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child Don’t give your child antidiarrhoeal and anti-vomiting medication, unless advised to by your GP or pharmacist. Make sure you and your child wash your hands regularly while your child is ill. Keep them away from school or nursery until at least 48 hours after their symptoms have cleared. Getting medical advice for your child You don’t usually need to see your GP if you think your child has gastroenteritis, as it should get better on its own, and taking them to a GP practice can put others at risk. Phone 111 or your GP practice if: You’re concerned about your child, or they: have symptoms of dehydration, such as passing less urine than normal, being unusually irritable or unresponsive, pale or mottled skin, or cold hands and feet have blood in their poo or green vomit are vomiting constantly and are unable to keep down any fluids or feeds have had diarrhoea for more than a week have been vomiting for 3 days or more have signs of a more serious illness, such as a high fever (over


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feeds have had diarrhoea for more than a week have been vomiting for 3 days or more have signs of a more serious illness, such as a high fever (over 38C or 100.4F), shortness of breath, rapid breathing, a stiff neck, a rash that doesn’t fade when you roll a glass over it or a bulging fontanelle (the soft spot on a baby’s head) have a serious underlying condition, such as inflammatory bowel disease or a weak immune system, and have diarrhoea and vomiting Your GP may suggest sending off a sample of your child’s poo to a laboratory to confirm what’s causing their symptoms. Antibiotics may be prescribed if this shows they have a bacterial infection. How gastroenteritis is spread The bugs that cause gastroenteritis can spread very easily from person to person. You can catch the infection if small particles of vomit or poo from an infected person get into your mouth, such as through: close contact with someone with gastroenteritis – they may breathe out small particles of vomit touching


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person get into your mouth, such as through: close contact with someone with gastroenteritis – they may breathe out small particles of vomit touching contaminated surfaces or objects eating contaminated food – this can happen if an infected person doesn’t wash their hands before handling food, or you eat food that has been in contact with contaminated surfaces or objects, or hasn’t been stored and cooked at the correct temperatures A person with gastroenteritis is most infectious from when their symptoms start until 48 hours after all their symptoms have passed, although they may also be infectious for a short time before and after this. Preventing gastroenteritis It’s not always possible to avoid getting gastroenteritis, but following this advice can help stop it spreading. Do stay off work, school or nursery until at least 48 hours after the symptoms have passed – you or your child should also avoid visiting anyone in hospital during this timeensure you and your child wash your


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after the symptoms have passed – you or your child should also avoid visiting anyone in hospital during this timeensure you and your child wash your hands frequently and thoroughly with soap and water, particularly after using the toilet and before preparing food – don’t rely on alcohol hand gels, as they’re not always effectivedisinfect any surfaces or objects that could be contaminated – it’s best to use a bleach-based household cleanerwash contaminated items of clothing or bedding separately on a hot washflush away any poo or vomit in the toilet or potty and clean the surrounding areapractice good food hygiene: make sure food is properly refrigerated, always cook your food thoroughly, and never eat food that is past its use-by date Don’t do not rely on alcohol hand gels, as they’re not always effectivedon’t share towels, flannels, cutlery or utensils while you or your child is ill Take extra care when travelling to parts of the world with poor sanitation, as you could pick up a


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cutlery or utensils while you or your child is ill Take extra care when travelling to parts of the world with poor sanitation, as you could pick up a stomach bug. For example, you may need to boil tap water before drinking it. Young children can have the rotavirus vaccination when they’re 2 to 3 months old, which can reduce their risk of developing gastroenteritis. Source: NHS 24 - Opens in new browser window Last updated: 13 December 2024 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Don’t 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 Self-help guide: Diarrhoea Self-help guide: Abdominal pain Dehydration Preparing and cooking food safely Other health sites fitfortravel: Norovirus NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS


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food safely Other health sites fitfortravel: Norovirus 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 © 2025 NHS 24 – v1.1.1.17852


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Genital herpes | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotland’s Service Directory 0 Home Illnesses and conditions Sexual and reproductive Genital herpes Genital herpes Genital herpes is a sexually transmitted infection (STI) caused by a virus called herpes simplex virus (HSV). There are 2 different types of the virus. Both of which affect the genitals. Genital herpes causes painful blisters and sores on and around the genitals. It can also sometimes cause problems if you have it for the first time during pregnancy. Symptoms of genital herpes Most people with the herpes virus don’t notice any symptoms and don’t know they have it. So it’s important to get tested if you think you’re infected. If you do get symptoms, it takes usually 2 to 12 days after contact for them to appear. Some people don’t get symptoms until months or sometimes years later. Once you have the herpes infection, the virus stays in


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for them to appear. Some people don’t get symptoms until months or sometimes years later. Once you have the herpes infection, the virus stays in your body. It can lie dormant for long periods but can reactivate in the area that was originally infected. If this happens, the sores and blisters can reappear. This is known as a ‘recurrent episode’ of genital herpes. This first episode of genital herpes may last from 2 to 4 weeks. Repeated episodes are not usually as severe, or long, as the first and you may never have a repeat episode. Symptoms of the first infection include: spots or red bumps around the genital area pain inside the vagina, head of penis or anus vaginal discharge pain peeing or being unable to pee fever flu-like symptoms, backache, headache and a temperature mild swelling of the lymph glands in the groin, armpits and neck If you have a recurrent infection, your symptoms may include: a tingling or burning sensation before blisters appear painful red blisters, which soon


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If you have a recurrent infection, your symptoms may include: a tingling or burning sensation before blisters appear painful red blisters, which soon burst to leave ulcers pain inside the vagina, head of penis or anus When to get medical advice Speak to your GP practice or midwife if: you’re pregnant and think you have genital herpes Testing for genital herpes If you think you might have genital herpes, get tested for free by: contacting your GP practice for an appointment booking an appointment at your local sexual health service Your doctor or nurse may be able to diagnose by looking at symptoms such as blisters, sores and ulcers. If you have visible blisters, your doctor or nurse may take a swab for testing. This is to check if it’s herpes and what type. The swab can also test for another STI which causes blisters called syphilis. The genital herpes swab tests are very reliable, though if the ulcer is too dry then it may be less likely to find a positive result. Treatment for


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The genital herpes swab tests are very reliable, though if the ulcer is too dry then it may be less likely to find a positive result. Treatment for genital herpes Genital herpes can be treated with antiviral medication. The symptoms of genital herpes can be treated, although it could keep coming back. Symptoms of recurrent genital herpes will usually clear up without any treatment. Some people experience recurrences of genital herpes. In these cases, a longer course of tablets should stop any recurrent episodes. You can talk to your GP or nurse about which treatment options are right for you. As there’s no screening test for herpes, partners should only have a test if they also have symptoms. How genital herpes are passed on You can get genital herpes: from skin to skin contact with the infected area (including vaginal, anal and oral sex) when there are no visible sores or blisters if a cold sore touches your genitals or face kissing (if the person has a cold sore on their face) by


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when there are no visible sores or blisters if a cold sore touches your genitals or face kissing (if the person has a cold sore on their face) by sharing sex toys with someone who has herpes Sometimes herpes can be passed on when your sexual partner has no visible sores or symptoms. This is because the virus can become active on the skin without causing any visible blisters or sores. This is sometimes called ‘asymptomatic shedding’. This risk goes down during the first months after you catch herpes and is not likely after two years. However, it is more common when people are still having frequent recurrences. Very rarely, herpes is passed to a newborn baby during childbirth. This is only likely to happen if a mother has her first episode of herpes after week 26 of the pregnancy. When women have had herpes longer than three months, normal delivery is expected even if there are symptoms at the time of delivery. How to prevent genital herpes The best way to reduce your risk of STIs is to


