches. Other things which help improve tension-type headaches are adequate sleep and avoiding excessive noise.

Occasionally, tension-type headaches can be caused by poor vision, particularly if reading in low light for long periods.

 

Migraines

Migraines are also very common. A typical migraine is one-sided and throbbing. Indeed, headaches that are one-sided, headaches that throb and headaches that make you feel sick are more likely to be migraines than anything else. Migraines are often severe enough to be disabling. Some patients need to go to bed to sleep off their headache.

Migraines can last anything from a few hours to three days. They are often made worse by movement or sound. Patients often feel sick (nausea) or are sick (vomit), even if the pain is not severe. Often patients find bright light and even TV make the headache worse. Most people with migraines have 1-2 attacks a month.

About a third of people have migraine with 'aura', or 'classical migraine'. In this condition warning symptoms (the aura) occur before the migraine. These most commonly consist of flashing lights, often in the shape of zigzags. They are sometimes described as being like firework displays. They tend to occur on one side of the vision only (although affecting both eyes at the same time). Some people actually lose half of their vision completely. Others experience tingling or weakness on one side of the body, or slurring of speech. These warning symptoms can last for up to an hour, and are generally followed by a headache. Typically the headache is on the opposite side to the visual symptoms.

​

Migraines can be triggered by stress, hunger, certain foods such as chocolate and red wine, tiredness, and lack of body fluid (dehydration). They can also be triggered by tension-type headaches.

​

What is the treatment for migraines?
Migraines tend to improve with rest, sleep, darkness and quiet. Drinking water can help if you don't feel sick, and simple painkillers such as paracetamol and ibuprofen can be effective. Many people find that they are not, and have special migraine medication prescribed by their doctor. These medications consist of tablets which you take when you have a migraine, and you take them as early as possible in the pain. They do not make the aura (if you have one) disappear.

Some people with frequent migraines opt to take a daily tablet to act as a migraine preventer. This can be a good solution for those whose headaches are interrupting or interfering with their regular activities.

 

Chronic daily headaches

Chronic daily headache or chronic tension-type headache is usually caused by muscle tension in the back of the neck and affects women more often than men. Chronic means that the condition is persistent and ongoing. These headaches can be started by neck injuries or tiredness and may be made worse by medication overuse (see below). A headache that occurs almost every day for three months or more is called a chronic daily headache.

What is the treatment for chronic daily headaches?
This type of headache is best treated by physiotherapy, avoiding painkillers and occasionally by certain antidepressant medications (many of which can be effective against chronic headaches). Using painkillers regularly for chronic daily headache is likely to make things worse, as you may also develop a medication-induced headache.

 

Trigeminal neuralgia

Trigeminal neuralgia causes facial pain. The pain consists of extremely short bursts of electric shock-like sensation in the face - in the area of the eyes, nose, scalp, forehead, jaws, and/or lips. It is usually one-sided, and is more common in people over the age of 50. It can be triggered by touch or light breeze on the face.

 

What is the treatment for trigeminal neuralgia?
Trigeminal neuralgia is usually treated with preventative medicines.

 

Medication-induced headaches

Medication-induced headache is an unpleasant and long-lasting headache. It is caused by taking painkilling medication - usually for headache. Unfortunately, when painkillers are taken regularly for headaches, the body responds by making more pain sensors in the head. Eventually the pain sensors are so many that the head is super-sensitive and the headache won't go away. People who have these headaches often take more and more painkillers to try to feel better. However, the painkillers have often long ceased to work.

​

What is the treatment for medication-induced headaches?
Unfortunately, the treatment is to stop all painkillers for at least a month. Most patients find this very hard to do and take a lot of convincing to even try, as this means living with the headaches without treatment. The headaches may take weeks or even months to lessen (subside) and may get worse first. Whilst they don't usually completely stop you from doing any activity, the constant nature of the headache can be very wearing and tiring and people find it difficult to function. Understanding that you have been taking very regular painkillers but they really have not solved the problem is perhaps the first step in recognising that you may have this type of headache.

Interestingly, this kind of pain receptor increase only appears to occur with headache. If you are taking regular painkilling medication for other conditions, such as arthritis, but you do not have a regular headache, then this does not lead to medication-induced headache. It appears that there is something particular about the pain receptors in people with regular headache which makes them ready to increase in number.

