# migrations

dir: embeddings_queue
filename: 00001-embeddings.sqlite.sql
hash: d3755dfd232be8e8301f4d7fcfb3a486
sql:
CREATE TABLE embeddings_queue (
    seq_id INTEGER PRIMARY KEY,
    created_at TIMESTAMP NOT NULL DEFAULT CURRENT_TIMESTAMP,
    operation INTEGER NOT NULL,
    topic TEXT NOT NULL,
    id TEXT NOT NULL,
    vector BLOB,
    encoding TEXT,
    metadata TEXT
);


dir: sysdb
filename: 00001-collections.sqlite.sql
hash: 38352d725ad1c16074fac420b22b4633
sql:
CREATE TABLE collections (
    id TEXT PRIMARY KEY,
    name TEXT NOT NULL,
    topic TEXT NOT NULL,
    UNIQUE (name)
);

CREATE TABLE collection_metadata (
    collection_id TEXT REFERENCES collections(id) ON DELETE CASCADE,
    key TEXT NOT NULL,
    str_value TEXT,
    int_value INTEGER,
    float_value REAL,
    PRIMARY KEY (collection_id, key)
);


dir: sysdb
filename: 00002-segments.sqlite.sql
hash: 2913cb6a503055a95f625448037e8912
sql:
CREATE TABLE segments (
    id TEXT PRIMARY KEY,
    type TEXT NOT NULL,
    scope TEXT NOT NULL,
    topic TEXT,
    collection TEXT REFERENCES collection(id)
);

CREATE TABLE segment_metadata (
    segment_id TEXT  REFERENCES segments(id) ON DELETE CASCADE,
    key TEXT NOT NULL,
    str_value TEXT,
    int_value INTEGER,
    float_value REAL,
    PRIMARY KEY (segment_id, key)
);


dir: sysdb
filename: 00004-tenants-databases.sqlite.sql
hash: 048867ce8fcdefe4023c7110e4433591
sql:
CREATE TABLE IF NOT EXISTS tenants (
    id TEXT PRIMARY KEY,
    UNIQUE (id)
);

CREATE TABLE IF NOT EXISTS databases (
    id TEXT PRIMARY KEY, -- unique globally
    name TEXT NOT NULL, -- unique per tenant
    tenant_id TEXT NOT NULL REFERENCES tenants(id) ON DELETE CASCADE,
    UNIQUE (tenant_id, name) -- Ensure that a tenant has only one database with a given name
);

CREATE TABLE IF NOT EXISTS collections_tmp (
    id TEXT PRIMARY KEY, -- unique globally
    name TEXT NOT NULL, -- unique per database
    topic TEXT NOT NULL,
    dimension INTEGER,
    database_id TEXT NOT NULL REFERENCES databases(id) ON DELETE CASCADE,
    UNIQUE (name, database_id)
);

-- Create default tenant and database
INSERT OR REPLACE INTO tenants (id) VALUES ('default_tenant'); -- The default tenant id is 'default_tenant' others are UUIDs
INSERT OR REPLACE INTO databases (id, name, tenant_id) VALUES ('00000000-0000-0000-0000-000000000000', 'default_database', 'default_tenant');

INSERT OR REPLACE INTO collections_tmp (id, name, topic, dimension, database_id)
    SELECT id, name, topic, dimension, '00000000-0000-0000-0000-000000000000' FROM collections;
DROP TABLE collections;
ALTER TABLE collections_tmp RENAME TO collections;


dir: sysdb
filename: 00005-remove-topic.sqlite.sql
hash: b1367c826b8fba5f96f27befdc1d42d2
sql:
-- Remove the topic column from the Collections and Segments tables

ALTER TABLE collections DROP COLUMN topic;
ALTER TABLE segments DROP COLUMN topic;


dir: sysdb
filename: 00006-collection-segment-metadata.sqlite.sql
hash: 4eea7468935bf25d4604a0fed2366116
sql:
-- SQLite does not support adding check with alter table, as a result, adding a check
-- involve creating a new table and copying the data over. It is over kill with adding
-- a boolean type column. The application write to the table needs to ensure the data
-- integrity.
ALTER TABLE collection_metadata ADD COLUMN bool_value INTEGER;
ALTER TABLE segment_metadata ADD COLUMN bool_value INTEGER;


dir: sysdb
filename: 00007-collection-config.sqlite.sql
hash: 1c7e63bba346a42a18b6ab7f1c989bed
sql:
-- Stores collection configuration dictionaries.
ALTER TABLE collections ADD COLUMN config_json_str TEXT;


dir: sysdb
filename: 00008-maintenance-log.sqlite.sql
hash: 0a0e7e93111a01789addf64961c6127c
sql:
-- Records when database maintenance operations are performed.
-- At time of creation, this table is only used to record vacuum operations.
CREATE TABLE maintenance_log (
  id INT PRIMARY KEY,
  timestamp INT NOT NULL,
  operation TEXT NOT NULL
);


dir: sysdb
filename: 00009-segment-collection-not-null.sqlite.sql
hash: 054355aef9e63702bf54ea29e61563f1
sql:
-- This makes segments.collection non-nullable.
CREATE TABLE segments_temp (
    id TEXT PRIMARY KEY,
    type TEXT NOT NULL,
    scope TEXT NOT NULL,
    collection TEXT REFERENCES collection(id) NOT NULL
);

INSERT INTO segments_temp SELECT * FROM segments;
DROP TABLE segments;
ALTER TABLE segments_temp RENAME TO segments;


dir: metadb
filename: 00001-embedding-metadata.sqlite.sql
hash: 2b4cf52c4bb2676e21d6860a4409f856
sql:
CREATE TABLE embeddings (
    id INTEGER PRIMARY KEY,
    segment_id TEXT NOT NULL,
    embedding_id TEXT NOT NULL,
    seq_id BLOB NOT NULL,
    created_at TIMESTAMP NOT NULL DEFAULT CURRENT_TIMESTAMP,
    UNIQUE (segment_id, embedding_id)
);

CREATE TABLE embedding_metadata (
    id INTEGER REFERENCES embeddings(id),
    key TEXT NOT NULL,
    string_value TEXT,
    int_value INTEGER,
    float_value REAL,
    PRIMARY KEY (id, key)
);

CREATE TABLE max_seq_id (
    segment_id TEXT PRIMARY KEY,
    seq_id BLOB NOT NULL
);

CREATE VIRTUAL TABLE embedding_fulltext USING fts5(id, string_value);


dir: metadb
filename: 00002-embedding-metadata.sqlite.sql
hash: 12a570f7121b3a8ce750a2a7c36da20f
sql:
-- SQLite does not support adding check with alter table, as a result, adding a check
-- involve creating a new table and copying the data over. It is over kill with adding
-- a boolean type column. The application write to the table needs to ensure the data
-- integrity.
ALTER TABLE embedding_metadata ADD COLUMN bool_value INTEGER


dir: metadb
filename: 00003-full-text-tokenize.sqlite.sql
hash: f97ad6334aeaa8f419f01110b648b97a
sql:
CREATE VIRTUAL TABLE embedding_fulltext_search USING fts5(string_value, tokenize='trigram');
INSERT INTO embedding_fulltext_search (rowid, string_value) SELECT rowid, string_value FROM embedding_metadata;
DROP TABLE embedding_fulltext;


dir: metadb
filename: 00004-metadata-indices.sqlite.sql
hash: fb36603a45ee2cd0254cef3ef86585e8
sql:
CREATE INDEX IF NOT EXISTS embedding_metadata_int_value ON embedding_metadata (key, int_value) WHERE int_value IS NOT NULL;
CREATE INDEX IF NOT EXISTS embedding_metadata_float_value ON embedding_metadata (key, float_value) WHERE float_value IS NOT NULL;
CREATE INDEX IF NOT EXISTS embedding_metadata_string_value ON embedding_metadata (key, string_value) WHERE string_value IS NOT NULL;


# embeddings_queue

created_at: 2025-05-10 05:59:55
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
id: ac33cdd9-20b0-489c-8094-c49e882518ea
encoding: FLOAT32
metadata:
{"source": "https://www.nhsinform.scot/illnesses-and-conditions/cancer/cancer-types-in-adults/pancreatic-cancer/", "start_index": 22927, "chroma:document": "endoluminal ultrasonography (EUS) can be carried out. During EUS, a thin, flexible instrument called an endoscope is passed through your mouth and guided towards your stomach. An ultrasound probe attached to the tip of the endoscope will then be used to take close-up pictures of your pancreas. Before the procedure, you may be given a sedative to help you relax. EUS can also be used to take a biopsy for further examination. Endoscopic retrograde cholangiopancreatography (ERCP) Endoscopic retrograde cholangiopancreatography (ERCP) is a procedure used to insert a plastic tube or stent into the bile duct if someone has jaundice. During ERCP, an endoscope is passed through your mouth and guided towards your stomach. The endoscope can then be used to inject a special dye into your bile and pancreatic ducts. After the dye has been injected, an X-ray will be taken. The dye will show up on the X-ray and will highlight any tumour that\u2019s blocking the bile and pancreatic ducts. During the"}


created_at: 2025-05-10 05:59:57
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
id: 58405426-6215-4b4b-b30f-d8fd4e761dff
encoding: FLOAT32
metadata:
{"source": "https://www.nhsinform.scot/illnesses-and-conditions/cancer/cancer-types-in-adults/pancreatic-cancer/", "start_index": 23773, "chroma:document": "an X-ray will be taken. The dye will show up on the X-ray and will highlight any tumour that\u2019s blocking the bile and pancreatic ducts. During the procedure, tissue samples may be taken. These samples can be looked at under a microscope to see whether the cells are cancerous. ERCP can take 30 to 60 minutes. As with EUS, you\u2019ll usually be given a sedative to help you relax. Laparoscopy A laparoscopy is a surgical procedure that allows the surgeon to access the inside of your abdomen and pelvis. During the procedure, a small incision will be made in your abdomen, and a laparoscope (a thin, flexible microscope) will be inserted. This will allow the surgeon to see inside your body and make sure the tumour hasn\u2019t spread before recommending its removal. This procedure will be carried out under a general anaesthetic (where you\u2019re put to sleep so you don\u2019t feel any pain or discomfort). Biopsy A biopsy involves taking a sample from a suspected tumour, which can then be tested to see if it\u2019s"}


created_at: 2025-05-10 05:59:57
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
id: bb558909-09c4-414e-bd6e-f13b7a0049bd
encoding: FLOAT32
metadata:
{"source": "https://www.nhsinform.scot/illnesses-and-conditions/cancer/cancer-types-in-adults/pancreatic-cancer/", "start_index": 24620, "chroma:document": "so you don\u2019t feel any pain or discomfort). Biopsy A biopsy involves taking a sample from a suspected tumour, which can then be tested to see if it\u2019s cancerous (malignant) or non-cancerous (benign). A biopsy can be carried out during an EUS, ERCP or laparoscopy using a small instrument attached to the endoscope to collect a number of cells. It\u2019s also possible for a biopsy to be carried out using a long, thin needle that\u2019s passed through your abdomen. The needle will be guided towards the tumour using an ultrasound or CT scan. Recovering from pancreatic cancer Recovering from pancreatic cancer surgery can be a long and difficult process. You\u2019ll probably experience some pain after your operation. The staff at your hospital will make sure you have adequate pain relief. After any type of surgery to your digestive system, your bowel will temporarily stop working. This means you won\u2019t be able to eat or drink straight away. You\u2019ll gradually be able to sip fluids, before eventually being able"}


created_at: 2025-05-10 05:59:57
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
id: 65eacaa0-5616-42d9-ac4f-143d3494df7e
encoding: FLOAT32
metadata:
{"source": "https://www.nhsinform.scot/illnesses-and-conditions/cancer/cancer-types-in-adults/pancreatic-cancer/", "start_index": 25476, "chroma:document": "stop working. This means you won\u2019t be able to eat or drink straight away. You\u2019ll gradually be able to sip fluids, before eventually being able to drink and eat more regularly. You may be referred to a dietitian, who can advise you about what foods you should eat following your operation. After the tumour has been removed, you will probably have a 6-month course of chemotherapy, which greatly increases your chance of being cured. However, as cancer of the pancreas is difficult to diagnose and treat, many people don\u2019t recover completely. Treatment can be very effective in helping to ease symptoms and make you as comfortable as possible. Chemotherapy can help shrink your tumour and slow down its growth. Source: NHS 24 - Opens in new browser window Last updated: 10 October 2024 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Don\u2019t include personal information e.g. name, location or any personal health conditions. Email Address e.g."}


created_at: 2025-05-10 05:59:57
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
id: 375e58a6-949a-4cde-986f-1ec29cbe9d07
encoding: FLOAT32
metadata:
{"source": "https://www.nhsinform.scot/illnesses-and-conditions/cancer/cancer-types-in-adults/pancreatic-cancer/", "start_index": 26324, "chroma:document": "You Your feedback has been received Don\u2019t include personal information e.g. name, location or any personal health conditions. Email Address e.g. you@example.com Message Maximum of 500 characters Send feedback Add this page to Info For Me Also on NHS inform Brain, nerves and spinal cord Chronic pancreatitis Other health sites Cancer Research UK: Pancreatic cancer Macmillan Cancer Support: Pancreatic cancer Pancreatic Cancer UK Pancreatic Cancer Action Care Information Scotland Scottish Cancer Network: Patient information Search for cancer support services near you Enter a place or postcode NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats \u00a9 2025 NHS 24 \u2013 v1.1.1.17852"}


created_at: 2025-05-10 05:59:57
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
id: dc52f98f-938e-4917-8ff3-d09fe341fe7c
encoding: FLOAT32
metadata:
{"source": "https://www.nhsinform.scot/illnesses-and-conditions/mental-health/panic-disorder/", "start_index": 0, "chroma:document": "The website is busy, please try later."}


created_at: 2025-05-10 05:59:57
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
id: df42ccea-c21c-4803-be0a-5ee48f43b106
encoding: FLOAT32
metadata:
{"source": "https://www.nhsinform.scot/illnesses-and-conditions/brain-nerves-and-spinal-cord/parkinsons-disease/", "start_index": 0, "chroma:document": "Parkinson's disease | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotland\u2019s Service Directory 0 Home Illnesses and conditions Brain, nerves and spinal cord Parkinson\u2019s disease Parkinson\u2019s disease About Parkinson\u2019s disease Symptoms of Parkinson\u2019s disease Causes of Parkinson\u2019s disease Diagnosing Parkinson\u2019s disease Treating Parkinson\u2019s disease Living with Parkinson\u2019s disease About Parkinson\u2019s disease Parkinson\u2019s disease is a condition in which parts of the brain become progressively damaged over many years. The three main symptoms of Parkinson\u2019s disease are: involuntary shaking of particular parts of the body (tremor) slow movement stiff and inflexible muscles A person with Parkinson\u2019s disease can also experience a wide range of other physical and psychological symptoms, including: depression and anxiety balance problems \u2013 this may increase the chance of a fall loss of sense of smell anosmis problems"}


created_at: 2025-05-10 05:59:57
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
id: 2c403c3f-6ac0-4c73-a100-b94397d888ad
encoding: FLOAT32
metadata:
{"source": "https://www.nhsinform.scot/illnesses-and-conditions/brain-nerves-and-spinal-cord/parkinsons-disease/", "start_index": 852, "chroma:document": "symptoms, including: depression and anxiety balance problems \u2013 this may increase the chance of a fall loss of sense of smell anosmis problems sleeping (insomnia) memory problems Read more about the symptoms of Parkinson\u2019s disease Seeking medical advice See your GP if you\u2019re concerned that you may have symptoms of Parkinson\u2019s disease. Your GP will ask about the problems you\u2019re experiencing and may refer you to a specialist for further tests. Read more about diagnosing Parkinson\u2019s disease Causes of Parkinson\u2019s disease Parkinson\u2019s disease is caused by a loss of nerve cells in part of the brain called the substantia nigra. This leads to a reduction in a chemical called dopamine in the brain. Dopamine plays a vital role in regulating the movement of the body. A reduction in dopamine is responsible for many of the symptoms of Parkinson\u2019s disease. Exactly what causes the loss of nerve cells is unclear. Most experts think that a combination of genetic and environmental factors is responsible."}


created_at: 2025-05-10 05:59:57
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
id: 7e2e2cc6-cbf7-4c05-84ee-63b296b1cdf4
encoding: FLOAT32
metadata:
{"source": "https://www.nhsinform.scot/illnesses-and-conditions/brain-nerves-and-spinal-cord/parkinsons-disease/", "start_index": 1705, "chroma:document": "Exactly what causes the loss of nerve cells is unclear. Most experts think that a combination of genetic and environmental factors is responsible. Read more about the causes of Parkinson\u2019s disease Who\u2019s affected? It\u2019s thought around 1 in 500 people are affected by Parkinson\u2019s disease, which means there are an estimated 127,000 people in the UK with the condition. Most people with Parkinson\u2019s start to develop symptoms when they\u2019re over 50, although around 1 in 20 people with the condition first experience symptoms when they\u2019re under 40. Men are slightly more likely to get Parkinson\u2019s disease than women. Treating Parkinson\u2019s disease Although there\u2019s currently no cure for Parkinson\u2019s disease, treatments are available to help reduce the main symptoms and maintain quality of life for as long as possible. These include: supportive treatments \u2013 such as physiotherapy and occupational therapy medication in some cases, brain surgery You may not need any treatment during the early stages of"}


created_at: 2025-05-10 05:59:57
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
id: 88ac7ebc-7778-4348-bc14-5bc3f4d99d0e
encoding: FLOAT32
metadata:
{"source": "https://www.nhsinform.scot/illnesses-and-conditions/brain-nerves-and-spinal-cord/parkinsons-disease/", "start_index": 2553, "chroma:document": "\u2013 such as physiotherapy and occupational therapy medication in some cases, brain surgery You may not need any treatment during the early stages of Parkinson\u2019s disease, as symptoms are usually mild. However, you may need regular appointments with your specialist so your condition can be monitored. Read more about treating Parkinson\u2019s disease Outlook As the condition progresses, the symptoms of Parkinson\u2019s disease can get worse and it can become increasingly difficult to carry out everyday activities without assistance. Many people respond well to treatment and only experience mild to moderate disability, whereas the minority may not respond as well and can, in time, become more severely disabled. Parkinson\u2019s disease doesn\u2019t directly cause people to die, but the condition can place great strain on the body, and can make some people more vulnerable to serious and life-threatening infections. However, with advances in treatment, most people with Parkinson\u2019s disease now have a normal or"}


created_at: 2025-05-10 05:59:57
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
id: 0f7312bd-8b4f-4e3a-8754-07670f3244fd
encoding: FLOAT32
metadata:
{"source": "https://www.nhsinform.scot/illnesses-and-conditions/brain-nerves-and-spinal-cord/parkinsons-disease/", "start_index": 3400, "chroma:document": "vulnerable to serious and life-threatening infections. However, with advances in treatment, most people with Parkinson\u2019s disease now have a normal or near-normal life expectancy. Read more about living with Parkinson\u2019s disease It may also be useful to read your guide to care and support \u2013 written for people with care and support needs, as well as their carers and relatives. Symptoms of Parkinson\u2019s disease The symptoms of Parkinson\u2019s disease usually develop gradually and are mild at first. There are many different symptoms associated with Parkinson\u2019s disease. Some of the more common symptoms are described below. However, the order in which these develop and their severity is different for each individual. It\u2019s unlikely that a person with Parkinson\u2019s disease would experience all or most of these. Main symptoms The three main symptoms of Parkinson\u2019s disease affect physical movement: tremor \u2013 shaking, which usually begins in the hand or arm and is more likely to occur when the limb is"}


created_at: 2025-05-10 05:59:57
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
id: 6ce67910-677a-4dbb-b1ff-06c32e5bf9b3
encoding: FLOAT32
metadata:
{"source": "https://www.nhsinform.scot/illnesses-and-conditions/brain-nerves-and-spinal-cord/parkinsons-disease/", "start_index": 4247, "chroma:document": "Parkinson\u2019s disease affect physical movement: tremor \u2013 shaking, which usually begins in the hand or arm and is more likely to occur when the limb is relaxed and resting slowness of movement (bradykinesia) \u2013 where physical movements are much slower than normal, which can make everyday tasks difficult and can result in a distinctive slow, shuffling walk with very small steps muscle stiffness (rigidity) \u2013 stiffness and tension in the muscles, which can make it difficult to move around and make facial expressions, and can result in painful muscle cramps (dystonia) These main symptoms are sometimes referred to by doctors as parkinsonism as there can be causes other than Parkinson\u2019s disease. Other symptoms Parkinson\u2019s disease can also cause a range of other physical and mental symptoms. Physical symptoms balance problems \u2013 these can make someone with the condition more likely to have a fall and injure themselves loss of sense of smell (anosmia) \u2013 sometimes occurs several years before other"}


created_at: 2025-05-10 05:59:58
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
id: 51bb09b5-45ca-4248-8b53-ba6d040bb7b7
encoding: FLOAT32
metadata:
{"source": "https://www.nhsinform.scot/illnesses-and-conditions/brain-nerves-and-spinal-cord/parkinsons-disease/", "start_index": 5099, "chroma:document": "with the condition more likely to have a fall and injure themselves loss of sense of smell (anosmia) \u2013 sometimes occurs several years before other symptoms develop nerve pain \u2013 can cause unpleasant sensations, such as burning, coldness or numbness problems with urination \u2013 such as having to get up frequently during the night to urinate or unintentionally passing urine (urinary incontinence) constipation an inability to obtain or sustain an erection (erectile dysfunction) in men difficulty becoming sexually aroused and achieving an orgasm (sexual dysfunction) in women dizziness, blurred vision or fainting when moving from a sitting or lying position to a standing one \u2013 caused by a sudden drop in blood pressure excessive sweating (hyperhidrosis) swallowing difficulties (dysphagia) \u2013 this can lead to malnutrition and dehydration excessive production of saliva (drooling) problems sleeping (insomnia) \u2013 this can result in excessive sleepiness during the day Cognitive and psychiatric"}


created_at: 2025-05-10 05:59:58
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
id: 0e2a714b-655a-4373-a524-d426f53a3064
encoding: FLOAT32
metadata:
{"source": "https://www.nhsinform.scot/illnesses-and-conditions/brain-nerves-and-spinal-cord/parkinsons-disease/", "start_index": 5947, "chroma:document": "production of saliva (drooling) problems sleeping (insomnia) \u2013 this can result in excessive sleepiness during the day Cognitive and psychiatric symptoms depression and anxiety mild cognitive impairment \u2013 slight memory problems and problems with activities that require planning and organisation dementia \u2013 a group of symptoms, including more severe memory problems, personality changes, seeing things that aren\u2019t there (visual hallucinations) and believing things that aren\u2019t true (delusions) When to seek medical advice See your GP if you\u2019re concerned you may have symptoms of Parkinson\u2019s disease. Your GP will ask about your symptoms and your medical history to help them decide whether it\u2019s necessary to refer you to a specialist for further tests. Read more about diagnosing Parkinson\u2019s disease Causes of Parkinson\u2019s disease Parkinson\u2019s disease is caused by a loss of nerve cells in the part of the brain called the substantia nigra. Nerve cells in this part of the brain are responsible for"}


created_at: 2025-05-10 05:59:58
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
id: 6957618c-2dc0-4100-a005-b2a5cca0c6ad
encoding: FLOAT32
metadata:
{"source": "https://www.nhsinform.scot/illnesses-and-conditions/brain-nerves-and-spinal-cord/parkinsons-disease/", "start_index": 6796, "chroma:document": "is caused by a loss of nerve cells in the part of the brain called the substantia nigra. Nerve cells in this part of the brain are responsible for producing a chemical called dopamine. Dopamine acts as a messenger between the parts of the brain and nervous system that help control and co-ordinate body movements. If these nerve cells die or become damaged, the amount of dopamine in the brain is reduced. This means the part of the brain controlling movement can\u2019t work as well as normal, causing movements to become slow and abnormal. The loss of nerve cells is a slow process. The symptoms of Parkinson\u2019s disease usually only start to develop when around 80% of the nerve cells in the substantia nigra have been lost. What causes the loss of nerve cells? It\u2019s not known why the loss of nerve cells associated with Parkinson\u2019s disease occurs, although research is ongoing to identify potential causes. Currently, it\u2019s believed a combination of genetic changes and environmental factors may be"}


created_at: 2025-05-10 05:59:58
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
id: db2dd3bc-e1fa-4fe4-895e-129ad8c1b70e
encoding: FLOAT32
metadata:
{"source": "https://www.nhsinform.scot/illnesses-and-conditions/brain-nerves-and-spinal-cord/parkinsons-disease/", "start_index": 7641, "chroma:document": "although research is ongoing to identify potential causes. Currently, it\u2019s believed a combination of genetic changes and environmental factors may be responsible for the condition. Genetics A number of genetic factors have been shown to increase a person\u2019s risk of developing Parkinson\u2019s disease, although exactly how these make some people more susceptible to the condition is unclear. Parkinson\u2019s disease can run in families as a result of faulty genes being passed to a child by their parents. However, it\u2019s rare for the disease to be inherited this way. Environmental factors Some researchers also feel environmental factors may increase a person\u2019s risk of developing Parkinson\u2019s disease. It\u2019s been suggested that pesticides and herbicides used in farming and traffic or industrial pollution may contribute to the condition. However, the evidence linking environmental factors to Parkinson\u2019s disease is inconclusive. Other causes of parkinsonism \u201cParkinsonism\u201d is the umbrella term used to"}


created_at: 2025-05-10 05:59:58
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
id: 716c3a60-5ae3-4006-8f65-1ce61fc2bf0f
encoding: FLOAT32
metadata:
{"source": "https://www.nhsinform.scot/illnesses-and-conditions/brain-nerves-and-spinal-cord/parkinsons-disease/", "start_index": 8492, "chroma:document": "linking environmental factors to Parkinson\u2019s disease is inconclusive. Other causes of parkinsonism \u201cParkinsonism\u201d is the umbrella term used to describe the symptoms of tremors, muscle rigidity and slowness of movement. Parkinson\u2019s disease is the most common type of parkinsonism, but there are also some rarer types where a specific cause can be identified. These include parkinsonism caused by: medication (drug-induced parkinsonism) \u2013 where symptoms develop after taking certain medications, such as some types of antipsychotic medication, and usually improve once the medication is stopped other progressive brain conditions \u2013 such as progressive supranuclear palsy, multiple systems atrophy, and corticobasal degeneration cerebrovascular disease \u2013 where a series of small strokes cause several parts of the brain to die You can read more about parkinsonism on the Parkinson\u2019s UK website. Diagnosing Parkinson\u2019s disease No tests can conclusively show that you have Parkinson\u2019s disease. Your"}


created_at: 2025-05-10 05:59:58
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/brain-nerves-and-spinal-cord/parkinsons-disease/", "start_index": 9340, "chroma:document": "parkinsonism on the Parkinson\u2019s UK website. Diagnosing Parkinson\u2019s disease No tests can conclusively show that you have Parkinson\u2019s disease. Your doctor will base a diagnosis on your symptoms, medical history and a detailed physical examination. Your GP will talk to you about the problems you\u2019re experiencing and may ask you to perform some simple mental or physical tasks, such as moving or walking around, to help with the diagnosis. In the early stages, your GP may find it difficult to say whether you definitely have the condition because symptoms are usually mild. Referral to a specialist If your GP suspects Parkinson\u2019s disease, you\u2019ll be referred to a specialist. This will usually be: a neurologist \u2013 a specialist in conditions affecting the brain and nervous system a geriatrician \u2013 a specialist in problems affecting elderly people If your GP thinks you may be in the early stages of Parkinson\u2019s disease, you should see a specialist within six weeks. If they think you may be in the"}


created_at: 2025-05-10 05:59:58
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/brain-nerves-and-spinal-cord/parkinsons-disease/", "start_index": 10188, "chroma:document": "your GP thinks you may be in the early stages of Parkinson\u2019s disease, you should see a specialist within six weeks. If they think you may be in the later stages, you should see a specialist within two weeks. The specialist will most likely ask you to perform a number of physical exercises so they can assess whether you have any problems with movement. A diagnosis of Parkinson\u2019s disease is likely if you have at least two of the three following symptoms: shaking or tremor in a part of your body that usually only occurs at rest slowness of movement (bradykinesia) muscle stiffness (rigidity) If your symptoms improve after taking a medication called levodopa, it\u2019s more likely you have Parkinson\u2019s disease. Special brain scans, such as a single photon emission computed tomography (SPECT) scan, may also be carried out in some cases to try to rule out other causes of your symptoms. Receiving the diagnosis Being told you have Parkinson\u2019s disease can be emotionally distressing, and the news can"}


created_at: 2025-05-10 05:59:58
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/brain-nerves-and-spinal-cord/parkinsons-disease/", "start_index": 11039, "chroma:document": "out other causes of your symptoms. Receiving the diagnosis Being told you have Parkinson\u2019s disease can be emotionally distressing, and the news can often be difficult to take in. This means it\u2019s important that you have the support of your family and a care team who will be able to help you come to terms with the diagnosis. You may find it useful to contact Parkinson\u2019s UK, the Parkinson\u2019s support and research charity. They can be contacted by: free helpline on 0808 800 0303 (Monday to Friday, 9am to 7pm, and 10am to 2pm on Saturdays) email: hello@parkinsons.org.uk Parkinson\u2019s UK brings people with Parkinson\u2019s, their carers and families together through a network of local groups, as well as online resources and a confidential helpline. Parkinson\u2019s UK provides information and support on every aspect of living with Parkinson\u2019s. Treating Parkinson\u2019s disease There are several therapies that can make living with Parkinson\u2019s disease easier and help you deal with your symptoms on a day-to-day"}


created_at: 2025-05-10 05:59:58
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/brain-nerves-and-spinal-cord/parkinsons-disease/", "start_index": 11896, "chroma:document": "disease There are several therapies that can make living with Parkinson\u2019s disease easier and help you deal with your symptoms on a day-to-day basis. There are efforts underway to try to increase the availability of these supportive therapies for Parkinson\u2019s patients on the NHS. Your local authority may be able to advise and help you. Ask your local authority for a care and support needs assessment. Physiotherapy A physiotherapist can work with you to relieve muscle stiffness and joint pain through movement (manipulation) and exercise. The physiotherapist aims to make moving easier, and improve your walking and flexibility. They also try to improve your fitness levels and ability to manage things for yourself. Occupational therapy An occupational therapist can identify areas of difficulty in your everyday life \u2013 for example, dressing yourself or getting to the local shops. They can help you work out practical solutions, and ensure your home is safe and properly set up for you. This"}


created_at: 2025-05-10 05:59:58
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/brain-nerves-and-spinal-cord/parkinsons-disease/", "start_index": 12750, "chroma:document": "or getting to the local shops. They can help you work out practical solutions, and ensure your home is safe and properly set up for you. This will help you maintain your independence for as long as possible. Read more about occupational therapy Speech and language therapy Many people with Parkinson\u2019s disease have swallowing difficulties (dysphagia) and problems with their speech. A speech and language therapist can often help you improve these problems by teaching speaking and swallowing exercises, or by providing assistive technology. Diet advice For some people with Parkinson\u2019s disease, making dietary changes can help improve some symptoms. These changes can include: increasing the amount of fibre in your diet and making sure you\u2019re drinking enough fluid to reduce constipation increasing the amount of salt in your diet and eating small, frequent meals to avoid problems with low blood pressure, such as dizziness when you stand up quickly making changes to your diet to avoid"}


created_at: 2025-05-10 05:59:58
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/brain-nerves-and-spinal-cord/parkinsons-disease/", "start_index": 13594, "chroma:document": "small, frequent meals to avoid problems with low blood pressure, such as dizziness when you stand up quickly making changes to your diet to avoid unintentional weight loss You may see a dietitian, a healthcare professional trained to give diet advice, if your care team thinks you may benefit from changing your diet. Medication Medication can be used to improve the main symptoms of Parkinson\u2019s disease, such as shaking (tremors) and movement problems. However, not all the medications available are useful for everyone, and the short- and long-term effects of each are different. Three main types of medication are commonly used: levodopa dopamine agonists monoamine oxidase-B inhibitors Your specialist can explain your medication options, including the risks associated with each medication, and discuss which may be best for you. Regular reviews will be required as the condition progresses and your needs change. Read on to learn about the treatments you may be offered. You can also see a"}


created_at: 2025-05-10 05:59:58
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/brain-nerves-and-spinal-cord/parkinsons-disease/", "start_index": 14445, "chroma:document": "will be required as the condition progresses and your needs change. Read on to learn about the treatments you may be offered. You can also see a summary of the pros and cons of treatments for Parkinson\u2019s disease, where you can compare your options. Levodopa Most people with Parkinson\u2019s disease eventually need a medication called levodopa. Levodopa is absorbed by the nerve cells in your brain and turned into the chemical dopamine, which is used to transmit messages between the parts of the brain and nerves that control movement. Increasing the levels of dopamine using levodopa usually improves movement problems. It is usually taken as a tablet or liquid, and is often combined with other medication, such as benserazide or carbidopa. These medications stop the levodopa being broken down in the bloodstream before it has a chance to get to the brain. They also reduce the side effects of levodopa, which include: feeling sick (nausea) or vomiting tiredness dizziness If you\u2019re prescribed"}


created_at: 2025-05-10 05:59:58
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/brain-nerves-and-spinal-cord/parkinsons-disease/", "start_index": 15292, "chroma:document": "the brain. They also reduce the side effects of levodopa, which include: feeling sick (nausea) or vomiting tiredness dizziness If you\u2019re prescribed levodopa, the initial dose is usually very small and will be gradually increased until it takes effect. At first, levodopa can cause a dramatic improvement in the symptoms. However, its effects can be less long-lasting over the following years \u2013 as more nerve cells in the brain are lost, there are fewer of them to absorb the medicine. This means the dose may need to be increased from time to time. Long-term use of levodopa is also linked to problems such as uncontrollable, jerky muscle movements (dyskinesias) and \u201con-off\u201d effects, where the person rapidly switches between being able to move (on) and being immobile (off). Dopamine agonists Dopamine agonists act as a substitute for dopamine in the brain and have a similar but milder effect compared with levodopa. They can often be given less frequently than levodopa. They are often taken as"}


created_at: 2025-05-10 05:59:59
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/brain-nerves-and-spinal-cord/parkinsons-disease/", "start_index": 16141, "chroma:document": "the brain and have a similar but milder effect compared with levodopa. They can often be given less frequently than levodopa. They are often taken as a tablet, but are also available as a skin patch (rotigotine). Sometimes dopamine agonists are taken at the same time as levodopa, as this allows lower doses of levodopa to be used. Possible side effects of dopamine agonists include: nausea or vomiting tiredness and sleepiness dizziness Dopamine agonists can also cause hallucinations and increased confusion, so they need to be used with caution, particularly in elderly patients, who are more susceptible. For some people, dopamine agonists have been linked to the development of compulsive behaviours, especially at high doses, including addictive gambling and an excessively increased libido. Talk to your healthcare specialist if you think you may be experiencing these problems. As the person themselves may not realise the problem, it\u2019s key that carers and family members also note any"}


created_at: 2025-05-10 05:59:59
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
id: 5504125b-54d7-41ef-8f6c-bae41185d307
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/brain-nerves-and-spinal-cord/parkinsons-disease/", "start_index": 16987, "chroma:document": "you may be experiencing these problems. As the person themselves may not realise the problem, it\u2019s key that carers and family members also note any abnormal behaviour and discuss it with an appropriate professional at the earliest opportunity. If you\u2019re prescribed a course of dopamine agonists, the initial dose is usually very small to prevent nausea and other side effects. The dosage is gradually increased over a few weeks. If nausea becomes a problem, your GP may prescribe anti-sickness medication. A potentially serious, but uncommon, complication of dopamine agonist therapy is sudden onset of sleep. This generally happens as the dose is being increased and tends to settle once the dose is stable. People are usually advised to avoid driving while the dose is being increased in case this complication occurs. Monoamine oxidase-B inhibitors Monoamine oxidase-B (MAO-B) inhibitors, including selegiline and rasagiline, are another alternative to levodopa for treating early Parkinson\u2019s"}