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delivery is expected even if there are symptoms at the time of delivery. How to prevent genital herpes The best way to reduce your risk of STIs is to practice safer sex. This means using a condom for vaginal, anal and oral sex. If your partner has herpes, avoiding sex when they have visible sores reduces your risk of getting herpes. Other STIs If you’ve been diagnosed with herpes it’s recommended that you are tested for all STIs including: chlamydia gonorrhoea syphilis HIV This is even more important if you have recurrent episodes. 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’t 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 Visiting a sexual


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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 Visiting a sexual health service 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 © 2025 NHS 24 – v1.1.1.17852


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https://www.nhsinform.scot/illnesses-and-conditions/cancer/cancer-types-in-children/germ-cell-tumours/


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Germ cell tumours | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotland’s Service Directory 0 Home Illnesses and conditions Cancer Cancer types in children Germ cell tumours Germ cell tumours Most children who develop germ cell tumours will be cured. More children than ever are surviving childhood cancer. There are new and better drugs and treatments, and we can now also work to reduce the after-effects of having had cancer in the past. It’s devastating to hear that your child has cancer. At times it can feel overwhelming but there are many healthcare professionals and support organisations to help you through this difficult time. Understanding more about the cancer your child has and the treatments that may be used can often help parents to cope. Your child’s specialist will give you more detailed information, and if you have any questions, it’s important to ask the specialist doctor or nurse who knows


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specialist will give you more detailed information, and if you have any questions, it’s important to ask the specialist doctor or nurse who knows your child’s individual situation. Germ cell tumours can appear at any age. They develop from cells that produce eggs or sperm so germ cell tumours can affect the ovaries or testes. However, it’s possible for a germ cell tumour to develop in other parts of the body. As a baby develops during pregnancy, the cells producing eggs or sperm normally move to the ovaries or testes. However, occasionally they can settle in other parts of the body where they can develop into tumours. The most common places for this to happen are the bottom of the spine (sacrococcygeal), the brain, chest, and abdomen. Germ cell tumours are sometimes given different names based on their characteristics. These include yolk-sac tumours, germinomas, embryonal carcinomas, mature teratomas and immature teratomas. They may be non-cancerous (benign) or cancerous (malignant).


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tumours, germinomas, embryonal carcinomas, mature teratomas and immature teratomas. They may be non-cancerous (benign) or cancerous (malignant). Malignant tumours have the ability to grow and spread to other parts of the body. Benign tumours do not spread but may cause problems by pressing on nearby tissue and organs. Immature teratomas fall between benign and malignant. They can spread within the abdomen but not beyond, and can be removed with an operation. Causes The cause of germ cell tumours is unknown but research into the causes of different cancers is ongoing. Signs and symptoms The symptoms depend on where the tumour develops. Usually it starts with a lump that can either be felt or causes other symptoms. How germ cell tumours are diagnosed Different tests may be needed to diagnose a germ cell tumour. Usually, the doctor will remove a sample of tissue from the lump (a biopsy) for examination under a microscope to find out if it is a cancer or not. CT or MRI scans may be used


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a sample of tissue from the lump (a biopsy) for examination under a microscope to find out if it is a cancer or not. CT or MRI scans may be used to see the exact position of a tumour within the body. Chest X-rays may be taken to see if there’s a tumour in the lungs. Germ cell tumours often produce proteins called tumour markers that can be measured in the blood. The ones that are produced by germ cell tumours are alpha-fetoprotein (AFP) and human chorionic gonadotrophin (HCG). Your child will have blood tests to check these tumour markers when they are being diagnosed. The doctors will continue to check these during treatment and after treatment is over. Sometimes a germ cell tumour can be diagnosed with a tumour marker and scan results so that a biopsy isn’t necessary. This is particularly so if surgery is not needed for treatment, for example if the tumour is in the brain. Staging The stage of a cancer describes its size and whether it has spread from where it started. Knowing the


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example if the tumour is in the brain. Staging The stage of a cancer describes its size and whether it has spread from where it started. Knowing the stage helps doctors to decide on the most appropriate treatment. Generally cancer is divided into 4 stages: stage 1 – the cancer is small, has not spread and has been completely removed stages 2 and 3 – the cancer is larger and may not have been completely removed, or may have spread to nearby organs stage 4 – the cancer has spread to other parts of the body Cancer that has spread to distant parts of the body and formed new tumours is known as secondary or metastatic cancer. Treatment The treatment your child will have usually depends on a number of factors, including the size, position and stage of the tumour. It usually includes either surgery or chemotherapy, or a combination. A benign tumour can be cured if it is removed by surgery. It may mean removing a testicle or an ovary if this is where the tumour started. If the tumour is


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tumour can be cured if it is removed by surgery. It may mean removing a testicle or an ovary if this is where the tumour started. If the tumour is malignant and can be completely removed with surgery, chemotherapy is not always needed, especially if it began in the testis or ovary. If the tumour cannot be removed easily or has spread, your child will be given chemotherapy. Chemotherapy is the use of anti-cancer (cytotoxic) drugs to destroy cancer cells. Germ cell tumours are very sensitive to chemotherapy. It’s usually given as injections and drips (infusions) into a vein. A combination of drugs is usually given every 3 weeks for 3 or 5 months. The length of time chemotherapy is given for depends on the position of the tumour, the level of AFP, and whether or not the tumour has spread. Treatment of malignant germ cell tumours in the brain is a little different. Although they are very sensitive to chemotherapy, treatment with radiotherapy is also needed. Radiotherapy is the use of


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brain is a little different. Although they are very sensitive to chemotherapy, treatment with radiotherapy is also needed. Radiotherapy is the use of high-energy rays to destroy cancer cells. Unlike germ cell tumours elsewhere in the body, it’s not always necessary to remove germ cell tumours in the brain with surgery. Side effects of treatment Treatment often causes side effects, and your child’s doctor will discuss these with you before treatment starts. The operation your child has will be individually planned to try to reduce any possible problems. The surgeon and specialist nurse will discuss this with you. The side effects of chemotherapy usually gradually improve when treatment is over and many of them can be well controlled. The side effects of treatment depend on the drugs used but can include: feeling sick (nausea) and being sick (vomiting) hair loss increased risk of infection bruising and bleeding tiredness diarrhoea Late side effects A small number of children may develop


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(vomiting) hair loss increased risk of infection bruising and bleeding tiredness diarrhoea Late side effects A small number of children may develop long-term side effects of treatment, sometimes many years later. These are not common but may include problems with how the kidneys or lungs work and some hearing loss. Your child’s specialist doctor or nurse will tell you more about any possible late side effects. If your child has only one ovary or testis removed, they’ll usually still be able to have children in the future. Clinical trials Many children have their treatment as part of a clinical research trial. Trials aim to improve our understanding of the best way to treat an illness, usually by comparing the standard treatment with a new or modified version. Specialist doctors carry out trials for children’s cancers. If appropriate, your child’s medical team will talk to you about taking part in a clinical trial and will answer any questions you have. Written information is often


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your child’s medical team will talk to you about taking part in a clinical trial and will answer any questions you have. Written information is often provided to help explain things. Taking part in a research trial is completely voluntary, and you’ll be given plenty of time to decide if it’s right for your child. Treatment guidelines Sometimes, clinical trials are not available for your child’s tumour. This may be because a recent trial has just finished, or because the tumour is very rare. In these cases, you can expect your doctors and nurses to offer treatment which is agreed to be the most appropriate, using guidelines which have been prepared by experts across the country. The Children’s Cancer and Leukaemia Group (CCLG) is an important organisation which helps to produce these guidelines. Follow-up care Your child will continue to have regular blood tests during and after treatment, to check their levels of AFP and HCG. If the levels rise, this indicates that the tumour might