Most common painkillers can cause persistent (chronic) daily headache, as can migraine treatments. However, medicines such as ibuprofen - non-steroidal anti-inflammatory drugs (NSAIDs) - are less likely to cause it. Headache preventers are also sometimes used.

Many doctors feel that the best way forward is to stop all headache pills and weather the worsening of the headache in order to get better in the end.

 

Headaches due to referred pain

Some headaches can be caused by pain in some other part of the head, such as tooth or ear pain, pain in the jaw joint and pains in the neck.

Sinusitis is a common cause. The sinuses are 'holes' in the skull which are there to stop it from being too heavy for the neck to carry around. They are lined with mucous membranes, like the lining of your nose, and this produces mucus in response to colds or allergy. The lining membranes also swell up, and may block the drainage of the mucus from the space. It then becomes thickened and infected, leading to headache. The headache of sinusitis is often felt at the front of the head and also in the face or teeth. Often the face feels tender to pressure, particularly just below the eyes and beside the nose. You may have a stuffy nose and the pain is often worse when you bend forwards. Acute sinusitis is the type that comes on quickly in association with a cold or sudden allergy. You may have a temperature and be producing a lot of mucus. Chronic sinusitis can be caused by allergy, by overusing decongestants or by an acute sinusitis that doesn't settle. The sinuses become chronically infected and the sinus linings chronically swollen. The contents of the sinuses may be thick but often not infected.

 

When should I be worried about a headache?

Most headaches don't have a serious underlying cause. However, healthcare professionals are trained to ask you about the signs and symptoms that might suggest your headache needs further investigation, just to make sure it's nothing serious.

The things which would suggest to your doctor and nurse that your headache might need further investigation include the following. They do not mean that your headache is serious or sinister, but they mean that the doctor or nurse might wish to do some further checks to be sure:

• You have had a significant head injury in the previous three months.

• Your headaches are worsening and accompanied by high temperature (fever).

• Your headaches start extremely suddenly.

• You have developed problems with speech and balance as well as headache.

• You have developed problems with your memory or changes in your behaviour or personality as well as headache.

• You are confused or muddled with your headache.

• Your headache started when you coughed, sneezed or strained.

• Your headache is worse when you sit or stand.

• Your headache is associated with red or painful eyes.

• Your headaches are not like anything you have ever experienced before.

• You have unexplained vomiting with the headache.

• You have low immunity - for example, if you have HIV, or are on oral steroid medication or immune suppressing drugs.

• You have or have had a type of cancer that can spread through the body.

 

Summary

Most headaches, whilst unpleasant, are harmless and respond to simple measures. Migraine, tension headache and medication-induced headache are all very common. Most of the population will experience one or more of these. Working out the underlying cause of any headaches through discussion with your doctor is often the best way to solve them. It is possible to develop a persistent (chronic) and continuous headache through taking simple painkilling medicines which you took to get rid of your headache. Your doctor can support you through the process of stopping painkillers if this is the case.

Headaches are, very rarely, a sign of a serious or sinister underlying condition, and most headaches go away by themselves.

If you have a headache which is unusual for you then you should discuss it with your doctor. You should also talk to your doctor about headaches which are particularly severe or that stop your regular activities, those which are associated with other symptoms like weakness or tingling, and those which make your scalp sore (especially if you are over 50 years of age). Finally, always talk to your doctor if you have an unremitting morning headache which is present for more than three days or is getting gradually worse.

Remember that headaches are less likely to occur in those who:

• Manage their stress levels well.

• Eat a balanced, regular diet.

• Take balanced regular exercise.

• Pay attention to posture and core muscles.

• Sleep on two pillows or fewer.

• Drink plenty of water.

• Have plenty of sleep.

Anything that you can do to improve any of these areas of your life will improve your health and well-being and reduce the number of headaches you experience.

​

​

(Source: patient.co.uk, Edited)

​

​

​

Pelvic Pain in Women

The pelvis is the lowest part of your tummy (abdomen). Pelvic pain is more common in women. There are many different causes of pain in your pelvis. They can be separated by when they tend to happen, if you are pregnant and if they are accompanied by other symptoms such as vaginal bleeding. The most common causes are mentioned below. Most will improve with painkillers. Most recurring causes have treatments available.

​

What is the pelvis?