created_at: 2025-05-10 05:59:59
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
id: 72f58681-dd81-43c3-8005-139486c466d3
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/brain-nerves-and-spinal-cord/parkinsons-disease/", "start_index": 17839, "chroma:document": "Monoamine oxidase-B (MAO-B) inhibitors, including selegiline and rasagiline, are another alternative to levodopa for treating early Parkinson\u2019s disease. They block the effects of an enzyme or brain substance that breaks down dopamine (monoamine oxidase-B), increasing dopamine levels. Both selegiline and rasagiline can improve the symptoms of Parkinson\u2019s disease, although their effects are small compared with levodopa. They can be used alongside levodopa or dopamine agonists. MAO-B inhibitors are generally very well tolerated, but can occasionally cause side effects, including: nausea headache abdominal pain high blood pressure Catechol-O-methyltransferase inhibitors Catechol-O-methyltransferase (COMT) inhibitors are prescribed for people in later stages of Parkinson\u2019s disease. They prevent levodopa from being broken down by the enzyme COMT. Side effects of COMT inhibitors include: nausea or vomiting diarrhoea abdominal pain Non-oral therapies When Parkinson\u2019s symptoms become difficult"}


created_at: 2025-05-10 05:59:59
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
id: 50df8a38-2062-47de-8c0e-554610e5bdaf
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/brain-nerves-and-spinal-cord/parkinsons-disease/", "start_index": 18692, "chroma:document": "Side effects of COMT inhibitors include: nausea or vomiting diarrhoea abdominal pain Non-oral therapies When Parkinson\u2019s symptoms become difficult to control with tablets alone, a number of other treatments can be considered. Apomorphine A dopamine agonist called apomorphine can be injected under the skin (subcutaneously) either by: a single injection, when required a continuous infusion using a small pump carried around on your belt, under your clothing, or in a bag Duodopa If you have severe on-off fluctuations, a type of levodopa called duodopa may be used. This medication comes as a gel that\u2019s continuously pumped into your gut through a tube inserted through your abdominal wall. There\u2019s an external pump attached to the end of the tube, which you carry around with you. About 25 specialist neuroscience centres in the UK offer this treatment. This treatment is only available if you have very severe on-off fluctuations or involuntary movements. Surgery Most people with Parkinson\u2019s"}


created_at: 2025-05-10 05:59:59
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/brain-nerves-and-spinal-cord/parkinsons-disease/", "start_index": 19548, "chroma:document": "This treatment is only available if you have very severe on-off fluctuations or involuntary movements. Surgery Most people with Parkinson\u2019s disease are treated with medication, although a type of surgery called deep brain stimulation is used in some cases. This surgery is also available in specialist neuroscience centres around the UK, but it\u2019s not suitable for everyone. If surgery is being considered, your specialist will discuss the possible risks and benefits with you. Deep brain stimulation Deep brain stimulation involves surgically implanting a pulse generator similar to a heart pacemaker into your chest wall. This is connected to one or two fine wires placed under the skin, and is inserted precisely into specific areas in your brain. A tiny electric current is produced by the pulse generator, which runs through the wire and stimulates the part of your brain affected by Parkinson\u2019s disease. Although surgery doesn\u2019t cure Parkinson\u2019s disease, it can ease the symptoms for some"}


created_at: 2025-05-10 05:59:59
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
id: b4d1898a-5a37-498f-97dd-c5fa269cf64d
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/brain-nerves-and-spinal-cord/parkinsons-disease/", "start_index": 20401, "chroma:document": "the part of your brain affected by Parkinson\u2019s disease. Although surgery doesn\u2019t cure Parkinson\u2019s disease, it can ease the symptoms for some people. Treating additional symptoms As well as the main symptoms of movement problems, people with Parkinson\u2019s disease can experience a wide range of additional symptoms that may need to be treated separately. These include: depression and anxiety \u2013 this can be treated with self care measures such as exercise, psychological therapy or medication; read more about treating depression problems sleeping (insomnia) \u2013 this can be improved by making changes to your normal bedtime routine; read more about treating insomnia erectile dysfunction \u2013 this can be treated with medication; read more about treating erectile dysfunction excessive sweating (hyperhidrosis) \u2013 this can be reduced using a prescription antiperspirant, or surgery in severe cases; read more about treating hyperhidrosis swallowing difficulties (dysphagia) \u2013 this can be improved by eating"}


created_at: 2025-05-10 05:59:59
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
id: 97d9173b-fe60-4353-aa82-feb514796da6
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/brain-nerves-and-spinal-cord/parkinsons-disease/", "start_index": 21264, "chroma:document": "or surgery in severe cases; read more about treating hyperhidrosis swallowing difficulties (dysphagia) \u2013 this can be improved by eating softened food, or by using a feeding tube in more severe cases; read more about treating dysphagia excessive drooling \u2013 this can be improved with swallowing exercises, or surgery or medication in severe cases urinary incontinence \u2013 this can be treated with exercises to strengthen the pelvic floor muscles, medication, or surgery in severe cases; read more about treating urinary incontinence dementia \u2013 this can be treated with cognitive therapies and medication in some cases; read more about treating dementia Clinical trials Much progress has been made in the treatment of Parkinson\u2019s disease as the result of clinical trials, where new treatments and treatment combinations are compared with standard ones. All clinical trials in the UK are carefully overseen to ensure they are worthwhile and safely conducted. Participants in clinical trials sometimes do"}


created_at: 2025-05-10 05:59:59
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
id: c1b518f8-f4ff-4067-8d9b-bb20e3ee9082
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/brain-nerves-and-spinal-cord/parkinsons-disease/", "start_index": 22112, "chroma:document": "All clinical trials in the UK are carefully overseen to ensure they are worthwhile and safely conducted. Participants in clinical trials sometimes do better overall than those in routine care. If you are asked if you want to take part in a trial, you will be given an information sheet about the trial. If you want to take part, you will be asked to sign a consent form. You can refuse to take part or withdraw from a clinical trial without it affecting your care. Complementary and alternative therapies Some people with Parkinson\u2019s disease find complementary therapies help them feel better. Many complementary treatments and therapies claim to ease the symptoms of Parkinson\u2019s disease. However, there\u2019s no clinical evidence they\u2019re effective in controlling the symptoms of Parkinson\u2019s disease. Most people think complementary treatments have no harmful effects. However, some can be harmful and they shouldn\u2019t be used instead of the medicines prescribed by your doctor. Some types of herbal"}


created_at: 2025-05-10 05:59:59
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
id: 0b2fbb40-df7e-4ede-9c3f-2314d38aaf9e
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/brain-nerves-and-spinal-cord/parkinsons-disease/", "start_index": 22957, "chroma:document": "no harmful effects. However, some can be harmful and they shouldn\u2019t be used instead of the medicines prescribed by your doctor. Some types of herbal remedies, such as St John\u2019s wort, can interact unpredictably if taken with some types of medication used to treat Parkinson\u2019s disease. If you\u2019re considering using an alternative treatment along with your prescribed medicines, check with your care team first. Living with Parkinson\u2019s disease It\u2019s important to do what you can to stay physically and mentally healthy if you have Parkinson\u2019s disease. Exercise and healthy eating Regular exercise is particularly important in helping relieve muscle stiffness, improving your mood, and relieving stress. There are many activities you can do to help keep yourself fit, ranging from more active sports like tennis and cycling, to less strenuous activities such as walking, gardening and yoga. You should also try to eat a balanced diet containing all the food groups to give your body the nutrition it needs"}


created_at: 2025-05-10 05:59:59
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
id: d57bfd2c-5f3f-47c9-bfd3-e9d17a2f9e4c
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/brain-nerves-and-spinal-cord/parkinsons-disease/", "start_index": 23810, "chroma:document": "as walking, gardening and yoga. You should also try to eat a balanced diet containing all the food groups to give your body the nutrition it needs to stay healthy. Vaccinations Everyone with a long-term condition is encouraged to get a yearly flu jab each autumn. The pneumococcal vaccination is also usually recommended, which is a one-off injection that protects against a serious chest infection called pneumococcal pneumonia. Relationships and support Being diagnosed with a long-term condition like Parkinson\u2019s disease can put a strain on you, your family and friends. It can be difficult to talk to people about your condition, even if they\u2019re close to you. Dealing with the deterioration of symptoms, such as increasing difficulty with movement, may make you feel frustrated and depressed. Spouses, partners or carers will inevitably feel anxious or frustrated as well. Be open about how you feel, and let your family and friends know what they can do to help. Don\u2019t feel shy about telling"}


created_at: 2025-05-10 05:59:59
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
id: 100cafa8-71da-48e0-b48e-64ae8ac20b83
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/brain-nerves-and-spinal-cord/parkinsons-disease/", "start_index": 24664, "chroma:document": "or frustrated as well. Be open about how you feel, and let your family and friends know what they can do to help. Don\u2019t feel shy about telling them you need some time to yourself, if that\u2019s what you want. Support If you have any questions about your condition, your GP or Parkinson\u2019s disease specialist nurse may be able to help. You may also find it helpful to talk to a trained counsellor or psychologist, or someone at a specialist helpline. Your GP surgery will have details of these. Some people find it helpful to talk to others with Parkinson\u2019s disease, either at a local support group or in an internet chat room. Care and support services It\u2019s worth taking time to think about your specific needs and what would help you achieve the best quality of life. For example, you may wish to consider equipment, help in your home, and home adaptations. Parkinson\u2019s UK Parkinson\u2019s UK is the main Parkinson\u2019s support and research charity in the UK. They can offer the support and advice you may need"}


created_at: 2025-05-10 05:59:59
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
id: 29c8dd06-9b0a-49dd-8ee0-f03370610976
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/brain-nerves-and-spinal-cord/parkinsons-disease/", "start_index": 25518, "chroma:document": "Parkinson\u2019s UK Parkinson\u2019s UK is the main Parkinson\u2019s support and research charity in the UK. They can offer the support and advice you may need if you\u2019re living with Parkinson\u2019s disease, and can let you know about support groups in your local area. They can be contacted by: free confidential helpline on 0808 800 0303 (Monday to Friday, 9am to 7pm, and 10am to 2pm on Saturdays) email: hello@parkinsons.org.uk The Parkinson\u2019s UK website also features all the latest news, publications and research updates, as well as an online community where you can share your experiences of living with Parkinson\u2019s. Work and finances Being diagnosed with Parkinson\u2019s doesn\u2019t mean you have to stop working. Many people with the condition keep working for years after their diagnosis. You may find it hard to cope financially if you do have to stop work or work part-time because of your condition. However, you may be entitled to one or more of the following types of financial support: You are entitled to"}


created_at: 2025-05-10 05:59:59
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/brain-nerves-and-spinal-cord/parkinsons-disease/", "start_index": 26367, "chroma:document": "part-time because of your condition. However, you may be entitled to one or more of the following types of financial support: You are entitled to Statutory Sick Pay from your employer if you have a job but can\u2019t work because of your illness. You may be entitled to Employment and Support Allowance (ESA) if you don\u2019t have a job and can\u2019t work because of your illness. You may be eligible for Personal Independence Payment (PIP), which replaced the Disability Living Allowance (DLA), if you\u2019re aged 64 and under and need help with personal care or have walking difficulties. You may be able to get Attendance Allowance if you\u2019re aged 65 or over. You may be entitled to Carer\u2019s Allowance if you\u2019re caring for someone with Parkinson\u2019s disease. You may be eligible for other benefits if you have children living at home or if you have a low household income. Driving If you\u2019ve been diagnosed with Parkinson\u2019s disease, you must inform the Driver and Vehicle Licensing Agency (DVLA) and your insurance"}


created_at: 2025-05-10 06:00:00
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
id: f16ab81d-c369-43b6-aa09-091c273c9948
encoding: FLOAT32
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/brain-nerves-and-spinal-cord/parkinsons-disease/", "start_index": 27214, "chroma:document": "income. Driving If you\u2019ve been diagnosed with Parkinson\u2019s disease, you must inform the Driver and Vehicle Licensing Agency (DVLA) and your insurance company. You won\u2019t necessarily have to stop driving. You\u2019ll be asked to complete a form providing more information about your condition, as well as details of your doctors and specialists. The DVLA will use this to decide whether you\u2019re fit to drive. Complex Parkinson\u2019s disease and palliative care Complex Parkinson\u2019s disease is defined as the stage when treatment is unable to consistently control symptoms, or the person has developed uncontrollable jerky movements (disabling dyskinesia). These problems can still be helped by adjustment or addition of some of the medications used to treat Parkinson\u2019s disease, under the supervision of a doctor with a specialist interest in Parkinson\u2019s disease. As Parkinson\u2019s disease progresses, you\u2019ll be invited to discuss the care you want with your healthcare team as you near the end of your life. This is"}


created_at: 2025-05-10 06:00:00
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/brain-nerves-and-spinal-cord/parkinsons-disease/", "start_index": 28064, "chroma:document": "As Parkinson\u2019s disease progresses, you\u2019ll be invited to discuss the care you want with your healthcare team as you near the end of your life. This is known as palliative care. When there\u2019s no cure for an illness, palliative care tries to alleviate symptoms, and is also aimed at making the end of a person\u2019s life as comfortable as possible. This is done by attempting to relieve pain and other distressing symptoms, while providing psychological, social and spiritual support for you and your family. Palliative care can be provided at home or in a hospice, residential home or hospital. You may want to consider talking to your family and care team in advance about where you\u2019d like to be treated and what care you wish to receive. Source: NHS 24 - Opens in new browser window Last updated: 21 June 2024 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Don\u2019t include personal information e.g. name, location or any personal health conditions. Email"}


created_at: 2025-05-10 06:00:00
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/brain-nerves-and-spinal-cord/parkinsons-disease/", "start_index": 28915, "chroma:document": "NHS inform Thank You Your feedback has been received Don\u2019t include personal information e.g. name, location or any personal health conditions. Email Address e.g. you@example.com Message Maximum of 500 characters Send feedback Add this page to Info For Me Other health sites Brain and Spine Foundation: Parkinson's disease Healthtalk.org: Parkinson's disease Parkinson's UK NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats \u00a9 2025 NHS 24 \u2013 v1.1.1.17852"}


created_at: 2025-05-10 06:00:00
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/chromosomal-conditions/pataus-syndrome/", "start_index": 0, "chroma:document": "The website is busy, please try later."}


created_at: 2025-05-10 06:00:00
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/muscle-bone-and-joints/leg-and-foot-problems-and-conditions/patellofemoral-pain-syndrome/", "start_index": 0, "chroma:document": "Patellofemoral pain syndrome | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotland\u2019s Service Directory 0 Home Illnesses and conditions Muscle, bone and joints Leg and foot problems and conditions Patellofemoral pain syndrome Patellofemoral pain syndrome This information may be useful for those who have been diagnosed with patellofemoral pain syndrome. People who are experiencing new or ongoing symptoms should contact their healthcare professional. Read about advice on dealing with a knee problem What is patellofemoral pain syndrome? Patellofemoral pain syndrome is a condition that causes pain behind or around the kneecap. It\u2019s a leading cause of chronic knee pain, which 1 in 3 adults may experience at some point in their life. What are the symptoms of patellofemoral pain syndrome? These can vary from person to person. People may experience some or all of these symptoms including: pain beneath or around"}


created_at: 2025-05-10 06:00:00
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
id: 6e84d034-f185-4697-8433-25004ccdeff3
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/muscle-bone-and-joints/leg-and-foot-problems-and-conditions/patellofemoral-pain-syndrome/", "start_index": 859, "chroma:document": "pain syndrome? These can vary from person to person. People may experience some or all of these symptoms including: pain beneath or around the kneecap especially on climbing up and down stairs, kneeling and squatting. clicking and grinding in the knee. giving way of the knee or sensation of this. pain after maintaining a sitting position for a period of time, such as driving or at the cinema. swelling. tight feeling in the calves and thighs. What causes patellofemoral pain syndrome? The causes can vary between individuals, but it\u2019s often as a result of altered loading of the patella (kneecap). The main contributing factors can be: weakness in the buttocks and thighs. tightness in the hamstrings and calf. sudden changes in activities. Other factors could be: repeated kneeling or bending of the knee. sitting or driving for a prolonged period of time. being overweight. What is the best treatment? The strongest evidence suggests that strengthening any weak or underactive muscles and"}


created_at: 2025-05-10 06:00:00
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/muscle-bone-and-joints/leg-and-foot-problems-and-conditions/patellofemoral-pain-syndrome/", "start_index": 1704, "chroma:document": "period of time. being overweight. What is the best treatment? The strongest evidence suggests that strengthening any weak or underactive muscles and stretching any short or tight muscles is very important. An important step in your recovery is identifying which activities are causing or increasing your pain. Modifying those activities can help to reduce symptoms, however, it\u2019s important to make sure you remain active. Modifying your activities may include: reducing the amount of kneeling take regular breaks while doing aggravating activities reduce the amount of time you sit still Read more about exercises for patellofemoral pain syndrome Read more about how to stay active Pain treatments Pain medication \u2013 this can help you move more comfortably, which can help your recovery More about taking painkillers Work A knee problem can sometimes mean you need to take some time off work to help recovery. How long you\u2019re off will depend on the nature of your condition and your role at work. You"}


created_at: 2025-05-10 06:00:00
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
id: 3e284c22-48c2-444a-a566-e06c17417f96
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/muscle-bone-and-joints/leg-and-foot-problems-and-conditions/patellofemoral-pain-syndrome/", "start_index": 2554, "chroma:document": "mean you need to take some time off work to help recovery. How long you\u2019re off will depend on the nature of your condition and your role at work. You do not need to be symptom free before you consider returning to work. Continuing to go to work, or returning to work as soon as is possible for you, will help your recovery. Gradually getting back to your normal daily activities can help to build up your strength and stamina levels. Help and support Following this advice, you should see gradual improvements over time. If your patellofemoral pain syndrome hasn\u2019t improved within 6 weeks, or it\u2019s got worse, after following this advice, talk to a healthcare professional about your symptoms. Read about how to access MSK services When dealing with any health condition it\u2019s important to also look after your mental wellbeing as this can impact your recovery. Source: NHS 24 MSK Clinical Advisory Group - Opens in new browser window Last updated: 07 February 2025 How can we improve this page? Help"}


created_at: 2025-05-10 06:00:00
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/muscle-bone-and-joints/leg-and-foot-problems-and-conditions/patellofemoral-pain-syndrome/", "start_index": 3404, "chroma:document": "recovery. Source: NHS 24 MSK Clinical Advisory Group - Opens in new browser window Last updated: 07 February 2025 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Don\u2019t include personal information e.g. name, location or any personal health conditions. Email Address e.g. you@example.com Message Maximum of 500 characters Send feedback Add this page to Info For Me Also on NHS inform Exercises for patellofemoral knee pain Knee problems NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats \u00a9 2025 NHS 24 \u2013 v1.1.1.17852"}


created_at: 2025-05-10 06:00:00
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/sexual-and-reproductive/pelvic-inflammatory-disease/", "start_index": 0, "chroma:document": "The website is busy, please try later."}


created_at: 2025-05-10 06:00:00
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/sexual-and-reproductive/pelvic-organ-prolapse/", "start_index": 0, "chroma:document": "Pelvic organ prolapse | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotland\u2019s Service Directory 0 Home Illnesses and conditions Sexual and reproductive Pelvic organ prolapse Pelvic organ prolapse Pelvic organ prolapse is when one or more of the pelvic organs (your womb, bladder or bowel) slip from their usual position. This causes the vaginal wall to bulge into, or out of, the vagina. Pelvic organ prolapse isn\u2019t life-threatening. In some cases it can cause little or no problems. However, in more severe cases, it may feel very uncomfortable. It might stop you doing the things that you enjoy, and affect your quality of life. Like incontinence, prolapse isn\u2019t an inevitable part of ageing. Speak to your doctor if you think you might have a prolapse. You don\u2019t need to suffer or feel embarrassed. Many women can experience prolapse, but it can be treated. Symptoms Some women with a pelvic organ prolapse don\u2019t"}


created_at: 2025-05-10 06:00:00
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/sexual-and-reproductive/pelvic-organ-prolapse/", "start_index": 848, "chroma:document": "need to suffer or feel embarrassed. Many women can experience prolapse, but it can be treated. Symptoms Some women with a pelvic organ prolapse don\u2019t have any symptoms at all. The condition may only discovered during an internal examination for another reason. For example, during a cervical screening test (smear test). Other women will experience symptoms. It\u2019s normal for your symptoms to feel more or less severe at different times of the day. Speak to your doctor if: You think you might have a prolapse or you have symptoms of a prolapse such as: a feeling of a bulge or something coming down the vagina a feeling of a bulge or something coming out the vagina, which sometimes needs pushed back up (you may be able to see this with a mirror) discomfort during sex problems peeing \u2013 a slow stream, a feeling of not emptying your bladder fully, needing to go to the toilet a lot or leaking Diagnosis A prolapse is a common condition. Seeing your doctor earlier may help you manage it more"}


created_at: 2025-05-10 06:00:00
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/sexual-and-reproductive/pelvic-organ-prolapse/", "start_index": 1697, "chroma:document": "needing to go to the toilet a lot or leaking Diagnosis A prolapse is a common condition. Seeing your doctor earlier may help you manage it more easily. Your doctor will need to carry out a pelvic examination, which will include an internal examination of your vagina. Your doctor will discuss this with you and you can ask any questions that you might have. As this is an intimate examination, the doctor may have another person (chaperone) present. You can ask for a female doctor or health professional if you prefer. The internal examination is similar to a smear test and should only take a few minutes. Your doctor will discuss with you if they think any further tests are needed. Types of prolapse Pelvic organ prolapse can affect the front, top or back of vagina. The main types of prolapse are: anterior prolapse (cystocele) \u2013 where the bladder bulges into the front wall of the vagina prolapse of the womb and / or cervix (the opening between the vagina and the womb) \u2013 where the womb and /"}


created_at: 2025-05-10 06:00:00
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/sexual-and-reproductive/pelvic-organ-prolapse/", "start_index": 2550, "chroma:document": "bulges into the front wall of the vagina prolapse of the womb and / or cervix (the opening between the vagina and the womb) \u2013 where the womb and / or cervix bulges down in to the vagina \u2018vault\u2019 prolapse \u2013 this can be as a result of a total hysterectomy where the new \u2018top\u2019 of the vagina bulges downwards posterior wall prolapse (rectocoele or enterocoele) \u2013 when the bowel bulges forward into the back wall of the vagina You can have more than one of these types of prolapse at the same time. A number system of 1 to 4 is usually used to describe how severe a pelvic organ prolapse is. For example, a 4 means a severe prolapse. You can ask your healthcare professional what this means for you, and any other questions you may have. Causes There isn\u2019t usually one cause, but the risk of developing pelvic organ prolapse is increased by: age \u2013 prolapse is more common as you get older, but it\u2019s not an inevitable part of ageing childbirth \u2013 particularly if you had a long or difficult labour, or have"}


created_at: 2025-05-10 06:00:01
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
id: 66681e22-a94f-4e80-9f8b-5e6951cd8d45
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/sexual-and-reproductive/pelvic-organ-prolapse/", "start_index": 3401, "chroma:document": "is more common as you get older, but it\u2019s not an inevitable part of ageing childbirth \u2013 particularly if you had a long or difficult labour, or have given birth to a large baby or multiple babies menopause \u2013 related to lower levels of oestrogen or weaker tissue being overweight having large fibroids or pelvic cysts which create a lot of pressure in the pelvis previous surgery on the pelvis \u2013 such as a hysterectomy repeated heavy lifting or manual work long term coughing or sneezing (caused by smoking, a lung condition or allergies) straining too much when going to the toilet for a poo because of long term constipation Prevention There are things you can do to reduce the risk of pelvic organ prolapse. Exercising your pelvic floor Do regular pelvic floor exercises to strength pelvic floor muscles maintain a healthy weight eat a high-fibre diet to avoid constipation or straining when you go to the toilet for a poo adopt good toilet habits avoid heavy lifting How to exercise your pelvic"}


created_at: 2025-05-10 06:00:01
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/sexual-and-reproductive/pelvic-organ-prolapse/", "start_index": 4249, "chroma:document": "diet to avoid constipation or straining when you go to the toilet for a poo adopt good toilet habits avoid heavy lifting How to exercise your pelvic floor muscles Treatment Treatment will depend on how much the issue is affecting your normal day to day activities. In mild cases of prolapse, your doctor may recommend lifestyle changes. For example, regular pelvic floor exercises and maintaining a healthy weight. Vaginal pessary A vaginal pessary is a device inserted into your vagina, which holds your vaginal walls in place and so pushes the prolapse back. Pessaries are usually made of latex (rubber) or silicone, and come in different shapes and sizes. A pessary might not be right for everyone. Your doctor will discuss with you to find out if it\u2019s the best option, and you can ask any questions you may have. Some side effects can include: vaginal discharge irritation, bleeding or sores inside your vagina stress incontinence difficulty with bowel movements difficulty having sex (although"}


created_at: 2025-05-10 06:00:01
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/sexual-and-reproductive/pelvic-organ-prolapse/", "start_index": 5105, "chroma:document": "discharge irritation, bleeding or sores inside your vagina stress incontinence difficulty with bowel movements difficulty having sex (although most women can have sex without problems) an imbalance of the usual bacteria found in your vagina If you have a pessary and experience any of these symptoms, speak to your healthcare professional. They can usually be treated. Hormone Replacement Therapy (HRT) HRT replaces the female hormones that are at a lower level as you experience the menopause. There is little evidence that HRT can directly treat pelvic organ prolapse, but it can relieve some of the symptoms associated with it. For example, vaginal dryness or discomfort during sex. Depending on your symptoms, you may wish to ask your doctor for more advice on whether this would be a suitable treatment option for you. Surgery Depending on your circumstances and how severe your symptoms are, your doctor may discuss with you whether a surgery might be helpful. They will go through the options"}


created_at: 2025-05-10 06:00:01
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/sexual-and-reproductive/pelvic-organ-prolapse/", "start_index": 5955, "chroma:document": "circumstances and how severe your symptoms are, your doctor may discuss with you whether a surgery might be helpful. They will go through the options with you. It\u2019s ok to ask any questions about your care to help you get the information you might need. You can then take some time to decide what the best option is for you. Source: Scottish Government - Opens in new browser window Last updated: 26 August 2024 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Don\u2019t include personal information e.g. name, location or any personal health conditions. Email Address e.g. you@example.com Message Maximum of 500 characters Send feedback Add this page to Info For Me Also on NHS inform Pelvic floor muscles It's OK to Ask Other health sites Pelvic Organ Prolapse: A physiotherapy guide for women Pelvic, Obstetric and Gynaecological Physiotherapy: Men\u2019s pelvic health NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about"}


created_at: 2025-05-10 06:00:01
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created_at: 2025-05-10 06:00:01
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/cancer/cancer-types-in-adults/penile-cancer/", "start_index": 0, "chroma:document": "The website is busy, please try later."}


created_at: 2025-05-10 06:05:34
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/brain-nerves-and-spinal-cord/peripheral-neuropathy/", "start_index": 0, "chroma:document": "Peripheral neuropathy | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotland\u2019s Service Directory 0 Home Illnesses and conditions Brain, nerves and spinal cord Peripheral neuropathy Peripheral neuropathy Peripheral neuropathy develops when the peripheral nerves are damaged. The symptoms experienced depend on which nerves are affected. In the UK, it\u2019s estimated that almost 1 in 10 people aged 55 or over are affected by peripheral neuropathy. What are peripheral nerves? The peripheral nervous system is the network of nerves that lie outside the central nervous system (the brain and spinal cord). This includes nerves in the feet and hands. Peripheral nerves: transmit sensations like pain and touch controlling muscles regulate some body functions like blood pressure Types of peripheral neuropathy There are 4 types of peripheral neuropathy: sensory neuropathy \u2013 damage to the nerves that carry sensations like"}


created_at: 2025-05-10 06:05:34
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/brain-nerves-and-spinal-cord/peripheral-neuropathy/", "start_index": 853, "chroma:document": "Types of peripheral neuropathy There are 4 types of peripheral neuropathy: sensory neuropathy \u2013 damage to the nerves that carry sensations like touch, temperature and pain motor neuropathy \u2013 damage to the nerves that control movement autonomic neuropathy \u2013 damage to the nerves that control bodily functions like digestion, bladder function and blood pressure mononeuropathy \u2013 damage to a single nerve outside the central nervous system Often people have more than 1 type of peripheral neuropathy at the same time. Symptoms of peripheral neuropathy Symptoms of peripheral neuropathy can vary depending on which type you have. They can also develop quickly or slowly. Symptoms of sensory neuropathy a prickling or tingling sensation in the affected body part \u2018pins and needles\u2019 in the affected body part a burning or sharp pain, usually in the feet numbness in the affected body part being less able to feel pain or changes in temperature, particularly in your feet being more able to feel pain, to"}


created_at: 2025-05-10 06:05:34
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/brain-nerves-and-spinal-cord/peripheral-neuropathy/", "start_index": 1701, "chroma:document": "numbness in the affected body part being less able to feel pain or changes in temperature, particularly in your feet being more able to feel pain, to the point that even a light touch causes you pain (allodynia) the loss of balance or co-ordination (sensory ataxia) Symptoms of motor neuropathy twitching and muscle cramps muscle weakness or paralysis that affects 1 or more muscles thinning (wasting) of your muscles foot drop (difficulty lifting the front part of your foot) that causes you to trip Symptoms of autonomic neuropathy constipation or diarrhoea, particularly at night feeling sick, bloating and belching low blood pressure, which can make you feel faint or dizzy when standing up rapid heartbeat problems with the amount you sweat (either too much or too little) problems with sexual function, like erectile dysfunction difficulty fully emptying your bladder Symptoms of mononeuropathy The symptoms of mononeuropathy can vary because they depend on which specific nerve has been"}


created_at: 2025-05-10 06:05:34
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/brain-nerves-and-spinal-cord/peripheral-neuropathy/", "start_index": 2547, "chroma:document": "fully emptying your bladder Symptoms of mononeuropathy The symptoms of mononeuropathy can vary because they depend on which specific nerve has been affected. Example symptoms could include: pain, weakness or altered sensation your fingers, feet or shins double vision or other problems with focusing your eyes, sometimes with eye pain weakness of one side of your face (Bell\u2019s palsy) Carpal tunnel syndrome Causes of peripheral neuropathy Diabetes (both type 1 and type 2) is the most common cause of peripheral neuropathy. This is called diabetic polyneuropathy Diabetic polyneuropathy The high blood sugar levels associated with diabetes can damage the nerves, causing diabetes. Peripheral neuropathy becomes more likely the longer you\u2019ve had diabetes. Your risk of diabetic polyneuropathy is higher if: your blood sugar is poorly controlled you smoke you regularly consume large amounts of alcohol you\u2019re over 40 years old There are many other possible causes of peripheral neuropathy. These can"}


created_at: 2025-05-10 06:05:34
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/brain-nerves-and-spinal-cord/peripheral-neuropathy/", "start_index": 3401, "chroma:document": "you regularly consume large amounts of alcohol you\u2019re over 40 years old There are many other possible causes of peripheral neuropathy. These can include: monoclonal gammopathy of undetermined significance (the presence of abnormal protein in the blood) cancers like lymphoma (cancer of the lymphatic system) and multiple myeloma (bone marrow cancer) low levels of vitamins like vitamin B12 drinking too much alcohol for a long period of time malnutrition (poor diet) some types of chemotherapy for cancer, particularly those used for bowel cancer, breast cancer, lymphoma or myeloma genetic conditions that cause nerve damage, like Charcot-Marie-Tooth disease some medications when taken for a long time, like metronidazole, nitrofurantoin, phenytoin, amiodarone and thalidomide physical injury to the nerves infections like shingles, lyme disease, diphtheria, botulism and HIV hypothyroidism (an underactive thyroid gland) chronic kidney disease or liver disease conditions caused by an overactive"}


created_at: 2025-05-10 06:05:34
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
id: 9f15e67c-11c4-4d3e-89a1-2bfff084e9aa
encoding: FLOAT32
metadata:
{"source": "https://www.nhsinform.scot/illnesses-and-conditions/brain-nerves-and-spinal-cord/peripheral-neuropathy/", "start_index": 4250, "chroma:document": "diphtheria, botulism and HIV hypothyroidism (an underactive thyroid gland) chronic kidney disease or liver disease conditions caused by an overactive immune system, like rheumatoid arthritis, lupus, Sjogren\u2019s syndrome or vasculitis (inflammation of the blood vessels) rare conditions like Guillain-Barr\u00e9 syndrome and amyloidosis exposure to high levels of toxins, like arsenic, lead or mercury Diagnosing peripheral neuropathy If you\u2019ve got symptoms of peripheral neuropathy, you should make an appointment with your GP. They\u2019ll ask about your symptoms and may arrange some tests to help find out the underlying cause. If you\u2019re taking a medication known to cause peripheral neuropathy, your GP may temporarily stop or reduce your dose to see whether your symptoms improve. Do not stop taking any prescribed medication without checking with your GP or healthcare provider first. You could make yourself very ill. If your GP isn\u2019t sure what\u2019s causing your peripheral neuropathy, you may be referred"}


created_at: 2025-05-10 06:05:34
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/brain-nerves-and-spinal-cord/peripheral-neuropathy/", "start_index": 5099, "chroma:document": "or healthcare provider first. You could make yourself very ill. If your GP isn\u2019t sure what\u2019s causing your peripheral neuropathy, you may be referred to a neurologist. This is a specialist in conditions affecting the nervous system. They may do some further tests. Generally, the sooner peripheral neuropathy is diagnosed, the better. Early diagnosis gives you the best chance of limiting the damage and preventing further complications. Speak to your GP practice if: You have: pain, tingling or loss of sensation in the feet loss of balance or weakness a cut or ulcer on your foot that isn\u2019t getting better Outlook with peripheral neuropathy The outlook for peripheral neuropathy varies. It depends on: the underlying cause which nerves have been damaged how severe the damage is If the underlying cause of your peripheral neuropathy can be treated, it may improve with treatment and time. For example, if your diabetes is well controlled, it may stop neuropathy getting worse. You may also find"}


created_at: 2025-05-10 06:05:35
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/brain-nerves-and-spinal-cord/peripheral-neuropathy/", "start_index": 5949, "chroma:document": "it may improve with treatment and time. For example, if your diabetes is well controlled, it may stop neuropathy getting worse. You may also find your neuropathy improves. It may be that the underlying cause of your peripheral neuropathy cannot be treated. In these cases, the damage may be permanent, and may get worse with time. Complications of peripheral neuropathy Peripheral neuropathy can cause further complications to your health. Some of these can be severe. They can include: cardiovascular autonomic neuropathy \u2013 when damage to the peripheral nerves cause problems with your heartbeat and blood circulation diabetic foot ulcers \u2013 when damaged to your blood vessels cause wounds to take an unusually long time to heal, leading to further problems Managing your symptoms Even if the cause of your peripheral neuropathy cannot be treated, you can get help with managing your symptoms. Pain If you\u2019re in pain, you may be prescribed different types of medication. This is because standard"}


created_at: 2025-05-10 06:05:35
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/brain-nerves-and-spinal-cord/peripheral-neuropathy/", "start_index": 6797, "chroma:document": "you can get help with managing your symptoms. Pain If you\u2019re in pain, you may be prescribed different types of medication. This is because standard painkillers (like ibuprofen and paracetamol) are often not effective at treating nerve pain. If you\u2019re experiencing pain in a particular area of your body, capsaicin cream may help. Capsaicin is the substance that makes chilli peppers hot. It\u2019s thought to stop the nerves sending pain messages to the brain, making it useful for nerve pain. Menthol cream can have a similar effect. If your pain only affects a small area of skin, you may be offered a lidocaine plaster. This is a large sticking plaster that contains a local anaesthetic, which is absorbed into the skin the plaster covers. If topical measures do not work, your GP may consider a neuropathic agent. These include some types of anti-depressants . Muscle weakness If you\u2019re struggling with muscle weakness, you may benefit from physiotherapy. It can help improve weakness. Occupational"}