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have regular blood tests during and after treatment, to check their levels of AFP and HCG. If the levels rise, this indicates that the tumour might have come back and further treatment is needed. If you have specific concerns about your child’s condition and treatment, it’s best to discuss them with your child’s doctor, who knows the situation in detail. Your feelings As a parent, the fact that your child has cancer is one of the worst situations you can be faced with. You may have many emotions, such as fear, guilt, sadness, anger and uncertainty. These are all normal reactions and are part of the process that many parents go through at such a difficult time. Your child may have a variety of powerful emotions throughout their experience with cancer. Further information and advice if your child has cancer Source: Children's Cancer and Leukaemia Group - Opens in new browser window Last updated: 09 October 2024 How can we improve this page? Help us improve NHS inform Thank You Your


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Leukaemia Group - 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’t 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 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 © 2025 NHS 24 – v1.1.1.17852


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Glandular fever | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotland’s Service Directory 0 Home Illnesses and conditions Infections and poisoning Glandular fever Glandular fever Return to Symptoms Enter age Last Updated: Next Review Date: Review my answers Find your local services Search for a service near you by entering your postcode below. Please input your postcode in the following format: A12 1BC GP Practices Dental Services Pharmacies Opticians Postcode Search NHS inform has more information on this condition. Read more Previous Start guide Review my answers × You told us your credentials were: : You said: Based on the information you gave us, we made the following recommendation: Close Keep a copy View PDF Glandular fever is a type of viral infection that mostly affects young adults. It normally gets better without treatment, but it can make you feel very ill. It normally lasts for 2 to 3 weeks,


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that mostly affects young adults. It normally gets better without treatment, but it can make you feel very ill. It normally lasts for 2 to 3 weeks, but in some cases you can feel ill for months. It can also be known as infectious mononucleosis, or ‘mono’. Symptoms of glandular fever Glandular fever is most common in 15 to 24 year olds. Common symptoms include: a high temperature (fever) a very sore throat swollen glands in the neck fatigue (extreme tiredness) headache Other symptoms of glandular fever Other symptoms include: feeling generally unwell aching muscles chills sweating a lot loss of appetite pain around or behind your eyes swollen tonsils and adenoids (small lumps of tissue at the back of the nose), which may affect your breathing a very red throat that oozes fluid small red or purple spots on the roof of your mouth a rash swelling or ‘puffiness’ around your eyes a tender or swollen tummy jaundice (yellowing of the skin and whites of the eyes) Phone 999 immediately if you:


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or ‘puffiness’ around your eyes a tender or swollen tummy jaundice (yellowing of the skin and whites of the eyes) Phone 999 immediately if you: develop a rasping breath (stridor) or have severe difficulty breathing can’t swallow, including your own saliva develop intense stomach pain Phone your GP practice or phone 111 immediately if you have: difficulty breathing or being more short of breath than normal difficulty swallowing Phone your GP practice if you have: a very high temperature or you feel hot and shivery a severe sore throat swelling either side of your neck (swollen glands) extreme tiredness or exhaustion a sore throat that’s not getting better Fever in adults self-help guide Complete this guide to assess your symptoms and find out more about where to get help. Diagnosing glandular fever To diagnose glandular fever, your GP will first ask about your symptoms. They will carry out a physical examination. They’ll look for signs of glandular fever, like swollen glands, tonsils,


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first ask about your symptoms. They will carry out a physical examination. They’ll look for signs of glandular fever, like swollen glands, tonsils, liver and spleen. Your GP may also recommend a blood test to help confirm the diagnosis and rule out infections that can cause similar symptoms. Treatment for glandular fever Glandular fever will normally get better on its own. But there are things you can do help ease the symptoms while you wait for your body to control the infection. Do drink plenty of fluids take over-the-counter painkillers, like paracetamol or ibuprofen get plenty of rest Occasionally, antibiotics or corticosteroids may be prescribed if you develop complications of glandular fever. Some people with particularly severe symptoms may need to be looked after in hospital for a few days. What causes glandular fever? Glandular fever is caused by the Epstein-Barr virus (EBV). This virus is found in the saliva of infected people and can be spread through: kissing exposure to


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fever is caused by the Epstein-Barr virus (EBV). This virus is found in the saliva of infected people and can be spread through: kissing exposure to coughs and sneezes sharing cups, glasses and unwashed cutlery sharing toothbrushes EBV may be found in the saliva of someone who has had glandular fever several months after their symptoms pass. Some people may continue to have the virus in their saliva on and off for years. How to prevent the spread of glandular fever You’re infectious for up to 7 weeks before you get symptoms, and you may be infectious for several months after being unwell. To help stop you spreading glandular fever when you’re infected: Do wash your hands regularly wash anything that may have your saliva on it Don’t do not kiss others do not share anything that you put in or near your mouth do not give blood while you have glandular fever Complications of glandular fever Complications linked with glandular fever are uncommon. If they they do occur they can be serious.


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glandular fever Complications of glandular fever Complications linked with glandular fever are uncommon. If they they do occur they can be serious. They can include: liver conditions like hepatitis kidney conditions heart problems like inflammation of the heart blood conditions like sepsis a ruptured (burst) spleen, which may need to be treated with surgery long-term tiredness or fatigue Source: NHS 24 - Opens in new browser window Last updated: 22 November 2024 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Don’t 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 Self-help guide: Fever in adults Other health sites Lab Tests Online UK NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy


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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 © 2025 NHS 24 – v1.1.1.17852


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https://www.nhsinform.scot/illnesses-and-conditions/muscle-bone-and-joints/arm-shoulder-and-hand-problems-and-conditions/golfers-elbow/


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Gonorrhoea | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotland’s Service Directory 0 Home Illnesses and conditions Sexual and reproductive Sexually transmitted infections (STIs) Gonorrhoea Gonorrhoea British Sign Language | 简体中文 | Polski | Română | slovenčina Gonorrhoea is a sexually transmitted infection caused by bacteria. Infection usually occurs in the genitals but can affect the throat, eyes and anus. Symptoms of gonorrhoea Many people with gonorrhoea won’t notice any symptoms. If you do get symptoms, it’s usually between 1 to 14 days after getting the infection. Symptoms of gonorrhoea may include: green or yellow fluid coming out of the penis pain or a burning sensation when peeing discomfort and swelling of the testicles increased discharge from the vagina pain in the lower tummy, particularly during sex bleeding in between periods or after sex Gonorrhoea can also infect the throat, eyes or anus.


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vagina pain in the lower tummy, particularly during sex bleeding in between periods or after sex Gonorrhoea can also infect the throat, eyes or anus. You may experience pain or discharge in these areas. Gonorrhoea in the throat usually has no symptoms. Having the infection during pregnancy can result in giving birth to the baby early (premature birth). Gonorrhoea can be passed on to the baby during birth and can result in eye infections in the infant. When to get medical advice Speak to your GP practice or midwife if: you’re pregnant and think you have gonorrhoea Testing for gonorrhoea If you think you might have gonorrhoea, get tested for free by: booking an appointment at your local sexual health service (if you have symptoms) contacting your GP practice for an appointment (if you have symptoms) ordering a home test kit (if you do not have symptoms) Services available may vary depending on where you live. What does a gonorrhoea test involve? The test for gonorrhoea is simple,


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not have symptoms) Services available may vary depending on where you live. What does a gonorrhoea test involve? The test for gonorrhoea is simple, painless and very reliable. It involves sending a sample from the area of the body thought to be infected to a lab for analysis. You usually don’t have to be examined by a doctor or nurse and can often collect the sample yourself. The 2 main ways the sample can be collected are: using a swab – a small cotton bud is gently wiped over the area that might be infected, such as inside the vagina, throat, or inside the anus urine sample (if you have a penis) – this is more accurate if it’s at least 1 or 2 hours after you last peed People who have had anal or oral sex may have a swab taken from their anus or throat. Some sexual health clinics may be able to carry out rapid tests and give you your test results straight away. Otherwise, you’ll have to wait up to 2 weeks to get the results. If you have gonorrhoea, your partner will be offered