The pelvis is the lowest part of your tummy (abdomen). Organs in your pelvis include your bowel, bladder, womb (uterus) and ovaries. Pelvic pain usually means pain that starts from one of these organs. In some cases the pain comes from your pelvic bones that lie next to these organs, or from nearby muscles, nerves, blood vessels or joints. So, there are many causes of pelvic pain.

Pelvic pain is more common in women than in men.

​

What are the causes of pelvic pain?

Pelvic pain can be acute or chronic. Acute means that it is the first time you have had this type of pain. Chronic means that pain has been a problem for a long time - more than six months.

​

Pelvic pain in pregnancy

Miscarriage: miscarriage is the loss of a pregnancy at any time up to the 24th week. 7 or 8 miscarriages out of 10 occur before 13 weeks of pregnancy. The usual symptoms of miscarriage are vaginal bleeding and lower tummy (abdominal) or pelvic cramps. You may then pass some tissue from the vagina, which often looks like a blood clot. 

Ectopic pregnancy: an ectopic pregnancy is a pregnancy that tries to develop outside the womb (uterus). It occurs in about 1 in 100 pregnancies. Usual symptoms include pain on one side of the lower abdomen or pelvis. It may develop sharply, or may slowly become worse over several days. It can become severe. Vaginal bleeding often occurs, but not always. It is often darker-coloured than the bleeding of a period.

Rupture of corpus luteum cyst: a corpus luteum makes hormones that help keep you pregnant, until other organs such as the placenta take over. It forms after the release of the egg at ovulation. They are often found, by chance, when you have an ultrasound scan for whatever reason. They often cause no problems at all and clear up without treatment. Sometimes it can become too swollen and may burst. This may cause sharp pain on one side of your pelvis. If you have pain in your pelvis in the first 12 weeks of your pregnancy, see your doctor.

Premature labour: normally labour starts after 37 completed weeks of pregnancy. Normal labour usually starts as tightenings felt across the lower abdomen. These become stronger, more painful and closer together. You may also have a 'show'. This is the mucous plug from the neck of the womb (cervix). If you have a gush of fluid from the vagina, your waters may have broken. You should contact your midwife immediately. If you have pelvic pains that come and go in a regular pattern, contact your midwife for advice.

Placental abruption: rarely (about 6 times in every 1,000 deliveries), the placenta detaches from the wall of the womb. Before 24 weeks of pregnancy this is a miscarriage; however, after 24 weeks it is called an abruption. When it happens it is an emergency. This is because the baby relies on the placenta for food and oxygen. Without a working placenta, the baby will die. The staff in the maternity department will quickly try to deliver the baby. This is usually by emergency caesarean section.

​​

Gynaecological problems
Ovulation: ovulation means producing an egg from your ovary. Some women develop a sharp pain when an egg is released. This ovulation pain is called 'Mittelschmerz' (middle pain - because it occurs mid-cycle). The pain may be on a different side each month, depending on which ovary releases the egg. This pain only lasts a few hours but some women find it is severe.

Period pains (dysmenorrhoea): most women have some pain during their periods. The pain is often mild but, in about 1 in 10 women, the pain is severe enough to affect day-to-day activities. The pain can be so severe that they are unable to go to school or work. Doctors may call period pain 'dysmenorrhoea'.

Pelvic inflammatory disease (PID): PID is an infection of your womb. Germs (bacteria) that cause the infection usually travel into your womb from your vagina or cervix. Most cases are caused by chlamydia or gonorrhoea. Symptoms of PID include pain in your lower abdomen or pelvis, high temperature (fever), abnormal vaginal bleeding and a vaginal discharge.

Rupture or torsion of ovarian cyst: an ovarian cyst is a fluid-filled sac which develops in an ovary. Most ovarian cysts are non-cancerous (benign) and cause no symptoms. Some cause problems such as pain and irregular bleeding. Pain may happen when they burst (rupture) or twist (called torsion). No treatment may be needed for certain types of ovarian cysts which tend to go away on their own.

Degenerative changes in a fibroid: fibroids are non-cancerous growths which can occur in your womb. They are common and usually cause no symptoms. However, they can sometimes cause heavy periods, abdominal swelling and urinary problems. Rarely, the fibroid outgrows its blood supply. This can make it shrink (degenerate) which can be very painful. 