created_at: 2025-05-10 06:05:35
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
id: 046144f9-5290-4773-b3de-0906fdb38885
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/brain-nerves-and-spinal-cord/peripheral-neuropathy/", "start_index": 7655, "chroma:document": ". Muscle weakness If you\u2019re struggling with muscle weakness, you may benefit from physiotherapy. It can help improve weakness. Occupational therapy can help you find new ways of completing difficult tasks. If you have foot drop or tripping, orthotics can help with ankle supports. Excess sweating If you\u2019re experiencing hyperhidrosis (excessive sweating), you may be offered botulinum toxin (botox) injections. These could help reduce your sweating. Difficulty emptying your bladder If you\u2019re struggling to empty your bladder, you may be offered urodynamic studies. Depending on the result, you may be offered medication or urinary catheterisation to help you. Source: Scottish Government - Opens in new browser window Last updated: 26 February 2025 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Don\u2019t include personal information e.g. name, location or any personal health conditions. Email Address e.g. you@example.com Message Maximum of 500"}


created_at: 2025-05-10 06:05:35
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/brain-nerves-and-spinal-cord/peripheral-neuropathy/", "start_index": 8504, "chroma:document": "Don\u2019t include personal information e.g. name, location or any personal health conditions. Email Address e.g. you@example.com Message Maximum of 500 characters Send feedback Add this page to Info For Me Also on NHS inform Trigeminal neuralgia Other health sites Pain Concern Trigeminal Neuralgia Assocation UK Diabetes UK: neuropathy NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats \u00a9 2025 NHS 24 \u2013 v1.1.1.17852"}


created_at: 2025-05-10 06:05:35
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/mental-health/personality-disorder/", "start_index": 0, "chroma:document": "Personality disorder | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotland\u2019s Service Directory 0 Home Illnesses and conditions Mental health Personality disorder Personality disorder Someone with a personality disorder thinks, feels, behaves or relates to others in a way that\u2019s different to the average person. There are different types of personality disorder. They can cause different symptoms. Paranoid personality disorder Schizoid personality disorder Schizotypal personality disorder Antisocial personality disorder Borderline personality disorder Histrionic personality disorder Narcissistic personality disorder Avoidant personality disorder Dependent personality disorder Obsessive compulsive personality disorder Symptoms of a personality disorder For example, borderline personality disorder (one of the most common types) can lead to: disordered thinking impulsive behaviour problems controlling your"}


created_at: 2025-05-10 06:05:35
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/mental-health/personality-disorder/", "start_index": 854, "chroma:document": "borderline personality disorder (one of the most common types) can lead to: disordered thinking impulsive behaviour problems controlling your emotions concerns that other people will abandon you intense but unstable relationships Antisocial personality disorder can cause: you to get frustrated easily difficulty controlling anger Other symptoms can include: avoiding other people being overwhelmed with feelings like anxiety or distress feeling empty and emotionally distressed difficulty maintaining stable and close relationships with other people periods of losing contact with reality Some people with personality disorders may have other mental health problems. For example, depression or drug and alcohol misuse. Causes of a personality disorder Personality disorders are a common mental health problem. They usually emerge in adolescence and continue into adulthood. Personality disorders may be mild, moderate or severe. People may have periods of \u201cremission\u201d where they function well."}


created_at: 2025-05-10 06:05:36
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/mental-health/personality-disorder/", "start_index": 1700, "chroma:document": "and continue into adulthood. Personality disorders may be mild, moderate or severe. People may have periods of \u201cremission\u201d where they function well. Personality disorders may be connected to genetic and family factors. Experiencing distress or fear during childhood can also contribute to a personality disorder. For example, experiencing neglect or abuse. Symptoms usually get worse with stress. Treatment for a personality disorder Treatment for a personality disorder usually involves therapy or medicine. Talking therapy A range of different psychotherapies are used to treat personality disorders. For example, talking therapy. Psychological therapy involves discussing your thoughts, emotions and behaviours with a trained professional. This aims to help you control your thoughts and emotions. Some therapies, especially group therapies, help people understand social relationships better. The psychotherapist will listen and discuss important issues with you. They can also suggest"}


created_at: 2025-05-10 06:05:36
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/mental-health/personality-disorder/", "start_index": 2545, "chroma:document": "help people understand social relationships better. The psychotherapist will listen and discuss important issues with you. They can also suggest strategies to resolve problems. If necessary, they\u2019ll help you change your attitudes and behaviour. Psychological therapy treatment usually lasts at least 6 months. But, it may last longer depending on the severity of the condition and other problems. Medicine Medicine may be prescribed to treat problems associated with a personality disorder, including: depression anxiety psychotic symptoms Supporting someone with a personality disorder Mind has information and guidance for friends and family of someone diagnosed with a personality disorder. This includes information on how to look after yourself while supporting someone else. Differences to obsessive compulsive disorder (OCD) Obsessive compulsive personality is different to obsessive compulsive disorder (OCD). People with OCD are aware that their behaviour is abnormal and are anxious about"}


created_at: 2025-05-10 06:05:36
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/mental-health/personality-disorder/", "start_index": 3398, "chroma:document": "personality is different to obsessive compulsive disorder (OCD). People with OCD are aware that their behaviour is abnormal and are anxious about it. Whereas, most people with obsessive compulsive personality disorder think their behaviour is acceptable. They usually have no desire to change it. Some people with OCD feel the need to carry out rituals. For example, having to touch every second lamppost as they walk down the street. This is not usually the case with people with obsessive compulsive personality disorder. People with OCD may feel the need to make lists or organise items in their house, but feel anxious about doing so. People with obsessive compulsive personality disorder feel less anxiety through such tasks. They may become irritated when prevented from doing so. Source: NHS 24 - Opens in new browser window Last updated: 25 April 2024 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Don\u2019t include personal information e.g."}


created_at: 2025-05-10 06:05:36
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/mental-health/personality-disorder/", "start_index": 4247, "chroma:document": "April 2024 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Don\u2019t include personal information e.g. name, location or any personal health conditions. Email Address e.g. you@example.com Message Maximum of 500 characters Send feedback Add this page to Info For Me NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats \u00a9 2025 NHS 24 \u2013 v1.1.1.17852"}


created_at: 2025-05-10 06:05:36
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/mental-health/phobias/", "start_index": 0, "chroma:document": "Phobias | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotland\u2019s Service Directory 0 Home Illnesses and conditions Mental health Phobias Phobias A phobia is a common type of anxiety disorder. Many people are afraid of things. Fear only becomes a phobia when you begin to organise your life around avoiding your fear. If you have a phobia, you\u2019ll have an overwhelming need to avoid all contact with the source of your anxiety. Coming into contact with the thing you\u2019re afraid of will cause you to feel anxiety and/or panic. Sometimes just thinking about it can cause these feelings. Phobias can be caused by many things, including: animals objects places situations If the cause of your phobia is an object or animal that you don\u2019t see regularly, it\u2019s unlikely to affect your day-to-day life. But, if you encounter the cause of your phobia regularly, you may find it very difficult to lead a normal life. Simple phobias"}


created_at: 2025-05-10 06:05:36
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/mental-health/phobias/", "start_index": 851, "chroma:document": "your day-to-day life. But, if you encounter the cause of your phobia regularly, you may find it very difficult to lead a normal life. Simple phobias Simple phobias are fears about specific objects, animals, situations or activities. Some common examples include: dogs spiders (arachnophobia) snakes enclosed spaces (claustrophobia) dentists flying While some people are able to manage their fears, others will need help and support to tackle the problem. Complex phobias Complex phobias can have a bigger impact than simple phobias. This is because they\u2019re often associated with a deep-rooted fear or anxiety about a particular circumstance or situation. Speaking to a GP about your anxiety may help to identify a complex phobia. Two common examples of complex phobias are agoraphobia and social phobia. Agoraphobia Agoraphobia is a fear of being in situations where escape might be difficult, or where help wouldn\u2019t be available if things go wrong. Agoraphobia often involves a combination of"}


created_at: 2025-05-10 06:05:37
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/mental-health/phobias/", "start_index": 1698, "chroma:document": "in situations where escape might be difficult, or where help wouldn\u2019t be available if things go wrong. Agoraphobia often involves a combination of several connected phobias. Someone with agoraphobia may also fear being left alone (monophobia). They might also fear places where they feel trapped (claustrophobia). This means someone with agoraphobia may find it difficult to: travel on public transport visit a shopping centre leave home (in extreme cases) Some people feel very apprehensive and anxious if they have to leave their home to visit the shops. Others may feel relatively comfortable travelling a short distance from their home. Social phobia If you have social phobia, you may experience fear of: being in social situations, like weddings performing in social situations, like public speaking leaving home because of the risk of meeting people (in extreme cases) If you have a social phobia, the thought of being seen in public can make you feel very anxious and frightened. These"}


created_at: 2025-05-10 06:05:37
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/mental-health/phobias/", "start_index": 2548, "chroma:document": "people (in extreme cases) If you have a social phobia, the thought of being seen in public can make you feel very anxious and frightened. These situations can make you feel vulnerable. Intentionally avoiding meeting people in social situations is a sign of social phobia. How common are phobias? Phobias are the most common type of anxiety disorder. In the UK, an estimated 10 million people have phobias. Phobias can affect anyone, regardless of age, sex and social background. Symptoms of phobias People with phobias usually need to avoid contact with the thing that causes fear. How far someone with a phobia will go to avoid contact varies. For example, someone with a fear of spiders (arachnophobia) may not want to touch a spider. Others may not be able to even look at a picture of a spider. All phobias can limit your daily activities. They can cause severe anxiety and depression. Physical symptoms Panic attacks are common among people with phobias. They can be very frightening and"}


created_at: 2025-05-10 06:05:37
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/mental-health/phobias/", "start_index": 3392, "chroma:document": "They can cause severe anxiety and depression. Physical symptoms Panic attacks are common among people with phobias. They can be very frightening and distressing. The symptoms often occur suddenly and without warning. Read more about panic attacks What causes phobias? Phobias usually develop during childhood, adolescence or early adulthood. They often begin after a frightening event or a stressful situation. But, it\u2019s not always clear why some phobias occur. If people in your family share your phobia, it\u2019s likely that you all learnt it from another family member as children. Diagnosing phobias Most people with a phobia are usually fully aware that they have one. Many people live with a phobia without having it formally diagnosed and by taking care to avoid the thing they\u2019re afraid of. If your phobia is interfering with your day to day life, you may benefit from speaking to your GP. They may refer you to a specialist, like a psychologist, who can help. Treatment for phobias Almost all"}


created_at: 2025-05-10 06:05:37
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/mental-health/phobias/", "start_index": 4244, "chroma:document": "you may benefit from speaking to your GP. They may refer you to a specialist, like a psychologist, who can help. Treatment for phobias Almost all phobias can be successfully treated and cured. Treating simple phobias Treating simple phobias involves gradually becoming exposed to what causes your fear. This is known as desensitisation or self-exposure therapy. Each phobia is different and no single programme will work for everyone. You may decide to get help from a specialist, like a psychologist. You might use your own self-help strategy. Our mental health self-help guides are based on Cognitive Behavioural Therapy (CBT). They can be helpful for people with anxiety and other mental health issues. Start the self-help guide for phobias Treating complex phobias Treatment for complex phobias often takes longer than for simple phobias. It might involve talking therapies, like counselling, psychotherapy and cognitive behavioural therapy (CBT). Speak to your GP for further information about"}


created_at: 2025-05-10 06:05:37
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
id: b926c404-9cd7-45c2-8809-4146bec2f7ab
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/mental-health/phobias/", "start_index": 5096, "chroma:document": "involve talking therapies, like counselling, psychotherapy and cognitive behavioural therapy (CBT). Speak to your GP for further information about treating a complex phobia. Medication Medication is not usually used to treat phobias. Source: NHS 24 - Opens in new browser window Last updated: 16 April 2025 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Don\u2019t include personal information e.g. name, location or any personal health conditions. Email Address e.g. you@example.com Message Maximum of 500 characters Send feedback Add this page to Info For Me Also on NHS inform Phobias self-help guide 10 ways to fight your fears NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats \u00a9 2025 NHS 24 \u2013 v1.1.1.17852"}


created_at: 2025-05-10 06:05:37
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/infections-and-poisoning/coronavirus-covid-19/complications/pims/", "start_index": 0, "chroma:document": "PIMS | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotland\u2019s Service Directory 0 Home Illnesses and conditions Infections and poisoning Coronavirus (COVID-19) Complications PIMS PIMS PIMS-TS or PIMS stands for Paediatric Multisystem Inflammatory Syndrome temporally associated with COVID-19. It\u2019s also sometimes called MISC-C (Multisystem Inflammatory syndrome in children associated with COVID). PIMS is a rare complication of coronavirus (COVID-19). It occurs mainly in school-age children, but can occasionally affect infants or young adults. Most children who catch coronavirus do not develop severe disease. PIMS is not like other forms of severe coronavirus. Children with PIMS will generally have had only mild symptoms or have had no symptoms at all at the time of their coronavirus infection. Symptoms usually start about 4 to 6 weeks later. What are the symptoms of PIMS? All children with PIMS have fever"}


created_at: 2025-05-10 06:05:37
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
id: d2db39b9-3387-42c6-bc46-e4751e979886
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/infections-and-poisoning/coronavirus-covid-19/complications/pims/", "start_index": 852, "chroma:document": "of their coronavirus infection. Symptoms usually start about 4 to 6 weeks later. What are the symptoms of PIMS? All children with PIMS have fever (temperature over 380C) lasting at least 3 to 4 days. Other common symptoms are: red rash (spots or blotches) which may be there all the time, or come and go red eyes (conjunctivitis) which are not sticky or itchy abdominal pain which might be severe, like appendicitis vomiting and/or diarrhoea sore throat, cough, breathlessness swollen glands sore red mouth swollen hands and feet headache dizziness sleepiness or confusion How is PIMS diagnosed? Many other illnesses can cause the same symptoms as PIMS. There\u2019s no specific test for PIMS. Doctors can diagnose PIMS by: asking about symptoms and how they\u2019ve progressed examination doing blood tests and scans which show signs of inflammation Is there treatment for PIMS? Although PIMS can make children very sick, there is effective treatment. The vast majority of children make a full recovery. The"}


created_at: 2025-05-10 06:05:37
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/infections-and-poisoning/coronavirus-covid-19/complications/pims/", "start_index": 1702, "chroma:document": "treatment for PIMS? Although PIMS can make children very sick, there is effective treatment. The vast majority of children make a full recovery. The most common medicines used are steroids and immunoglobulin. These are given into the vein and reduce inflammation. PIMS can affect the way the heart works, and cause inflammation in other organs. Some children will also need other treatments to help the heart and other body systems. Speak to your GP if: Your child has a fever lasting 3 to 4 days and: is feeling very weak or dizzy is very sleepy or confused has a rash and/or red eyes has severe or worsening abdominal pain If your GP is closed, phone 111. In an emergency phone 999. Source: NHS 24 - Opens in new browser window Last updated: 19 July 2022 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Don\u2019t include personal information e.g. name, location or any personal health conditions. Email Address e.g. you@example.com Message Maximum of"}


created_at: 2025-05-10 06:05:37
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/infections-and-poisoning/coronavirus-covid-19/complications/pims/", "start_index": 2558, "chroma:document": "Don\u2019t include personal information e.g. name, location or any personal health conditions. Email Address e.g. you@example.com Message Maximum of 500 characters Send feedback Add this page to Info For Me Also on NHS inform Long-term effects of COVID-19 (long COVID) Coronavirus (COVID-19) NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats \u00a9 2025 NHS 24 \u2013 v1.1.1.17852"}


created_at: 2025-05-10 06:05:37
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/muscle-bone-and-joints/leg-and-foot-problems-and-conditions/plantar-heel-pain/", "start_index": 0, "chroma:document": "Plantar heel pain | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotland\u2019s Service Directory 0 Home Illnesses and conditions Muscle, bone and joints Leg and foot problems and conditions Plantar heel pain Plantar heel pain This information is useful for those who have been diagnosed with plantar heel pain. People experiencing new or ongoing symptoms should contact a healthcare professional for assessment and diagnosis. Read more about self-managing a foot problem What is plantar heel pain? Plantar heel pain, or pain in the heel at the sole of the foot, is a common foot problem. This is called plantar fasciopathy, which used to be known as plantar fasciitis. The pain is usually worse first thing in the morning, or when you first take a step after a period of inactivity. The symptoms usually build up gradually and get worse over time. What causes plantar heel pain? The plantar fascia is a tough and flexible"}


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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/muscle-bone-and-joints/leg-and-foot-problems-and-conditions/plantar-heel-pain/", "start_index": 860, "chroma:document": "The symptoms usually build up gradually and get worse over time. What causes plantar heel pain? The plantar fascia is a tough and flexible band of tissue that runs under the sole of the foot. It connects the heel bone with your toes, and acts as a shock absorber to the foot. Sudden or repeated stresses can cause the plantar fascia to thicken, resulting in heel pain. The surrounding muscles and the heel bone can also be involved. It\u2019s unlikely you would need an x-ray or scan unless it\u2019s to rule out another condition. Treating plantar heel pain Plantar heel pain is often referred to as a self limiting condition. This means it can get better on its own over time. There are things you can do yourself that can help relieve heel pain and speed up your recovery. Exercises for plantar heel pain Exercises designed to stretch both your calf muscles and your plantar fascia should help relieve pain and improve flexibility in the affected foot. Learn about exercises for foot conditions Pacing your"}


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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/muscle-bone-and-joints/leg-and-foot-problems-and-conditions/plantar-heel-pain/", "start_index": 1711, "chroma:document": "and your plantar fascia should help relieve pain and improve flexibility in the affected foot. Learn about exercises for foot conditions Pacing your activities While recovering you should try to stay as active as you can. Remember a little activity is better than nothing. Continue to stay within acceptable pain limits but remember you don\u2019t need to be pain free. Aim to do a little bit more each day or every few days. How to tell if you\u2019re exercising at the right level. This guide can help you to understand if you\u2019re pacing your daily activities at the right level as you build your movement levels up. It\u2019ll also let you see how much pain or discomfort is acceptable. It can be helpful to rate your pain out of 10 (0 being no pain, 10 being the worst pain you\u2019ve ever had), for example: 0 to 3 \u2013 minimal pain 4 to 5 \u2013 acceptable pain 6 to 10 \u2013 excessive pain Pain during activity Aim to keep your pain within a rating of 0 to 5. If your pain gets above this level, you can change the level of"}


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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/muscle-bone-and-joints/leg-and-foot-problems-and-conditions/plantar-heel-pain/", "start_index": 2561, "chroma:document": "excessive pain Pain during activity Aim to keep your pain within a rating of 0 to 5. If your pain gets above this level, you can change the level of activity by: reducing the number of times you do a movement reducing the pace of an activity increasing rest time between activities Pain after activity Activity shouldn\u2019t make your existing pain worse overall. Increasing activity can lead to increased discomfort as your body gets used to regaining your activity levels. This kind of pain should ease quickly and your pain should be no worse the morning after. Pain treatments The following can help to reduce the pain: pain medication \u2013 this can help you move more comfortably, which can help your recovery ice packs More about taking painkillers Treating with ice Ice can be beneficial in the initial stages of plantar heel pain. Never place ice directly on your skin. Use a barrier, like a towel, to protect your skin from a burn. How long you use ice as a treatment can vary. However, you should"}


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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/muscle-bone-and-joints/leg-and-foot-problems-and-conditions/plantar-heel-pain/", "start_index": 3418, "chroma:document": "on your skin. Use a barrier, like a towel, to protect your skin from a burn. How long you use ice as a treatment can vary. However, you should generally apply ice for up to 15 minutes. You should also leave a few hours between treatments. You should stop treating the area with ice and seek advice from a medical professional if you notice the skin in the area has: an increase in redness discolouration blistering If you have any issues with circulation or sensation, you shouldn\u2019t use ice as a treatment for heel pain. Work A foot problem can sometimes mean you need to take some time off work to help recovery. How long you\u2019re off will depend on the nature of your condition and your role at work. You do not need to be symptom free before you consider returning to work. Continuing to go to work, or returning to work as soon as is possible for you, will help your recovery. Gradually getting back to your normal daily activities can help to build up your strength and stamina levels Help and"}


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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/muscle-bone-and-joints/leg-and-foot-problems-and-conditions/plantar-heel-pain/", "start_index": 4267, "chroma:document": "you, will help your recovery. Gradually getting back to your normal daily activities can help to build up your strength and stamina levels Help and support Following this advice, you should see gradual improvements over time. Talk to a healthcare professional about your symptoms if you\u2019ve been following this advice and: your symptoms haven\u2019t improved within 12 weeks your symptoms are worsening Find out how to access MSK services in your area When dealing with any health condition it\u2019s important to also look after your mental wellbeing as this can impact your recovery. Source: NHS 24 MSK Clinical Advisory Group - Opens in new browser window Last updated: 07 February 2025 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Don\u2019t include personal information e.g. name, location or any personal health conditions. Email Address e.g. you@example.com Message Maximum of 500 characters Send feedback Add this page to Info For Me Also on NHS inform"}


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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/muscle-bone-and-joints/leg-and-foot-problems-and-conditions/plantar-heel-pain/", "start_index": 5116, "chroma:document": "health conditions. Email Address e.g. you@example.com Message Maximum of 500 characters Send feedback Add this page to Info For Me Also on NHS inform Foot problems Exercises for foot problems NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats \u00a9 2025 NHS 24 \u2013 v1.1.1.17852"}


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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/lungs-and-airways/pleurisy/", "start_index": 0, "chroma:document": "Pleurisy | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotland\u2019s Service Directory 0 Home Illnesses and conditions Lungs and airways Pleurisy Pleurisy Pleurisy is inflammation of the layers that cover the lungs (the pleura). It causes sharp chest pain (pleuritic pain) that gets worse when breathing or coughing. It can affect people of all ages. People aged 65 years and over are most at risk because they\u2019re more likely to get a chest infection. When to get medical advice Phone 999 or go to A&E if: you have severe difficulty breathing \u2013 for example, you struggle to speak without pausing, gasping or choking you have pain when breathing in or coughing, particularly if you also have other symptoms, such as coughing up blood or leg swelling you have severe chest pain in the middle of your chest that isn\u2019t going away \u2013 it may feel like pressure, tightness or squeezing you have pain that spreads to your arms,"}


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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/lungs-and-airways/pleurisy/", "start_index": 849, "chroma:document": "pain in the middle of your chest that isn\u2019t going away \u2013 it may feel like pressure, tightness or squeezing you have pain that spreads to your arms, back, neck and jaw you feel more drowsy than usual or find it more difficult to wake up your lips or skin are turning pale, blue or grey \u2013 on brown or black skin this is easier to see on the palms of your hands Contact your GP practice urgently if you: have difficulty breathing \u2013 you may be more short of breath than usual are feeling confused, dizzy, or lightheaded feel sick or are being sick \u2013 for example, you can\u2019t keep food or fluids down have heart palpitations \u2013 this may feel like your heart is racing, going too slowly or skipping a beat or like a fluttering feeling in your chest have a sharp shoulder pain when breathing deeply have previously had a deep vein thrombosis (DVT) or a blood clot in the lungs (pulmonary embolism) take blood thinning medication are peeing less than usual \u2013 this can be a sign of dehydration have a very high"}


created_at: 2025-05-10 06:05:38
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/lungs-and-airways/pleurisy/", "start_index": 1698, "chroma:document": "clot in the lungs (pulmonary embolism) take blood thinning medication are peeing less than usual \u2013 this can be a sign of dehydration have a very high or low temperature \u2013 for example, you feel either hot or cold to touch or you\u2019re shivering If your GP is closed, phone 111. Speak to your GP practice if: you have breathlessness which is not improving you have had a cough for more than 3 weeks your symptoms are not improving or they are affecting your daily life Diagnosing pleurisy Pleurisy can usually be diagnosed by checking your symptoms. Your GP can listen to your chest to check for sounds that suggest you may have pleurisy. Further tests may be needed to find the underlying cause and how severe it is. Tests can include: blood tests to determine whether you have an infection or an autoimmune condition chest X-rays an ultrasound scan a computerised tomography (CT) scan a biopsy \u2013 a small sample of pleural or lung tissue is removed for further testing Treatment for pleurisy Treatment"}


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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/lungs-and-airways/pleurisy/", "start_index": 2546, "chroma:document": "computerised tomography (CT) scan a biopsy \u2013 a small sample of pleural or lung tissue is removed for further testing Treatment for pleurisy Treatment for pleurisy depends on the underlying cause. For example, pleurisy caused by a viral infection will often resolve itself without treatment. However, pleurisy caused by a bacterial infection is usually treated with antibiotics. People who are frail or already in poor health may be admitted to hospital. Non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, are often used to relieve the chest pain. If excess fluid builds up between the pleural layers, it may need drained to prevent breathing difficulties. This is known as pleural effusion. What causes pleurisy? Most cases are the result of a viral infection (such as the flu) or a bacterial infection (such as pneumonia). Methicillin-resistant Staphylococcus aureus (MRSA) can cause pleurisy, especially in hospital patients. MRSA is a type of bacteria with a resistance to a"}


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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/lungs-and-airways/pleurisy/", "start_index": 3408, "chroma:document": "Staphylococcus aureus (MRSA) can cause pleurisy, especially in hospital patients. MRSA is a type of bacteria with a resistance to a number of commonly used antibiotics. In rarer cases, pleurisy can be caused by conditions such as a blood clot or lung cancer. Source: Scottish Government - Opens in new browser window Last updated: 12 December 2024 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Don\u2019t include personal information e.g. name, location or any personal health conditions. Email Address e.g. you@example.com Message Maximum of 500 characters Send feedback Add this page to Info For Me Also on NHS inform Chest infection Flu Pneumonia NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats \u00a9 2025 NHS 24 \u2013 v1.1.1.17852"}


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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/lungs-and-airways/pneumonia/", "start_index": 0, "chroma:document": "Pneumonia | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotland\u2019s Service Directory 0 Home Illnesses and conditions Lungs and airways Pneumonia Pneumonia Pneumonia is inflammation of the lung tissue. It\u2019s usually caused by a bacterial infection. There are clusters of tiny air sacs in your lungs. If you have pneumonia, these tiny sacs become inflamed and fill up with fluid. The symptoms of pneumonia can develop suddenly over 24 to 48 hours, or they may come on more slowly over several days. Pneumonia is more widespread in autumn and winter. When to get medical advice Phone 999 or go to A&E if: you have severe difficulty breathing \u2013 for example, you struggle to speak without pausing, gasping or choking you have severe chest pain in the middle of your chest that isn\u2019t going away \u2013 it may feel like pressure, tightness or squeezing you have pain that spreads to your arms, back, neck and jaw you feel more"}


created_at: 2025-05-10 06:05:38
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/lungs-and-airways/pneumonia/", "start_index": 847, "chroma:document": "that isn\u2019t going away \u2013 it may feel like pressure, tightness or squeezing you have pain that spreads to your arms, back, neck and jaw you feel more drowsy than usual or find it more difficult to wake up your lips or skin are turning very pale, blue or grey \u2013 on brown or black skin this is easier to see on the palms of your hands Contact your GP practice urgently if you: are more short of breath than usual have pain when breathing in or coughing are feeling confused, dizzy, or lightheaded feel sick or are being sick \u2013 for example, you can\u2019t keep food or fluids down are coughing up blood (haemoptysis) have heart palpitations \u2013 this may feel like your heart is racing, going too slowly or skipping a beat or like a fluttering feeling in your chest are peeing less than usual \u2013 this can be a sign of dehydration have a very high or low temperature \u2013 for example, you feel either hot or cold to touch or you\u2019re shivering If your GP practice is closed, phone 111. Speak to your GP practice if: you"}


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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/lungs-and-airways/pneumonia/", "start_index": 1699, "chroma:document": "\u2013 for example, you feel either hot or cold to touch or you\u2019re shivering If your GP practice is closed, phone 111. Speak to your GP practice if: you have breathlessness which is not improving you have had a cough for more than 3 weeks your symptoms are not improving or they are affecting your daily life Diagnosing pneumonia Your GP may be able to diagnose pneumonia by asking about your symptoms and examining your chest. Further tests may be needed in some cases. Pneumonia can be difficult to diagnose because it has similar symptoms to other conditions. For example the common cold, bronchitis and asthma. To help make a diagnosis, your GP may ask you: whether you feel breathless if you\u2019re breathing faster than usual how long you\u2019ve had your cough whether you\u2019re coughing up mucus and if so, what colour it is if the pain in your chest is worse when you breathe in or out Your GP may also take your temperature and listen to your chest and back with a stethoscope to check for any crackling or"}


created_at: 2025-05-10 06:05:39
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/lungs-and-airways/pneumonia/", "start_index": 2550, "chroma:document": "when you breathe in or out Your GP may also take your temperature and listen to your chest and back with a stethoscope to check for any crackling or rattling sounds. They may also listen to your chest by tapping it. Lungs filled with fluid produce a different sound from normal healthy lungs. If you have mild pneumonia, you may need a chest X-ray and some blood tests. You will not need a sputum sample unless you have recurrent infections, or persistent infections that don\u2019t respond to treatments. Treatment for pneumonia Mild pneumonia can usually be treated at home. Pneumonia isn\u2019t usually passed from one person to another. So it\u2019s safe to be around others, including family members. But people with a weakened immune system should avoid close contact with a person with pneumonia until they start to get better. Things you can do to help your symptoms Do get plenty of rest take antibiotics if prescribed them \u2013 always finish the course, even if you feel better, unless you\u2019re told otherwise"}


created_at: 2025-05-10 06:05:39
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/lungs-and-airways/pneumonia/", "start_index": 3401, "chroma:document": "symptoms Do get plenty of rest take antibiotics if prescribed them \u2013 always finish the course, even if you feel better, unless you\u2019re told otherwise by a healthcare professional drink plenty of fluids take pain relief such as paracetamol if needed \u2013 always follow the manufacturer\u2019s instructions Cough medicines aren\u2019t recommended. A warm honey and lemon drink can help relieve discomfort caused by coughing. If you smoke, it\u2019s more important than ever to stop, as smoking damages your lungs. Full recovery from pneumonia can take up to 3 months. Speak to your GP if your symptoms don\u2019t improve within 3 days of starting antibiotics. Treatment in hospital You may need treatment in hospital if your symptoms are severe. You may be given antibiotics and fluids intravenously through a drip, and you may need oxygen if your blood oxygen levels are low. In very serious cases of pneumonia, breathing assistance through a ventilator in a high dependency unit (HDU) or an intensive care unit (ICU) may be"}


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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/lungs-and-airways/pneumonia/", "start_index": 4252, "chroma:document": "In very serious cases of pneumonia, breathing assistance through a ventilator in a high dependency unit (HDU) or an intensive care unit (ICU) may be required. Follow-up Your GP may arrange a follow-up appointment for you. In some cases, they may arrange follow-up tests if: your symptoms haven\u2019t improved your symptoms have come back you smoke you\u2019re over the age of 50 Some people may be advised to have a flu vaccination or pneumococcal vaccination after recovering. What causes pneumonia? Pneumonia is commonly the result of pneumococcal infection. A bacteria called Streptococcus pneumoniae causes pneumococcal infection. Other causes of pneumonia are: other types of bacteria including Haemophilus influenzae and Staphylococcus aureus viruses fungi (rarely) As well as bacterial pneumonia, other types include: viral pneumonia \u2013 viruses including the respiratory syncytial virus (RSV), coronavirus (COVID-19) and sometimes influenza type A or B; viruses are a common cause of pneumonia in young"}


created_at: 2025-05-10 06:05:39
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/lungs-and-airways/pneumonia/", "start_index": 5104, "chroma:document": "the respiratory syncytial virus (RSV), coronavirus (COVID-19) and sometimes influenza type A or B; viruses are a common cause of pneumonia in young children aspiration pneumonia \u2013 caused by breathing in vomit, a foreign object, such as a peanut, or a harmful substance, such as smoke or a chemical fungal pneumonia \u2013 rare in the UK and more likely to affect people with a weakened immune system hospital-acquired pneumonia \u2013 pneumonia that develops in hospital while being treated for another condition or having an operation; people in intensive care on breathing machines are particularly at risk of developing ventilator-associated pneumonia Who\u2019s most at risk of pneumonia? Pneumonia can affect people of any age. It\u2019s more common \u2013 and can be more serious \u2013 in certain groups of people. People in these risk groups are more likely to need hospital treatment. The groups with an increased risk of developing pneumonia are: babies and very young children elderly people people who smoke people"}


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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/lungs-and-airways/pneumonia/", "start_index": 5957, "chroma:document": "treatment. The groups with an increased risk of developing pneumonia are: babies and very young children elderly people people who smoke people with other health conditions, such as asthma, cystic fibrosis, or a heart, kidney or liver condition people with a weakened immune system Source: Scottish Government - Opens in new browser window Last updated: 18 February 2025 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Don\u2019t include personal information e.g. name, location or any personal health conditions. Email Address e.g. you@example.com Message Maximum of 500 characters Send feedback Add this page to Info For Me Also on NHS inform Antibiotics Chest infection Pleurisy Quit Your Way Scotland Shortness of breath NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and"}


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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/lungs-and-airways/pneumonia/", "start_index": 6806, "chroma:document": "about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats \u00a9 2025 NHS 24 \u2013 v1.1.1.17852"}


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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/infections-and-poisoning/polio/", "start_index": 0, "chroma:document": "Polio | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotland\u2019s Service Directory 0 Home Illnesses and conditions Infections and poisoning Polio Polio Polio is a serious viral infection that used to be common in the UK and worldwide. It\u2019s rare nowadays because it can be prevented with vaccination. Most people with polio don\u2019t have any symptoms and won\u2019t know they\u2019re infected. But for up to 1 in 100 people, the polio virus causes temporary or permanent paralysis, which can be life threatening. Cases of polio in the UK fell dramatically when routine vaccination was introduced in the mid-1950s. There hasn\u2019t been a case of polio caught in the UK since the mid-90s. But the infection is still found in some parts of the world, and there remains a very small risk it could be brought back to the UK. There\u2019s no cure for polio, so it\u2019s important to make sure that you and your children are fully vaccinated against it."}


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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/infections-and-poisoning/polio/", "start_index": 855, "chroma:document": "be brought back to the UK. There\u2019s no cure for polio, so it\u2019s important to make sure that you and your children are fully vaccinated against it. Symptoms of polio About 95% of people with polio won\u2019t have any symptoms and will fight off the infection without even realising they were infected. A small number of people will experience a flu-like illness 3 to 21 days after they\u2019re infected. Symptoms can include: a high temperature (fever) of 38C (100.4F) or above a sore throat a headache abdominal (tummy) pain aching muscles feeling and being sick These symptoms will usually pass within about a week. In less than 1% of cases, the polio virus attacks the nerves in the spine and base of the brain. This can cause paralysis, usually in the legs, that develops over hours or days. The paralysis isn\u2019t usually permanent, and movement will often slowly return over the next few weeks and months. But some people are left with persistent problems. If the breathing muscles are affected, it can be"}


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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/infections-and-poisoning/polio/", "start_index": 1701, "chroma:document": "slowly return over the next few weeks and months. But some people are left with persistent problems. If the breathing muscles are affected, it can be life threatening. Long-term problems caused by polio Although polio often passes quickly without causing any other problems, it can sometimes lead to persistent or lifelong difficulties. About 1 in every 200 people with the infection will have some degree of permanent paralysis, and others may be left with problems that require long-term treatment and support. These can include: muscle weakness shrinking of the muscles (atrophy) tight joints (contractures) deformities, such as twisted feet or legs There\u2019s also a chance that someone who\u2019s had polio in the past will develop similar symptoms again, or worsening of their existing symptoms, many decades later. This is known as post-polio syndrome. How do you get polio? You can become infected with the polio virus if you come into contact with the poo (faeces) of someone with the infection, or"}