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test results straight away. Otherwise, you’ll have to wait up to 2 weeks to get the results. If you have gonorrhoea, your partner will be offered testing and treatment. Treatment for gonorrhoea Antibiotics will treat the gonorrhoea infection. These can be given in pill form or as an injection. Some strains of gonorrhoea are becoming resistant to antibiotics. This can make it more difficult to treat. You may be tested again 3 weeks later to check the antibiotics have worked. If there’s a high chance you have gonorrhoea, you may be given treatment before you get your results back. You may also be offered treatment if your partner (s) is found to have gonorrhoea. Tell the doctor or nurse if you: are pregnant think you might be pregnant are breastfeeding This may make a difference to the antibiotic you’re prescribed. If your infection is untreated you may pass it on to other sexual partners. If gonorrhoea is left untreated in women, it can spread to the womb and cause a serious condition


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you may pass it on to other sexual partners. If gonorrhoea is left untreated in women, it can spread to the womb and cause a serious condition called pelvic inflammatory disease (PID). This is a major cause of ectopic pregnancy and infertility in women. If men are not treated, the infection may spread to the testicles and cause discomfort. This could affect your fertility. Do not have sex until you and your partner have both finished the treatment. You should also wait until you’ve had the results of the 2 week test to prevent being infected again. How gonorrhoea is passed on Gonorrhoea is passed through unprotected vaginal, anal or oral sex (without a condom). It can also be passed on by: sharing sex toys that aren’t washed or covered with a new condom each time they’re used infected semen or vaginal fluid getting into your eye it can also be passed to a newborn during childbirth Reducing the risk of gonorrhoea The best way to prevent all sexually transmitted infections is to


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can also be passed to a newborn during childbirth Reducing the risk of gonorrhoea The best way to prevent all sexually transmitted infections is to practice safer sex. This means using a condom for vaginal, anal or oral sex. Other STIs If you have been diagnosed with gonorrhoea you should get tested for all STIs including: syphilis HIV chlamydia 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’t 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 | 简体中文 | Polski | Română | slovenčina British Sign Language | 简体中文 | Polski | Română | slovenčina Add this page to Info For Me Also on NHS inform Book a sexual health appointment online Gonorrhoea (BSL)


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| 简体中文 | Polski | Română | slovenčina Add this page to Info For Me Also on NHS inform Book a sexual health appointment online Gonorrhoea (BSL) Gonorrhoea (Chinese) Gonorrhoea (Polish) Gonorrhoea (Romanian) Gonorrhoea (Slovak) Visiting a sexual health service 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 © 2025 NHS 24 – v1.1.1.17852


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https://www.nhsinform.scot/illnesses-and-conditions/muscle-bone-and-joints/leg-and-foot-problems-and-conditions/gout/


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https://www.nhsinform.scot/illnesses-and-conditions/muscle-bone-and-joints/leg-and-foot-problems-and-conditions/greater-trochanteric-pain-syndrome/


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Greater trochanteric pain syndrome | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotland’s Service Directory 0 Home Illnesses and conditions Muscle, bone and joints Leg and foot problems and conditions Greater trochanteric pain syndrome Greater trochanteric pain syndrome This information is useful for those who have been diagnosed with greater trochanteric pain syndrome (GTPS). People who are experiencing new or ongoing symptoms should contact a healthcare professional for assessment and diagnosis. Read more about self-managing hip problems What is greater trochanteric pain syndrome? Greater trochanteric pain syndrome (GTPS), also known as lateral hip pain or trochanteric bursitis, is a common and painful condition which affects the outer side of the hip and thigh. It occurs when the tissues which lie over the outside of the hip bone (greater trochanter) become irritated. The soft tissues that attach to


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thigh. It occurs when the tissues which lie over the outside of the hip bone (greater trochanter) become irritated. The soft tissues that attach to the outside of the hip include tendons and bursa. When these become overloaded they are the primary sources of pain caused by GTPS. It’s more common in females and in those aged between 40 and 60 years old but can affect any age. Signs and Symptoms of GTPS These can vary from person to person. People may experience some or all of these symptoms including: Pain in the hip/thigh/buttock area. Worse pain when lying on your side or with direct pressure. Pain increasing with exercise such as periods of walking, standing or running. Tenderness to touch. Pain sitting with your legs crossed. Pain when standing on the affected leg (sometimes called hanging on the hip) Pain when climbing stairs Pain when lifting legs in/out a car or bed What causes GTPS Often it can occur for no apparent reason but these are some factors which appear to contribute


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lifting legs in/out a car or bed What causes GTPS Often it can occur for no apparent reason but these are some factors which appear to contribute to it: a sudden increased load on your hip a change to your activity levels such as increased walking distances or pace increased pressure to your hip area through sitting or standing in one position for too long or weight bearing on one leg reduced strength and flexibility of the muscles around the hip and buttock having a sedentary, inactive lifestyle or being overweight an injury such as a fall on to the side of your hip area hormone changes may also influence this condition this can also be related to osteoarthritis of the hips and knees or low back pain How can GTPS be managed? An important step in your recovery is identifying which activities are causing or increasing your pain. Modifying those activities can help to reduce symptoms. The key to success is slow progressive loading of the soft tissues through exercise that strengthen the


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those activities can help to reduce symptoms. The key to success is slow progressive loading of the soft tissues through exercise that strengthen the muscles involved. Read more about exercises for greater trochanteric pain syndrome Over time it is important to gradually increase the exercises to help the tendons and muscles become stronger, less painful and more able to cope with your normal activity levels. Other ways to help improve symptoms include: spreading your weight evenly across both feet and not leaning on just one leg. avoiding low chairs. avoid sitting with your legs crossed. avoid sleeping on the painful side. Try lying on your back with a pillow under your knees or lie on your good side with a pillow between your legs to keep them in line with your hip joints. try to keep active and stay at work even if you have to modify your duties. losing weight if you are overweight. This condition can often take 6 to 12 months of rehabilitation to settle, but this will depend on


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your duties. losing weight if you are overweight. This condition can often take 6 to 12 months of rehabilitation to settle, but this will depend on the cause. It is normal to have flare ups during this time. If this happens, then it may be best to reduce the repetitions or rest for a few days before starting again. Managing pain Pain medication can help you move more comfortably, which can help your recovery. More about taking painkillers Corticosteroid injections If painkillers aren’t helping to control the pain, your healthcare professional may discuss the option of having a corticosteroid injection into the outer hip. Corticosteroids are medicines that help reduce pain and inflammation. They may also be given with a local anaesthetic. Injections may not cure your condition, they are used to help with the pain. Read more about corticosteroids Work A hip problem can sometimes mean you need to take some time off work to help recovery. How long you’re off will depend on the nature of


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Work A hip problem can sometimes mean you need to take some time off work to help recovery. How long you’re 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 symptoms haven’t improved within 6 weeks, or it’s got worse, after following this advice, talk to a healthcare professional about your symptoms. Find out how to access MSK services in your area. When dealing with any health condition it’s 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


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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’t 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 greater trochanteric pain syndrome Exercises for hip 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 © 2025 NHS 24 – v1.1.1.17852


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string_value:
https://www.nhsinform.scot/illnesses-and-conditions/stomach-liver-and-gastrointestinal-tract/haemorrhoids-piles/


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https://www.nhsinform.scot/illnesses-and-conditions/infections-and-poisoning/hand-foot-and-mouth-disease/


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Hand, foot and mouth disease | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotland’s Service Directory 0 Home Illnesses and conditions Infections and poisoning Hand, foot and mouth disease Hand, foot and mouth disease Hand, foot and mouth disease is a common illness. It causes mouth ulcers and spots on the hands and feet. It’s most common in young children, particularly those under 10. But, it can affect older children and adults as well. The infection is not linked to foot and mouth disease, which affects cattle, sheep and pigs. Symptoms of hand, foot and mouth disease The signs of hand, foot and mouth disease can include: a high temperature (fever) feeling unwell loss of appetite coughing abdominal (tummy) pain a sore throat and mouth Source: dermnetnz.org More images of hand, foot and mouth disease Source: dermnetnz.org Source: dermnetnz.org Mouth ulcers After 1 or 2 days, red spots appear on the