Endometriosis: this is a condition found in women between the ages of 13 and 50. It is most commonly diagnosed in women in their thirties. It is more common in women who are having trouble conceiving. In these women it can be found in 1 out of 5 of them. It causes pain around the time of your period. It may also cause pain when you have sex.

Chronic pelvic pain: this is the term used when a woman has had pain for at least six months. Chronic pelvic pain can occur in around 1 in 6 women so it is very common. Sometimes a cause is found (such as those above) and sometimes there is no obvious cause. If the source of your chronic pelvic pain can be found, treatment focuses on that cause. Some women never receive a specific diagnosis that explains their pain. If no cause can be found, your treatment will focus on managing the pain. Keeping a symptom diary is helpful. This may identify a pattern to the pain and triggers in your life that may be responsible. Depression, chronic stress or a past history of sexual or physical abuse increases your risk of developing chronic pelvic pain. In addition, any emotional distress often makes pain worse and living with chronic pain contributes to emotional distress. Your doctor will often consider psychological treatments to help with the pain.

​

Bowel or bladder problems

Appendicitis: appendicitis means inflammation of your appendix. The appendix is a small pouch that comes off the gut wall. Appendicitis is common. Typical symptoms include abdominal pain and being sick (vomiting) that gradually get worse over 6-24 hours. Some people have less typical symptoms. An operation to remove the inflamed appendix is usually done before it bursts (perforates). A perforated appendix is serious. 

Irritable bowel syndrome (IBS): IBS is a common gut disorder. The cause is not known. Symptoms can be quite variable and include abdominal pain, bloating, and sometimes bouts of diarrhoea and/or constipation. Symptoms tend to come and go. There is no cure for IBS but symptoms can often be eased with treatment. 

Cystitis: this is a urine infection in the bladder. It is common in women. A short course of antibiotic medication is a common treatment. It may improve spontaneously without the need for antibiotics. Cystitis clears quickly without complications in most cases. If you have symptoms of cystitis but there are no signs of infection when your urine is tested, you may have Interstitial cystitis. This is a poorly understood condition where the walls of the bladder are inflamed. It is a cause of long-term pain. It is also called 'painful bladder syndrome'.

Adhesions: adhesions may happen after surgery. As your body tries to heal after surgery, the tissues become sticky. The stickiness may accidentally cause tissues to stick together. The most common organ affected is the bowel. This may cause pain.

Strangulated hernia: a hernia occurs where there is a weakness in the wall of the abdomen. As a result, some of the contents within the abdomen can then push through (bulge) under the skin. You can then feel a soft lump or swelling under the skin. There is a small chance that the hernia might strangulate. A hernia strangulates when too much bowel has come through the gap in the muscle or ligament and then becomes squeezed. This can cut off the blood supply to the portion of intestine in the hernia. This can lead to severe pain and some damage to the part of the intestines in the hernia.

​

Muscle and bone problems

Problems with your lower back, bones in your pelvis and nearby joints such as your hip joints can cause pain. Often it is clear where the pain is coming from. However, in some cases, the pain can feel like it is in your pelvis and it can be difficult to pinpoint its origin.

​

What should I do if I have pelvic pain?

There are many different causes of pelvic pain. Some are more serious than others. If you are confident that you know the cause or the pain - for example, period pain - you could try taking a painkiller such as paracetamol or ibuprofen.

If you are not sure of the cause of the pain or if the pain is severe, you should see a doctor. In particular, some causes are emergencies - for example, an ectopic pregnancy. Seek medical help urgently if you suspect this. You may also want to see a doctor if the pain keeps coming back. For many of the conditions listed above, there are treatments available.

​

What investigations may be advised?

Your doctor will ask you some questions and may examine you. Based on what they find, they may advise you to have some further investigations.

A urine infection is a very common cause of pelvic pain and your doctor may ask for a urine sample. If they think there is a risk of an infection, they may ask to take a sample (swab). A pregnancy test may be advised if you are unsure. They may arrange an urgent ultrasound (if miscarriage or ectopic pregnancy is suspected) at your local hospital. A routine ultrasound scan can be arranged to diagnose problems such as ovarian cysts.

Laparoscopy is commonly undertaken by gynaecologists. In this procedure, a small telescope is put through a small cut in your belly button. This allows the doctor to see inside your pelvis.