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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/infections-and-poisoning/polio/", "start_index": 2553, "chroma:document": "How do you get polio? You can become infected with the polio virus if you come into contact with the poo (faeces) of someone with the infection, or with the droplets launched into the air when they cough or sneeze. You can also get the infection from food or water that\u2019s been contaminated with infected poo or droplets. If the virus gets into your mouth, it travels to your throat and bowels, where it starts to multiply. In some cases, it can also get into the bloodstream and spread to the nervous system. The virus can be spread by someone with the infection from about a week before any symptoms develop, until several weeks afterwards. Infected people who don\u2019t have any symptoms can still pass polio on to others. There have been rare cases where polio has been caused by being vaccinated with a live version of the polio virus. This is no longer a risk in the UK because the vaccine used nowadays contains an inactive version of the virus. Where is polio found? As a result of routine"}


created_at: 2025-05-10 06:05:39
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/infections-and-poisoning/polio/", "start_index": 3397, "chroma:document": "no longer a risk in the UK because the vaccine used nowadays contains an inactive version of the virus. Where is polio found? As a result of routine vaccination programmes, polio has been largely wiped out in most parts of the world. Areas declared polio-free by the World Health Organization (WHO) include Europe, the Americas, the western Pacific region and, most recently, southeast Asia. But polio is found in some places. It\u2019s still a significant problem in Afghanistan, Nigeria and Pakistan, and there\u2019s a potential risk of infection in other parts of Africa and some Middle Eastern countries. You can use the Travel Health Pro website to check if there\u2019s a risk of getting polio in a country you plan to visit. Use the website\u2019s country guide for further information. Treating polio There\u2019s currently no cure for polio. Treatment focuses on supporting bodily functions and reducing the risk of long-term problems while the body fights off the infection. This can include bed rest in hospital,"}


created_at: 2025-05-10 06:05:39
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/infections-and-poisoning/polio/", "start_index": 4256, "chroma:document": "bodily functions and reducing the risk of long-term problems while the body fights off the infection. This can include bed rest in hospital, painkillers, breathing support and regular stretches or exercises to prevent problems with the muscles and joints. If you\u2019re left with long-term problems as a result of a polio infection, you\u2019ll probably need ongoing treatment and support. This may include physiotherapy to help with any movement problems, devices such as splints and braces to support weak limbs or joints, occupational therapy to help you adapt to any difficulties, and possibly surgery to correct any deformities. Polio immunisation The polio vaccine is offered as part of the NHS routine childhood immunisation programme. It\u2019s given in 5 separate doses: at 8, 12 and 16 weeks of age \u2013 as part of the 6-in-1 (DTaP/IPV/Hib/HepB) vaccine at 3 years and 4 months of age \u2013 as part of the 4-in-1 (DTaP/IPV) pre-school booster between 13 and 18 years of age \u2013 as part of the 3-in-1 (Td/IPV)"}


created_at: 2025-05-10 06:05:39
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/infections-and-poisoning/polio/", "start_index": 5103, "chroma:document": "at 3 years and 4 months of age \u2013 as part of the 4-in-1 (DTaP/IPV) pre-school booster between 13 and 18 years of age \u2013 as part of the 3-in-1 (Td/IPV) teenage booster If you\u2019re planning to travel to a polio-affected country, you should get immunised if you\u2019ve not been fully immunised before, or have a booster dose if it\u2019s been 10 years or more since your last dose of the vaccine. Read more about travel immunisations What to do if you haven\u2019t had a polio vaccine You can also get immunised at any point if you haven\u2019t been fully immunised before, even if you\u2019re not travelling somewhere where there\u2019s a risk of infection. If you\u2019ve had polio in the past and haven\u2019t been immunised, it\u2019s still recommended that you get fully immunised. There are 3 types of polio virus that the vaccine protects against, and people who have had the infection before will only be immune to one of these. The polio immunisation is routinely offered for free on the NHS. What are the travel precautions for polio? As"}


created_at: 2025-05-10 06:05:40
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/infections-and-poisoning/polio/", "start_index": 5952, "chroma:document": "will only be immune to one of these. The polio immunisation is routinely offered for free on the NHS. What are the travel precautions for polio? As the result of an increase in worldwide cases of polio in early 2014, the WHO issued temporary additional travel recommendations for people visiting countries where polio is found. Depending on where you intend to travel, what you\u2019ll be doing there and how long you\u2019re staying for, you may now be advised to have a booster polio immunisation before travelling if you haven\u2019t had one in the past 12 months. Some of the countries where there\u2019s risk of infection will require proof of immunisation before you\u2019re permitted to travel elsewhere. If you don\u2019t have this, you may be given a booster dose before departing. Source: NHS 24 - Opens in new browser window Last updated: 15 June 2023 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Don\u2019t include personal information e.g. name, location or any"}


created_at: 2025-05-10 06:05:40
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/infections-and-poisoning/polio/", "start_index": 6796, "chroma:document": "improve this page? Help us improve NHS inform Thank You Your feedback has been received Don\u2019t include personal information e.g. name, location or any personal health conditions. Email Address e.g. you@example.com Message Maximum of 500 characters Send feedback Add this page to Info For Me Also on NHS inform The 6-in-1 vaccine The 4-in-1 vaccine Td/IPV vaccine NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats \u00a9 2025 NHS 24 \u2013 v1.1.1.17852"}


created_at: 2025-05-10 06:05:40
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{"source": "https://www.nhsinform.scot/healthy-living/womens-health/girls-and-young-women-puberty-to-around-25/periods-and-menstrual-health/polycystic-ovary-syndrome-pcos/", "start_index": 0, "chroma:document": "Polycystic ovary syndrome (PCOS) | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotland\u2019s Service Directory 0 Home Healthy living Women's health Girls and young women (puberty to around 25) Periods and menstrual health Polycystic ovary syndrome (PCOS) Polycystic ovary syndrome (PCOS) \u0627\u0644\u0639\u0631\u0628\u064a\u0629 | \u7b80\u4f53\u4e2d\u6587 | Polski | \u0a2a\u0a70\u0a1c\u0a3e\u0a2c\u0a40 | \u0627\u0631\u062f\u0648 | Easy Read Return to Symptoms Enter age Last Updated: Next Review Date: Review my answers Find your local services Search for a service near you by entering your postcode below. Please input your postcode in the following format: A12 1BC GP Practices Dental Services Pharmacies Opticians Postcode Search NHS inform has more information on this condition. Read more Previous Start guide Review my answers \u00d7 You told us your credentials were: : You said: Based on the information you gave us, we made the following recommendation: Close Keep a copy View PDF Polycystic ovary syndrome (PCOS) is a"}


created_at: 2025-05-10 06:05:40
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
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{"source": "https://www.nhsinform.scot/healthy-living/womens-health/girls-and-young-women-puberty-to-around-25/periods-and-menstrual-health/polycystic-ovary-syndrome-pcos/", "start_index": 854, "chroma:document": "said: Based on the information you gave us, we made the following recommendation: Close Keep a copy View PDF Polycystic ovary syndrome (PCOS) is a condition that affects how your ovaries work. Despite the name, there are no cysts on the ovaries. During ovulation, an egg is released once a month. PCOS can have an impact on this and cause irregular ovulation, or no ovulation at all. If you want to have a family, PCOS can make it difficult to get pregnant. PCOS can also affect your metabolism (the chemical reactions in the body\u2019s cells that change food into energy) making it easier to gain weight and more difficult to lose weight. Symptoms You are born with PCOS, but symptoms often start during puberty although for some people this can be later, up to their early twenties. There are lots of different symptoms that can be caused by PCOS. The main symptoms are: irregular periods \u2013 you should have at least 3 or 4 periods a year to keep the womb healthy if you\u2019re not using hormonal"}


created_at: 2025-05-10 06:05:40
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
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{"source": "https://www.nhsinform.scot/healthy-living/womens-health/girls-and-young-women-puberty-to-around-25/periods-and-menstrual-health/polycystic-ovary-syndrome-pcos/", "start_index": 1694, "chroma:document": "PCOS. The main symptoms are: irregular periods \u2013 you should have at least 3 or 4 periods a year to keep the womb healthy if you\u2019re not using hormonal contraception excess facial or body hair which is caused by slightly higher levels of \u2018male\u2019 hormones in your body (androgen) Other symptoms can include: weight gain hair loss or hair thinning oily skin or acne difficulty or delays getting pregnant People who have PCOS can also struggle with depression and with their mental health as a result of the condition. PCOS can increase your risk of certain health conditions, including type 2 diabetes and high cholesterol. You should speak to your doctor if you are experiencing these symptoms and you are not pregnant or on hormone treatment. Symptom questionnaire You can use our menstrual health symptom questionnaire (PDF, 421KB) to keep a note of your symptoms and how you\u2019re feeling. You can print it and talk about it with your healthcare professional to help them understand the different"}


created_at: 2025-05-10 06:05:40
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
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{"source": "https://www.nhsinform.scot/healthy-living/womens-health/girls-and-young-women-puberty-to-around-25/periods-and-menstrual-health/polycystic-ovary-syndrome-pcos/", "start_index": 2539, "chroma:document": "of your symptoms and how you\u2019re feeling. You can print it and talk about it with your healthcare professional to help them understand the different symptoms you\u2019re experiencing. Complete the symptom questionnaire Causes The exact cause of PCOS isn\u2019t known but it\u2019s thought to be caused by a hormone and metabolic (the chemical reactions in the body\u2019s cells that change food into energy) imbalance in the body. PCOS can run in families so if someone in your family has the condition, it\u2019s more likely you may have it too. You should let your doctor know if this is the case for you. People with PCOS have a higher risk of developing health problems in later life, such as type 2 diabetes and high cholesterol levels, as PCOS can make it easier to gain weight and more difficult to lose weight. Diagnosis Your doctor will talk to you about your symptoms to help rule out any other health conditions. It can be helpful to keep a note of your period dates and symptoms using a calendar, a diary or an"}


created_at: 2025-05-10 06:05:40
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
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{"source": "https://www.nhsinform.scot/healthy-living/womens-health/girls-and-young-women-puberty-to-around-25/periods-and-menstrual-health/polycystic-ovary-syndrome-pcos/", "start_index": 3391, "chroma:document": "to help rule out any other health conditions. It can be helpful to keep a note of your period dates and symptoms using a calendar, a diary or an app. This can help you track how the symptoms are affecting your life, and will give your doctor more of an insight. Your doctor might recommend you have some hormone and/or blood tests, to rule out any other hormone-related conditions. You might also need to have an ultrasound scan, as this will help them to diagnose PCOS. If you\u2019re diagnosed with PCOS, you may be referred to a specialist. Treatment Treatment can vary depending on your symptoms. Although there\u2019s no cure, there are lots of treatment options available to help manage your symptoms. Treatments can also help prevent complications and, if you want to have a family, improve your chances of getting pregnant. If you don\u2019t want to become pregnant you should still use contraception as you may still ovulate sometimes. Your doctor can discuss the options so that you can decide what\u2019s"}


created_at: 2025-05-10 06:05:40
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
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{"source": "https://www.nhsinform.scot/healthy-living/womens-health/girls-and-young-women-puberty-to-around-25/periods-and-menstrual-health/polycystic-ovary-syndrome-pcos/", "start_index": 4241, "chroma:document": "pregnant you should still use contraception as you may still ovulate sometimes. Your doctor can discuss the options so that you can decide what\u2019s best for you, and you can ask any questions that you might have. Having a healthy diet and exercising regularly can significantly help your PCOS symptoms. It can also reduce your chances of developing other health conditions, including type 2 diabetes and high cholesterol. You should try to: eat lots of fruit and vegetables eat more fibre drink plenty of water eat oily fish reduce meat and dairy products avoid sugary food and drink avoid or limit alcohol going for regular walks keeping active, in particular aerobic exercise If you\u2019re struggling with managing your symptoms, your doctor can provide further support. Source: Scottish Government - Opens in new browser window Last updated: 30 May 2023 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Don\u2019t include personal information e.g. name,"}


created_at: 2025-05-10 06:05:40
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{"source": "https://www.nhsinform.scot/healthy-living/womens-health/girls-and-young-women-puberty-to-around-25/periods-and-menstrual-health/polycystic-ovary-syndrome-pcos/", "start_index": 5087, "chroma:document": "2023 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Don\u2019t include personal information e.g. name, location or any personal health conditions. Email Address e.g. you@example.com Message Maximum of 500 characters Send feedback Other languages and formats \u0627\u0644\u0639\u0631\u0628\u064a\u0629 | \u7b80\u4f53\u4e2d\u6587 | Polski | \u0a2a\u0a70\u0a1c\u0a3e\u0a2c\u0a40 | \u0627\u0631\u062f\u0648 | Easy Read \u0627\u0644\u0639\u0631\u0628\u064a\u0629 | \u7b80\u4f53\u4e2d\u6587 | Polski | \u0a2a\u0a70\u0a1c\u0a3e\u0a2c\u0a40 | \u0627\u0631\u062f\u0648 | Easy Read Add this page to Info For Me Also on NHS inform Type 2 diabetes High cholesterol Food and nutrition Keeping active Self-help tool: Periods and mental wellbeing Other health sites Verity UK British Fibroid Trust PCOS Relief PCOS Relief: video Wellbeing of Women: Period Symptom Checker NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats \u00a9 2025 NHS 24 \u2013 v1.1.1.17852"}


created_at: 2025-05-10 06:05:40
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/muscle-bone-and-joints/conditions-that-can-affect-multiple-parts-of-the-body/polymyalgia-rheumatica/", "start_index": 0, "chroma:document": "Polymyalgia rheumatica | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotland\u2019s Service Directory 0 Home Illnesses and conditions Muscle, bone and joints Conditions that can affect multiple parts of the body Polymyalgia rheumatica Polymyalgia rheumatica Polymyalgia rheumatica is a condition that causes pain, stiffness and inflammation. This is mostly around the shoulders, neck and hips. Symptoms of polymyalgia rheumatica Polymyalgia rheumatica often causes pain and stiffness. This can affect the shoulders, neck and hips. These symptoms can develop quickly over a few days or weeks. Both sides of the body are usually affected. The stiffness often feels worse first thing in the morning after you wake up. It usually starts to improve after about 45 minutes as you become more active. Polymyalgia rheumatica may also cause: high temperature (fever) and sweating extreme tiredness (fatigue) loss of appetite weight"}


created_at: 2025-05-10 06:05:40
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/muscle-bone-and-joints/conditions-that-can-affect-multiple-parts-of-the-body/polymyalgia-rheumatica/", "start_index": 851, "chroma:document": "become more active. Polymyalgia rheumatica may also cause: high temperature (fever) and sweating extreme tiredness (fatigue) loss of appetite weight loss depression Speak to your GP practice urgently or phone 111 if: You have been diagnosed with polymyalgia rheumatic and you suddenly develop: a persistent and severe headache jaw pain or cramping in your jaw muscles which is worse when you\u2019re eating pain in your tongue when chewing If you have been diagnosed with polymyalgia rheumatica and you suddenly develop vision loss or changes in your vision, like double vision, contact an optician immediately or phone 111. Diagnosing polymyalgia rheumatica It can take a long time to diagnose polymyalgia rheumatica. You may need different tests to help diagnose it. This is because it shares symptoms with other health conditions that need to be ruled out first. There\u2019s no specific test for polymyalgia rheumatic. But you should have blood tests to look for things like signs of inflammation before"}


created_at: 2025-05-10 06:05:40
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/muscle-bone-and-joints/conditions-that-can-affect-multiple-parts-of-the-body/polymyalgia-rheumatica/", "start_index": 1701, "chroma:document": "out first. There\u2019s no specific test for polymyalgia rheumatic. But you should have blood tests to look for things like signs of inflammation before starting any corticosteroid treatment. An X-ray or ultrasound scan may also be used to look at the condition of your bones and joints. Causes of polymyalgia rheumatica The cause of polymyalgia rheumatica is unknown. But, genetic and environmental factors can influence it. Polymyalgia rheumatica is also age-related. Most people who are diagnosed with the condition are over 70. It\u2019s very rare in people younger than 50. Polymyalgia rheumatic is more common in women than men. Treatment for polymyalgia rheumatica The main treatment for polymyalgia rheumatica is a corticosteroid medication called prednisolone. This comes as a pill that\u2019s prescribed by your GP. Prednisolone blocks certain chemicals that cause inflammation in the body. You\u2019ll be prescribed a higher dose of prednisolone at first. This will be slowly reduced over time. This is"}


created_at: 2025-05-10 06:05:40
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/muscle-bone-and-joints/conditions-that-can-affect-multiple-parts-of-the-body/polymyalgia-rheumatica/", "start_index": 2550, "chroma:document": "that cause inflammation in the body. You\u2019ll be prescribed a higher dose of prednisolone at first. This will be slowly reduced over time. This is likely to be over a year. Other medications Sometimes you may be prescribed other medicines with corticosteroids. This can help to prevent relapses or it may allow your dose of prednisolone to be reduced. Additional medicines are usually added by rheumatology doctors. They include a weekly dose of methotrexate or a daily dose of leflunomide. Painkillers may also be recommended. These can be helpful if you also have arthritis or chronic pain. There are side effects linked to taking steroids long-term. This means your healthcare professional may also prescribe medication to protect your bones. For example, calcium and vitamin D supplements and bisphosphonates. You may also be prescribed proton pump inhibitors (PPIs) to protect your stomach. Living with polymyalgia rheumatica If you have been diagnosed with polymyalgia rheumatica, you will need"}


created_at: 2025-05-10 06:05:41
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/muscle-bone-and-joints/conditions-that-can-affect-multiple-parts-of-the-body/polymyalgia-rheumatica/", "start_index": 3401, "chroma:document": "inhibitors (PPIs) to protect your stomach. Living with polymyalgia rheumatica If you have been diagnosed with polymyalgia rheumatica, you will need to have regular appointments at your GP practice. They will check: how well you\u2019re responding to treatment whether your dose of prednisolone needs to be adjusted how well you\u2019re coping with the side effects of the medication You will also have blood tests at these appointments. You will usually have a follow-up appointment within a week of starting your steroid treatment. This is to check how you are responding to them. You\u2019ll then have checks regularly to make sure the inflammation levels in your blood are normal while the steroids are being gradually reduced. You should speak to your GP practice if your symptoms return during any part of your treatment. This is because the dosage of your medication may need to be adjusted. Your GP may refer you to a rheumatologist. Further information and support You can find other sources of information"}


created_at: 2025-05-10 06:05:41
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/muscle-bone-and-joints/conditions-that-can-affect-multiple-parts-of-the-body/polymyalgia-rheumatica/", "start_index": 4259, "chroma:document": "may need to be adjusted. Your GP may refer you to a rheumatologist. Further information and support You can find other sources of information and support with polymyalgia rheumatica at: PMR-GCA Scotland Versus Arthritis Royal Osteoporosis Society Source: Scottish Society for Rheumatology - Opens in new browser window Last updated: 07 February 2025 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Don\u2019t include personal information e.g. name, location or any personal health conditions. Email Address e.g. you@example.com Message Maximum of 500 characters Send feedback Add this page to Info For Me Also on NHS inform Corticosteroids Other health sites Versus Arthritis: PMR NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats \u00a9 2025 NHS 24 \u2013 v1.1.1.17852"}


created_at: 2025-05-10 06:05:41
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/injuries/head-and-neck-injuries/post-concussion-syndrome-pcs/", "start_index": 0, "chroma:document": "Post-concussion syndrome | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotland\u2019s Service Directory 0 Home Illnesses and conditions Injuries Head and neck injuries Post-concussion syndrome Post-concussion syndrome Post-concussion syndrome (PCS) describes a set of symptoms that sometimes happen after a concussion. They can last for several weeks or months. The exact cause of PCS is not known. One theory is that PCS is the result of a chemical imbalance in the brain. This imbalance is triggered by the injury that caused the initial concussion. Another theory suggests PCS may be caused by damage to nerve cells in the brain. Symptoms of post-concussion syndrome The symptoms of PCS can be physical, psychological or cognitive (affecting your ability to think). You may have more than one type of symptom at a time, but are unlikely to have them all. Physical symptoms persistent headaches that can be mild or"}


created_at: 2025-05-10 06:05:41
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/injuries/head-and-neck-injuries/post-concussion-syndrome-pcs/", "start_index": 846, "chroma:document": "You may have more than one type of symptom at a time, but are unlikely to have them all. Physical symptoms persistent headaches that can be mild or severe, but last a long time dizziness nausea (feeling sick) sensitivity to bright lights sensitivity to loud noises tinnitus (ringing in the ears) double or blurred vision fatigue (tiredness) changed or reduced sense of smell and taste Psychological symptoms depression anxiety irritability lack of energy loss of interest in activities you normally enjoy problems sleeping changes in appetite sudden outbursts of emotion, like crying for no clear reason Cognitive symptoms decreased concentration forgetfulness difficulty remembering things or learning new information difficulties with reasoning (working out problems) Your symptoms may make it difficult to work and look after yourself. Diagnosing post-concussion syndrome PCS does not show on any scans or blood tests. This means that your healthcare professional will diagnose PCS using: your"}


created_at: 2025-05-10 06:05:41
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/injuries/head-and-neck-injuries/post-concussion-syndrome-pcs/", "start_index": 1696, "chroma:document": "post-concussion syndrome PCS does not show on any scans or blood tests. This means that your healthcare professional will diagnose PCS using: your medical history (that you\u2019ve experienced a recent head injury) the types symptoms you\u2019re experiencing when your symptoms began (before or after a head injury) Managing post-concussion syndrome There\u2019s no specific treatment that cures PCS. But there are a lot of strategies that can help. For most patients the symptoms gradually improve over time. Pacing strategies are often used to help manage PCS. These are strategies that allow you to gradually increase your activities. They can help you return to work and leisure activities. Some activities can make PCS symptoms worse. You should avoid overstimulating activities that make your symptoms worse. These might include: late nights alcohol crowded rooms conversations with multiple people at once vigorous exercises prolonged screen time You may be prescribed antidepressants or anti-migraine"}


created_at: 2025-05-10 06:05:41
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/injuries/head-and-neck-injuries/post-concussion-syndrome-pcs/", "start_index": 2545, "chroma:document": "rooms conversations with multiple people at once vigorous exercises prolonged screen time You may be prescribed antidepressants or anti-migraine medication. This doesn\u2019t mean your healthcare professional thinks you\u2019re depressed or experiencing migraines. These medicines work by reducing abnormal nerve activity in the brain. This means they can help with the physical symptoms of PCS. If you\u2019re experiencing psychological symptoms, antidepressants can also help with this. Your healthcare professional may also suggest talking treatments (like psychological therapy). Last updated: 15 January 2025 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Don\u2019t include personal information e.g. name, location or any personal health conditions. Email Address e.g. you@example.com Message Maximum of 500 characters Send feedback Add this page to Info For Me Also on NHS inform Concussion Minor head injury Severe head injury Other health sites"}


created_at: 2025-05-10 06:05:41
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/injuries/head-and-neck-injuries/post-concussion-syndrome-pcs/", "start_index": 3384, "chroma:document": "of 500 characters Send feedback Add this page to Info For Me Also on NHS inform Concussion Minor head injury Severe head injury Other health sites Neurosymptoms: post-concussion syndrome Sport Scotland: sports concussion guidance Headway: post-concussion syndrome NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats \u00a9 2025 NHS 24 \u2013 v1.1.1.17852"}


created_at: 2025-05-10 06:05:41
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/brain-nerves-and-spinal-cord/post-polio-syndrome/", "start_index": 0, "chroma:document": "Post-polio syndrome | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotland\u2019s Service Directory 0 Home Illnesses and conditions Brain, nerves and spinal cord Post-polio syndrome Post-polio syndrome Post-polio syndrome is a slow progressive condition that affects some people that have had polio. It\u2019s not life threatening but it can cause problems in your ability to carry out daily activities. Polio is a serious viral infection that used to be common in the UK and worldwide. It\u2019s rarer now because it can be prevented with vaccination. In around 1 in 100 people, the polio virus causes paralysis, which in rare cases can be life threatening. Cases of polio in the UK fell dramatically when routine vaccination was introduced in the mid-1950s. Symptoms of post-polio syndrome The symptoms of post-polio syndrome include: muscle weakness shrinking of the muscles (atrophy) tight joints (contractures) pain in muscles or"}


created_at: 2025-05-10 06:05:41
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/brain-nerves-and-spinal-cord/post-polio-syndrome/", "start_index": 858, "chroma:document": "The symptoms of post-polio syndrome include: muscle weakness shrinking of the muscles (atrophy) tight joints (contractures) pain in muscles or joints chronic fatigue including physical tiredness and brain fatigue swallowing and speech problems respiratory problems like breathlessness and sleep apnoea cramps and muscle twitching being sensitive to cold temperatures The muscle weakness and atrophy usually affects muscles that were previously affected by polio. Sometimes it affects other muscles. This can impact your mobility and your ability to do everyday tasks like brushing your teeth or drying your hair. Chronic fatigue is one of the most common and troublesome symptoms of post-polio syndrome. This can be physical fatigue (tiredness) and brain fatigue. Brain fatigue can cause problems with concentration, attention and memory. MRI scans can show white spots in the brains of polio survivors which may be related to brain fatigue. The symptoms can gradually get worse over many years."}


created_at: 2025-05-10 06:05:41
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/brain-nerves-and-spinal-cord/post-polio-syndrome/", "start_index": 1707, "chroma:document": "can show white spots in the brains of polio survivors which may be related to brain fatigue. The symptoms can gradually get worse over many years. There are supportive treatments that can help with symptoms. Although post-polio syndrome is rarely life threatening, some people can develop breathing and swallowing difficulties that can lead to serious problems like chest infections. Some people experience a sensitivity to some types of anaesthesia causing them to take longer to recover from having anaesthesia. Causes of post-polio syndrome Post-polio syndrome is caused by the polio virus. It only affects people who\u2019ve had polio although it can take 15 \u2013 40 years after the infection for it to develop. It\u2019s not known if there\u2019s anything that can be done to prevent it. The exact cause behind who\u2019ll experience post-polio syndrome after having the polio virus is unclear. It could be because of gradual degeneration (breaking down) of nerve cells (motor neurones) in the brainstem or spinal"}


created_at: 2025-05-10 06:05:41
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/brain-nerves-and-spinal-cord/post-polio-syndrome/", "start_index": 2556, "chroma:document": "the polio virus is unclear. It could be because of gradual degeneration (breaking down) of nerve cells (motor neurones) in the brainstem or spinal cord that were damaged by the polio virus. This gradual change explains why it can take years for post-polio syndrome symptoms to appear. During recovery from polio, surviving motor neurone cells grow new nerve ends to connect with other muscle fibres. This helps to regain muscle strength as someone recovers from the polio virus. Over time, these new nerve ends put the motor neurone cell under stress. The cells slowly break down, resulting in the loss of muscle strength. People who have had severe polio at a young age or during adolescence (teenage years) might be more likely to experience post-polio syndrome. People who had a more serious infection in early adulthood are also more likely to develop post-polio syndrome. Post-polio syndrome is not contagious. Diagnosis of post-polio syndrome It can be difficult to diagnose post-polio"}


created_at: 2025-05-10 06:05:41
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/brain-nerves-and-spinal-cord/post-polio-syndrome/", "start_index": 3401, "chroma:document": "to develop post-polio syndrome. Post-polio syndrome is not contagious. Diagnosis of post-polio syndrome It can be difficult to diagnose post-polio syndrome. There are no specific tests for it, and it can be mistaken for other conditions. Your GP might suspect post-polio syndrome if: you had polio followed by a long period of stable symptoms (usually 15 years) your symptoms have developed gradually The symptoms of post-polio syndrome are slow and progressive. The sudden appearance of symptoms is more likely to be caused by something else. A prolonged period of bed rest as a result of another illness or serious injury can trigger post-polio syndrome symptoms. There are some tests that can be done to rule out conditions with similar symptoms. You might be offered blood tests and scans of your spine. Other tests that might be offered include: electromyography (EMG) tests \u2013 these will measure the electrical activity in your nerves and muscles and detect damage that may have been caused by"}


created_at: 2025-05-10 06:05:41
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/brain-nerves-and-spinal-cord/post-polio-syndrome/", "start_index": 4252, "chroma:document": "electromyography (EMG) tests \u2013 these will measure the electrical activity in your nerves and muscles and detect damage that may have been caused by having polio sleep studies \u2013 if you\u2019re experiencing sleep apnoea or you\u2019re feeling unusually tired tests to check your heart function and heart rate a magnetic resonance imaging (MRI) scan or computerised tomography (CT) scan of your brain, spine and muscles lung function tests like a spirometry to measure your breathing test to investigate dysphagia (swallowing problems) Treatment of post-polio syndrome As there\u2019s no cure for post-polio syndrome, treatment will help you manage your symptoms and quality of life. It\u2019s likely you\u2019ll have a multidisciplinary team of healthcare professionals working together to care for you including: neurologists respiratory specialists physiotherapists orthotists psychologists pain management specialists occupational therapists They\u2019ll discuss the most suitable plan for your care which might include a"}


created_at: 2025-05-10 06:05:41
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/brain-nerves-and-spinal-cord/post-polio-syndrome/", "start_index": 5104, "chroma:document": "psychologists pain management specialists occupational therapists They\u2019ll discuss the most suitable plan for your care which might include a mixture of the following: Exercise and rest Exercise can help slow down the progressive muscle weakness that post-polio syndrome causes. However, being active can become difficult because your symptoms might become worse after exercise or activity. Any exercise should be pain free because too much exercise can cause more damage. You should pace yourself to avoid becoming exhausted from exercise. Your healthcare team might suggest you try using pacing techniques. This might involve: prioritising tasks finding different ways of doing tasks which prevent pain or exhaustion getting help from others to do particularly exhausting tasks taking regular breaks and having rest periods regularly throughout your day doing some regular gentle exercise that you can gradually build up and stopping before you become exhausted Pacing can help you prevent becoming"}


created_at: 2025-05-10 06:05:42
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/brain-nerves-and-spinal-cord/post-polio-syndrome/", "start_index": 5955, "chroma:document": "day doing some regular gentle exercise that you can gradually build up and stopping before you become exhausted Pacing can help you prevent becoming worn out. It can help to space out activities throughout the day to allow for rest periods where you can recover in between. Making effective and efficient use of your muscles and strength in this way can help them to last longer. Painkillers Medication to relieve pain might be used in addition to pacing techniques. Your healthcare team might suggest over the counter painkillers like aspirin, paracetamol or ibuprofen. Other stronger anti-inflammatory drugs and opiates might be considered too depending on individual needs. Talk to your GP if you\u2019re taking over the counter medicines as they shouldn\u2019t be used long term. They can cause complications like stomach ulcers if taken over a long period of time. Your healthcare team or GP might suggest medication like gabapentin or pregabalin for your pain if over the counter medications aren\u2019t"}


created_at: 2025-05-10 06:05:42
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/brain-nerves-and-spinal-cord/post-polio-syndrome/", "start_index": 6806, "chroma:document": "of time. Your healthcare team or GP might suggest medication like gabapentin or pregabalin for your pain if over the counter medications aren\u2019t working. When taking medication for your pain, you might not feel the damage being caused to your muscles and joints through too much activity. This means it\u2019s important you follow your pacing routine even when you don\u2019t feel tired or aren\u2019t in any pain. Mobility aids You might benefit from a mobility aid like: braces to support weakened muscles and joints, prevent falls and improve posture walking sticks to help you balance and prevent falls an electric scooter a wheelchair Your healthcare team will discuss the most suitable options for you depending on your needs. Many mobility aids are provided for free by the NHS. Treatment of breathing problems If you have breathing problems, you might benefit from treatment or lifestyle changes. Your breathing problems will be assessed to identify the cause. For example, your breathing problems might be"}


created_at: 2025-05-10 06:05:42
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/brain-nerves-and-spinal-cord/post-polio-syndrome/", "start_index": 7658, "chroma:document": "from treatment or lifestyle changes. Your breathing problems will be assessed to identify the cause. For example, your breathing problems might be caused by stiff ribs, scoliosis or weak respiratory muscles. Finding the cause will help to choose the correct treatment for you. You might be offered a machine to deliver pressurised air into your lungs through a mask during sleep. This is to help stop your airways closing if you have sleep apnoea. There are exercises you can do to increase the strength of your breathing muscles. A respiratory physiotherapist will help you to find suitable and safe exercises for you. Your healthcare team might suggest you have the pneumococcal vaccination, COVID-19 vaccines and annual flu jab. This is to reduce your risk of getting chest infections which can cause further complications. If you smoke, stopping smoking can help improve your breathing too. Healthy eating and weight control If you\u2019re overweight, you might be putting your weakened muscles under"}


created_at: 2025-05-10 06:05:42
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/brain-nerves-and-spinal-cord/post-polio-syndrome/", "start_index": 8508, "chroma:document": "smoking can help improve your breathing too. Healthy eating and weight control If you\u2019re overweight, you might be putting your weakened muscles under further pressure. This can cause problems with your energy levels and overall health. Losing weight (if you\u2019re overweight) can help improve your symptoms and general health. Your healthcare team can tell you about specific exercises suitable for you. Eating a healthy, balanced diet can help you reduce and control your weight. It\u2019ll also improve your general health. Following a plan that includes healthy foods that provide energy that\u2019s released slowly over time can help improve your symptoms. Read our Eatwell Guide: How to eat a healthy balanced diet Coping with psychological factors The symptoms of post-polio syndrome can be distressing. Developing post-polio syndrome after living with the polio virus as a child can cause anxiety, isolation and stress. This can lead to depression. Speak to your GP if you\u2019re feeling down and you no"}


created_at: 2025-05-10 06:05:42
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/brain-nerves-and-spinal-cord/post-polio-syndrome/", "start_index": 9354, "chroma:document": "the polio virus as a child can cause anxiety, isolation and stress. This can lead to depression. Speak to your GP if you\u2019re feeling down and you no longer enjoy things you used to. Source: Scottish Government - Opens in new browser window Last updated: 17 February 2025 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Don\u2019t include personal information e.g. name, location or any personal health conditions. Email Address e.g. you@example.com Message Maximum of 500 characters Send feedback Add this page to Info For Me Also on NHS inform Polio Coping with fatigue Anxiety self-help guide Depression self-help guide Other health sites Scottish Muscle Network Scottish Post-Polio Network Optimal Clinical Pathway: British Polio Fellowship NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other"}


created_at: 2025-05-10 06:05:42
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/brain-nerves-and-spinal-cord/post-polio-syndrome/", "start_index": 10207, "chroma:document": "Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats \u00a9 2025 NHS 24 \u2013 v1.1.1.17852"}


created_at: 2025-05-10 06:05:42
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/mental-health/post-traumatic-stress-disorder-ptsd/", "start_index": 0, "chroma:document": "Post-traumatic stress disorder (PTSD) | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotland\u2019s Service Directory 0 Home Illnesses and conditions Mental health Post-traumatic stress disorder (PTSD) Post-traumatic stress disorder (PTSD) Post-traumatic stress disorder (PTSD) is a mental health problem caused by traumatic events. PTSD can cause symptoms like problems sleeping, flashbacks and difficulty concentrating. This can have a big impact on your day-to-day life. What causes PTSD? There are many different traumatic events that can lead to PTSD. Some examples include: a serious road accident rape or sexual assault a mugging or robbery abuse, harassment or bullying, including racism, sexism or abuse targeting your identity kidnap or being held hostage an event where you fear for your life witnessing violence, including in military combat, a terrorist attack or violent assault seeing other people injured or"}


created_at: 2025-05-10 06:05:42
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/mental-health/post-traumatic-stress-disorder-ptsd/", "start_index": 851, "chroma:document": "where you fear for your life witnessing violence, including in military combat, a terrorist attack or violent assault seeing other people injured or killed natural disasters, like severe floods or earthquakes being diagnosed with a life-threatening condition an unexpected injury or death of someone you\u2019re close to doing a job where you see or hear traumatic things, for example in the armed forces or emergency services traumatic childbirth Symptoms of PTSD Everyone has a different experience of PTSD. You may have symptoms soon after the traumatic event or it may be a while before you have any. Some people with PTSD have symptoms all the time. Others, will have periods where their symptoms come and go. Reliving some of the things that happened People with PTSD often relive the traumatic event through: nightmares flashbacks (feeling like the event is happening now) intrusive thoughts or images physical sensations like pain, sweating, feeling sick or trembling Alertness or feeling on edge"}


created_at: 2025-05-10 06:05:42
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/mental-health/post-traumatic-stress-disorder-ptsd/", "start_index": 1702, "chroma:document": "event is happening now) intrusive thoughts or images physical sensations like pain, sweating, feeling sick or trembling Alertness or feeling on edge People with PTSD can feel alert or on edge which means you may: panic when reminded of the trauma get angry or upset easily have sleeping problems (insomnia) feel jumpy or easily startled feel irritable have difficulty concentrating be very alert (hypervigilance) have symptoms of anxiety Avoiding feelings or memories People with PTSD often try to avoid being reminded of the traumatic event. This means you may: avoid people and places that remind you of the trauma avoid talking about your experience try to distract yourself with other things like work or hobbies be unable to remember details of what happened feel numb or cut off from your feelings feel detached from your body be unable to show affection do self-destructive or reckless things use alcohol or drugs Difficult beliefs or feelings PTSD can cause difficult beliefs or feelings."}


created_at: 2025-05-10 06:05:42
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
id: db4b213b-f218-46c8-8378-a9bec2bfcf9d
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/mental-health/post-traumatic-stress-disorder-ptsd/", "start_index": 2553, "chroma:document": "affection do self-destructive or reckless things use alcohol or drugs Difficult beliefs or feelings PTSD can cause difficult beliefs or feelings. You may feel like: you can\u2019t trust anyone nowhere is safe nobody understands you\u2019re to blame for what happened You may also have overwhelming feelings of anger, sadness, guilt or shame. PTSD in children PTSD can affect children as well as adults. Children with PTSD can have similar symptoms to adults. They may also: wet the bed be very anxious about being separated from a parent or another adult re-enact the traumatic event through play Further information on PTSD in children When to seek help for PTSD It\u2019s normal to experience upsetting and confusing thoughts after a traumatic event. In most cases, this will improve after a few weeks. Speak to your GP practice if: You or your child: are still having problems about 4 weeks after the traumatic experience, or the symptoms are particularly troublesome If necessary, your GP can refer you to"}


created_at: 2025-05-10 06:05:42
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/mental-health/post-traumatic-stress-disorder-ptsd/", "start_index": 3402, "chroma:document": "having problems about 4 weeks after the traumatic experience, or the symptoms are particularly troublesome If necessary, your GP can refer you to mental health specialists for further assessment and treatment. Treatment for PTSD PTSD can be treated even if it develops many years after a traumatic event. There are different treatments for PTSD. The best option for you will depend on how severe your symptoms are and when they developed. Watchful waiting Your GP may recommend \u2018watchful waiting\u2019 if: you have had symptoms of PTSD for less than 4 weeks, or your symptoms are mild Watchful waiting means your GP will monitor your symptoms to see if they improve or get worse. You should have a follow-up appointment within one month. PTSD and complex PTSD (CPTSD) self-help guide The PTSD and CPTSD self-help guide is for people with mild-to-moderate symptoms. It aims to help you: consider whether you\u2019re experiencing symptoms of PTSD or CPTSD understand more about PTSD and CPTSD think about ways"}


created_at: 2025-05-10 06:05:42
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/mental-health/post-traumatic-stress-disorder-ptsd/", "start_index": 4252, "chroma:document": "symptoms. It aims to help you: consider whether you\u2019re experiencing symptoms of PTSD or CPTSD understand more about PTSD and CPTSD think about ways to manage or recover from PTSD or CPTSD Start the PTSD and CPTSD self-help guide Trauma-focused cognitive behavioural therapy (CBT) Trauma-focused CBT uses a range of techniques to help you come to terms with the traumatic event. For example, your therapist may ask you to address your traumatic memories by thinking about them in detail. During this process, the therapist will help you cope with any distress you feel. They\u2019ll also identify any unhelpful thoughts or misrepresentations you have about the experience. For example, feeling you\u2019re to blame for what happened or feeling scared that it\u2019ll happen again. You\u2019ll usually have 8 to 12 weekly sessions of trauma-focused CBT, although fewer may be needed. Sessions usually last for around 60 to 90 minutes. You\u2019ll see the same therapist each week. Eye movement desensitisation and reprocessing"}


created_at: 2025-05-10 06:05:42
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/mental-health/post-traumatic-stress-disorder-ptsd/", "start_index": 5103, "chroma:document": "be needed. Sessions usually last for around 60 to 90 minutes. You\u2019ll see the same therapist each week. Eye movement desensitisation and reprocessing (EMDR) Eye movement desensitisation and reprocessing (EMDR) is quite a new treatment for PTSD. It involves making rhythmic eye movements whilst describing the traumatic event to a therapist. The rapid eye moments aim to mirror the way your brain processes information when you\u2019re asleep. Further information about EMDR Medication Medication isn\u2019t regularly used to treat PTSD. It may be recommended if you: are unable to, or don\u2019t want to try, talking therapies like CBT also have depression have sleep problems caused by PTSD If you\u2019re offered medication to treat PTSD, it\u2019ll usually be an antidepressant. Group therapy It can be helpful to talk about your experience of PTSD with other people who have it. You can do this through group therapy. Group therapy can help you understand PTSD. It also teaches you different ways to manage your symptoms."}