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More images of hand, foot and mouth disease Source: dermnetnz.org Source: dermnetnz.org Mouth ulcers After 1 or 2 days, red spots appear on the tongue and inside the mouth. These quickly develop into larger yellow-grey mouth ulcers with red edges. The ulcers can be painful and make eating, drinking and swallowing difficult. They should pass within a week. Spotty rash and blisters Soon after the mouth ulcers appear, you may notice a rash made up of small, raised red spots on the skin. These can develop on the: fingers back of the hands palms of the hand soles of the feet buttocks groin The spots may then turn into small blisters with a grey centre. The spots and blisters can sometimes be itchy or uncomfortable and usually last up to 10 days. When to get medical advice Seek medical advice if: you or your child’s symptoms are getting worse or do not improve after 7 to 10 days you or your child have a very high temperature, or feel hot and shivery your child develops fits (seizures),


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or do not improve after 7 to 10 days you or your child have a very high temperature, or feel hot and shivery your child develops fits (seizures), confusion, weakness or a loss of consciousness your child is under 3 months old and has a temperature of 38°C (101°F) or above, or is between 3 and 6 months old and has a temperature of 39°C (102°F) or above the skin becomes very painful, red, swollen and hot, or there’s a discharge of pus you’re worried about your child’s symptoms your child is unable or unwilling to drink any fluids your child is dehydrated (they’re not peeing as often as usual) you’re pregnant and get hand, foot and mouth disease Hand, foot and mouth disease can be spread to other people.Check with your GP practice before going. They may suggest a phone consultation. Pregnancy and hand, foot and mouth disease Speak to your GP practice if you’re pregnant and you become infected within a few weeks of your due date. Infection in pregnancy is usually nothing to worry about.


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GP practice if you’re pregnant and you become infected within a few weeks of your due date. Infection in pregnancy is usually nothing to worry about. But, there’s a small chance it could make your baby ill if you’re infected shortly before you give birth. Read more about the risks of hand, foot and mouth disease in pregnancy Treatment for hand, foot and mouth disease Hand, foot and mouth disease can be unpleasant, but it will usually clear up by itself within 7 to 10 days. You can normally look after yourself or your child at home. There’s no cure for hand, foot and mouth disease. Antibiotics won’t help as hand, foot and mouth disease is caused by a virus. You should keep your child away from nursery or school until they’re feeling better. Adults with the condition should stay away from work until they’re feeling better. Things you can do to help your symptoms Do rest at home drink lots of water eat soft foods like yoghurt or soup if swallowing is uncomfortable take paracetamol or


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do to help your symptoms Do rest at home drink lots of water eat soft foods like yoghurt or soup if swallowing is uncomfortable take paracetamol or ibuprofen to ease a sore throat or fever use mouth gels, rinses or sprays for mouth ulcers How is hand, foot and mouth disease spread? Hand, foot and mouth disease is easily passed on to other people. It’s spread through coughs, sneezes, poo and the fluid in blisters. The infection is caused by many different viruses so you can get it more than once. Most people develop immunity to these viruses as they get older. How to prevent hand, foot and mouth disease It’s not always possible to avoid getting hand, foot and mouth disease. But, following this advice can help stop the infection spreading. Do stay off work, school or nursery until you or your child are feeling better use tissues to cover your mouth and nose when you cough or sneeze put used tissues in a bin as soon as possible wash your hands with soap and water often disinfect any


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your mouth and nose when you cough or sneeze put used tissues in a bin as soon as possible wash your hands with soap and water often disinfect any surfaces or objects often wash any bedding or clothing on a hot wash Don’t do not share cups, utensils, towels and clothes with people who are infected Source: NHS 24 - Opens in new browser window Last updated: 31 October 2024 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Don’t 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 Blisters Fever in children Fever in adults Mouth ulcer 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 © 2025 NHS 24 –


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for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats © 2025 NHS 24 – v1.1.1.17852


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https://www.nhsinform.scot/illnesses-and-conditions/cancer/cancer-types-in-adults/head-and-neck-cancer/


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Head and neck cancer | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotland’s Service Directory 0 Home Illnesses and conditions Cancer Cancer types in adults Head and neck cancer Head and neck cancer Head and neck cancer is a relatively uncommon type of cancer. There are more than 30 areas within the head and neck where cancer can develop, including the: mouth (including the lips) voice box (larynx) throat (pharynx) salivary glands nose and sinuses area at the back of the nose and mouth (nasopharynx) Oesophageal (gullet) cancer, thyroid cancer, brain tumours and eye cancer don’t tend to be classified as a head and neck cancer. Mouth cancer Mouth cancer is the most common type of head and neck cancer. It can affect a number of areas in and around the mouth, including the: lips tongue inside of the cheeks floor or roof of the mouth gums Symptoms of mouth cancer can include persistent mouth ulcers and/or a


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including the: lips tongue inside of the cheeks floor or roof of the mouth gums Symptoms of mouth cancer can include persistent mouth ulcers and/or a lump in your mouth, both of which may be painful. Read more about mouth cancer. Laryngeal cancer Laryngeal cancer develops in the tissue of the larynx (voice box). Symptoms of laryngeal cancer can include: a change in the voice, such as persistent hoarseness difficulty or pain when swallowing noisy breathing shortness of breath a persistent cough a lump or swelling in your neck Read more about laryngeal cancer. Throat cancers Doctors don’t tend to use the term throat cancer, as the throat (pharynx) includes many different parts that can be affected by cancer. The main areas that can be affected are the: oropharynx – the part of the throat at the back of the mouth hypopharynx – the part of the throat connecting the oropharynx to the gullet and windpipe nasopharynx – the part of the throat that connects the back of the nose to the back of


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throat connecting the oropharynx to the gullet and windpipe nasopharynx – the part of the throat that connects the back of the nose to the back of the mouth (see below) The most common symptoms of cancer in the oropharynx or hypopharynx include a lump in the neck, a persistent sore throat and difficulty swallowing. Macmillan Cancer Support has more information about oropharyngeal cancer. Salivary gland cancer Salivary glands produce saliva, which keeps your mouth moist and helps with swallowing and digestion. There are 3 main pairs of salivary glands. They are the: parotid glands – located between your cheeks and your ears sublingual glands – located under your tongue submandibular glands – located under each side of your jawbone Salivary gland cancer most commonly affects the parotid glands. The main symptom of salivary gland cancer is a lump or swelling on or near your jaw, or in your mouth or neck, although the vast majority of these lumps are non-cancerous. Other symptoms can


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is a lump or swelling on or near your jaw, or in your mouth or neck, although the vast majority of these lumps are non-cancerous. Other symptoms can include numbness in part of your face and drooping on one side of your face. To read more about salivary gland cancer, visit Cancer Research UK and Macmillan Cancer Support. Nose and sinus cancer Nose and sinus cancer affects the nasal cavity (above the roof of your mouth) and the sinuses (the small, air-filled cavities inside the bones of the nose and within the cheekbones and forehead). The symptoms of nose and sinus cancer are similar to viral or bacterial infections, such as the common cold or sinusitis, and include: a persistent blocked nose, which usually only affects one side nosebleeds a decreased sense of smell mucus running from the nose or down the throat Read more about nose and sinus cancer. Nasopharyngeal cancer Nasopharyngeal cancer affects the part of the throat that connects the back of the nose to the back of the mouth.