Doctors who specialise in the bowel may use flexible telescopes to look inside your bowel. The gullet and stomach can be seen by gastroscopy. The lower bowel (rectum and colon) are looked at by colonoscopy.

​

What may be advised to help manage the problem?

This will depend on the likely cause. Follow the links above to the separate leaflets for more information on this.

If the problem is not an emergency, your doctor may refer you to a consultant for further specialist investigations - as above.

​

 

​

(Source: patient.co.uk, Edited)

​

​

​

​

Chest Infection

A chest infection is an infection that affects your lower large airways (bronchi) and your lungs. Pneumonia and bronchitis are the most common chest infections. Bronchitis is usually caused by a viral infection. Pneumonia is usually due to bacterial infection. Pneumonia may be serious and need hospital admission.

None of us like colds - and none of us can avoid them unless we plan to live our lives in a sterile bubble. But even though they can't be 'cured', at least they settle with no ill effects within a few days. Chest infections, on the other hand, can range from mild but unpleasant to life-threatening - and catching them early is key to reducing the risk of serious complications. That's why it's essential to know how to spot the signs of a chest infection.

​

What is a chest infection and what causes it?

Your 'respiratory tract' runs from your nose all the way down to the alveoli - tiny air spaces deep inside your lungs. Doctors call the large airways (bronchi) of the lungs and the lungs themselves the lower respiratory tract. A chest infection is an infection affecting your lower respiratory tract. Any infection higher up (including your nose and throat) is known as an upper respiratory tract infection (URTI).

The vast majority of URTIs are caused by viral infections. Your immune system will fight these off without any help within a few days. Because URTIs are caused by viruses rather than bacteria, antibiotics won't help in any way.

​

Sometimes an infection in the upper airways can spread deeper, causing a chest infection. Sometimes germs (bacteria) already living in your lungs can multiply, with the same result.

There are two main types of chest infection - acute bronchitis and pneumonia.

• Acute bronchitis - Bronchitis is inflammation due to infection of the bronchi. '-itis' is the medical term for inflammation. It can be acute or chronic. Acute means lasting a short time and chronic means lasting a long time. Acute bronchitis is common and is often due to a viral infection. Infection with a germ (bacterium) is a less common cause.

• Pneumonia - This is usually a bacterial infection of the lung and may be serious. Treatment with antibiotics is usually needed.

 

Who gets chest infections?

Chest infections are very common, especially during the autumn and winter. They often occur after a cold or flu. Anyone can get a chest infection but they are more common in:

• Young children and the elderly.

• People who smoke.

• Pregnant women.

• People with long-term chest problems such as asthma, chronic obstructive pulmonary disease (COPD), cystic fibrosis, heart disease, diabetes, kidney disease or liver disease.

People with an immune system that's weakened either by conditions such as some cancers (including lymphoma, myeloma and leukaemia) or AIDS; or by treatments such as high-dose steroids, chemotherapy or other medicines that can suppress your immune system.


(Source: patient.co.uk, Edited)

​

​

Paracetamol

Paracetamol belongs to a group of medicines known as analgesics, or painkillers. It is used to relieve mild to moderate pain. It is also useful for lowering a raised temperature (fever), such as during a cold or after childhood immunisations.

Paracetamol is a common painkiller and is available to buy from many retail outlets as tablets/capsules and as liquid medicine. Many brands of 'over-the-counter' combination painkillers contain paracetamol, as do many cold and flu remedies. It is important that you check the label on any preparation that you buy to make sure that you are not taking more than one preparation containing paracetamol.

 

Before taking paracetamol

Most people can take paracetamol without any problem, but to make sure it is the right treatment for you, speak with a doctor or pharmacist before you start taking it if:

• You are pregnant or breast-feeding. This is because, while you are expecting or feeding a baby, you should only take medicines on the recommendation of a doctor.

• You have a serious problem with the way your liver works, or if you regularly drink large amounts of alcohol.

• You are taking medicines prescribed by a doctor.

• You have ever had an allergic reaction to a medicine.

 

How to take paracetamol

Before taking paracetamol, read the manufacturer's printed information leaflet from inside your pack. The manufacturer's leaflet will give you more information about paracetamol and a full list of the side-effects which you may experience from taking it.

• Take paracetamol exactly as you have been told by your doctor or pharmacist, or as directed on the label of the container.