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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/mental-health/post-traumatic-stress-disorder-ptsd/", "start_index": 5956, "chroma:document": "it. You can do this through group therapy. Group therapy can help you understand PTSD. It also teaches you different ways to manage your symptoms. Treatment for PTSD in children and young people It\u2019s usually recommended that children and young people with PTSD have trauma-focused CBT. This will usually be in 8 to 12 sessions. These are adapted to suit the child\u2019s age, circumstances and development. If it\u2019s appropriate, the treatment will involve the child\u2019s family. Medication isn\u2019t usually recommended for children and young people with PTSD. Further support with PTSD There are many organisations that provide counselling and support for PTSD. This includes: Combat Stress \u2013 a military charity specialising in helping ex-servicemen and women Rape Crisis Scotland \u2013 provide services for women and girls who have experienced abuse, domestic violence and sexual assault Turn to SARCS \u2013 information on where to find support if you\u2019ve been raped or sexually assaulted Victim Support Scotland \u2013"}


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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/mental-health/post-traumatic-stress-disorder-ptsd/", "start_index": 6801, "chroma:document": "violence and sexual assault Turn to SARCS \u2013 information on where to find support if you\u2019ve been raped or sexually assaulted Victim Support Scotland \u2013 provide support and information to victims or witnesses of crime Cruse Bereavement Support \u2013 provide support and information for people who have experienced bereavement Source: NHS 24 - Opens in new browser window Last updated: 11 April 2025 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Don\u2019t include personal information e.g. name, location or any personal health conditions. Email Address e.g. you@example.com Message Maximum of 500 characters Send feedback Add this page to Info For Me Also on NHS inform Post-traumatic stress disorder (PTSD) (BSL) PTSD and CPTSD self-help guide Anxiety Depression Counselling and psychotherapy Other health sites BABCP - What is CBT? PTSD Resolution: Veteran outreach programme NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback"}


created_at: 2025-05-10 06:05:43
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created_at: 2025-05-10 06:05:43
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/mental-health/postnatal-depression/", "start_index": 0, "chroma:document": "Postnatal depression | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotland\u2019s Service Directory 0 Home Illnesses and conditions Mental health Postnatal depression Postnatal depression Postnatal depression is a type of depression. Many parents experience it after having a baby. It\u2019s a common problem, affecting more than 1 in every 10 mothers within a year of giving birth. It can also affect fathers and partners, although this is less common. With the right support, which can include self-help strategies and therapy, most people make a full recovery. Symptoms of postnatal depression Postnatal depression affects everyone differently. It can start at any point in the first year after giving birth. It can continue from depression in pregnancy. It may develop suddenly or gradually. Many people feel a bit down, tearful or anxious in the first week after giving birth. This is often called the \u2018baby blues\u2019 and is"}


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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/mental-health/postnatal-depression/", "start_index": 854, "chroma:document": "or gradually. Many people feel a bit down, tearful or anxious in the first week after giving birth. This is often called the \u2018baby blues\u2019 and is so common that it\u2019s considered normal. The baby blues don\u2019t last for more than 2 weeks after giving birth. If your symptoms last longer or start later, you could have postnatal depression. The main symptoms of postnatal depression include: a persistent feeling of sadness and low mood loss of interest in the world around you no longer enjoying things that used to give you pleasure lack of energy and feeling tired all the time trouble sleeping at night feeling sleepy during the day feeling that you\u2019re unable to look after your baby problems concentrating and making decisions loss of appetite or an increased appetite (comfort eating) feeling agitated, irritable or very apathetic (you \u2018can\u2019t be bothered\u2019) feelings of guilt, hopelessness and self-blame difficulty bonding with your baby \u2013 feeling of indifference and no sense of enjoyment in their"}


created_at: 2025-05-10 06:05:43
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/mental-health/postnatal-depression/", "start_index": 1710, "chroma:document": "feelings of guilt, hopelessness and self-blame difficulty bonding with your baby \u2013 feeling of indifference and no sense of enjoyment in their company frightening thoughts, for example, about hurting your baby \u2013 these can be scary, but they\u2019re very rarely acted upon thinking about suicide and self-harm These symptoms can affect your day-to-day life and your relationships with your baby, family and friends. Speak to your GP or health visitor as soon as possible if: you think you have postnatal depression Don\u2019t struggle on alone and hope the problem will go away. It can take a lot longer to feel better if it\u2019s not addressed. Spotting the signs of postnatal depression Postnatal depression can develop gradually and it can be hard to recognise. Some parents may avoid talking to family and friends about how they\u2019re feeling. This may be because they worry they\u2019ll be judged for not coping or not appearing happy. Signs for partners, family and friends to look out for in new parents include:"}


created_at: 2025-05-10 06:05:43
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/mental-health/postnatal-depression/", "start_index": 2559, "chroma:document": "they worry they\u2019ll be judged for not coping or not appearing happy. Signs for partners, family and friends to look out for in new parents include: frequently crying for no obvious reason having difficulty bonding with their baby getting no pleasure from playing with them or feeling no good as a parent withdrawing from contact with other people speaking negatively all the time and claiming that they\u2019re hopeless neglecting themselves, like not washing or changing their clothes losing all sense of time, like being unaware whether 10 minutes or 2 hours have passed losing their sense of humour constantly worrying that something is wrong with their baby, regardless of reassurance from others If you think someone you know is depressed, encourage them to talk about their feelings. This could be to talk to you, a friend, their GP or their health visitor. Causes of postnatal depression The cause of postnatal depression isn\u2019t completely clear. Some of the factors it has been associated with"}


created_at: 2025-05-10 06:05:43
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/mental-health/postnatal-depression/", "start_index": 3408, "chroma:document": "visitor. Causes of postnatal depression The cause of postnatal depression isn\u2019t completely clear. Some of the factors it has been associated with include: a history of mental health problems, particularly depression, earlier in life or during pregnancy having no close family or friends to support you a poor relationship with your partner recent stressful life events, like a bereavement experiencing the \u2018baby blues\u2019 Even if you don\u2019t have any of these symptoms, having a baby is a life-changing event that can sometimes trigger depression. It often takes time to adapt to becoming a new parent. Looking after a small baby can be stressful and exhausting. Treating postnatal depression Postnatal depression can be lonely, distressing and frightening. But, support and treatments are available. With the right treatment and support, most people make a full recovery, although it can take time. Talk to your GP about the pros and cons of different treatments so you can decide together what\u2019s best"}


created_at: 2025-05-10 06:05:43
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/mental-health/postnatal-depression/", "start_index": 4259, "chroma:document": "a full recovery, although it can take time. Talk to your GP about the pros and cons of different treatments so you can decide together what\u2019s best for you. Your GP might also want to check your physical health to see if there are any problems that may need to be addressed as well. For example, you may be anaemic after giving birth. This could add to any feelings of depression you might have. Psychological treatments for postnatal depression Psychological therapies are usually the first treatment recommended for postnatal depression. Guided self-help Guided self-help involves working through a book or an online course. You can do this on your own or with some help from a therapist. It focusses on the issues you might be facing, with practical advice on how to deal with them. The courses typically last 9 to 12 weeks. Cognitive behavioural therapy Cognitive behavioural therapy (CBT) is a type of talking therapy. It\u2019s based on the idea that unhelpful and unrealistic thinking leads to"}


created_at: 2025-05-10 06:05:43
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/mental-health/postnatal-depression/", "start_index": 5108, "chroma:document": "therapy Cognitive behavioural therapy (CBT) is a type of talking therapy. It\u2019s based on the idea that unhelpful and unrealistic thinking leads to negative behaviour. CBT aims to break this cycle and find new ways of thinking that can help you behave in a more positive way. CBT can be carried out either one-to-one with a therapist or in a group. Treatment will often last 3 to 4 months. Interpersonal therapy Interpersonal therapy (IPT) involves talking to a therapist about the problems you\u2019re experiencing. It aims to identify problems in your relationships with family, friends or partners. It then looks at how they might relate to your feelings of depression. Treatment also usually lasts 3 to 4 months. Antidepressants Antidepressants may be recommended if: you have moderate or severe depression you don\u2019t want to try psychological treatment psychological treatment doesn\u2019t help you have mild postnatal depression and a previous history of depression They can help ease symptoms like: low"}


created_at: 2025-05-10 06:05:43
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/mental-health/postnatal-depression/", "start_index": 5958, "chroma:document": "psychological treatment doesn\u2019t help you have mild postnatal depression and a previous history of depression They can help ease symptoms like: low mood irritability lack of concentration sleeplessness This helps you to function normally and helps you cope better with your new baby. Antidepressants usually need to be taken for at least a week before the benefit starts to be felt. This means it\u2019s important to keep taking them even if you don\u2019t notice an improvement straight away. You\u2019ll usually need to take them for around 6 months after you begin to feel better. If you stop too early, your depression may return. If you\u2019re breastfeeding, talk to your doctor about suitable medicines. Some types of antidepressants are safe to take while breastfeeding.Your doctor should explain any risks of taking antidepressants. You should be offered the type with the least risk for you and your baby. Self-help There are many things you can try yourself to improve your symptoms and help you cope. Do talk"}


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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/mental-health/postnatal-depression/", "start_index": 6810, "chroma:document": "with the least risk for you and your baby. Self-help There are many things you can try yourself to improve your symptoms and help you cope. Do talk to your partner, friends and family to help them understand how you\u2019re feeling talk to your loved ones about what they can do to support you accept help from others when it\u2019s offered ask your loved ones if they can help look after the baby and do tasks like housework, cooking and shopping make time for yourself \u2013 try to do activities that you find relaxing and enjoyable rest when you can \u2013 although it can be difficult when you\u2019re looking after a baby, try to sleep whenever you get the chance follow good sleeping habits ask your partner to help with the night-time work exercise regularly \u2013 this has been shown to help boost mood in people with mild depression eat regular, healthy meals Don\u2019t do not go for long periods without eating do not drink alcohol or take drugs, as this can make you feel worse Support groups Ask your health visitor"}


created_at: 2025-05-10 06:05:43
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/mental-health/postnatal-depression/", "start_index": 7657, "chroma:document": "do not go for long periods without eating do not drink alcohol or take drugs, as this can make you feel worse Support groups Ask your health visitor about support services in your area. They may be able to put you in touch with a social worker, counsellor or local support group. It can be reassuring to meet other people who are going through something similar. Find postnatal depression support and information in your area Treatments for severe postnatal depression You might be referred to a specialist perinatal mental health team if your depression: is very severe doesn\u2019t respond to treatment like antidepressants, self-help or therapy Your team might be able to offer other treatments, like: more intensive CBT other psychological treatments, like psychotherapy therapies such as baby massage which can improve depression and help build your relationships with your baby different medications electroconvulsive therapy (ECT) where electrodes are placed on your head and pulses of electricity"}


created_at: 2025-05-10 06:05:43
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/mental-health/postnatal-depression/", "start_index": 8507, "chroma:document": "relationships with your baby different medications electroconvulsive therapy (ECT) where electrodes are placed on your head and pulses of electricity are sent through the brain For a small number of people, coming into hospital can help speed up recovery. You may be offered a place in a Mother and Baby Unit, where you can continue to look after your baby while you get the best treatment for your illness. Source: NHS 24 - Opens in new browser window Last updated: 09 July 2024 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Don\u2019t include personal information e.g. name, location or any personal health conditions. Email Address e.g. you@example.com Message Maximum of 500 characters Send feedback Add this page to Info For Me Also on NHS inform Depression Depression self-help guide Other health sites SIGN: Perinatal mental health conditions NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info"}


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{"source": "https://www.nhsinform.scot/long-covid/postural-orthostatic-tachycardia-syndrome-pots/", "start_index": 0, "chroma:document": "Postural orthostatic tachycardia syndrome (PoTS) | NHS inform 0 Long-term effects of COVID-19 (long COVID) About long COVID Signs and symptoms Other languages and accessible formats Back Long-term effects of COVID-19 Home Long-term effects of COVID-19 (long COVID) Signs and symptoms Postural orthostatic tachycardia syndrome (PoTS) Postural orthostatic tachycardia syndrome (PoTS) This information is for people aged 18 and over. Contact your GP or paediatric team if you\u2019re worried about possible long COVID symptoms and you\u2019re either: under 18 a parent, guardian or carer of a young person or child Postural orthostatic tachycardia syndrome (PoTS) is when your heart rate increases very quickly after getting up from sitting or lying down. Symptoms may ease with changes to your daily routine. Some people may need treatment with medicines. Symptoms of PoTS Symptoms of PoTS include: dizziness or light-headedness fainting or almost fainting a noticeably strong, fast heartbeat (palpitations)"}


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{"source": "https://www.nhsinform.scot/long-covid/postural-orthostatic-tachycardia-syndrome-pots/", "start_index": 853, "chroma:document": "of PoTS Symptoms of PoTS include: dizziness or light-headedness fainting or almost fainting a noticeably strong, fast heartbeat (palpitations) chest pain shortness of breath shaking sweating sleep disturbance Some symptoms of PoTS happen when you stand up and get better when you lie down. You may also experience other symptoms, like: problems with your stomach or digestion, like feeling sick, being sick, diarrhoea, constipation and abdominal pain headaches extreme tiredness (fatigue) problems with your vision, like blurred vision or tunnel vision your hands and feet look blue \u2013 this may be more difficult to see if you have brown or black skin weakness and feeling of heaviness in legs and arms brain fog Some people experience mild symptoms, while other people\u2019s symptoms can have a big impact on their daily life. There are some factors that can make your symptoms worse, like: feeling too hot not drinking enough fluids eating, especially some forms of carbohydrates like white bread"}


created_at: 2025-05-10 06:05:44
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{"source": "https://www.nhsinform.scot/long-covid/postural-orthostatic-tachycardia-syndrome-pots/", "start_index": 1699, "chroma:document": "that can make your symptoms worse, like: feeling too hot not drinking enough fluids eating, especially some forms of carbohydrates like white bread drinking alcohol resting too much exercise being on your period Speak to your GP if: you have symptoms of PoTS Causes of PoTS The causes of PoTS are not known. It can develop suddenly or gradually over time. It may happen after an infection like coronavirus (COVID-19) and flu. How is PoTS diagnosed? If you have symptoms of PoTS, a GP may check your blood pressure and heart rate before and after you stand up. If they suspect you have PoTS, they may do further tests, like: blood tests urine test heart and blood pressure tests, like an echocardiogram, an ECG, and 24-hour blood pressure and heart rate monitoring It may take some time for people to be diagnosed with PoTS, as the symptoms are similar to other health conditions. Your GP will be able to rule out other health conditions and may refer you to a specialist. Find out more about how"}


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{"source": "https://www.nhsinform.scot/long-covid/postural-orthostatic-tachycardia-syndrome-pots/", "start_index": 2551, "chroma:document": "to other health conditions. Your GP will be able to rule out other health conditions and may refer you to a specialist. Find out more about how PoTS is diagnosed Treatments for PoTS If you\u2019re diagnosed with PoTS, finding the right treatment for you can take time. A specialist may suggest making some practical changes to your daily routine like: changes to your diet pacing to manage and conserve your energy compression clothing for example support tights sleep management specialised exercise (discuss with your healthcare professional before starting) You may also be prescribed medicines by your specialist to help control your symptoms, such as beta-blockers. You may need to try several different medicines or combination of medicines. Things you can do if you have PoTS If you have PoTS, there are things you can do to help ease your symptoms. If you\u2019re feeling faint or dizzy, you can try lying down and raising your legs until you feel better. If you\u2019re unable to lie down, you can try:"}


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{"source": "https://www.nhsinform.scot/long-covid/postural-orthostatic-tachycardia-syndrome-pots/", "start_index": 3403, "chroma:document": "If you\u2019re feeling faint or dizzy, you can try lying down and raising your legs until you feel better. If you\u2019re unable to lie down, you can try: crossing your legs, with 1 leg in front of the other while standing up rocking up and down on your toes clenching your buttocks and stomach muscles clenching your fists Making practical changes to your routine can also help relieve symptoms of PoTS. Do try to avoid things that trigger your symptoms drink plenty of fluids pace your activities raise the head of your bed so you\u2019re not lying completely flat sit for a while before standing up wear support tights to help improve blood flow avoid heavy meals Don\u2019t do not stand up for too long do not get up too quickly after lying down do not drink too much caffeine or alcohol PoTS and long COVID PoTS is very common in long COVID. There\u2019s a patient information booklet for people with long COVID. Source: Scottish Government - Opens in new browser window Last updated: 18 October 2023 How can we improve"}


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{"source": "https://www.nhsinform.scot/long-covid/postural-orthostatic-tachycardia-syndrome-pots/", "start_index": 4260, "chroma:document": "booklet for people with long COVID. Source: Scottish Government - Opens in new browser window Last updated: 18 October 2023 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Don\u2019t include personal information e.g. name, location or any personal health conditions. Email Address e.g. you@example.com Message Maximum of 500 characters Send feedback Add this page to Info For Me Also on NHS inform Heart and blood vessels Other health sites PoTS UK STARS: Postural Tachycardia Syndrome SIGN: Long COVID support Royal College of Occupational Therapists: Recovering from COVID-19: Post viral-fatigue and conserving energy NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats \u00a9 2025 NHS 24 \u2013 v1.1.1.17852"}


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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/skin-hair-and-nails/pressure-ulcers/", "start_index": 0, "chroma:document": "Pressure ulcers | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotland\u2019s Service Directory 0 Home Illnesses and conditions Skin, hair and nails Pressure ulcers Pressure ulcers Pressure ulcers are areas of damage to the skin and the tissue underneath. This happens when an area of skin is put under pressure. Pressure ulcers can also be known as pressure sores or bed sores. You\u2019re more likely to get pressure ulcers if you have difficulty moving. For example, if you\u2019re confined to lying in a bed or sitting for long periods of time. Symptoms of pressure ulcers Pressure ulcers usually form on bony parts of the body that aren\u2019t covered with much body fat. This includes areas like the heels, elbows, hips and tailbone. Symptoms include patches of skin that: are discoloured and don\u2019t change colour when pressed \u2013 the patches are usually red on white skin, or purple or blue on black or brown skin feel warm, spongy or"}


created_at: 2025-05-10 06:05:44
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/skin-hair-and-nails/pressure-ulcers/", "start_index": 856, "chroma:document": "and don\u2019t change colour when pressed \u2013 the patches are usually red on white skin, or purple or blue on black or brown skin feel warm, spongy or hard become painful Pressure ulcers usually come on gradually, but sometimes appear quite quickly. Sometimes pressure ulcers can blister or become an open wound. If aren\u2019t treated they\u2019ll continue to get worse, and might deepen to reach muscle or bone. When to get medical advice Ask your GP for an urgent appointment or phone 111 if: You or someone you care for have symptoms of a pressure ulcer and: hot, swollen or red skin \u2013 it can look purple or blue on brown or black skin pus coming out of the ulcer a high temperature severe pain or pain that\u2019s getting worse Speak to your GP practice if: you think you or someone you care for has a pressure ulcer Who\u2019s most at risk of pressure ulcers? Pressure ulcers can happen to anyone, but it\u2019s more common if you have problems moving. This is because the weight of your body puts pressure on the same areas"}


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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/skin-hair-and-nails/pressure-ulcers/", "start_index": 1711, "chroma:document": "can happen to anyone, but it\u2019s more common if you have problems moving. This is because the weight of your body puts pressure on the same areas of skin which can damage it. You have a higher chance of getting a pressure ulcer if you have: problems moving had a pressure ulcer before been seriously ill in intensive care recently had surgery swollen, sweaty or broken skin poor circulation fragile skin problems feeling sensation or pain It\u2019s also more likely if you\u2019re underweight. Severity of pressure ulcers Pressure ulcers can vary in severity. Healthcare professionals in Scotland use a grading system to describe how severe pressure ulcers are. In other places, a category or staging system may be used. The higher the grade or category, the more severe the pressure ulcer is. Grade 1 A grade 1 pressure ulcer is the least severe type of ulcer. A grade 1 pressure ulcer may: be painful feel warm or cool feel either warm and spongy, or hard cause the affected area of skin to become discoloured"}


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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/skin-hair-and-nails/pressure-ulcers/", "start_index": 2561, "chroma:document": "A grade 1 pressure ulcer may: be painful feel warm or cool feel either warm and spongy, or hard cause the affected area of skin to become discoloured It may not: turn white when pressed have an open wound This stage of pressure ulcer might be difficult to detect in darker skin tones. Grade 1 pressure ulcer \u2013 the following image contains graphic content Pressure ulcer on the heel of the foot. Source: dermnet.nz Grade 2 In grade 2 pressure ulcers, some of the outer surface of the skin (epidermis) or the deeper layer of skin (dermis) is damaged. This can lead to skin loss. The ulcer looks like an open or burst blister. This can be red or pink. It won\u2019t have any yellow or white in the wound. Grade 2 pressure ulcer \u2013 the following image contains graphic content Pressure ulcer on the tail bone. Source: dermnet.nz Grade 3 In a grade 3 pressure ulcer, skin loss can affect the entire thickness of the skin. The tissue underneath is also damaged, but the bone, muscle or tendon are not. The ulcer"}


created_at: 2025-05-10 06:05:44
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/skin-hair-and-nails/pressure-ulcers/", "start_index": 3417, "chroma:document": "skin loss can affect the entire thickness of the skin. The tissue underneath is also damaged, but the bone, muscle or tendon are not. The ulcer looks like a deep wound and there might be signs of of dead tissue. For example, there may be white, yellow or green discharge coming from the wound. Grade 3 pressure ulcer \u2013 the following image contains graphic content Severe pressure ulcer on the heel of the foot. Source: dermnet.nz Grade 4 A grade 4 pressure ulcer is the most severe type of pressure ulcer. The skin is severely damaged and the tissue around it begins to die. This is called tissue necrosis. The bone, muscles or tendons underneath may be damaged. People with grade 4 pressure ulcers have a high risk of developing an infection. Grade 4 pressure ulcer \u2013 the following image contains graphic content Infected pressure ulcer. Source: dermnet.nz Suspected deep tissue injury (SDTI) A SDTI occurs when the top layer of the skin isn\u2019t broken, but it\u2019s thought there\u2019s a problem underneath"}


created_at: 2025-05-10 06:05:45
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/skin-hair-and-nails/pressure-ulcers/", "start_index": 4275, "chroma:document": "Suspected deep tissue injury (SDTI) A SDTI occurs when the top layer of the skin isn\u2019t broken, but it\u2019s thought there\u2019s a problem underneath the skin. A SDTI may mean: the surface of the skin isn\u2019t broken the skin is purple or brownish red there\u2019s a blister filled with blood the skin breaks down and causes deep tissue loss the depth of the wound isn\u2019t known Ungradable/unstageable An ungradable or unstageable pressure ulcer means the area is covered by dead body tissue. Healthcare professionals won\u2019t be able to tell how deep the wound is. They may be able to find out what grade or category the pressure ulcer is after dead tissue has been removed. Mucosal pressure ulcer Mucosal pressure ulcers affect soft and delicate areas of the body (mucosal membranes) like: tongue nostrils mouth Mucosal membranes can\u2019t be graded because they don\u2019t have layers of skin like the rest of the body. This means they\u2019re called mucosal pressure ulcers. Diagnosing pressure ulcers Pressure ulcers can be"}


created_at: 2025-05-10 06:05:45
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/skin-hair-and-nails/pressure-ulcers/", "start_index": 5120, "chroma:document": "have layers of skin like the rest of the body. This means they\u2019re called mucosal pressure ulcers. Diagnosing pressure ulcers Pressure ulcers can be diagnosed by looking at the affected area. However, it\u2019s better to prevent ulcers from developing in the first instance. To help find out if you\u2019re at risk of pressure ulcers, healthcare professionals will look at: your general health your ability to move whether you have any problems that affect your posture whether you have any symptoms of an infection your mental health whether you\u2019ve had pressure ulcers before whether you have urinary incontinence or bowel incontinence your diet how well your blood circulation system is working You may also be referred for other tests. Checking for pressure ulcers If you\u2019re at risk of pressure ulcers, check for areas on your skin that are: discoloured feel unusually spongy or tough Use a mirror to check parts of your body that can be difficult to see, like your back or buttocks. Contact your GP or your"}


created_at: 2025-05-10 06:05:45
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/skin-hair-and-nails/pressure-ulcers/", "start_index": 5971, "chroma:document": "unusually spongy or tough Use a mirror to check parts of your body that can be difficult to see, like your back or buttocks. Contact your GP or your healthcare team if you notice any signs of damage. Treatment for pressure ulcers The type of treatment you get will depend on how severe the pressure ulcer is. Changing position and moving regularly is important to help relieve pressure on the ulcers. It can also help to stop new ones from forming. Other treatments include: specially designed mattresses and cushions dressings to protect the ulcer and help it heal creams and ointments antibiotics (if the ulcer is infected) cleaning the ulcer If the pressure ulcer is severe or other treatments haven\u2019t worked, you may need to have surgery. This is to clean and close the ulcer. How quickly do pressure ulcers heal? How quickly pressure ulcers heal will be different for everyone. It can depend on: your treatment plan how severe the ulcer is your nutrition if there\u2019s an infection if you have any"}


created_at: 2025-05-10 06:05:45
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/skin-hair-and-nails/pressure-ulcers/", "start_index": 6822, "chroma:document": "will be different for everyone. It can depend on: your treatment plan how severe the ulcer is your nutrition if there\u2019s an infection if you have any other health conditions If you\u2019re worried that you ulcer isn\u2019t healing, speak to a healthcare professional. What causes pressure ulcers? Pressure ulcers are caused by something putting pressure on your skin. It can also happen if something rubs the skin. For example, a bed or a wheelchair. How to prevent pressure ulcers There are things that can help lower your chances of getting a pressure ulcer. Do change position regularly use specially designed mattresses and cushions keep skin as clean and dry as possible check your skin every day for symptoms of a pressure ulcer try to stay active, if possible eat a healthy, balanced diet Don\u2019t do not smoke Complications of pressure ulcers Pressure ulcers can become infected. There are different types of infection, including: cellulitis sepsis bone and joint infections Other complications of"}


created_at: 2025-05-10 06:05:45
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/skin-hair-and-nails/pressure-ulcers/", "start_index": 7668, "chroma:document": "ulcers can become infected. There are different types of infection, including: cellulitis sepsis bone and joint infections Other complications of pressure ulcers can include: pain distress longer hospital stays reduced quality of life Source: NHS 24 - Opens in new browser window Last updated: 10 April 2025 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Don\u2019t include personal information e.g. name, location or any personal health conditions. Email Address e.g. you@example.com Message Maximum of 500 characters Send feedback Add this page to Info For Me Other health sites Legs Matter: Pressure ulcers NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats \u00a9 2025 NHS 24 \u2013 v1.1.1.17852"}


created_at: 2025-05-10 06:05:45
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/brain-nerves-and-spinal-cord/progressive-supranuclear-palsy-psp/", "start_index": 0, "chroma:document": "Progressive supranuclear palsy (PSP) | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotland\u2019s Service Directory 0 Home Illnesses and conditions Brain, nerves and spinal cord Progressive supranuclear palsy (PSP) Progressive supranuclear palsy (PSP) Progressive supranuclear palsy (PSP) is a neurological condition. It\u2019s caused by the loss of nerve cells in parts of the brain. This can lead to problems with balance, movement, vision, speech and swallowing. Symptoms of PSP PSP usually develops gradually and can sometimes be mistaken for other conditions. The symptoms tend to get worse over many years. Early symptoms The first symptoms of PSP you might experience include: repeated falls (often backwards) caused by a sudden loss of balance when walking muscle stiffness, especially in the neck fatigue changes in personality like mood swings and irritability changes in behaviour like recklessness and poor judgement"}