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sinus cancer. Nasopharyngeal cancer Nasopharyngeal cancer affects the part of the throat that connects the back of the nose to the back of the mouth. It’s one of the rarest types of head and neck cancer in the UK. Symptoms can include: a lump in the neck, due to the cancer spreading to the lymph nodes (pea-sized lumps of tissue that make up part of the immune system) in the neck a blocked or stuffy nose nosebleeds hearing loss (usually only in one ear) Read more about nasopharyngeal cancer. Source: NHS 24 - Opens in new browser window Last updated: 14 October 2024 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Don’t 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 Mouth cancer Thyroid cancer Laryngeal (larynx) cancer Nasopharyngeal cancer Nasal and sinus cancer Other


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this page to Info For Me Also on NHS inform Mouth cancer Thyroid cancer Laryngeal (larynx) cancer Nasopharyngeal cancer Nasal and sinus cancer Other health sites Cancer Research UK: Head and neck cancer Macmillan Cancer Support: Head and neck cancers National Association of Laryngectomee Clubs 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 © 2025 NHS 24 – v1.1.1.17852


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Headaches | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotland’s Service Directory 0 Home Illnesses and conditions Brain, nerves and spinal cord Headaches Headaches Return to Symptoms Enter age Last Updated: Next Review Date: Review my answers Find your local services Search for a service near you by entering your postcode below. Please input your postcode in the following format: A12 1BC GP Practices Dental Services Pharmacies Opticians Postcode Search NHS inform has more information on this condition. Read more Previous Start guide Review my answers × You told us your credentials were: : You said: Based on the information you gave us, we made the following recommendation: Close Keep a copy View PDF Most headaches are not serious. In many cases, you can treat your headache at home. Headache self-help guide Complete our self-help guide to check your symptoms and find out what to do next. How you can help


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your headache at home. Headache self-help guide Complete our self-help guide to check your symptoms and find out what to do next. How you can help your headache yourself Do resttake painkillers such as paracetamol or ibuprofendrink plenty of fluidsrelax (if stress is the cause)take regular exercise When to get professional advice Your local pharmacy can provide: advice about headaches treatments to help relieve headaches Find your local pharmacy Speak to a GP if: treatments recommended by your pharmacist do not relieve your headache your headache is getting worse despite taking painkillers painful or frequent headaches affect your daily activities or cause you to miss work Phone 111 if: your headache does not go away and gets worse over time your headache is triggered suddenly by coughing, laughing, sneezing, changing posture, or physical effort You have a headache and: a sore scalp jaw pain while chewing you feel weak Phone 999 if: your headache occurs suddenly and is very severe –


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effort You have a headache and: a sore scalp jaw pain while chewing you feel weak Phone 999 if: your headache occurs suddenly and is very severe – it may feel like a blinding pain your headache occurs after a severe head injury You have an extremely painful headache and: slurred speech or memory loss a very high temperature, feel hot and shivery, and have a stiff neck or a rash drowsiness or confusion vision problems severe pain and redness in one of your eyes Tension headaches Tension headaches are the most common type of headache. They’re what we think of as normal, ‘everyday’ headaches. They feel like a constant ache that affects both sides of the head, as though a tight band is stretched around it. Normally, tension headaches are not severe enough to prevent you doing everyday activities. They usually last for 30 minutes to several hours, but can last for several days. What causes a tension headache? The exact cause is unclear, but tension headaches have been linked to things such


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but can last for several days. What causes a tension headache? The exact cause is unclear, but tension headaches have been linked to things such as: stress poor posture skipping meals dehydration How to treat a tension headache You can usually treat tension headaches with painkillers such as paracetamol and ibuprofen. Lifestyle changes may also help, for example: getting regular sleep reducing stress staying well hydrated Migraines Migraines are less common than tension headaches. They’re usually felt as a severe, throbbing pain at the front or side of the head. Some people also have other symptoms, such as: nausea vomiting increased sensitivity to light or sound Migraines can stop you carrying out your normal daily activities. They usually last at least a couple of hours. Some people find they need to stay in bed for days at a time. How to treat migraines Most people can treat their migraines with over-the-counter medication from the pharmacist. If your migraines are severe, you may


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to treat migraines Most people can treat their migraines with over-the-counter medication from the pharmacist. If your migraines are severe, you may need to be prescribed stronger medication by your GP. This may be able to relieve and prevent your migraines. Read further information about migraines Cluster headaches Cluster headaches are a rare type of headache. They occur in clusters for a month or two at a time around the same time of year.Cluster headaches are excruciatingly painful. They cause intense pain around one eye, and often occur with other symptoms, such as a: watering or red eye blocked or runny nose Pharmacy medications don’t usually ease the symptoms of a cluster headache. Your GP can prescribe specific treatments to ease the pain and help prevent further attacks. Medication and painkiller headaches Some headaches are a side effect of taking a particular medication. Frequent headaches can also be caused by taking too many painkillers. This is known as a painkiller or


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side effect of taking a particular medication. Frequent headaches can also be caused by taking too many painkillers. This is known as a painkiller or medication-overuse headache. A medication-overuse headache will usually get better within a few weeks once you stop taking the painkillers that are causing it. But, pain may get worse for a few days before it starts to improve. Hormone headaches Headaches in women are often caused by hormones, and many women notice a link with their periods. The combined contraceptive pill, the menopause and pregnancy are also potential triggers. You may be able to help reduce headaches associated with your menstrual cycle by: reducing your stress levels having a regular sleeping pattern making sure you do not miss meals Other causes of headaches Headaches can also have a number of other causes, including: drinking too much alcohol a head injury or concussion a cold or flu temporomandibular disorders – problems affecting the ‘chewing’ muscles and the


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drinking too much alcohol a head injury or concussion a cold or flu temporomandibular disorders – problems affecting the ‘chewing’ muscles and the joints between the lower jaw and the base of the skull sinusitis – inflammation of the lining of the sinuses carbon monoxide poisoning sleep apnoea – a condition where the walls of the throat relax and narrow during sleep, interrupting normal breathing Source: NHS 24 - Opens in new browser window Last updated: 14 March 2024 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Don’t 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: Headache The Migraine Trust National Migraine Centre Find your local pharmacy Enter a place or postcode NHS inform About NHS inform Editorial policy Contact us Webchat Give


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National Migraine Centre Find your local pharmacy Enter a place or postcode NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats © 2025 NHS 24 – v1.1.1.17852


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https://www.nhsinform.scot/illnesses-and-conditions/cardiovascular-disease/heart-disease/heart-attack/


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Heart attack | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotland’s Service Directory 0 Home Illnesses and conditions Cardiovascular disease Heart disease Heart attack Heart attack Phone 999 immediately if: You or someone else has symptoms like: central chest pain or discomfort in the chest that doesn’t go away – it may feel like pressure, tightness or squeezing pain that goes down the left arm, or both arms, or to the neck, jaw, back or stomach unconsciousness seizures or fitting difficulty breathing (snoring or rasping) rapid heart beat low or undetectable heart beat chest pain and breathlessness, nausea or sweating What is a heart attack? A heart attack happens when there’s a reduction in blood supply to part of the heart muscle. This lack of blood flow can cause damage to the heart. Sometimes, when chest pain occurs suddenly, it’s unclear if it’s due to unstable angina or a heart attack. Until tests


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can cause damage to the heart. Sometimes, when chest pain occurs suddenly, it’s unclear if it’s due to unstable angina or a heart attack. Until tests confirm the diagnosis, doctors sometimes call this Acute Coronary Syndrome (ACS). Diagnosing a heart attack In order to find out if you’re having a heart attack, you’ll need to have some tests. These tests can include: an electrocardiogram (ECG) – to check your heart’s rhythm and electrical activity blood tests – to check troponin levels, a protein that’s released into the blood stream when the heart muscle is damaged an assessment of blood pressure an assessment of blood oxygen levels a chest X-ray an echocardiogram – to assess the structure and function of your heart a coronary angiogram – to identify any blood vessels that are narrowed or blocked Based on your test results, your clinical team will decide your treatment plan. Treating a heart attack When someone has a heart attack, it’s important to restore blood flow quickly. This’ll