• Recommended doses of paracetamol are:

  • For adults and children aged 16 years and older: 500 mg-1 g every 4-6 hours up to a maximum of 4 g daily.

  • For children aged 12-15 years: 480-750 mg every 4-6 hours up to a maximum of four doses daily.

  • For children aged 10-11 years: 480-500 mg every 4-6 hours up to a maximum of four doses daily.

  • For children aged 8-9 years: 360-375 mg every 4-6 hours up to a maximum of four doses daily.

  • For children aged 6-7 years: 240-250 mg every 4-6 hours up to a maximum of four doses daily.

  • For children aged 4-5 years: 240 mg every 4-6 hours up to a maximum of four doses daily.

  • For children aged 2-3 years: 180 mg every 4-6 hours up to a maximum of four doses daily.

  • For children aged 6 months-1 year: 120 mg every 4-6 hours up to a maximum of four doses daily.

  • For children aged 3-5 months: 60 mg every 4-6 hours up to a maximum of four doses daily.

  • For children aged 2 months following immunisation: 60 mg, repeated once after 4-6 hours if needed.

• You can take a dose of paracetamol every 4-6 hours if needed, up to four times a day. Remember to leave at least four hours between doses and do not take more than four doses of paracetamol in any 24-hour period.

• You can take paracetamol before or after food.

• If you are giving paracetamol to your child, always check the label carefully to make sure you are giving the correct dose for the age of your child.

• Never take more than the dose recommended on the label. Taking too much paracetamol can cause damage to your liver. If you suspect that you or someone else might have taken an overdose of paracetamol, go to the accident and emergency department of your local hospital at once, even if you/they feel well. Take the container with you so that the doctor knows what has been taken.

If you forget to take a dose, do not worry. If you need it, take a dose as soon as you remember but do not take two doses together to make up for a forgotten dose.

Getting the most from your treatment

If your pain is not relieved by taking paracetamol, speak with your pharmacist or doctor for further advice.

It is important that you do not take more than one preparation containing paracetamol at a time. Paracetamol is an ingredient in a number of over-the-counter preparations, including many cold and flu products. Paracetamol may also be contained in painkillers which you may already have been prescribed by your doctor. Before taking any other medicines, check the label to see whether they contain paracetamol.

​

Can paracetamol cause problems?

Paracetamol rarely causes side-effects when it is taken as recommended, but if you experience any symptoms which you think may be due to it, discuss them with your pharmacist or doctor.

 

How to store paracetamol

• Keep all medicines out of the reach and sight of children.

• Store in a cool, dry place, away from direct heat and light.

​

​

​

Overview

Infectious diseases are disorders caused by organisms — such as bacteria, viruses, fungi or parasites. Many organisms live in and on our bodies. They're normally harmless or even helpful, but under certain conditions, some organisms may cause disease.

Some infectious diseases can be passed from person to person. Some are transmitted by bites from insects or animals. And others are acquired by ingesting contaminated food or water or being exposed to organisms in the environment.

Signs and symptoms vary depending on the organism causing the infection, but often include fever and fatigue. Mild infections may respond to rest and home remedies, while some life-threatening infections may require hospitalization.

Many infectious diseases, such as measles and chickenpox, can be prevented by vaccines. Frequent and thorough hand-washing also helps protect you from most infectious diseases.

Symptoms

Each infectious disease has its own specific signs and symptoms. General signs and symptoms common to a number of infectious diseases include:

• Fever

• Diarrhea

• Fatigue

• Muscle aches

• Coughing

When to see a doctor

Seek medical attention if you:

• Have been bitten by an animal

• Are having trouble breathing

• Have been coughing for more than a week

• Have severe headache with fever

• Experience a rash or swelling

• Have unexplained or prolonged fever

• Have sudden vision problems

Request an Appointment at Mayo Clinic

Causes

Infectious diseases can be caused by:

• Bacteria. These one-cell organisms are responsible for illnesses such as strep throat, urinary tract infections and tuberculosis.

• Viruses. Even smaller than bacteria, viruses cause a multitude of diseases — ranging from the common cold to AIDS.

• Fungi. Many skin diseases, such as ringworm and athlete's foot, are caused by fungi. Other types of fungi can infect your lungs or nervous system.

• Parasites. Malaria is caused by a tiny parasite that is transmitted by a mosquito bite. Other parasites may be transmitted to humans from animal feces.