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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/brain-nerves-and-spinal-cord/progressive-supranuclear-palsy-psp/", "start_index": 855, "chroma:document": "especially in the neck fatigue changes in personality like mood swings and irritability changes in behaviour like recklessness and poor judgement dislike of bright lights (photophobia) eye problems like blurred or double vision, problems looking up and down, or involuntary eye closure tremors (involuntary shaking of parts of the body) slow movement Mid term symptoms The symptoms of PSP, like balance and mobility problems, are likely to progressively get worse. The new symptoms that might develop at this stage include: slurred, slow or quiet speech problems with swallowing (dysphagia) involuntary blinking or twitching of the eyelids reduced blinking reflex which causes the eyes to become dry and irritated problems sleeping memory problems slowness of thought back, neck and joint pain Long term symptoms As the symptoms of PSP get worse, your speech might become slower and more slurred. Mobility problems might get worse and you might need a wheelchair to help you get around. At the"}


created_at: 2025-05-10 06:05:45
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/brain-nerves-and-spinal-cord/progressive-supranuclear-palsy-psp/", "start_index": 1702, "chroma:document": "your speech might become slower and more slurred. Mobility problems might get worse and you might need a wheelchair to help you get around. At the advanced stage, people with PSP are likely to have difficulty controlling the muscles of their mouth, tongue and throat. Swallowing problems can become worse because of the loss of control of the throat muscles. PSP can cause problems like constipation and difficulty passing urine (peeing). It can also cause frequent peeing during the night. Sometimes it can cause you to lose control of your bowel and bladder movements (incontinence). Causes of PSP It\u2019s believed that a protein called tau, which builds up in certain areas of the brain, forms into clumps. This causes damage to the nerve cells. Over time this build up can lead to someone experiencing the symptoms of PSP. The location of the clumps and the amount of tau varies between people with PSP. This also affects the type and severity of symptoms. PSP tends not to run in families and is"}


created_at: 2025-05-10 06:05:45
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/brain-nerves-and-spinal-cord/progressive-supranuclear-palsy-psp/", "start_index": 2553, "chroma:document": "and the amount of tau varies between people with PSP. This also affects the type and severity of symptoms. PSP tends not to run in families and is not believed to be hereditary in most cases. Diagnosing PSP There\u2019s no single test for PSP. The many different symptoms can make it difficult to diagnose. A specialist doctor will ask you about your symptoms to rule out other similar conditions, like Parkinson\u2019s disease. You might have other tests and scans. Brain scans You might have: an MRI scan a dopamine SPECT scan which involves an injection of radioactive material to allow a gamma camera to create picture of the brain The scans will also help to rule out other conditions that can cause similar symptoms. Neuropsychological testing You might have neuropsychological testing to evaluate your symptoms. These tests will assess your: concentration memory communication ability to process visual information like pictures and words Treating PSP Although there\u2019s no cure for PSP, there are lots"}


created_at: 2025-05-10 06:05:45
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/brain-nerves-and-spinal-cord/progressive-supranuclear-palsy-psp/", "start_index": 3406, "chroma:document": "memory communication ability to process visual information like pictures and words Treating PSP Although there\u2019s no cure for PSP, there are lots of ways you can manage your symptoms. It\u2019s likely you\u2019ll have a multi disciplinary team (MDT) who\u2019ll work together to help manage your symptoms. Visit the PSP Association for information and support about living with PSP. They have a dedicated PSP Care Navigator who can help to support you. Medication There\u2019s no specific medication that can treat PSP. Taking medication used to treat Parkinson\u2019s disease can help some people with PSP. This can help to improve stiffness, movement and balance for some people. The effect, however, is sometimes limited and might only last a few years. Some antidepressants can help improve problems with pain, stiffness and sleep problems. You might be offered antidepressants to help with depression. You should discuss your symptoms with your doctor to make sure you\u2019re prescribed the best treatment. Physiotherapy A"}


created_at: 2025-05-10 06:05:45
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/brain-nerves-and-spinal-cord/progressive-supranuclear-palsy-psp/", "start_index": 4262, "chroma:document": "to help with depression. You should discuss your symptoms with your doctor to make sure you\u2019re prescribed the best treatment. Physiotherapy A physiotherapist can give you regular exercises to do. This can help strengthen your muscles and prevent your joints from stiffening. They\u2019ll also consider if there\u2019s any equipment that would help you. You might try a walking frame or shoes that can help reduce your risk of falls. You can try breathing exercises to reduce the chance of developing aspiration pneumonia when you eat. Aspiration pneumonia is a chest infection caused by inhaling particles of food into your lungs. Speech and language therapy A speech and language therapist will try to help with your problems with speech and swallowing (dysphagia). They might suggest changing the consistency of your food to make it easier to swallow. They might be able to give you techniques you can use to make your voice clearer. They\u2019ll suggest communication aids or devices if they think they might"}


created_at: 2025-05-10 06:05:45
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/brain-nerves-and-spinal-cord/progressive-supranuclear-palsy-psp/", "start_index": 5111, "chroma:document": "might be able to give you techniques you can use to make your voice clearer. They\u2019ll suggest communication aids or devices if they think they might help you. Nutritional support A dietitian will talk to you about how to eat a healthy balanced diet. They can help you include more food and liquids that are easy to swallow. If there\u2019s a risk of malnutrition and dehydration, you might be offered a feeding tube. Occupational therapy An occupational therapist will assess your home for hazards that could cause you to fall and injure yourself. There might be things that can be fitted around your home to make it safer for you like handles around the bath. Read more about occupational therapy Eye problems If you have problems controlling your eyelids, botulinum toxin (like Botox) can help relax your eyelid muscles. It usually lasts up to 3 months. If you have dry eyes because of reduced blinking, eyedrops can be used to reduce irritation. You might want to try wearing dark wraparound glasses if"}


created_at: 2025-05-10 06:05:46
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/brain-nerves-and-spinal-cord/progressive-supranuclear-palsy-psp/", "start_index": 5961, "chroma:document": "If you have dry eyes because of reduced blinking, eyedrops can be used to reduce irritation. You might want to try wearing dark wraparound glasses if you\u2019re sensitive to light (photophobia). There are also glasses you can wear to help you if you have problems looking down (prisms). Palliative care You can choose to have palliative care at any stage of PSP in addition to other treatments. Palliative care aims to relieve pain and other symptoms along with psychological, spiritual and social support. You might receive palliative care: at home in a hospice or care home as an outpatient in a hospital in a hospital Read more about palliative care Advance care planning You might want to consider making plans for the future to help your family and health professionals plan your medical care. This will be useful if you\u2019re unable to communicate later on because you\u2019re too ill. You don\u2019t have to make these plans if you don\u2019t want to. Source: Scottish Government - Opens in new browser window Last"}


created_at: 2025-05-10 06:05:46
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/brain-nerves-and-spinal-cord/progressive-supranuclear-palsy-psp/", "start_index": 6814, "chroma:document": "on because you\u2019re too ill. You don\u2019t have to make these plans if you don\u2019t want to. Source: Scottish Government - Opens in new browser window Last updated: 23 April 2024 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Don\u2019t include personal information e.g. name, location or any personal health conditions. Email Address e.g. you@example.com Message Maximum of 500 characters Send feedback Add this page to Info For Me Other health sites PSP Association NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats \u00a9 2025 NHS 24 \u2013 v1.1.1.17852"}


created_at: 2025-05-10 06:05:46
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/cancer/cancer-types-in-adults/prostate-cancer/", "start_index": 0, "chroma:document": "Prostate cancer | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotland\u2019s Service Directory 0 Home Illnesses and conditions Cancer Cancer types in adults Prostate cancer Prostate cancer About prostate cancer Symptoms of prostate cancer Causes of prostate cancer Diagnosing prostate cancer Testing for prostate cancer Treating prostate cancer Living with prostate cancer About prostate cancer Prostate cancer is the most common cancer in men and anyone with a prostate in the UK. Prostate cancer usually develops slowly, so there may be no signs you have it for many years. Symptoms often only become apparent when your prostate is large enough to affect the urethra (the tube that carries urine from the bladder to the penis). When this happens, you may notice things like an increased need to urinate, straining while urinating and a feeling that your bladder has not fully emptied. These symptoms shouldn\u2019t be ignored,"}


created_at: 2025-05-10 06:05:46
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/cancer/cancer-types-in-adults/prostate-cancer/", "start_index": 853, "chroma:document": "an increased need to urinate, straining while urinating and a feeling that your bladder has not fully emptied. These symptoms shouldn\u2019t be ignored, but they do not mean you definitely have prostate cancer. It is more likely that they are caused by something else, such as benign prostatic hyperplasia (also known as BPH or prostate enlargement). Read more about the symptoms of prostate cancer What is the prostate? The prostate is a small gland in the pelvis. About the size of a satsuma, it\u2019s located between the penis and the bladder and surrounds the urethra. The main function of the prostate is to help in the production of semen. It produces a thick white fluid that is mixed with the sperm produced by the testicles, to create semen. Why does prostate cancer happen? The causes of prostate cancer are largely unknown. However, certain things can increase your risk of developing the condition. The chances of developing prostate cancer increase as you get older. Most cases develop in men"}


created_at: 2025-05-10 06:05:46
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/cancer/cancer-types-in-adults/prostate-cancer/", "start_index": 1703, "chroma:document": "can increase your risk of developing the condition. The chances of developing prostate cancer increase as you get older. Most cases develop in men and anyone with a prostate aged 50 or older. For reasons not yet understood, prostate cancer is more common in men and anyone with a prostate of African-Caribbean African descent. It\u2019s less common in men and anyone with a prostate of Asian descent. Men and anyone with a prostate who have first-degree male relatives (such as a father or brother) affected by prostate cancer are also at a slightly increased risk. Read more about the causes of prostate cancer Tests for prostate cancer There is no single test for prostate cancer. All the tests used to help diagnose the condition have benefits and risks, which your doctor should discuss with you. The most commonly used tests for prostate cancer are blood tests, a physical examination of your prostate (known as a digital rectal examination or DRE) and a biopsy. The blood test, known as a"}


created_at: 2025-05-10 06:05:46
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/cancer/cancer-types-in-adults/prostate-cancer/", "start_index": 2548, "chroma:document": "are blood tests, a physical examination of your prostate (known as a digital rectal examination or DRE) and a biopsy. The blood test, known as a prostate-specific antigen (PSA) test, measures the level of PSA and may help detect early prostate cancer. Men and anyone with a prostate are not routinely offered PSA tests to screen for prostate cancer, as results can be unreliable. This is because the PSA blood test is not specific to prostate cancer. PSA can be raised due to a large non-cancerous growth of the prostate (BPH), a urinary tract infection or inflammation of the prostate, as well as prostate cancer. Raised PSA levels also cannot tell a doctor whether a man has life-threatening prostate cancer or not. This means a raised PSA can lead to unnecessary tests and treatment. However, you can ask to be tested for prostate cancer once the benefits and risks have been explained to you. Read more about diagnosing prostate cancer and PSA screening for prostate cancer How is prostate"}


created_at: 2025-05-10 06:05:46
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/cancer/cancer-types-in-adults/prostate-cancer/", "start_index": 3394, "chroma:document": "the benefits and risks have been explained to you. Read more about diagnosing prostate cancer and PSA screening for prostate cancer How is prostate cancer treated? In many cases, treatment is not immediately necessary. If the cancer is at an early stage and not causing symptoms, a policy of \u2018watchful waiting\u2019 or \u2018active surveillance\u2019 may be adopted. This involves carefully monitoring your condition. Some cases of prostate cancer can be cured if treated in the early stages. Treatments include surgically removing the prostate, radiotherapy and hormone therapy. Some cases are only diagnosed at a later stage when the cancer has spread. If the cancer spreads to other parts of the body, typically the bones, it cannot be cured and treatment is focused on prolonging life and relieving symptoms. All treatment options carry the risk of significant side effects, including erectile dysfunction and urinary incontinence. For this reason, many people choose to delay treatment until there is a risk"}


created_at: 2025-05-10 06:05:46
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/cancer/cancer-types-in-adults/prostate-cancer/", "start_index": 4244, "chroma:document": "side effects, including erectile dysfunction and urinary incontinence. For this reason, many people choose to delay treatment until there is a risk the cancer might spread. Newer treatments, such as high-intensity focused ultrasound (HIFU) or cryotherapy, aim to reduce these side effects. Some hospitals may offer them as an alternative to surgery, radiotherapy or hormone therapy. However, the long-term effectiveness of these treatments are not yet known. Read more about treating prostate cancer Living with prostate cancer As prostate cancer usually progresses very slowly, you can live for decades without symptoms or needing treatment. Nevertheless, it can have an effect on your life. As well as causing physical problems such as erectile dysfunction and urinary incontinence, a diagnosis of prostate cancer can understandably make you feel anxious or depressed. You may find it beneficial to talk about the condition with your family, friends, a family doctor and other people with prostate"}


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topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/cancer/cancer-types-in-adults/prostate-cancer/", "start_index": 5101, "chroma:document": "or depressed. You may find it beneficial to talk about the condition with your family, friends, a family doctor and other people with prostate cancer. Financial support is also available if prostate cancer reduces your ability to work. Read more about living with prostate cancer Symptoms of prostate cancer Prostate cancer does not normally cause symptoms until the cancer has grown large enough to put pressure on the urethra. This normally results in problems associated with urination. Symptoms can include: needing to urinate more frequently, often during the night needing to rush to the toilet difficulty in starting to pee (hesitancy) straining or taking a long time while urinating weak flow feeling that your bladder has not emptied fully Your prostate may get larger as you get older due to a non-cancerous condition known as prostate enlargement or benign prostatic hyperplasia. Symptoms that the cancer may have spread include bone and back pain, a loss of appetite, pain in the"}


created_at: 2025-05-10 06:05:46
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/cancer/cancer-types-in-adults/prostate-cancer/", "start_index": 5947, "chroma:document": "enlargement or benign prostatic hyperplasia. Symptoms that the cancer may have spread include bone and back pain, a loss of appetite, pain in the testicles and unexplained weight loss. Read further information: Cancer Research UK: prostate cancer symptoms Causes of prostate cancer It\u2019s not known exactly what causes prostate cancer, although a number of things can increase your risk of developing the condition. These include: age \u2013 risk rises as you get older and most cases are diagnosed in men and anyone with a prostate over 50 years of age ethnic group \u2013 prostate cancer is more common among men and anyone with a prostate of African-Caribbean and African descent than in men and anyone with a prostate of Asian descent family history \u2013 having a brother or father who developed prostate cancer under the age of 60 seems to increase the risk of you developing it; having a close female relative who developed breast cancer may also increase your risk of developing prostate cancer obesity \u2013"}


created_at: 2025-05-10 06:05:46
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
id: a379b53d-ae5d-4f1c-b169-4ccad447f774
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/cancer/cancer-types-in-adults/prostate-cancer/", "start_index": 6795, "chroma:document": "of you developing it; having a close female relative who developed breast cancer may also increase your risk of developing prostate cancer obesity \u2013 there may be a link between obesity and prostate cancer exercise \u2013 men and anyone with a prostate who regularly exercises have also been found to be at lower risk of developing prostate cancer diet \u2013 research is ongoing into the links between diet and prostate cancer; a diet high in calcium is linked to an increased risk of developing prostate cancer In addition, some research has shown that prostate cancer rates appear to be lower in men and anyone with a prostate who eat foods containing certain nutrients including lycopene, found in cooked tomatoes and other red fruit, and selenium, found in brazil nuts. However, more research is needed. Read further information: Prostate Cancer UK: who is at risk of prostate cancer Cancer Research UK: prostate cancer risks and causes Diagnosing prostate cancer If you have symptoms that could be caused"}


created_at: 2025-05-10 06:05:46
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
id: d39dd273-756e-47d2-beaa-df0bd7056fdc
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/cancer/cancer-types-in-adults/prostate-cancer/", "start_index": 7646, "chroma:document": "at risk of prostate cancer Cancer Research UK: prostate cancer risks and causes Diagnosing prostate cancer If you have symptoms that could be caused by prostate cancer, you should visit your GP. There is no single, definitive test for prostate cancer, so your GP will discuss the pros and cons of the various tests with you to try to avoid unnecessary anxiety. Your doctor is likely to: ask for a urine sample to check for infection take a blood sample to test your level of prostate-specific antigen (PSA) examine your prostate (digital rectal examination) In 2015, the National Institute for Health and Care Excellence (NICE) published guidelines to help GPs recognise the signs and symptoms of prostate cancer and refer people for the right tests faster. To find out if you should be referred for further tests for suspected prostate cancer, read the NICE 2015 guidelines on Suspected Cancer: Recognition and Referral. PSA testing PSA is a protein produced by the prostate gland. All men and"}


created_at: 2025-05-10 06:05:46
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
id: a4014154-70e3-4d04-a426-61247c380d7b
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/cancer/cancer-types-in-adults/prostate-cancer/", "start_index": 8491, "chroma:document": "read the NICE 2015 guidelines on Suspected Cancer: Recognition and Referral. PSA testing PSA is a protein produced by the prostate gland. All men and anyone with a prostate have a small amount of PSA in their blood, and it increases with age. Prostate cancer can increase the production of PSA, and so a PSA test looks for raised levels of PSA in the blood that may be a sign of the condition in its early stages. However, PSA testing is not a specific test for prostate cancer. Most men and anyone with a prostate who has prostate cancer will not have a raised PSA level. Most people with a raised PSA level will not have cancer, as PSA levels rise in all men and anyone with a prostate as they get older. Read more about PSA screening for prostate cancer Digital rectal examination (DRE) The next step is a DRE, which can be done by your GP. During a DRE, your GP will insert a lubricated and gloved finger into your rectum. The rectum is close to your prostate gland, so your GP can check to feel"}


created_at: 2025-05-10 06:05:47
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
id: 3e1b780a-186b-4562-9ba9-14b15dabd49c
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/cancer/cancer-types-in-adults/prostate-cancer/", "start_index": 9342, "chroma:document": "a DRE, your GP will insert a lubricated and gloved finger into your rectum. The rectum is close to your prostate gland, so your GP can check to feel if the surface of the gland has changed. This will feel a little uncomfortable, but should not be painful. Prostate cancer can make the gland hard and bumpy. However, in most cases, the cancer causes no changes to the gland and a DRE may not be able to detect the cancer. DRE is useful in ruling out prostate enlargement caused by benign prostatic hyperplasia, as this causes the gland to feel firm and smooth. Biopsy Your GP will assess your risk of having prostate cancer based on a number of factors, including your PSA levels, the results of your DRE, and your age, family history and ethnic group. If you are at risk, you should be referred to hospital to discuss the options of further tests. The most commonly used test is a transrectal ultrasound-guided biopsy (TRUS). A biopsy may also be taken during a cystoscopy examination or through the"}


created_at: 2025-05-10 06:05:47
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/cancer/cancer-types-in-adults/prostate-cancer/", "start_index": 10194, "chroma:document": "most commonly used test is a transrectal ultrasound-guided biopsy (TRUS). A biopsy may also be taken during a cystoscopy examination or through the skin behind the testicles (perineum). During a TRUS biopsy, an ultrasound probe (a machine that uses sound waves to build a picture of the inside of your body) is inserted into your rectum. This allows the doctor or specialist nurse to see exactly where to pass a needle through the wall of your rectum to take small samples of tissue from your prostate. The procedure can be uncomfortable and sometimes painful, so you may be given a local anaesthetic to minimise any discomfort. As with any procedure, there may be complications, including bleeding and infection. Although it is more reliable than a PSA test, the TRUS biopsy can have problems. It can miss up to 1 in 5 cancers, because the location of the cancer is unknown when it is carried out. The doctors can see the prostate using the ultrasound scan, but not the tumour(s) if they are"}


created_at: 2025-05-10 06:05:47
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/cancer/cancer-types-in-adults/prostate-cancer/", "start_index": 11044, "chroma:document": "of the cancer is unknown when it is carried out. The doctors can see the prostate using the ultrasound scan, but not the tumour(s) if they are present. You may need another biopsy if your symptoms persist, or your PSA level continues to rise. Your doctor may request an MRI scan of the prostate before another biopsy. The TRUS biopsy can also find small low-risk cancers that do not need treatment, but may cause you anxiety. Many people often choose to undergo surgery or radiotherapy that may not benefit them but causes side effects, such as incontinence and erectile dysfunction. The samples of tissue from the biopsy are studied in a laboratory. If cancerous cells are found, they can be studied further to see how quickly the cancer will spread. This process is known as \u2018staging and grading\u2019 and helps doctors to decide which treatment is the most appropriate. Read further information: Cancer Research UK: The stages of prostate cancer Macmillan: Grading and staging of prostate cancer"}


created_at: 2025-05-10 06:05:47
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/cancer/cancer-types-in-adults/prostate-cancer/", "start_index": 11890, "chroma:document": "the most appropriate. Read further information: Cancer Research UK: The stages of prostate cancer Macmillan: Grading and staging of prostate cancer Further testing If there is a significant chance the cancer has spread from your prostate to other parts of the body, further tests may be recommended. These include: a magnetic resonance imaging (MRI) or computerised tomography (CT) scan \u2013 these scans build a detailed picture of the inside of your body an isotope bone scan \u2013 this can tell if the cancer has spread to your bones; a small amount of radiation dye is injected into the vein and collects in parts of the bone where there are any abnormalities Read further information: Cancer Research UK: Prostate cancer tests Testing for prostate cancer There is currently no screening programme for prostate cancer in the UK. This is because it has not been proved that the benefits would outweigh the risks. PSA screening Routinely screening all men and anyone with a prostate to check their"}


created_at: 2025-05-10 06:05:47
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
id: 343f2d15-ce7c-4b3d-95aa-f1f6989a20d7
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/cancer/cancer-types-in-adults/prostate-cancer/", "start_index": 12734, "chroma:document": "has not been proved that the benefits would outweigh the risks. PSA screening Routinely screening all men and anyone with a prostate to check their prostate-specific antigen (PSA) levels is a controversial subject in the international medical community. There are several reasons for this: PSA tests are unreliable and can suggest prostate cancer when no cancer exists (a false-positive result) \u2013 this means that many men often have invasive and sometimes painful biopsies for no reason the PSA test can find aggressive prostate cancer that needs treatment, but it can also find slow-growing cancer that may never cause symptoms or shorten life \u2013 some men and anyone with a prostate may therefore face difficult decisions about treatment treating prostate cancer in its early stages can be beneficial in some cases but the side effects of the various treatments are potentially so serious that men may choose to delay treatment until it is absolutely necessary although screening has been shown to"}


created_at: 2025-05-10 06:05:47
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
id: c214fe1f-b6bb-46d8-b0d6-d6a8f6dacfdd
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/cancer/cancer-types-in-adults/prostate-cancer/", "start_index": 13585, "chroma:document": "treatments are potentially so serious that men may choose to delay treatment until it is absolutely necessary although screening has been shown to reduce a man\u2019s chance of dying from prostate cancer, it would mean many people receive treatment unnecessarily More research is needed to determine whether a screening programme would provide men and anyone with a prostate with more benefit than harm. One European study showed deaths from prostate cancer could be reduced by 20% if there was a screening programme, but this needs to be balanced against the harms of: overdiagnosis \u2013 people being diagnosed with a cancer that will never cause symptoms or death during their lifetime overtreatment \u2013 people being treated unnecessarily for tumours that would be unlikely to be harmful Improving the test As there are many reasons why PSA levels may be high at any one time, researchers are trying to make the PSA test, or a variation of it, more accurate. This includes looking at how PSA levels change"}


created_at: 2025-05-10 06:05:47
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
id: c66282aa-b90b-4dac-bf96-b0ea3f509348
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/cancer/cancer-types-in-adults/prostate-cancer/", "start_index": 14437, "chroma:document": "at any one time, researchers are trying to make the PSA test, or a variation of it, more accurate. This includes looking at how PSA levels change over time and comparing the PSA level to prostate size. Researchers are also looking at whether new imaging tests, such as MRI scans, or other blood and urine tests, can be used to decide which people with an elevated PSA should have a biopsy. Instead of a national screening programme, there is an informed choice programme called prostate cancer risk management for healthy men and anyone with a prostate aged 50 or over who ask their GP about PSA testing. It aims to give men and anyone with a prostate good information on the pros and cons of a PSA test. If you\u2019re aged 50 or over with a prostate and decide to have your PSA levels tested after talking to your GP, they will be able to arrange for it to be carried out for free on the NHS. If results show you have a raised level of PSA, your GP may suggest further tests. Should I have a PSA test?"}


created_at: 2025-05-10 06:05:47
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
id: 0822dded-c642-4be3-b104-e3c33e99b6ea
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/cancer/cancer-types-in-adults/prostate-cancer/", "start_index": 15288, "chroma:document": "to be carried out for free on the NHS. If results show you have a raised level of PSA, your GP may suggest further tests. Should I have a PSA test? Because the results of the PSA test are not as reliable as doctors would like, other tests and investigations are needed to diagnose prostate cancer. A PSA test cannot identify prostate cancer on its own, and changes in PSA levels alone are not a good reason to start treatment. If you are thinking about asking for a PSA test, it is important that you first discuss whether it is right for you with your GP so you understand what the results might mean. The Prostate Cancer Risk Management Programme has information on the risks and benefits of the PSA test to help you decide whether or not to have it. Treating prostate cancer Staging of prostate cancer Doctors will use the results of your prostate examination, biopsy and scans to identify the \u2018stage\u2019 of your prostate cancer (how far the cancer has spread). The stage of the cancer will"}


created_at: 2025-05-10 06:05:47
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
id: 21f1eb1c-f60b-4c15-ba75-cb3ecfb3c486
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/cancer/cancer-types-in-adults/prostate-cancer/", "start_index": 16130, "chroma:document": "prostate examination, biopsy and scans to identify the \u2018stage\u2019 of your prostate cancer (how far the cancer has spread). The stage of the cancer will determine which types of treatments will be necessary. A widely used method of staging is a number staging system. The stages are: stage 1 \u2013 the cancer is very small and completely within the prostate gland stage 2 \u2013 the cancer is within the prostate gland, but is larger stage 3 \u2013 the cancer has spread from the prostate and may have grown into the tubes that carry semen stage 4 \u2013 the cancer has spread into the lymph nodes or another part of the body, including the bladder, rectum or bones; about 20 to 30% of cases are diagnosed at this stage If prostate cancer is diagnosed at an early stage, the chances of survival are generally good. Read further information: Cancer Research UK: The stages of prostate cancer Watchful waiting Watchful waiting is often recommended for older men and anyone with a prostate when it is unlikely that the cancer"}


created_at: 2025-05-10 06:05:47
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
id: 709ff8ab-6063-4b93-93e1-a8cceadd5958
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/cancer/cancer-types-in-adults/prostate-cancer/", "start_index": 16982, "chroma:document": "prostate cancer Watchful waiting Watchful waiting is often recommended for older men and anyone with a prostate when it is unlikely that the cancer will affect your natural life span. If the cancer is in its early stages and not causing symptoms, you may decide to delay treatment, and wait to see if any symptoms of progressive cancer develop. If this happens, pain medication and hormone medication to control prostate cancer are usually used. Watchful waiting may also be recommended for people with a higher risk of prostate cancer if: your general health means you are unable to receive any form of treatment your life expectancy means you will die with the cancer rather than from it In this case, hormone treatment may be started if there are symptoms caused by the prostate cancer. Active surveillance Active surveillance aims to avoid unnecessary treatment of harmless cancers, while still providing timely treatment for men and anyone with a prostate who needs it. When they are diagnosed,"}


created_at: 2025-05-10 06:05:47
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
id: a655146a-6f55-43ab-b086-c8cf43c4a38f
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/cancer/cancer-types-in-adults/prostate-cancer/", "start_index": 17838, "chroma:document": "treatment of harmless cancers, while still providing timely treatment for men and anyone with a prostate who needs it. When they are diagnosed, around half to two-thirds of men and anyone with a prostate with low-risk prostate cancer do not need treatment. Surveillance is a safe strategy that provides a period of observation to gather extra information over time to see whether the disease is changing. Active surveillance involves you having regular PSA tests and often several biopsies to ensure any signs of progression are found as early as possible. Sometimes, MRI scans may also be carried out. If these tests reveal the cancer is changing or progressing, you can then make a decision about further treatment. About 1 in 3 people who undergo surveillance will later have treatment. This does not mean they made the wrong initial decision. Good evidence shows that active surveillance is safe over an average of 6 years. Men undergoing active surveillance will have delayed any"}


created_at: 2025-05-10 06:05:47
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
id: 5c29e073-3185-490c-80cf-909c90331305
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/cancer/cancer-types-in-adults/prostate-cancer/", "start_index": 18675, "chroma:document": "decision. Good evidence shows that active surveillance is safe over an average of 6 years. Men undergoing active surveillance will have delayed any treatment-related side effects, and those who eventually need treatment will be reassured that it was necessary. Radical prostatectomy A radical prostatectomy is the surgical removal of your prostate gland. This treatment is an option for curing localised prostate cancer and locally-advanced prostate cancer. Like any operation, this surgery carries some risks, and there may be some side effects: some people have problems with urinary incontinence \u2013 this can range from leaking small drips of urine, to leaking larger amounts but this usually clears up within 3 to 6 months of the operation some men have problems getting an erection (erectile dysfunction) \u2013 this sometimes improves with time, but around half will have long-term problems in extremely rare cases, problems arising after surgery can be fatal For many men and anyone with a prostate,"}


created_at: 2025-05-10 06:05:48
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
id: 90b07c72-a385-41ca-86ef-fc2a1311e5cb
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/cancer/cancer-types-in-adults/prostate-cancer/", "start_index": 19531, "chroma:document": "half will have long-term problems in extremely rare cases, problems arising after surgery can be fatal For many men and anyone with a prostate, having a radical prostatectomy will get rid of the cancer cells. However, for around 1 in 3 people, the cancer cells may not be fully removed, and the cancer cells may return sometime after the operation. Radiotherapy after prostate removal surgery may increase the chances of a cure, although research is still being carried out into when it should be used after surgery. After a radical prostatectomy, you will no longer ejaculate during sex. This means that you will not be able to have a child through sexual intercourse. You may want to ask your doctors about storing a sperm sample before the operation, so it can be used later for in vitro fertilisation (IVF). Read further information: Macmillan: Surgery for early prostate cancer Radiotherapy Radiotherapy involves using radiation to kill cancerous cells. This treatment is an option for curing"}


created_at: 2025-05-10 06:05:48
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
id: 49bc2ea3-74a0-4436-81e9-2456be8cbbdd
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/cancer/cancer-types-in-adults/prostate-cancer/", "start_index": 20380, "chroma:document": "Surgery for early prostate cancer Radiotherapy Radiotherapy involves using radiation to kill cancerous cells. This treatment is an option for curing localised prostate cancer and locally-advanced prostate cancer. Radiotherapy can also be used to slow the progression of metastatic prostate cancer and relieve symptoms. Radiotherapy is normally given as an outpatient at a hospital near you. It is done in short sessions for 5 days a week, for 4 to 8 weeks. There are short-term and long-term side effects associated with radiotherapy. You may receive hormone therapy before undergoing radiotherapy to increase the chance of successful treatment. Hormone therapy may also be recommended after radiotherapy to reduce the chances of cancerous cells returning. Short-term effects of radiotherapy can include: discomfort around the rectum and anus (the opening through which stools pass out of your body) diarrhoea loss of pubic hair tiredness cystitis \u2013 an inflammation of the bladder lining, which can"}


created_at: 2025-05-10 06:05:48
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
id: 89ccaa6a-950f-45cc-9e32-f13b7e61317b
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/cancer/cancer-types-in-adults/prostate-cancer/", "start_index": 21236, "chroma:document": "through which stools pass out of your body) diarrhoea loss of pubic hair tiredness cystitis \u2013 an inflammation of the bladder lining, which can cause you to urinate frequently; urination may be painful Possible long-term side effects can include: an inability to obtain an erection urinary incontinence back passage problems (diarrhoea, bleeding, discomfort) As with radical prostatectomy, there is a 1 in3 chance the cancer will return. In these cases, medication is usually used to control the cancer instead of surgery. This is because there is a higher risk of complications from surgery in men and anyone with a prostate who have previously had radiotherapy. Some hospitals now offer new minimally invasive treatments if radiotherapy fails to work, sometimes as part of a clinical trial. These new treatments are called high-intensity focused ultrasound (HIFU) and cryotherapy. These treatments have fewer side effects, but the long-term outcomes are not yet known. Read further information:"}


created_at: 2025-05-10 06:05:48
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
id: 8bde3859-b9ab-4a44-92a7-bdf612194ebf
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/cancer/cancer-types-in-adults/prostate-cancer/", "start_index": 22083, "chroma:document": "ultrasound (HIFU) and cryotherapy. These treatments have fewer side effects, but the long-term outcomes are not yet known. Read further information: Macmillan Cancer Support: Radiotherapy for prostate cancer Brachytherapy Brachytherapy is a form of radiotherapy where the radiation dose is delivered inside the prostate gland. It is also known as internal or interstitial radiotherapy. The radiation can be delivered using a number of tiny radioactive seeds that are surgically implanted into the tumour. This is called low dose-rate brachytherapy. The radiation can also be delivered through hollow, thin needles placed inside the prostate. This is called high dose-rate brachytherapy. This method has the advantage of delivering a high dose of radiation to the prostate, while minimising damage to other tissues. However, the risk of sexual dysfunction and urinary problems is the same as with radiotherapy, although the risk of bowel problems is slightly lower. Read further information: Cancer"}


created_at: 2025-05-10 06:05:48
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
id: b919b80f-d162-4d35-8b1d-b6ac46e4c2a8
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/cancer/cancer-types-in-adults/prostate-cancer/", "start_index": 22938, "chroma:document": "and urinary problems is the same as with radiotherapy, although the risk of bowel problems is slightly lower. Read further information: Cancer Research UK: Internal radiotherapy (brachytherapy) for prostate cancer Hormone therapy Hormone therapy is often used in combination with radiotherapy. For example, you may receive hormone therapy before undergoing radiotherapy to increase the chance of a successful treatment. Hormone therapy may also be recommended after radiotherapy to reduce the chances of cancerous cells returning. Hormone therapy alone should not normally be used to treat localised prostate cancer in people who are fit and willing to receive surgery or radiotherapy. This is because it does not cure the cancer on its own. Hormone therapy can be used to slow the progression of advanced prostate cancer and relieve symptoms. Hormones control the growth of cells in the prostate. In particular, prostate cancer needs the hormone testosterone to grow. The purpose of hormone therapy"}


created_at: 2025-05-10 06:05:48
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
id: a256bd27-8e06-4eb5-bf2c-f83142b57e9e
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/cancer/cancer-types-in-adults/prostate-cancer/", "start_index": 23791, "chroma:document": "control the growth of cells in the prostate. In particular, prostate cancer needs the hormone testosterone to grow. The purpose of hormone therapy is to block the effects of testosterone, either by stopping its production or by stopping your body being able to use testosterone. Hormone therapy can be given as: injections to stop your body making testosterone, called luteinising hormone-releasing hormone (LHRH) agonists tablets to block the effects or reduce the production of testosterone, called anti-androgen treatment combined LHRH and anti-androgen treatment The main side effects of hormone treatment are caused by their effects on testosterone. They usually go away when treatment stops. They include loss of sex drive and erectile dysfunction (this is more common with LHRH agonists than anti-androgens). Other possible side effects include: hot flushes sweating weight gain swelling and tenderness of the breasts An alternative to hormone therapy is to surgically remove the testicles,"}


created_at: 2025-05-10 06:05:48
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/cancer/cancer-types-in-adults/prostate-cancer/", "start_index": 24644, "chroma:document": "hot flushes sweating weight gain swelling and tenderness of the breasts An alternative to hormone therapy is to surgically remove the testicles, called orchidectomy. The operation does not cure prostate cancer, but by removing the testosterone, it controls the growth of the cancer and its symptoms. Read further information: Cancer Research UK: Hormone therapy for prostate cancer Trans-urethral resection of the prostate (TURP) During TURP, a thin metal wire with a loop at the end is inserted into your urethra (the tube that carries urine from your bladder to your penis) and pieces of the prostate are removed. This is carried out under general anaesthetic or a spinal anaesthetic (epidural). This is done to relieve pressure from the urethra to treat any problematic symptoms you may have with urination. It does not cure the cancer. Read more information about transurethral resection of the prostate (TURP). High intensity focused ultrasound (HIFU) HIFU is sometimes used to treat men and"}


created_at: 2025-05-10 06:05:48
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
id: c8bdbd1e-48ec-4892-9b42-e4f563fcff32
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/cancer/cancer-types-in-adults/prostate-cancer/", "start_index": 25494, "chroma:document": "information about transurethral resection of the prostate (TURP). High intensity focused ultrasound (HIFU) HIFU is sometimes used to treat men and anyone with a prostate with localised prostate cancer that has not spread beyond their prostate. An ultrasound probe inserted into the rectum releases high-frequency sound waves through the wall of the rectum. These sound waves kill cancer cells in the prostate gland by heating them to a high temperature. The risk of side effects from HIFU is usually lower than other treatments. However, possible effects can include impotence (in 5 to 10 in every 100) or urinary incontinence (in less than 1 in every 100). Back passage problems are rare. Fistulas (an abnormal channel between the urinary system and rectum) are also rare, affecting less than 1 in every 500. This is because the treatment targets the cancer area only and not the whole prostate. However, HIFU treatment is still going through clinical trials for prostate cancer. In some cases,"}


created_at: 2025-05-10 06:05:48
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
id: 8ce48098-88a6-4f91-aaea-d0c9624fbf4e
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/cancer/cancer-types-in-adults/prostate-cancer/", "start_index": 26342, "chroma:document": "the cancer area only and not the whole prostate. However, HIFU treatment is still going through clinical trials for prostate cancer. In some cases, doctors can carry out HIFU treatment outside of clinical trials. HIFU is not widely available and its long-term effectiveness has not yet been conclusively proven. Read further information: Cancer Research UK: High intensity focused ultrasound (HIFU) for prostate cancer Cryotherapy Cryotherapy is a method of killing cancer cells by freezing them. It is sometimes used to treat men and anyone with a prostate with localised prostate cancer that has not spread beyond their prostate gland. Tiny probes called cryoneedles are inserted into the prostate gland through the wall of the rectum. They freeze the prostate gland and kill the cancer cells, but some normal cells also die. The aim is to kill cancer cells while causing as little damage as possible to healthy cells. The side effects of cryotherapy can include: erectile dysfunction \u2013 this can"}


created_at: 2025-05-10 06:05:48
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
id: 521502de-83a8-4f38-8d4a-0597360024de
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/cancer/cancer-types-in-adults/prostate-cancer/", "start_index": 27196, "chroma:document": "cells while causing as little damage as possible to healthy cells. The side effects of cryotherapy can include: erectile dysfunction \u2013 this can affect between 2 and 9 in every 10 incontinence \u2013 this affects less than 1 in 20 It is rare for cryotherapy to cause rectal problems or fistulas. Cryotherapy is still undergoing clinical trials for prostate cancer. In some cases, doctors can carry out cryotherapy treatment outside of clinical trials. It is not widely available and its long-term effectiveness has not yet been conclusively proven. Treating advanced prostate cancer If the cancer has reached an advanced stage, it is no longer possible to cure it. However, it may be possible to slow its progression, prolong your life and relieve symptoms. Treatment options include: radiotherapy hormone treatment chemotherapy If the cancer has spread to your bones, medicines called bisphosphonates may be used. Bisphosphonates help reduce bone pain and bone loss. Chemotherapy Chemotherapy is mainly"}