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team will decide your treatment plan. Treating a heart attack When someone has a heart attack, it’s important to restore blood flow quickly. This’ll minimise damage to the heart muscle and start to alleviate symptoms. Your treatment plan will depend on: the type of heart attack you’ve had your individual situation Types of treatment Treatment for a heart attack may consist of: anti-emetics – to stop sickness and nausea antiplatelet therapy – medication that thins the blood and gets rid of blood clots coronary angioplasty – a procedure to widen coronary arteries that are blocked or narrow oxygen therapy – to help with your breathing and oxygen levels pain-relieving drugs – like morphine reperfusion treatment – to help restore blood flow and maintain the heart’s pumping action thrombolysis – a ‘clot-busting drug’ to help restore blood flow to your heart People who’ve had a heart attack will need to take several different types of medication. Your doctor will try to find the best drugs


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to your heart People who’ve had a heart attack will need to take several different types of medication. Your doctor will try to find the best drugs for you with the fewest side effects. Complications of a heart attack Sometimes there are complications following a heart attack. The most common complications after a heart attack are: arrhythmias – problems with your heart’s natural electrical rhythm heart failure – when the heart isn’t pumping blood around the body as well as it should Many problems resolve themselves quite quickly. However, sometimes problems linger and can often be helped by medication. Recovering from a heart attack How long you stay in hospital will depend upon your circumstances and treatment. Don’t be afraid to ask your medical team about what’s happening. On discharge, you should be referred onto a cardiac rehabilitation programme. Cardiac rehabilitation You should receive an assessment to determine your individual goals and needs after a heart attack.


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rehabilitation programme. Cardiac rehabilitation You should receive an assessment to determine your individual goals and needs after a heart attack. Rehabilitation is usually a mix of exercise and education sessions. This helps to provide you with the information, advice and support to: understand your condition and medication recover from your heart attack, procedure or surgery make lifestyle changes to improve your heart health Your cardiac rehabilitation team can also give you advice on practical issues after a heart attack, including: driving mental wellbeing relationships sexual relationships returning to work long term recovery The British Heart Foundation has further information on cardiac rehabilitation. Source: Scottish Government - Opens in new browser window Last updated: 05 February 2025 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Don’t include personal information e.g. name, location or any personal health conditions.


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NHS inform Thank You Your feedback has been received Don’t 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 What to do in a heart emergency Chest pain Other health sites British Heart Foundation: Heart attack Chest Heart & Stroke Scotland: Heart attack St John Ambulance: Heart attack 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 © 2025 NHS 24 – v1.1.1.17852


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string_value:
https://www.nhsinform.scot/illnesses-and-conditions/cardiovascular-disease/heart-disease/heart-block/


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Heart disease | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotland’s Service Directory 0 Home Illnesses and conditions Cardiovascular disease Heart disease Heart disease Heart disease Information on symptoms and conditions that can affect the heart What is heart disease? Heart disease includes a range of conditions that affect the heart, such as: conditions where the blood flow to the heart is interrupted or reduced (coronary heart disease) heart failure problems with the rhythm of the heart conditions that can be passed on through your parents’ genes (inherited) conditions that are present at birth (congenital) Coronary heart disease Coronary heart disease is a term used to describe what happens when the blood flow to the heart is interrupted or reduced. Angina and heart attacks often happen as a result of coronary heart disease. Angina Information about angina, symptoms and treatments Chest pain What


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Angina and heart attacks often happen as a result of coronary heart disease. Angina Information about angina, symptoms and treatments Chest pain What to do if you have chest pain and when to seek help Coronary heart disease Information about coronary heart disease, symptoms and treatments Heart attack Information about heart attack, symptoms and treatments Heart failure Heart failure is a condition where your heart cannot pump blood around your body as well as it should. Heart failure Information about heart failure, symptoms and treatments Heart rhythm disorders A heart rhythm problem, also known as arrhythmia, usually means your heart is beating too fast, too slow or irregularly. Atrial fibrillation Information about atrial fibrillation, symptoms and treatments Heart block Information about heart block, symptoms and treatment Heart palpitations Information about heart palpitations, symptoms and treatments Supraventricular tachycardia Information about supraventricular tachycardia,


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Information about heart palpitations, symptoms and treatments Supraventricular tachycardia Information about supraventricular tachycardia, symptoms and treatments Wolff-Parkinson-White syndrome Information about Wolff-Parkinson-White syndrome, symptoms and treatments Inherited heart conditions Inherited heart conditions, sometimes referred to as inherited cardiac conditions (ICC), are a group of heart conditions that are passed on through your parents’ genes. Inherited heart conditions Information about inherited heart conditions, symptoms and treatments Congenital heart disease Congenital heart disease is a condition or problem with the heart that is there from birth. Congenital heart disease Information about congenital heart disease, symptoms and treatments Women’s heart health Heart disease is a major cause of ill health and death for women in Scotland. Women’s heart health Information on heart disease in women and where to get support Give feedback about this page Let us know


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for women in Scotland. Women’s heart health Information on heart disease in women and where to get support Give feedback about this page Let us know what you liked, what you didn’t or what you think is missing by emailing nhs.inform@nhs24.scot.nhs.uk Please don’t include personal information like your name, location or any personal health conditions. 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 © 2025 NHS 24 – v1.1.1.17852


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https://www.nhsinform.scot/illnesses-and-conditions/cardiovascular-disease/heart-disease/heart-failure/


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https://www.nhsinform.scot/illnesses-and-conditions/cardiovascular-disease/heart-disease/heart-palpitations/


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Heart palpitations | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotland’s Service Directory 0 Home Illnesses and conditions Cardiovascular disease Heart disease Heart palpitations Heart palpitations Palpitation is an awareness of your heartbeat. For example, your heart might feel like it’s pounding, fluttering or beating irregularly. This is often just for a few seconds or minutes. You may feel these sensations in your chest, throat or neck. Palpitations might feel alarming but in most cases they aren’t a sign of any significant problems with your heart. Phone 999 or go to A&E if: You or someone else has heart palpitations and: dizziness sudden shortness of breath chest pain loses consciousness Speak to your GP practice if: You have heart palpitations and: they keep coming back they’re getting worse they last longer than a few minutes you have a heart condition you have a history of heart problems in


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they keep coming back they’re getting worse they last longer than a few minutes you have a heart condition you have a history of heart problems in your family Causes of heart palpitations Common causes of heart palpitations include some lifestyle factors like: stress anxiety panic attacks lack of sleep strenuous exercise drinking too much alcohol drinking lots of caffeine smoking taking illegal or recreational drugs Medications Heart palpitations can also be a side effect of some medications. This includes COPD and asthma inhalers and tablets for a thyroid problem. This may be particularly noticeable if you have just started taking the medication. Speak to your healthcare professional if you think your medication may be causing heart palpitations. Do not stop taking a treatment without speaking to your healthcare professional first. Hormone changes Hormone changes can cause heart palpitations. This might happen during: periods pregnancy perimenopause the menopause Medical conditions


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changes Hormone changes can cause heart palpitations. This might happen during: periods pregnancy perimenopause the menopause Medical conditions Sometimes, a medical condition may cause heart palpitations. This includes: a heart problem, like arrhythmia an overactive thyroid dehydration (not enough fluid in the body) diabetes infections iron deficiency anaemia low blood sugar level some types of low blood pressure Arrhythmia Heart palpitations can sometimes be a symptom of an arrhythmia. Arrhythmia means there’s a problem with the heart’s rhythm. Some common arrhythmias include atrial fibrillation and supraventricular tachycardia. If your doctor thinks that you have an arrhythmia you may be sent for some tests to assess your heart. Managing heart palpitations Do try to reduce your stress levels practise deep breathing exercises drink less caffeinated drinks like tea, coffee, energy drinks and some fizzy drinks eat a healthy diet Further support and advice Lifestyle factors like