Direct contact

An easy way to catch most infectious diseases is by coming in contact with a person or animal who has the infection. Three ways infectious diseases can be spread through direct contact are:

• Person to person. A common way for infectious diseases to spread is through the direct transfer of bacteria, viruses or other germs from one person to another. This can occur when an individual with the bacterium or virus touches, kisses, or coughs or sneezes on someone who isn't infected.

These germs can also spread through the exchange of body fluids from sexual contact. The person who passes the germ may have no symptoms of the disease, but may simply be a carrier.

• Animal to person. Being bitten or scratched by an infected animal — even a pet — can make you sick and, in extreme circumstances, can be fatal. Handling animal waste can be hazardous, too. For example, you can acquire a toxoplasmosis infection by scooping your cat's litter box.

• Mother to unborn child. A pregnant woman may pass germs that cause infectious diseases to her unborn baby. Some germs can pass through the placenta. Germs in the vagina can be transmitted to the baby during birth.

Indirect contact

Disease-causing organisms also can be passed by indirect contact. Many germs can linger on an inanimate object, such as a tabletop, doorknob or faucet handle.

When you touch a doorknob handled by someone ill with the flu or a cold, for example, you can pick up the germs he or she left behind. If you then touch your eyes, mouth or nose before washing your hands, you may become infected.

Insect bites

Some germs rely on insect carriers — such as mosquitoes, fleas, lice or ticks — to move from host to host. These carriers are known as vectors. Mosquitoes can carry the malaria parasite or West Nile virus, and deer ticks may carry the bacterium that causes Lyme disease.

Food contamination

Another way disease-causing germs can infect you is through contaminated food and water. This mechanism of transmission allows germs to be spread to many people through a single source. E. coli, for example, is a bacterium present in or on certain foods — such as undercooked hamburger or unpasteurized fruit juice.

Risk factors

While anyone can catch infectious diseases, you may be more likely to get sick if your immune system isn't working properly. This may occur if:

• You're taking steroids or other medications that suppress your immune system, such as anti-rejection drugs for a transplanted organ

• You have HIV or AIDS

• You have certain types of cancer or other disorders that affect your immune system

In addition, certain other medical conditions may predispose you to infection, including implanted medical devices, malnutrition and extremes of age, among others.

Complications

Most infectious diseases have only minor complications. But some infections — such as pneumonia, AIDS and meningitis — can become life-threatening. A few types of infections have been linked to a long-term increased risk of cancer:

• Human papillomavirus is linked to cervical cancer

• Helicobacter pylori is linked to stomach cancer and peptic ulcers

• Hepatitis B and C have been linked to liver cancer

In addition, some infectious diseases may become silent, only to appear again in the future — sometimes even decades later. For example, someone who's had a chickenpox infection may develop shingles much later in life.

Prevention

Infectious agents can enter your body through:

• Skin contact or injuries

• Inhalation of airborne germs

• Ingestion of contaminated food or water

• Tick or mosquito bites

• Sexual contact

Follow these tips to decrease your risk of infecting yourself or others:

• Wash your hands. This is especially important before and after preparing food, before eating, and after using the toilet. And try not to touch your eyes, nose or mouth with your hands, as that's a common way germs enter the body.

• Get vaccinated. Immunization can drastically reduce your chances of contracting many diseases. Make sure to keep up to date on your recommended vaccinations, as well as your children's.

• Stay home when ill. Don't go to work if you are vomiting, have diarrhea or have a fever. Don't send your child to school if he or she has these signs and symptoms, either.

• Prepare food safely. Keep counters and other kitchen surfaces clean when preparing meals. Cook foods to the proper temperature using a food thermometer to check for doneness. For ground meats, that means at least 160 F (71 C); for poultry, 165 F (74 C); and for most other meat, at least 145 F (63 C).

In addition, promptly refrigerate leftovers — don't let cooked foods remain at room temperature for extended periods of time.

• Practice safe sex. Always use condoms if you or your partner has a history of sexually transmitted infections or high-risk behavior.

• Don't share personal items. Use your own toothbrush, comb and razor. Avoid sharing drinking glasses or dining utensils.

• Travel wisely. If you're traveling out of the country, talk to your doctor about any special vaccinations — such as yellow fever, cholera, hepatitis A or B, or typhoid fever — you may need.