created_at: 2025-05-10 06:05:48
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
id: 75c3e87a-0214-4b52-887b-f323fd724523
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/cancer/cancer-types-in-adults/prostate-cancer/", "start_index": 28044, "chroma:document": "to your bones, medicines called bisphosphonates may be used. Bisphosphonates help reduce bone pain and bone loss. Chemotherapy Chemotherapy is mainly used to treat prostate cancer that has spread to other parts of the body (metastatic prostate cancer) and which is not responding to hormone therapy. Chemotherapy destroys cancer cells by interfering with the way they multiply. Chemotherapy does not cure prostate cancer, but can keep it under control and reduce symptoms (such as pain) so everyday life is less affected. The main side effects of chemotherapy are caused by their effects on healthy cells, such as immune cells. They include infections, tiredness, hair loss, sore mouth, loss of appetite, nausea and vomiting. Many of these side effects can be prevented or controlled with other medicines, which your doctor can prescribe for you. Steroids Steroid tablets are used when hormone therapy no longer works because the cancer is resistant to it. This is called hormone-refractory cancer."}


created_at: 2025-05-10 06:05:48
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
id: 9d11b1c0-7e76-44ea-a6bb-7863aa866a97
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/cancer/cancer-types-in-adults/prostate-cancer/", "start_index": 28900, "chroma:document": "Steroid tablets are used when hormone therapy no longer works because the cancer is resistant to it. This is called hormone-refractory cancer. Steroids can be used to try to shrink the tumour and stop it from growing. The most effective steroid treatment is dexamethasone. Other medical treatments There are a number of new medications that could be used if hormones and chemotherapy fail. Your medical team can tell you if these are suitable and available for you. Deciding against treatment As many of the treatments above have unpleasant side effects that can affect your quality of life, you may decide against treatment. This may be especially true if you are at an age when you feel that treating the cancer is unlikely to significantly extend your life expectancy. This is entirely your decision, and your MDT will respect it. If you decide not to have treatment, your GP and hospital team will still give you support and pain relief. This is called palliative care. Support is also available"}


created_at: 2025-05-10 06:05:49
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
id: b7304af3-85c3-4e14-aaa4-87b3cbbaf150
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/cancer/cancer-types-in-adults/prostate-cancer/", "start_index": 29752, "chroma:document": "to have treatment, your GP and hospital team will still give you support and pain relief. This is called palliative care. Support is also available for your family and friends. Living with prostate cancer Impact on everyday activities If you have no symptoms, prostate cancer should have little or no effect on your everyday activities. You should be able to work, care for your family, carry on your usual social and leisure activities, and look after yourself. However, you may be understandably worried about your future. This may make you feel anxious or depressed, and affect your sleep. If your prostate cancer progresses, you may not feel well enough to do all the things you used to. After an operation or other treatment, such as radiotherapy or chemotherapy, you will probably feel tired and need time to recover. If you have advanced prostate cancer that has spread to other parts of your body, you may have symptoms that slow you down and make it difficult to do things. You may have to"}


created_at: 2025-05-10 06:05:49
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
id: d76e2a57-e3af-4826-afd0-df05a63f1a6f
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/cancer/cancer-types-in-adults/prostate-cancer/", "start_index": 30606, "chroma:document": "cancer that has spread to other parts of your body, you may have symptoms that slow you down and make it difficult to do things. You may have to reduce your working hours or stop working altogether. Whatever stage your prostate cancer has reached, try to give yourself time to do the things you enjoy and spend time with those who care about you. Read further information: Cancer Research UK: Coping and support if you have prostate cancer Complications of prostate cancer Erection problems If you have erectile dysfunction, speak to your GP. It may be possible to treat you with a type of medicine known as phosphodiesterase type 5 inhibitors (PDE5). PDE5s work by increasing the blood supply to your penis. The most commonly used PDE5 is sildenafil (Viagra). Other PDE5s are available if sildenafil is not effective. Another alternative is a device called a vacuum pump. It is a simple tube connected to a pump. You place your penis in the tube and then pump out all the air. This creates a"}


created_at: 2025-05-10 06:05:49
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
id: a689261a-913d-4915-b3e9-4cbd416dc269
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/cancer/cancer-types-in-adults/prostate-cancer/", "start_index": 31450, "chroma:document": "device called a vacuum pump. It is a simple tube connected to a pump. You place your penis in the tube and then pump out all the air. This creates a vacuum, which causes the blood to rush to your penis. You then place a rubber ring around the base of your penis. This keeps the blood in place and allows you to maintain an erection for around 30 minutes. Urinary incontinence If your urinary incontinence is mild, you may be able to control it by learning some simple exercises. Pelvic floor exercises can strengthen your control over your bladder. To carry out pelvic floor exercises: Sit or lie comfortably with your knees slightly apart. Squeeze or lift at the front as if you were trying to stop the passage of urine, then squeeze or lift at the back as if you were trying to stop the passage of wind. Hold this contraction for as long as you can (at least 2 seconds, increasing up to 10 as you improve). Relax for the same amount of time before repeating. If your urinary incontinence is more"}


created_at: 2025-05-10 06:05:49
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
id: 7d8a5d80-4522-4566-b9b0-7929948c7ad9
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/cancer/cancer-types-in-adults/prostate-cancer/", "start_index": 32301, "chroma:document": "(at least 2 seconds, increasing up to 10 as you improve). Relax for the same amount of time before repeating. If your urinary incontinence is more severe, it may be possible to treat it with surgery. This would involve implanting an artificial sphincter \u2013 a sphincter is a muscle used to control the bladder. Read further information: Prostate Cancer UK: Sex and relationships Prostate Cancer UK: Urinary problems after prostate cancer treatment Relationships Being diagnosed with prostate cancer often brings families and friends closer, although it can put pressure on relationships too. Most people want to help, though they may not know what to do. A few people find it hard to talk to someone with prostate cancer, and may try to avoid them. Being open and honest about how you feel and what your family and friends can do to help may put others at ease. But do not feel shy about telling people that you need some time to yourself, if that is what you need. Read further information: Macmillan"}


created_at: 2025-05-10 06:05:49
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/cancer/cancer-types-in-adults/prostate-cancer/", "start_index": 33152, "chroma:document": "at ease. But do not feel shy about telling people that you need some time to yourself, if that is what you need. Read further information: Macmillan Cancer Support: Cancer and your emotions Talking to your kids about cancer Talk to others If you have questions, your doctor or nurse may be able to reassure you, or you may find it helpful to talk to a trained counsellor, psychologist or specialist helpline. Your GP practice will have information on these. You may find it helpful to talk to others with prostate cancer at a local support group or through an internet chat room. Read further information: Prostate Cancer UK: Online community Prostate Cancer UK: phone the confidential helpline on 0800 074 8383 to speak to a specialist nurse Money and financial support If you have to reduce or stop work because of your prostate cancer, you may find it hard to cope financially. If you have prostate cancer or are caring for someone with prostate cancer, you may be entitled to financial support."}


created_at: 2025-05-10 06:05:49
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
id: 8f41ef66-de5a-4ef6-8ead-308bcd232e44
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/cancer/cancer-types-in-adults/prostate-cancer/", "start_index": 34004, "chroma:document": "it hard to cope financially. If you have prostate cancer or are caring for someone with prostate cancer, you may be entitled to financial support. if you have a job but cannot work because of your illness, you are entitled to Statutory Sick Pay from your employer if you do not have a job and cannot work because of your illness, you may be entitled to Employment Support Allowance if you are caring for someone with cancer, you may be entitled to Carer\u2019s Allowance you may be eligible for other benefits if you have children living at home or if you have a low household income Find out early what help is available to you. Speak to the social worker at your hospital, who can give you the information you need. Read further information: GOV.UK: Benefits Citizens Advice Scotland Money Advice Service Source: NHS 24 - Opens in new browser window Last updated: 09 October 2024 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Don\u2019t include personal"}


created_at: 2025-05-10 06:05:49
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/cancer/cancer-types-in-adults/prostate-cancer/", "start_index": 34856, "chroma:document": "updated: 09 October 2024 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Don\u2019t include personal information e.g. name, location or any personal health conditions. Email Address e.g. you@example.com Message Maximum of 500 characters Send feedback Add this page to Info For Me Other health sites Malecare Prostate Cancer UK Scottish Cancer Network: Patient information NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats \u00a9 2025 NHS 24 \u2013 v1.1.1.17852"}


created_at: 2025-05-10 06:05:49
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/skin-hair-and-nails/psoriasis/", "start_index": 0, "chroma:document": "Psoriasis | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotland\u2019s Service Directory 0 Home Illnesses and conditions Skin, hair and nails Psoriasis Psoriasis About psoriasis Symptoms of psoriasis Causes of psoriasis Treating psoriasis Living with psoriasis About psoriasis Psoriasis is a skin condition that causes red, flaky, crusty patches of skin covered with silvery scales. These patches normally appear on your elbows, knees, scalp and lower back, but can appear anywhere on your body. Most people are only affected with small patches. In some cases, the patches can be itchy or sore. Psoriasis affects around 2% of people in the UK. It can start at any age, but most often develops in adults under 35 years old. The condition affects men and women equally. The severity of psoriasis varies greatly from person to person. For some people it\u2019s just a minor irritation, but for others it can have a major impact on"}


created_at: 2025-05-10 06:05:49
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
id: 66c6c886-474d-467e-8d65-4c26a594d94b
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/skin-hair-and-nails/psoriasis/", "start_index": 858, "chroma:document": "of psoriasis varies greatly from person to person. For some people it\u2019s just a minor irritation, but for others it can have a major impact on their quality of life. Psoriasis is a long-lasting (chronic) disease that usually involves periods when you have no symptoms or mild symptoms, followed by periods when symptoms are more severe. Read more about the symptoms of psoriasis. Psoriasis causes areas of red, flaky and crusty skin.Source: https://dermnetnz.org/ Why it happens People with psoriasis have an increased production of skin cells. Skin cells are normally made and replaced every 3 to 4 weeks, but in psoriasis this process only lasts about 3 to 7 days. The resulting build-up of skin cells is what creates the patches associated with psoriasis. Although the process isn\u2019t fully understood, it\u2019s thought to be related to a problem with the immune system. The immune system is your body\u2019s defence against disease and infection, but for people with psoriasis, it attacks healthy skin cells"}


created_at: 2025-05-10 06:05:49
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
id: f35d1f65-5ca7-4bc3-ab36-025a0ae869b2
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/skin-hair-and-nails/psoriasis/", "start_index": 1710, "chroma:document": "immune system. The immune system is your body\u2019s defence against disease and infection, but for people with psoriasis, it attacks healthy skin cells by mistake. Psoriasis can run in families, although the exact role that genetics plays in causing psoriasis is unclear. Many people\u2019s psoriasis symptoms start or become worse because of a certain event, known as a \u201ctrigger\u201d. Possible triggers of psoriasis include an injury to your skin, throat infections and using certain medicines. The condition isn\u2019t contagious, so it can\u2019t be spread from person to person. Read more about the causes of psoriasis. How psoriasis is diagnosed A GP can often diagnose psoriasis based on the appearance of your skin. In rare cases, a small sample of skin, called a biopsy, will be sent to the laboratory for examination under a microscope. This determines the exact type of psoriasis and rules out other skin disorders, such as seborrhoeic dermatitis, lichen planus, lichen simplex and pityriasis rosea. You may be"}


created_at: 2025-05-10 06:05:49
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
id: 0bd285d9-db97-4659-809a-9fabc529da82
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/skin-hair-and-nails/psoriasis/", "start_index": 2559, "chroma:document": "type of psoriasis and rules out other skin disorders, such as seborrhoeic dermatitis, lichen planus, lichen simplex and pityriasis rosea. You may be referred to a dermatologist (a specialist in diagnosing and treating skin conditions) if your doctor is uncertain about your diagnosis, or if your condition is severe. If your doctor suspects you have psoriatic arthritis, which is sometimes a complication of psoriasis, you may be referred to a rheumatologist (a doctor who specialises in arthritis). You may have blood tests to rule out other conditions, such as rheumatoid arthritis, and X-rays of the affected joints may be taken. Treating psoriasis There\u2019s no cure for psoriasis, but a range of treatments can improve symptoms and the appearance of skin patches. In most cases, the first treatment used will be a topical treatment, such as vitamin D analogues or topical corticosteroids. Topical treatments are creams and ointments applied to the skin. If these aren\u2019t effective, or your"}


created_at: 2025-05-10 06:05:50
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
id: 2f01be64-537e-4a2c-810f-510198a3dbcb
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/skin-hair-and-nails/psoriasis/", "start_index": 3402, "chroma:document": "vitamin D analogues or topical corticosteroids. Topical treatments are creams and ointments applied to the skin. If these aren\u2019t effective, or your condition is more severe, a treatment called phototherapy may be used. Phototherapy involves exposing your skin to certain types of ultraviolet light. In severe cases, where the above treatments are ineffective, systemic treatments may be used. These are oral or injected medicines that work throughout the whole body. Read more about treating psoriasis. Living with psoriasis Although psoriasis is just a minor irritation for some people, it can have a significant impact on quality of life for those more severely affected. For example, some people with psoriasis have low self-esteem because of the effect the condition has on their appearance. It\u2019s also quite common to develop tenderness, pain and swelling in the joints and connective tissue. This is known as psoriatic arthritis. Speak to your GP or healthcare team if you have psoriasis and"}


created_at: 2025-05-10 06:05:50
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
id: 34f26e34-563a-4c60-921b-ad43398a8572
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/skin-hair-and-nails/psoriasis/", "start_index": 4249, "chroma:document": "and swelling in the joints and connective tissue. This is known as psoriatic arthritis. Speak to your GP or healthcare team if you have psoriasis and you have any concerns about your physical and mental wellbeing. They can offer advice and further treatment if necessary. There are also support groups for people with psoriasis, such as The Psoriasis Association, where you can speak to other people with the condition. Read more about living with psoriasis. Further information You can find support and information from organisations like: Changing Faces \u2013 a charity for people who have a visible difference or facial disfigurement, who can be contacted on 0300 012 0275 for counselling and advice The Psoriasis Association \u2013 provides support groups for people with psoriasis where you can speak to other people with the condition Symptoms of psoriasis Psoriasis typically causes patches of skin that are dry, red and covered in silver scales. Some people find their psoriasis causes itching or"}


created_at: 2025-05-10 06:05:50
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
id: 8319dc37-3016-4f2a-9f18-28dea639990d
encoding: FLOAT32
metadata:
{"source": "https://www.nhsinform.scot/illnesses-and-conditions/skin-hair-and-nails/psoriasis/", "start_index": 5103, "chroma:document": "Psoriasis typically causes patches of skin that are dry, red and covered in silver scales. Some people find their psoriasis causes itching or soreness. There are several different types of psoriasis. Many people have only one form of psoriasis at a time, although 2 different types can occur together. One type may change into another type, or become more severe. Most cases of psoriasis go through cycles, causing problems for a few weeks or months before easing or stopping. You should see your GP if you think you may have psoriasis. Psoriasis often occurs on the elbow area.Source: https://dermnetnz.org/ Common types of psoriasis Plaque psoriasis (psoriasis vulgaris) This is the most common form, accounting for about 80% of cases. Its symptoms are dry, red skin lesions, known as plaques, which are covered in silver scales. They normally appear on your elbows, knees, scalp and lower back, but can appear anywhere on your body. The plaques can be itchy, sore or both. In severe cases, the"}


created_at: 2025-05-10 06:05:50
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
id: 5de404b6-0027-4382-bb4f-4f30c359ffd4
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/skin-hair-and-nails/psoriasis/", "start_index": 5956, "chroma:document": "on your elbows, knees, scalp and lower back, but can appear anywhere on your body. The plaques can be itchy, sore or both. In severe cases, the skin around your joints may crack and bleed. Scalp psoriasis This can occur on parts of your scalp or on the whole scalp. It causes red patches of skin covered in thick silvery-white scales. Some people find scalp psoriasis extremely itchy, while others have no discomfort. In extreme cases it can cause hair loss, although this is usually only temporary. Nail psoriasis In about half of all people with psoriasis, the condition affects the nails. Psoriasis can cause your nails to develop tiny dents or pits, become discoloured, or grow abnormally. Nails can often become loose and separate from your nail bed. In severe cases, your nails may crumble. Guttate psoriasis Guttate psoriasis causes small (less than 1cm or 1/3 inch) drop-shaped sores on your chest, arms, legs and scalp. There\u2019s a good chance that guttate psoriasis will disappear completely"}


created_at: 2025-05-10 06:05:50
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
id: cde42836-539b-4f58-adc1-c25e338080c8
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/skin-hair-and-nails/psoriasis/", "start_index": 6808, "chroma:document": "than 1cm or 1/3 inch) drop-shaped sores on your chest, arms, legs and scalp. There\u2019s a good chance that guttate psoriasis will disappear completely after a few weeks, but some people go on to develop plaque psoriasis. This type of psoriasis sometimes occurs after a streptococcal throat infection and is more common among children and teenagers. Inverse (flexural) psoriasis This affects folds or creases in your skin, such as the armpits, groin, between the buttocks and under the breasts. It can cause large, smooth red patches in some or all of these areas. Inverse psoriasis is made worse by friction and sweating, so it can be particularly uncomfortable in hot weather. Pustular psoriasis Pustular psoriasis is a rarer type of psoriasis that causes pus-filled blisters (pustules) to appear on your skin. Different types of pustular psoriasis affect different parts of the body. Generalised pustular psoriasis or von Zumbusch psoriasis This causes pustules on a wide area of skin, which develop"}


created_at: 2025-05-10 06:05:50
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
id: 6b281a36-bb2c-44b8-a0e9-27e2ad423bc0
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/skin-hair-and-nails/psoriasis/", "start_index": 7662, "chroma:document": "different parts of the body. Generalised pustular psoriasis or von Zumbusch psoriasis This causes pustules on a wide area of skin, which develop very quickly. The pus consists of white blood cells and is not a sign of infection. The pustules may reappear every few days or weeks in cycles. During the start of these cycles, von Zumbusch psoriasis can cause fever, chills, weight loss and fatigue. Palmoplantar pustular psoriasis This causes pustules to appear on the palms of your hands and the soles of your feet. The pustules gradually develop into circular brown, scaly spots, which then peel off. Pustules may reappear every few days or weeks. Acropustulosis This causes pustules to appear on your fingers and toes. The pustules then burst, leaving bright red areas that may ooze or become scaly. These may lead to painful nail deformities. Erythrodermic psoriasis Erythrodermic psoriasis is a rare form of psoriasis that affects nearly all the skin on the body. This can cause intense itching"}


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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/skin-hair-and-nails/psoriasis/", "start_index": 8521, "chroma:document": "psoriasis Erythrodermic psoriasis is a rare form of psoriasis that affects nearly all the skin on the body. This can cause intense itching or burning. Erythrodermic psoriasis can cause your body to lose proteins and fluid, leading to further problems such as infection, dehydration, heart failure, hypothermia and malnutrition. Causes of psoriasis Psoriasis occurs when skin cells are replaced more quickly than usual. It\u2019s not known exactly why this happens, but research suggests it\u2019s caused by a problem with the immune system. Your body produces new skin cells in the deepest layer of skin. These skin cells gradually move up through the layers of skin until they reach the outermost level. Then they die and flake off. This whole process normally takes around 3 to 4 weeks. In people with psoriasis, this process only takes about 3 to 7 days. As a result, cells that aren\u2019t fully mature build up rapidly on the surface of the skin, causing red, flaky, crusty patches covered with silvery"}


created_at: 2025-05-10 06:05:50
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
id: 6abd23c4-7feb-4c55-a698-c2c065968c9c
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/skin-hair-and-nails/psoriasis/", "start_index": 9369, "chroma:document": "As a result, cells that aren\u2019t fully mature build up rapidly on the surface of the skin, causing red, flaky, crusty patches covered with silvery scales. Problems with the immune system Your immune system is your body\u2019s defence against disease and it helps fight infection. One of the main types of cell used by the immune system is called a T-cell. T-cells normally travel through the body to detect and fight invading germs such as bacteria, but in people with psoriasis they start to attack healthy skin cells by mistake. This causes the deepest layer of skin to produce new skin cells more quickly than usual, which in turn triggers the immune system to produce more T-cells. It\u2019s not known what exactly causes this problem with the immune system, although certain genes and environmental triggers may play a role. Genetics Psoriasis runs in families. 1 in 3 people with psoriasis has a close relative with the condition. However, the exact role that genetics plays in causing psoriasis is"}


created_at: 2025-05-10 06:05:50
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
id: f379990e-c725-4841-a429-b9cf71e1c240
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/skin-hair-and-nails/psoriasis/", "start_index": 10214, "chroma:document": "families. 1 in 3 people with psoriasis has a close relative with the condition. However, the exact role that genetics plays in causing psoriasis is unclear. Research studies have shown many different genes are linked to the development of psoriasis. It\u2019s likely that different combinations of genes may make people more vulnerable to the condition. However, having these genes doesn\u2019t necessarily mean you\u2019ll develop it. Psoriasis triggers Many people\u2019s psoriasis symptoms start or become worse because of a certain event, known as a trigger. Knowing your triggers may help you to avoid a flare-up. Common triggers include: an injury to your skin, such as a cut, scrape, insect bite or sunburn (this is known as the Koebner response) drinking excessive amounts of alcohol smoking stress hormonal changes, particularly in women (for example, during puberty and the menopause) certain medicines such as lithium, some antimalarial medicines, anti-inflammatory medicines including ibuprofen, ACE"}


created_at: 2025-05-10 06:05:50
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
id: 4d19f668-a65b-4414-aa0b-0caaff203f1d
encoding: FLOAT32
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/skin-hair-and-nails/psoriasis/", "start_index": 11062, "chroma:document": "puberty and the menopause) certain medicines such as lithium, some antimalarial medicines, anti-inflammatory medicines including ibuprofen, ACE inhibitors (used to treat high blood pressure) and beta blockers (used to treat congestive heart failure) throat infections \u2013 in some people, usually children and young adults, a form of psoriasis called guttate psoriasis develops after a streptococcal throat infection (although most people who have streptococcal throat infections don\u2019t develop psoriasis) other immune disorders, such as HIV, which cause psoriasis to flare up or to appear for the first time Psoriasis isn\u2019t contagious, so it can\u2019t be spread from person to person. Treating psoriasis Treatment overview Treatments are determined by the type and severity of your psoriasis and the area of skin affected. Your doctor will probably start with a mild treatment, such as topical creams (which are applied to the skin), and then move on to stronger treatments if necessary. A wide range of"}


created_at: 2025-05-10 06:05:50
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
id: 0ebb1496-305d-4b77-9edf-31771c7a509c
encoding: FLOAT32
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/skin-hair-and-nails/psoriasis/", "start_index": 11910, "chroma:document": "with a mild treatment, such as topical creams (which are applied to the skin), and then move on to stronger treatments if necessary. A wide range of treatments are available for psoriasis, but identifying which treatment is most effective can be difficult. Talk to your doctor if you feel a treatment isn\u2019t working or you have uncomfortable side effects. Treatments fall into 3 categories: topical \u2013 creams and ointments that are applied to your skin phototherapy \u2013 your skin is exposed to certain types of ultraviolet light systemic\u2013 oral and injected medications that work throughout the entire body Often, different types of treatment are used in combination. Your treatment for psoriasis may need to be reviewed regularly. You may want to make a care plan (an agreement between you and your health professional) as this can help you manage your day-to-day health. The various treatments for psoriasis are outlined below. You can also read a summary of the pros and cons of the treatments for"}


created_at: 2025-05-10 06:05:50
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
id: 5ea54c63-bf23-47e5-828c-1d8684304c9e
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/skin-hair-and-nails/psoriasis/", "start_index": 12759, "chroma:document": "day-to-day health. The various treatments for psoriasis are outlined below. You can also read a summary of the pros and cons of the treatments for psoriasis, allowing you to compare your treatment options. Topical treatments Topical treatments are usually the first treatments used for mild to moderate psoriasis. These are creams and ointments you apply to affected areas. Some people find that topical treatments are all they need to control their condition, although it may take up to 6 weeks before there\u2019s a noticeable effect. If you have scalp psoriasis, a combination of shampoo and ointment may be recommended. Emollients Emollients are moisturising treatments applied directly to the skin to reduce water loss and cover it with a protective film. If you have mild psoriasis, an emollient is probably the first treatment your GP will suggest. The main benefit of emollients is to reduce itching and scaling. Some topical treatments are thought to work better on moisturised skin. It\u2019s"}


created_at: 2025-05-10 06:05:51
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
id: 1a31b467-1027-4cca-a57e-3aa08984d347
encoding: FLOAT32
metadata:
{"source": "https://www.nhsinform.scot/illnesses-and-conditions/skin-hair-and-nails/psoriasis/", "start_index": 13610, "chroma:document": "The main benefit of emollients is to reduce itching and scaling. Some topical treatments are thought to work better on moisturised skin. It\u2019s important to wait at least half an hour before applying a topical treatment after an emollient. Emollients are available as a wide variety of products and can be bought over the counter from a pharmacy or prescribed by your GP, nurse or health visitor. Steroid creams or ointments Steroid creams or ointments (topical corticosteroids) are commonly used to treat mild to moderate psoriasis in most areas of the body. The treatment works by reducing inflammation. This slows the production of skin cells and reduces itching. Topical corticosteroids range in strength from mild to very strong. Only use topical corticosteroids when recommended by your doctor. Stronger topical corticosteroids can be prescribed by your doctor and should only be used on small areas of skin or on particularly thick patches. Overusing topical corticosteroids can lead to skin"}


created_at: 2025-05-10 06:05:51
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
id: 1a3ac01f-9652-401a-a47a-752679dcb6ec
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/skin-hair-and-nails/psoriasis/", "start_index": 14460, "chroma:document": "by your doctor and should only be used on small areas of skin or on particularly thick patches. Overusing topical corticosteroids can lead to skin thinning. Vitamin D analogues Vitamin D analogue creams are commonly used along with or instead of steroid creams for mild to moderate psoriasis affecting areas such as the limbs, trunk or scalp. They work by slowing the production of skin cells. They also have an anti-inflammatory effect. Examples of vitamin D analogues are calcipotriol, calcitriol and tacalcitol. There are very few side effects, as long as you don\u2019t use more than the recommended amount. Calcineurin inhibitors Calcineurin inhibitors, such as tacrolimus and pimecrolimus, are ointments or creams that reduce the activity of the immune system and help to reduce inflammation. They\u2019re sometimes used to treat psoriasis affecting sensitive areas (such as the scalp, the genitals and folds in the skin) if steroid creams aren\u2019t effective. These medications can cause skin irritation"}


created_at: 2025-05-10 06:05:51
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
id: c4fb64a2-f5fa-40a6-9bf5-bf1b3842ca69
encoding: FLOAT32
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/skin-hair-and-nails/psoriasis/", "start_index": 15316, "chroma:document": "areas (such as the scalp, the genitals and folds in the skin) if steroid creams aren\u2019t effective. These medications can cause skin irritation or a burning and itching sensation when they\u2019re started, but this usually improves within a week. Coal tar Coal tar is a thick, heavy oil and is probably the oldest treatment for psoriasis. How it works isn\u2019t exactly known, but it can reduce scales, inflammation and itchiness. It may be used to treat psoriasis affecting the limbs, trunk or scalp if other topical treatments aren\u2019t effective. Coal tar can stain clothes and bedding, and has a strong smell. It can be used in combination with phototherapy (see below). Dithranol Dithranol has been used for over 50 years to treat psoriasis. It has been shown to be effective in suppressing the production of skin cells and has few side effects. However, it can burn if too concentrated. It\u2019s typically used as a short-term treatment for psoriasis affecting the limbs or trunk under hospital supervision, as"}


created_at: 2025-05-10 06:05:51
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
id: 817cfbca-30ed-4934-b289-7011ac005ad8
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/skin-hair-and-nails/psoriasis/", "start_index": 16165, "chroma:document": "can burn if too concentrated. It\u2019s typically used as a short-term treatment for psoriasis affecting the limbs or trunk under hospital supervision, as it stains everything it comes into contact with, including skin, clothes and bathroom fittings. It\u2019s applied to your skin (while wearing gloves) and left for 10 to 60 minutes before being washed off. Dithranol can be used in combination with phototherapy (see below). Phototherapy Phototherapy uses natural and artificial light to treat psoriasis. Artificial light therapy can be given in hospitals and some specialist centres, usually under the care of a dermatologist. These treatments aren\u2019t the same as using a sunbed. UVB phototherapy Ultraviolet B (UVB) phototherapy uses a wavelength of light that is invisible to human eyes. The light slows down the production of skin cells and is an effective treatment for some types of psoriasis that haven\u2019t responded to topical treatments. Each session only takes a few minutes, but you may need to go"}


created_at: 2025-05-10 06:05:51
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
id: 0503edb3-acf6-4376-9cf5-7cf50549e2ea
encoding: FLOAT32
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/skin-hair-and-nails/psoriasis/", "start_index": 17018, "chroma:document": "treatment for some types of psoriasis that haven\u2019t responded to topical treatments. Each session only takes a few minutes, but you may need to go to hospital 2 or 3 times a week for 6 to 8 weeks. Psoralen plus ultraviolet A (PUVA) For this treatment, you\u2019ll first be given a tablet containing compounds called psoralens, or psoralen may be applied directly to the skin. This makes your skin more sensitive to light. Your skin is then exposed to a wavelength of light called ultraviolet A (UVA). This light penetrates your skin more deeply than ultraviolet B light. This treatment may be used if you have severe psoriasis that hasn\u2019t responded to other treatment. Side effects of the treatment include nausea, headaches, burning and itchiness. You may need to wear special glasses for 24 hours after taking the tablet to prevent the development of cataracts. Long-term use of this treatment isn\u2019t encouraged, as it can increase your risk of developing skin cancer. Combination light therapy Combining"}


created_at: 2025-05-10 06:05:51
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
id: 2a761702-6177-4a90-9742-ace930b70cd8
encoding: FLOAT32
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/skin-hair-and-nails/psoriasis/", "start_index": 17876, "chroma:document": "Long-term use of this treatment isn\u2019t encouraged, as it can increase your risk of developing skin cancer. Combination light therapy Combining phototherapy with other treatments often increases its effectiveness. Some doctors use UVB phototherapy in combination with coal tar, as the coal tar makes the skin more receptive to light. Combining UVB phototherapy with dithranol cream may also be effective (this is known as Ingram treatment). Systemic treatments If your psoriasis is severe or other treatments haven\u2019t worked, you may be prescribed systemic treatments by a specialist. Systemic treatments are treatments that work throughout the entire body. These medications can be very effective in treating psoriasis, but they all have potentially serious side effects. All the systemic treatments for psoriasis have benefits and risks. Before starting treatment, talk to your doctor about your treatment options and any risks associated with them. There are 2 main types of systemic treatment,"}


created_at: 2025-05-10 06:05:51
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
id: 2a94b5a1-ca9d-404e-977f-56baba643085
encoding: FLOAT32
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/skin-hair-and-nails/psoriasis/", "start_index": 18729, "chroma:document": "treatment, talk to your doctor about your treatment options and any risks associated with them. There are 2 main types of systemic treatment, called non-biological (usually given as tablets or capsules) and biological (usually given as injections). These are described in more detail below. Non-biological medications Methotrexate Methotrexate can help to control psoriasis by slowing down the production of skin cells and suppressing inflammation. It\u2019s usually taken once a week. Methotrexate can cause nausea and may affect the production of blood cells. Long-term use can cause liver damage. People who have liver disease shouldn\u2019t take methotrexate, and you shouldn\u2019t drink alcohol when taking it. Methotrexate can be very harmful to a developing baby, so it\u2019s important that women use contraception and don\u2019t become pregnant while they take this drug and for 3 months after they stop. Methotrexate can also affect the development of sperm cells, so men shouldn\u2019t father a child during treatment"}


created_at: 2025-05-10 06:05:51
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
id: 7cbe8a48-7b7f-4ee9-8d02-435eb9fbdf68
encoding: FLOAT32
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/skin-hair-and-nails/psoriasis/", "start_index": 19580, "chroma:document": "drug and for 3 months after they stop. Methotrexate can also affect the development of sperm cells, so men shouldn\u2019t father a child during treatment and for 3 weeks afterwards. Ciclosporin Ciclosporin is a medicine that suppresses your immune system (immunosuppressant). It was originally used to prevent transplant rejection, but has proved effective in treating all types of psoriasis. It\u2019s usually taken daily. Ciclosporin increases your chances of kidney disease and high blood pressure, which will need to be monitored. Acitretin Acitretin is an oral retinoid that reduces the production of skin cells. It\u2019s used to treat severe psoriasis that hasn\u2019t responded to other non-biological systemic treatments. It\u2019s usually taken daily. Acitretin has a wide range of side effects, including dryness and cracking of the lips, dryness of the nasal passages and, in rarer cases, hepatitis. Acitretin can be very harmful to a developing baby, so it\u2019s important that women use contraception and don\u2019t"}


created_at: 2025-05-10 06:05:51
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
id: 84c615c0-5339-4bc7-8890-4c55747d2129
encoding: FLOAT32
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/skin-hair-and-nails/psoriasis/", "start_index": 20426, "chroma:document": "passages and, in rarer cases, hepatitis. Acitretin can be very harmful to a developing baby, so it\u2019s important that women use contraception and don\u2019t become pregnant while they take this drug, and for 2 years after they stop taking it. However, it\u2019s safe for a man taking acitretin to father a baby. Biological treatments Biological treatments reduce inflammation by targeting overactive cells in the immune system. These treatments are usually used if you have severe psoriasis that hasn\u2019t responded to other treatments, or if you can\u2019t use other treatments. Etanercept Etanercept is injected twice a week and you\u2019ll be shown how to do this. If there\u2019s no improvement in your psoriasis after 12 weeks, the treatment will be stopped. The main side effect of etanercept is a rash where the injection is given. However, as etanercept affects the whole immune system, there\u2019s a risk of serious side effects, including severe infection. If you had tuberculosis in the past, there\u2019s a risk it may return."}


created_at: 2025-05-10 06:05:51
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
id: 7e9292d9-6ff5-40f4-a8cc-0ccc1392f365
encoding: FLOAT32
metadata:
{"source": "https://www.nhsinform.scot/illnesses-and-conditions/skin-hair-and-nails/psoriasis/", "start_index": 21276, "chroma:document": "immune system, there\u2019s a risk of serious side effects, including severe infection. If you had tuberculosis in the past, there\u2019s a risk it may return. You\u2019ll be monitored for side effects during your treatment. Adalimumab Adalimumab is injected once every 2 weeks and you\u2019ll be shown how to do this. If there\u2019s no improvement in your psoriasis after 16 weeks, the treatment will be stopped. Adalimumab can be harmful to a developing baby, so it\u2019s important that women use contraception and don\u2019t become pregnant while they take this drug, and for 5 months after the treatment finishes. The main side effects of adalimumab include headaches, a rash at the injection site and nausea. However, as adalimumab affects the whole immune system, there\u2019s a risk of serious side effects, including severe infections. You\u2019ll be monitored for side effects during your treatment. Infliximab Infliximab is given as a drip (infusion) into your vein at the hospital. You\u2019ll have 3 infusions in the first 6 weeks,"}


created_at: 2025-05-10 06:05:51
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
id: 523c56ba-871d-42b7-a665-a4033547ddd9
encoding: FLOAT32
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/skin-hair-and-nails/psoriasis/", "start_index": 22126, "chroma:document": "your treatment. Infliximab Infliximab is given as a drip (infusion) into your vein at the hospital. You\u2019ll have 3 infusions in the first 6 weeks, then 1 infusion every 8 weeks. If there\u2019s no improvement in your psoriasis after 10 weeks, the treatment will be stopped. The main side effect of infliximab is a headache. However, as infliximab affects the whole immune system, there\u2019s a risk of serious side effects, including severe infections. You\u2019ll be monitored for side effects during your treatment. Ustekinumab Ustekinumab is injected at the beginning of treatment, then again 4 weeks later. After this, injections are every 12 weeks. If there\u2019s no improvement in your psoriasis after 16 weeks, the treatment will be stopped. The main side effects of ustekinumab are a throat infection and a rash at the injection site. However, as ustekinumab affects the whole immune system, there\u2019s a risk of serious side effects, including severe infections. You\u2019ll be monitored for side effects during your"}


created_at: 2025-05-10 06:05:52
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
id: 206a4a3a-a18d-46b3-a1e1-b278fea89b7f
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/skin-hair-and-nails/psoriasis/", "start_index": 22982, "chroma:document": "the whole immune system, there\u2019s a risk of serious side effects, including severe infections. You\u2019ll be monitored for side effects during your treatment. Living with psoriasis Although psoriasis is just a minor irritation for some people, it can have a significant impact on quality of life for those more severely affected. If you have psoriasis, you may find the following advice helpful. Self care Self care is an essential part of your daily life. It involves taking responsibility for your own health and wellbeing with support from those involved in your care. Self care includes staying fit and maintaining good physical and mental health, preventing illness or accidents, and caring more effectively for minor illnesses and long-term conditions. People with long-term conditions can benefit enormously from self care. They can live longer, have less pain, anxiety, depression and fatigue, a better quality of life, and be more active and independent. Having a care plan will help you manage"}


created_at: 2025-05-10 06:05:52
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
id: 13ba54d0-4700-4489-89a0-7c2545a473aa
encoding: FLOAT32
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/skin-hair-and-nails/psoriasis/", "start_index": 23835, "chroma:document": "less pain, anxiety, depression and fatigue, a better quality of life, and be more active and independent. Having a care plan will help you manage your treatment so that it fits your lifestyle. Keep up your treatment It\u2019s important to use your treatment as prescribed, even if your psoriasis improves. Continuous treatment can help to prevent flare-ups. If you have any questions or concerns about your treatment or any side effects, talk to your GP or healthcare team. Regular reviews Because psoriasis is usually a long-term condition, you may be in regular contact with your healthcare team. Discuss your symptoms or concerns with them, as the more the team knows, the more they can help you. Healthy eating and exercise People with psoriasis have a slightly higher risk of developing diabetes and cardiovascular disease than the general population, although it\u2019s not known why. Regular exercise and a healthy diet are recommended for everyone, not just people with psoriasis, because they can"}


created_at: 2025-05-10 06:05:52
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
id: f0b355dd-e90d-408b-a628-eb16ff146b1d
encoding: FLOAT32
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/skin-hair-and-nails/psoriasis/", "start_index": 24687, "chroma:document": "although it\u2019s not known why. Regular exercise and a healthy diet are recommended for everyone, not just people with psoriasis, because they can help to prevent many health problems. Eating a healthy, balanced diet and exercising regularly can also relieve stress, which may improve your psoriasis. Emotional impact of psoriasis Because of the effect that psoriasis can have on physical appearance, low self-esteem and anxiety are common among people with the condition. This can lead to depression, especially if the psoriasis gets worse. Your GP or dermatologist will understand the psychological and emotional impact of psoriasis, so talk to them about your concerns or anxieties. Psoriatic arthritis Some people with psoriasis develop psoriatic arthritis. This causes tenderness, pain and swelling in the joints and connective tissue, as well as stiffness. It commonly affects the ends of the fingers and toes. In some people, it affects the lower back, neck and knees. Most people develop"}


created_at: 2025-05-10 06:05:52
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
id: 5bc4e132-0585-4dca-8906-6a43fae8ea96
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/skin-hair-and-nails/psoriasis/", "start_index": 25533, "chroma:document": "as stiffness. It commonly affects the ends of the fingers and toes. In some people, it affects the lower back, neck and knees. Most people develop psoriatic arthritis after psoriasis, but about 20% develop it before they\u2019re diagnosed with psoriasis. There\u2019s no single test for psoriatic arthritis. It\u2019s normally diagnosed using a combination of methods, including looking at your medical history, physical examinations, blood tests, X-rays and MRI scans. If you have psoriasis, you\u2019ll usually have an annual assessment to look for signs of psoriatic arthritis. If your doctor thinks you have psoriatic arthritis, you\u2019ll usually be referred to a specialist called a rheumatologist, so you can be treated with anti-inflammatory or anti-rheumatic medicines. Pregnancy Psoriasis doesn\u2019t affect fertility, and women with psoriasis can have a normal pregnancy and a healthy baby. Some women find their psoriasis improves during pregnancy, but for others it gets worse. Talk to your healthcare team if"}


created_at: 2025-05-10 06:05:52
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/skin-hair-and-nails/psoriasis/", "start_index": 26387, "chroma:document": "and a healthy baby. Some women find their psoriasis improves during pregnancy, but for others it gets worse. Talk to your healthcare team if you\u2019re thinking of having a baby. Some treatments for psoriasis can be harmful to a developing baby, so use contraception while taking them. This can apply to both men and women, depending on the medication. Your healthcare team can suggest the best ways to control your psoriasis before you start trying for a family. Talk to others Many people with psoriasis have found that getting involved in support groups helps them. Support groups can increase your self-confidence, reduce feelings of isolation, and give you practical advice about living with the condition. Further information and support for psoriasis is available from the charity Changing Faces. Source: NHS 24 - Opens in new browser window Last updated: 20 February 2025 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Don\u2019t include personal"}


created_at: 2025-05-10 06:05:52
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/skin-hair-and-nails/psoriasis/", "start_index": 27237, "chroma:document": "updated: 20 February 2025 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Don\u2019t include personal information e.g. name, location or any personal health conditions. Email Address e.g. you@example.com Message Maximum of 500 characters Send feedback Add this page to Info For Me Also on NHS inform Depression Other health sites British Association of Dermatologists PAPAA: psoriasis support Psoriasis: young people Psoriasis Association Changing Faces NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats \u00a9 2025 NHS 24 \u2013 v1.1.1.17852"}


created_at: 2025-05-10 06:05:52
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/muscle-bone-and-joints/conditions-that-can-affect-multiple-parts-of-the-body/psoriatic-arthritis/", "start_index": 0, "chroma:document": "Psoriatic arthritis | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotland\u2019s Service Directory 0 Home Illnesses and conditions Muscle, bone and joints Conditions that can affect multiple parts of the body Psoriatic arthritis Psoriatic arthritis Psoriatic arthritis is a type of arthritis that sometimes develops in people with the skin condition psoriasis. It affects the joints and can cause them to become swollen, stiff and painful. It is estimated that around 1 in 4 patients with psoriasis have psoriatic arthritis. In most cases, people will experience problems with their skin before they notice any symptoms in their joints. In a small number of cases, skin problems may start at the same time as joint problems or after. Psoriatic arthritis can be caused by the immune system wrongly attacking healthy tissue. It\u2019s not clear why some people with psoriasis develop psoriatic arthritis and others don\u2019t. Symptoms"}


created_at: 2025-05-10 06:05:52
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/muscle-bone-and-joints/conditions-that-can-affect-multiple-parts-of-the-body/psoriatic-arthritis/", "start_index": 852, "chroma:document": "immune system wrongly attacking healthy tissue. It\u2019s not clear why some people with psoriasis develop psoriatic arthritis and others don\u2019t. Symptoms of psoriatic arthritis Psoriatic arthritis can affect any joint in the body. It causes pain, swelling and stiffness in the joints. It often affects particular areas including the: hands feet knees elbows neck and spine Psoriatic arthritis can also affect the area where tendons and ligaments are connected to the bone. This is called entheses or enthesitis when inflamed. Sometimes, the whole finger or toe can get inflamed and look sausage-like. This is called dactylitis Symptoms usually develop slowly. This means that many people don\u2019t know they\u2019re developing psoriatic arthritis. In rare cases, symptoms can develop suddenly without warning. The severity of psoriatic arthritis varies. Some people may have severe problems affecting many joints. Others may only notice mild symptoms in 1 or 2 joints. There may be times when your symptoms get"}


created_at: 2025-05-10 06:05:52
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/muscle-bone-and-joints/conditions-that-can-affect-multiple-parts-of-the-body/psoriatic-arthritis/", "start_index": 1704, "chroma:document": "may have severe problems affecting many joints. Others may only notice mild symptoms in 1 or 2 joints. There may be times when your symptoms get better and worse. These are called flare-ups or relapses. Some people may reach a point where they have no symptoms at all (known as remission). Relapses can be hard to predict. But they can be managed with medication. When to get medical advice Speak to your GP practice if you have: constant pain in your joints swelling in your joints stiffness in your joints You should do this even if you haven\u2019t been diagnosed with psoriasis. You should have check-ups at least once a year if you have been diagnosed with psoriatic arthritis. Make sure you let your doctor know if you\u2019re experiencing any problems with your joints. Diagnosing psoriatic arthritis If your doctor thinks you may have psoriatic arthritis, they should refer you to a rheumatologist for an assessment. A rheumatologist is a specialist in joint conditions. If you have psoriasis and"}


created_at: 2025-05-10 06:05:52
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/muscle-bone-and-joints/conditions-that-can-affect-multiple-parts-of-the-body/psoriatic-arthritis/", "start_index": 2558, "chroma:document": "they should refer you to a rheumatologist for an assessment. A rheumatologist is a specialist in joint conditions. If you have psoriasis and problems with your joints, a rheumatologist should be able to diagnose psoriatic arthritis. Other types of arthritis, like rheumatoid arthritis and osteoarthritis, would need to be ruled out first. You may get some tests to help confirm a diagnosis, including: blood tests to check for signs of inflammation and other types of arthritis X-rays of your joints scans of your joints Treatment for psoriatic arthritis The main aims of treatment will be to: help your symptoms slow the progression of the condition improve your quality of life You may be prescribed medication to help treat psoriatic arthritis. For example: non-steroidal anti-inflammatory drugs (NSAIDs) steroid medications disease-modifying anti-rheumatic drugs (DMARDs) Some people may be prescribed other medications to block chemicals that activate the immune system. These are known as"}


created_at: 2025-05-10 06:05:52
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/muscle-bone-and-joints/conditions-that-can-affect-multiple-parts-of-the-body/psoriatic-arthritis/", "start_index": 3404, "chroma:document": "anti-rheumatic drugs (DMARDs) Some people may be prescribed other medications to block chemicals that activate the immune system. These are known as biological medications. But, you will usually be given DMARDs to try first. For most people, this will mean trying many different medications. Some of these can also treat psoriasis. Managing related conditions to psoriatic arthritis As with psoriasis and other types of inflammatory arthritis, you may be more likely to get some other conditions (such as cardiovascular disease (CVD)) if you have psoriatic arthritis. CVD is the term for conditions of the heart or blood vessels, such as heart disease and stroke. Your GP should carry out tests each year (such as blood pressure and cholesterol tests) so they can check whether you have CVD. They may offer additional treatment, if necessary. Psoriatic arthritis can also cause inflammation of the eyes, such as Conjunctivitis and Iritis. If psoriatic arthritis affects your skin and joints, you may"}


created_at: 2025-05-10 06:05:52
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/muscle-bone-and-joints/conditions-that-can-affect-multiple-parts-of-the-body/psoriatic-arthritis/", "start_index": 4257, "chroma:document": "arthritis can also cause inflammation of the eyes, such as Conjunctivitis and Iritis. If psoriatic arthritis affects your skin and joints, you may notice changes in your nails such as: dents pits discolouration loosening from the nail bed This is less common if only your skin is affected. Your care team As well as your GP and a rheumatologist, you may also be cared for by: a specialist nurse \u2013 often your first point of contact with your specialist care team a dermatologist (skin specialist) \u2013 responsible for treating psoriasis symptoms a physiotherapist \u2013 can create an exercise plan to keep your joints mobile an occupational therapist \u2013 can help you overcome difficulties in your everyday life a psychologist \u2013 can offer psychological support if you need it a podiatrist \u2013 can offer assessment and advice on foot problems Living with psoriatic arthritis Psoriatic arthritis is a long-term condition. When it affects many joints, regular treatment will likely be needed to keep the disease"}


created_at: 2025-05-10 06:05:53
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/muscle-bone-and-joints/conditions-that-can-affect-multiple-parts-of-the-body/psoriatic-arthritis/", "start_index": 5109, "chroma:document": "arthritis Psoriatic arthritis is a long-term condition. When it affects many joints, regular treatment will likely be needed to keep the disease under control. An early diagnosis and the right treatment can slow down the progression of psoriatic arthritis. Treatment can also help reduce or prevent permanent damage to your joints. In some patients with severe disease, the joints may become permanently damaged or deformed, requiring surgical treatment. You can also help yourself by: having a good balance between rest and regular physical activity losing weight, if you\u2019re overweight not smoking only drinking moderate amounts of alcohol Losing weight Losing weight will help your general health and reduce the strain on your joints. There is evidence that weight loss can also improve the control of psoriatic arthritis and the response to treatment. Read more about how to lose weight safely Stopping smoking Several studies have shown that patients with psoriatic arthritis who don\u2019t smoke"}


created_at: 2025-05-10 06:05:53
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/muscle-bone-and-joints/conditions-that-can-affect-multiple-parts-of-the-body/psoriatic-arthritis/", "start_index": 5964, "chroma:document": "Read more about how to lose weight safely Stopping smoking Several studies have shown that patients with psoriatic arthritis who don\u2019t smoke tend to have less severe disease and respond much better to treatment compared to those who do smoke. Read more about stopping smoking Source: Scottish Society for Rheumatology - Opens in new browser window Last updated: 07 February 2025 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Don\u2019t include personal information e.g. name, location or any personal health conditions. Email Address e.g. you@example.com Message Maximum of 500 characters Send feedback Add this page to Info For Me Also on NHS inform Arthritis Psoriasis NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats \u00a9 2025 NHS 24 \u2013 v1.1.1.17852"}


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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/mental-health/psychosis/", "start_index": 0, "chroma:document": "The website is busy, please try later."}


created_at: 2025-05-10 06:05:53
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/sexual-and-reproductive/pubic-lice/", "start_index": 0, "chroma:document": "Pubic lice | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotland\u2019s Service Directory 0 Home Illnesses and conditions Sexual and reproductive Sexually transmitted infections (STIs) Pubic lice Pubic lice British Sign Language (BSL) | \u7b80\u4f53\u4e2d\u6587 | Polski | Rom\u00e2n\u0103 | sloven\u010dina Pubic lice, also known as crabs, are tiny insects that live on coarse human body hair, such as pubic hair around the penis or vagina. Pubic lice are not linked to poor personal hygiene. Symptoms of pubic lice It can take up to 3 weeks after coming into contact with pubic lice before you notice any symptoms. The most common symptom of pubic lice is itchy red spots. The itching is caused by an allergy to the lice saliva or poo. It can take 1 to 3 weeks for itching to develop after the first infestation, and it\u2019ll usually be worse at night. Public lice are very small (2mm long) and grey-brown in colour. They\u2019re hard to spot, but sometimes you"}


created_at: 2025-05-10 06:05:53
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/sexual-and-reproductive/pubic-lice/", "start_index": 857, "chroma:document": "and it\u2019ll usually be worse at night. Public lice are very small (2mm long) and grey-brown in colour. They\u2019re hard to spot, but sometimes you may be able to see them in your hair. They live mostly on pubic hair, but can also be found in hair on the chest, armpits, face and eyelashes. They do not affect hair on your head. You may also notice the following symptoms: small red or blue spots on your skin (lice bites) white or yellow dots attached to your hair (lice eggs) dark red or brown spots in your underwear (lice poo) crusty or sticky eyelashes, if they\u2019re infected When to get medical advice Speak to your GP practice, local pharmacy or local sexual health clinic if: you think you might have pubic lice Testing for pubic lice If you think you might have pubic lice, get checked for free by: booking an appointment at your local sexual health service contacting your GP practice for an appointment What does a pubic lice test involve? There is no test for pubic lice. Your doctor or nurse"}


created_at: 2025-05-10 06:05:53
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/sexual-and-reproductive/pubic-lice/", "start_index": 1707, "chroma:document": "service contacting your GP practice for an appointment What does a pubic lice test involve? There is no test for pubic lice. Your doctor or nurse will check your hair for lice. They may check your pubic hair around your penis or vagina and any other areas that could be affected. To help spot any pubic lice, your doctor or nurse may use a comb and a magnifying lens. You can also buy treatment over the counter at your local pharmacy although they will not be able to diagnose the infestation. Treatment for pubic lice Pubic lice are treated with medicated creams or shampoos that kill the lice. You\u2019ll usually need to use treatment on your whole body and leave it on for a few hours before washing it off. You\u2019ll need to repeat this a week later to make sure all the lice have been killed. You may be asked to come back to your GP practice or sexual health clinic once you\u2019ve finished treatment to check the treatment has worked. Your partner(s) should also be treated, even if they do not have"}


created_at: 2025-05-10 06:05:53
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/sexual-and-reproductive/pubic-lice/", "start_index": 2559, "chroma:document": "health clinic once you\u2019ve finished treatment to check the treatment has worked. Your partner(s) should also be treated, even if they do not have symptoms. Resistance Some pubic lice can be resistant to treatment. Resistance means that the lice will not be affected by a particular treatment. If your symptoms don\u2019t settle, you may need to try more than one type of treatment. Speak to your GP practice or local sexual health clinic if your first treatment hasn\u2019t worked. Treatment of lice in the eye area Treatment of lice in the eye area is usually different from elsewhere. Certain creams and lotions are not safe for use near the eye area. Lice here can be removed with tweezers or Vaseline can be used to suffocate the lice before removal. Things you can do While you\u2019re being treated for pubic lice, there are some things you can do to help stop the lice from spreading. Do wash your clothes and bedding on a hot wash (50 degrees or higher), have them dry cleaned or put them in a plastic bag"}


created_at: 2025-05-10 06:05:53
topic: persistent://default/default/eac8fe53-d737-429e-bdb7-0242ce89c428
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/sexual-and-reproductive/pubic-lice/", "start_index": 3410, "chroma:document": "the lice from spreading. Do wash your clothes and bedding on a hot wash (50 degrees or higher), have them dry cleaned or put them in a plastic bag for at least a week \u2013 this will help kill any lice hoover your mattress to remove any lice Don\u2019t do not share clothes, bedding or hygiene products (including razors) do not have any close body contact (including sexual contact) with anyone during treatment How pubic lice are passed on Pubic lice are spread through close body contact with someone who has them, most commonly sexual contact. The lice crawl from hair to hair but can\u2019t fly or jump. They need human blood to survive, so generally only leave the body to move from one person to another. Pubic lice don\u2019t live on other animals such as cats or dogs. If you or your partner has pubic lice, you should avoid having sex (vaginal, anal or oral). You should also avoid close bodily contact. Do this until you\u2019ve both finished treatment, including any follow-up treatment. How to prevent pubic"}


created_at: 2025-05-10 06:05:53
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/sexual-and-reproductive/pubic-lice/", "start_index": 4261, "chroma:document": "You should also avoid close bodily contact. Do this until you\u2019ve both finished treatment, including any follow-up treatment. How to prevent pubic lice Pubic lice are easily spread, and condoms don\u2019t protect against them. To reduce the risk of getting pubic lice, you should limit the number of people you have intimate or sexual contact with. Other STIs If you have been diagnosed with pubic lice you should get tested for other STIs including: gonorrhoea chlamydia syphilis Find your local sexual health clinic Source: Scottish Government - Opens in new browser window Last updated: 16 April 2025 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Don\u2019t include personal information e.g. name, location or any personal health conditions. Email Address e.g. you@example.com Message Maximum of 500 characters Send feedback Other languages and formats British Sign Language (BSL) | \u7b80\u4f53\u4e2d\u6587 | Polski | Rom\u00e2n\u0103 | sloven\u010dina British Sign Language (BSL) | \u7b80\u4f53\u4e2d\u6587"}


created_at: 2025-05-10 06:05:53
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/sexual-and-reproductive/pubic-lice/", "start_index": 5117, "chroma:document": "Send feedback Other languages and formats British Sign Language (BSL) | \u7b80\u4f53\u4e2d\u6587 | Polski | Rom\u00e2n\u0103 | sloven\u010dina British Sign Language (BSL) | \u7b80\u4f53\u4e2d\u6587 | Polski | Rom\u00e2n\u0103 | sloven\u010dina Add this page to Info For Me Also on NHS inform Book a sexual health appointment online Pubic lice (BSL) Pubic lice (Chinese) Pubic lice (Polish) Pubic lice (Romanian) Pubic lice (Slovak) Visiting a sexual health service Other health sites Sexual Health Scotland BASHH: sexual health Sexual Health Scotland: Contraception NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats \u00a9 2025 NHS 24 \u2013 v1.1.1.17852"}


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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/a-to-z/pulmonary-hypertension/", "start_index": 0, "chroma:document": "The website is busy, please try later."}


created_at: 2025-05-10 06:05:53
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/rare-conditions/", "start_index": 0, "chroma:document": "Rare conditions | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotland\u2019s Service Directory 0 Home Illnesses and conditions Rare conditions Rare conditions Rare conditions There are around 7000 known rare conditions, with new conditions being discovered every year. In Scotland, around 400,000 people are affected by a rare condition. This means that about 1 in 17 people will be affected by a rare condition at some point in their lives. Some rare conditions are more common but many only affect a small number of people. Some extremely rare conditions may only affect a handful of people in the whole world. What is a rare condition? A rare condition is one that affects less than 1 in 2000 people. Most rare conditions are chronic. This means they are a long-term condition that often has to be managed throughout a person\u2019s life. Most symptoms of a rare condition start in childhood. These can often be managed with"}


created_at: 2025-05-10 06:05:53
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/rare-conditions/", "start_index": 857, "chroma:document": "that often has to be managed throughout a person\u2019s life. Most symptoms of a rare condition start in childhood. These can often be managed with treatment. Over time, individuals will also learn about managing their own health and wellbeing. This means many people with a rare condition will be able to live active and fulfilling lives. Diagnosing a rare condition There are many different types of rare condition. Most are genetic but some are acquired (non-genetic conditions). Rare conditions can be diagnosed before birth, during childhood or later in life. It can be challenging to diagnose a rare condition. This means that many patients experience a long journey to get a diagnosis. Dealing with this uncertainty can be frustrating and unsettling. Sometimes a condition is so rare that it may not be possible to diagnose. If you think you may be affected by a rare condition, you should discuss this with your GP practice. They may refer you to specialist services and recommend genetic"}


created_at: 2025-05-10 06:05:54
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/rare-conditions/", "start_index": 1701, "chroma:document": "may be affected by a rare condition, you should discuss this with your GP practice. They may refer you to specialist services and recommend genetic testing. Testing for a rare condition Healthcare professionals will request different tests depending on your symptoms. These may include blood tests, x-rays or scans. They may also consider genetic testing. Genetic conditions Most rare conditions are genetic (about 80%). A genetic condition is sometimes passed through one or both parents to their child. Some genetic conditions also happen in a family for the first time and may not be inherited from a parent. Genetic testing There are lots of types of genetic testing but a blood test is usually used. Your genetic team will explain any tests that are relevant to your condition in more detail. Some tests aim to find changes in genes or chromosomes (the packages for your genes). Genetic testing is always advancing so new conditions are being diagnosed every year. Genetic centres If it\u2019s"}


created_at: 2025-05-10 06:05:54
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/rare-conditions/", "start_index": 2554, "chroma:document": "(the packages for your genes). Genetic testing is always advancing so new conditions are being diagnosed every year. Genetic centres If it\u2019s thought that you could have a rare genetic condition, you may be referred to a genetic centre. They can provide specialist counselling about genetic testing. In Scotland, there are 4 regional genetic centres. These have expertise in rare genetic conditions. These are based in: Glasgow Aberdeen Dundee Edinburgh Living with a rare condition Living with a rare condition can be overwhelming and frightening. But, you\u2019re not alone and support is available. If you\u2019re struggling to get a diagnosis, don\u2019t give up. You should continue to reach out to your healthcare professionals. Remember, it\u2019s ok to ask questions about your healthcare. Healthy living If you have a rare condition, it\u2019s important to maintain a healthy and active lifestyle. The symptoms of a rare condition can worsen if you also have a common condition like: diabetes obesity high blood"}


created_at: 2025-05-10 06:05:54
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/rare-conditions/", "start_index": 3403, "chroma:document": "a healthy and active lifestyle. The symptoms of a rare condition can worsen if you also have a common condition like: diabetes obesity high blood pressure Your GP practice can offer advice about healthy living. Further information on healthy living Specialist services In NHS Scotland, there are some networks and services for specific conditions. These provide information and support for healthcare professionals, patients and their families. Further information about specialist services Further information about specialist networks Support and information Support groups and charities can be a good source of help and information. If there\u2019s not a specific support group for your condition, you might find a more general group helpful. Genetic Alliance UK Genetic Alliance UK supports people with rare, undiagnosed and genetic conditions. They can direct you to relevant information and support for your rare condition. Rare Resources Scotland has information for people living with rare"}


created_at: 2025-05-10 06:05:54
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/rare-conditions/", "start_index": 4247, "chroma:document": "They can direct you to relevant information and support for your rare condition. Rare Resources Scotland has information for people living with rare conditions in Scotland. It also supports their families and healthcare professionals. SWAN UK is run by Genetic Alliance UK. It\u2019s a support network for families affected by a condition that doesn\u2019t have a name. These conditions are genetic and are so rare they often remain undiagnosed. Office for Rare Conditions The Office for Rare Conditions provide information and support in Scotland. This is for everyone affected by rare and undiagnosed conditions. More about the Office for Rare Conditions Unique Unique is an international group for anyone affected by: a rare chromosome disorder an autosomal dominant single gene disorder They provide: information leaflets for some rare conditions practical guides for families on topics like sleep and education signposting to local and social resources, including support groups and Facebook groups More"}


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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/rare-conditions/", "start_index": 5098, "chroma:document": "guides for families on topics like sleep and education signposting to local and social resources, including support groups and Facebook groups More about Unique Contact Contact work with families with disabled children. This work includes: providing support to families in hospital running workshops for parents on sleep, money matters and more providing help to find support groups More about Contact Scotland Last updated: 19 November 2024 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Don\u2019t include personal information e.g. name, location or any personal health conditions. Email Address e.g. you@example.com Message Maximum of 500 characters Send feedback Add this page to Info For Me Also on NHS inform Cancer Cystic fibrosis Huntington's Disease Other health sites Genetic Alliance NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies"}


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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/rare-conditions/", "start_index": 5944, "chroma:document": "inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats \u00a9 2025 NHS 24 \u2013 v1.1.1.17852"}


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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/a-to-z/raynauds-phenomenon/", "start_index": 0, "chroma:document": "Raynaud's phenomenon | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotland\u2019s Service Directory 0 Home Raynaud\u2019s phenomenon Raynaud\u2019s phenomenon About Raynaud\u2019s phenomenon Causes of Raynaud\u2019s phenomenon Diagnosing Raynaud\u2019s phenomenon Treating Raynaud\u2019s phenomenon Complications of Raynaud\u2019s phenomenon About Raynaud\u2019s phenomenon Raynaud\u2019s phenomenon is a common condition that affects the blood supply to certain parts of the body \u2013 usually the fingers and toes. It\u2019s often referred to as Raynaud\u2019s syndrome, Raynaud\u2019s disease or just Raynaud\u2019s. Why does it happen? Raynaud\u2019s is usually triggered by cold temperatures, anxiety or stress. The condition occurs because your blood vessels go into a temporary spasm, which blocks the flow of blood. This causes the affected area to change colour to white, then blue and then red, as the bloodflow returns. You may also experience numbness, pain, and pins and needles."}


created_at: 2025-05-10 06:05:54
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/a-to-z/raynauds-phenomenon/", "start_index": 852, "chroma:document": "area to change colour to white, then blue and then red, as the bloodflow returns. You may also experience numbness, pain, and pins and needles. Symptoms of Raynaud\u2019s can last from a few minutes to several hours. IIt\u2019s not a serious threat to your health, but can be painful and difficult to live with. If can affect your ability to move your fingers and hands. People with Raynaud\u2019s often go for long periods without any symptoms, and sometimes the condition goes away altogether. Other parts of the body that can be affected by Raynaud\u2019s include the ears, nose, nipples and lips. Treating Raynaud\u2019s In many cases, it may be possible to control the symptoms of Raynaud\u2019s yourself by avoiding the cold, wearing gloves and using relaxation techniques when feeling stressed. Stopping smoking can also improve symptoms, as smoking can affect your circulation. If you\u2019re unable to control your symptoms yourself, then a medication called nifedipine may be recommended. Read more about treating Raynaud\u2019s."}


created_at: 2025-05-10 06:05:54
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/a-to-z/raynauds-phenomenon/", "start_index": 1708, "chroma:document": "If you\u2019re unable to control your symptoms yourself, then a medication called nifedipine may be recommended. Read more about treating Raynaud\u2019s. Types of Raynaud\u2019s There are two types of Raynaud\u2019s: primary \u2013 when the condition develops by itself (this is the most common type) secondary \u2013 when it\u2019s caused by another health condition Most cases of secondary Raynaud\u2019s are associated with conditions that cause the immune system to attack healthy tissue (autoimmune conditions), such as scleroderma and lupus. The causes of primary Raynaud\u2019s are unclear. However 1 in 10 people with primary Raynaud\u2019s goes on to develop a condition associated with secondary Raynaud\u2019s, such as lupus. Your GP can help to determine whether you have primary or secondary Raynaud\u2019s by examining your symptoms and carrying out blood tests. Read more about what causes Raynaud\u2019s and diagnosing Raynaud\u2019s. Possible complications Secondary Raynaud\u2019s can severely restrict the blood supply, so it carries a higher risk of"}


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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/a-to-z/raynauds-phenomenon/", "start_index": 2553, "chroma:document": "Raynaud\u2019s and diagnosing Raynaud\u2019s. Possible complications Secondary Raynaud\u2019s can severely restrict the blood supply, so it carries a higher risk of complications, such as ulcers, scarring and even tissue death (gangrene) in the most serious cases. However, severe complications are rare. Read more about the complications of Raynaud\u2019s. Who gets Raynaud\u2019s? Raynaud\u2019s phenomenon is a common condition. It affects up to 20% of the adult population worldwide. There may be as many as 10 million people with the condition in the UK. Primary Raynaud\u2019s usually begins in your 20s or 30s. Secondary Raynaud\u2019s can develop at any age, depending on the cause. Raynaud\u2019s is slightly more common in women than men. Causes of Raynaud\u2019s phenomenon Raynaud\u2019s phenomenon is the result of over-sensitive blood vessels in the body\u2019s extremities. In many cases, no cause is identified, although it\u2019s sometimes linked to other health conditions. When your body is exposed to cold temperatures, the extremities, such as"}


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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/a-to-z/raynauds-phenomenon/", "start_index": 3406, "chroma:document": "is identified, although it\u2019s sometimes linked to other health conditions. When your body is exposed to cold temperatures, the extremities, such as your fingers and toes, lose heat. This is because the small blood vessels under the skin spasm, slowing down the blood supply that is helping to preserve your body\u2019s core temperature. In people with Raynaud\u2019s, the sensitive blood vessels overreact to cold temperatures and become narrower than usual, significantly restricting the blood flow. Symptoms can be triggered by mildly cool weather, getting something out of the freezer, or running your hands under a cold tap. Strong emotions such as stress or anxiety may also trigger symptoms. Primary Raynaud\u2019s The most common form of Raynaud\u2019s is primary Raynaud\u2019s phenomenon. This means the condition occurs by itself, without being associated with another health condition. It seems that primary Raynaud\u2019s is caused by disruptions in how the nervous system controls blood vessels. Exactly what causes"}


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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/a-to-z/raynauds-phenomenon/", "start_index": 4259, "chroma:document": "health condition. It seems that primary Raynaud\u2019s is caused by disruptions in how the nervous system controls blood vessels. Exactly what causes these disruptions is unclear. There\u2019s some evidence that primary Raynaud\u2019s may be an inherited condition, as cases have been known to run in families. Secondary Raynaud\u2019s In some cases, an underlying health condition could be causing the blood vessels to overreact. This is called secondary Raynaud\u2019s. Autoimmune conditions The majority of cases of secondary Raynaud\u2019s are associated with autoimmune conditions, which cause the immune system to attack healthy tissue. Autoimmune conditions known to be associated with secondary Raynaud\u2019s include: scleroderma \u2013 a condition that causes hardening and thickening of the skin rheumatoid arthritis \u2013 which causes joint pain and swelling Sjogren\u2019s syndrome \u2013 where the immune system attacks the body\u2019s sweat and tear glands lupus \u2013 which causes tiredness, joint pain and skin rashes Around 1 in 10 people with"}


created_at: 2025-05-10 06:05:55
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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/a-to-z/raynauds-phenomenon/", "start_index": 5113, "chroma:document": "the immune system attacks the body\u2019s sweat and tear glands lupus \u2013 which causes tiredness, joint pain and skin rashes Around 1 in 10 people with primary Raynaud\u2019s go on to develop an autoimmune condition. Infections Blood-born viral infections, hepatitis B and hepatitis C, can occasionally trigger Raynaud\u2019s in some people. Cancer Some types of cancer can cause secondary Raynaud\u2019s. These are usually cancers that develop inside the blood, bone marrow or immune system, such as: acute lymphoblastic leukaemia \u2013 a cancer of the white blood cells that mainly affects children lymphoma \u2013 a cancer that develops inside one or more of the glands that are part of the immune system multiple myeloma \u2013 a cancer that develops inside bone marrow Medicines Secondary Raynaud\u2019s can also be a side effect of taking certain medicines, including: some types of anti-migraine medication \u2013 such as sumatriptan and ergotamine beta-blockers \u2013 which are used to treat high blood pressure and heart disease some"}


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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/a-to-z/raynauds-phenomenon/", "start_index": 5958, "chroma:document": "of anti-migraine medication \u2013 such as sumatriptan and ergotamine beta-blockers \u2013 which are used to treat high blood pressure and heart disease some chemotherapy medicines decongestants the contraceptive pill medicines used in hormone replacement therapy some types of medicines used to treat high blood pressure Illegal drugs, such as cocaine and amphetamines, can also cause secondary Raynaud\u2019s. Injury and overuse Raynaud\u2019s sometimes results from a physical injury. It can also affect musicians, people who type a lot, or other people who use their fingers and hands more than usual. Skin and tissue damage caused by frostbite can also lead to Raynaud\u2019s. Smoking Smoking cigarettes also increases your risk of developing Raynaud\u2019s. Read about the support available to help you quit smoking. Vibration white finger Vibration white finger is a term used when secondary Raynaud\u2019s has been caused by vibration. This typically happens to people who regularly use certain types of vibrating tools, such"}


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{"source": "https://www.nhsinform.scot/illnesses-and-conditions/a-to-z/raynauds-phenomenon/", "start_index": 6807, "chroma:document": "used when secondary Raynaud\u2019s has been caused by vibration. This typically happens to people who regularly use certain types of vibrating tools, such as: sanders, grinders and disc cutters hammer drills chainsaws, hedge trimmers and power mowers Any vibrating tool that causes tingling or numbness in your fingers could lead to vibration white finger. Your employer has a responsibility to protect you from vibration white finger. If the job can\u2019t be done without vibrating tools: ask to use suitable low-vibration tools make sure you\u2019re using the right tool for the job check tools are properly maintained keep cutting tools sharp reduce the amount of time you use the tool in one go by doing other jobs in between keep warm at work wear anti-vibration gloves store tools indoors, so they don\u2019t have cold handles when next used encourage your blood circulation by keeping warm, stopping smoking and massaging and exercising your fingers during your breaks If you\u2019re diagnosed with the condition,"}