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less caffeinated drinks like tea, coffee, energy drinks and some fizzy drinks eat a healthy diet Further support and advice Lifestyle factors like smoking, alcohol and drugs can trigger heart palpitations. You can get advice on giving up smoking through Quit Your Way Scotland. Phone them on 0800 84 84 84 (8am to 10pm, Monday to Friday) for further information. Drinkline provide advice for anyone who is worried about their own or someone else’s drinking. You can phone them on 0800 7 314 314 (8am to 11pm, Monday to Sunday) for further information. NHS inform has details of services that provide support for people affected by drugs. Source: Scottish Government - Opens in new browser window Last updated: 04 July 2024 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Don’t 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


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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 © 2025 NHS 24 – v1.1.1.17852


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https://www.nhsinform.scot/illnesses-and-conditions/stomach-liver-and-gastrointestinal-tract/hepatitis-a/


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https://www.nhsinform.scot/illnesses-and-conditions/stomach-liver-and-gastrointestinal-tract/hepatitis-b/


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Hepatitis B | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotland’s Service Directory 0 Home Illnesses and conditions Stomach, liver and gastrointestinal tract Hepatitis B Hepatitis B Hepatitis B is a liver infection that’s spread through blood and body fluids. The chance of getting it in the UK is low. It often doesn’t cause any symptoms in adults and usually passes in a few months without treatment. In children it often persists for years and may eventually cause serious liver damage. A hepatitis B vaccine is available on the NHS as part of routine child vaccination, or if you’re at high risk. Symptoms of hepatitis B Many people with hepatitis B won’t have any symptoms. If you do develop symptoms, they tend to occur 2 or 3 months after exposure to the hepatitis B virus. Symptoms of hepatitis B include: tiredness a high temperature (fever) of 38°C (100.4°F) or above general aches and pains loss of


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hepatitis B virus. Symptoms of hepatitis B include: tiredness a high temperature (fever) of 38°C (100.4°F) or above general aches and pains loss of appetite feeling and being sick diarrhoea abdominal pain yellowing of the skin and eyes (jaundice) When to get medical advice Speak to your GP practice if: you think you may have been exposed to the hepatitis B virus – emergency treatment can help prevent infection if given within a few days of exposure you have symptoms of hepatitis B you’re at high risk of hepatitis B Diagnosing hepatitis B A blood test can check if you have hepatitis B or have had it in the past. The hepatitis B vaccine may also be recommended to reduce your risk of infection. Treatments for hepatitis B Treatment for hepatitis B depends on how long you’ve been infected for. Emergency treatment If you’ve been exposed to the virus in the last few days, emergency treatment can help stop you becoming infected. Treatment for acute hepatitis B Acute hepatitis B means you’ve


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virus in the last few days, emergency treatment can help stop you becoming infected. Treatment for acute hepatitis B Acute hepatitis B means you’ve only had the infection for a few weeks or months. You may only need treatment to relieve your symptoms while your body fights off the infection itself. Treatment for chronic hepatitis B Chronic hepatitis B means you’ve had the infection for more than 6 months. You may be offered medicines that can keep the virus under control and reduce the risk of liver damage. Chronic hepatitis B often requires: long-term or lifelong treatment regular checks for any further liver problems How is hepatitis B spread? The hepatitis B virus is found in the blood, semen and vaginal fluids and bodily fluids of an infected person. It can be spread by: a mother to her newborn baby, particularly in countries where the infection is common within families (child to child) in countries where the infection is common injecting drugs and sharing needles and other drug


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infection is common within families (child to child) in countries where the infection is common injecting drugs and sharing needles and other drug equipment, such as spoons and filters having sex with an infected person without using a condom having a tattoo, body piercing, or medical or dental treatment with unsterilised equipment sharing toothbrushes, razors or scissors contaminated with infected blood Hepatitis B is not spread by kissing, holding hands, hugging, coughing, sneezing, or sharing crockery and utensils. How to prevent hepatitis B A vaccine that offers protection against hepatitis B is available for all babies born in the UK on or after 1 August 2017. It’s also available for people at high risk of the infection or complications from it. People at high risk of hepatitis B People at high risk of hepatitis B include: babies born to mothers with hepatitis B close family and sexual partners of someone with hepatitis B people travelling to a part of the world where hepatitis B


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to mothers with hepatitis B close family and sexual partners of someone with hepatitis B people travelling to a part of the world where hepatitis B is widespread families adopting or fostering children from high-risk countries people who inject drugs or have a sexual partner who injects drugs people who change their sexual partner often men who have sex with men male and female sex workers people whose job puts them at risk of contact with blood or body fluids, such as nurses, prison staff, doctors, dentists and laboratory staff people with chronic liver disease people with chronic kidney disease people in prison people receiving regular blood or blood products, and their carers Hepatitis B core antibody (anti-HBc) testing NHS Scotland is making the blood supply safer by introducing enhanced hepatitis B screening. This is an additional measure to improve testing for blood donors and further increase the safety of the blood supply chain. NHS Scotland has been conducting this enhanced


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measure to improve testing for blood donors and further increase the safety of the blood supply chain. NHS Scotland has been conducting this enhanced screening on all donations since April 2022. Only a small number of donors are impacted, however, these donors will no longer be able to donate. Living with hepatitis B As well as medical treatments, there are some things you can do when you have hepatitis B to help ease the symptoms and stop the infection spreading to others. Do eat a healthy and balanced diet rest and stay hydrated take painkillers like paracetamol and ibuprofen – ask your doctor for advice about how much paracetamol you should take as you may not be able to take a normal dose keep your room well ventilated, wear loose clothing and avoid hot showers and baths if you feel itchy speak to your doctor if you’re thinking of having a baby Don’t do not have unprotected sex – including anal and oral sex do not drink alcohol – this can increase your risk of developing serious


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a baby Don’t do not have unprotected sex – including anal and oral sex do not drink alcohol – this can increase your risk of developing serious liver problems do not share toothbrushes, razors or needles with other people Your close contacts, such as family members, may need to be vaccinated. Complications of hepatitis B Most people do not have any lasting problems after having a hepatitis B infection. In some patients chronic hepatitis B can cause liver damage (cirrhosis) and increase your risk of getting liver cancer. It is important that all patients with chronic hepatitis B are followed up in specialist clinics. If required, treatment can control hepatitis B infection, preventing serious complications. Source: NHS Greater Glasgow & Clyde - 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’t include personal information e.g. name, location or any personal health conditions.


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NHS inform Thank You Your feedback has been received Don’t 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 Hepatitis C Hepatitis A Other health sites Hepatitis B Foundation NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats © 2025 NHS 24 – v1.1.1.17852


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https://www.nhsinform.scot/illnesses-and-conditions/stomach-liver-and-gastrointestinal-tract/hepatitis-c/


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https://www.nhsinform.scot/illnesses-and-conditions/stomach-liver-and-gastrointestinal-tract/hiatus-hernia/


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Hiatus hernia | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotland’s Service Directory 0 Home Illnesses and conditions Stomach, liver and gastrointestinal tract Hiatus hernia Hiatus hernia About hiatus hernia Diagnosing hiatus hernia Treating hiatus hernia Complications of hiatus hernia About hiatus hernia A hiatus hernia, or hiatal hernia, is when part of the stomach squeezes up into the chest through an opening (‘hiatus’) in the diaphragm. The diaphragm is a large, thin sheet of muscle between the chest and the abdomen (tummy). Hiatus hernia and heartburn A hiatus hernia itself rarely has any noticeable symptoms. However, it can cause a problem called gastro-oesophageal reflux disease (GORD). GORD is where stomach acid leaks into the oesophagus (the tube that carries food to the stomach). It can occur if a hiatus hernia prevents the valve at the bottom of the oesophagus from working properly. Your


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that carries food to the stomach). It can occur if a hiatus hernia prevents the valve at the bottom of the oesophagus from working properly. Your oesophagus can become severely irritated, because it’s not protected against stomach acid. This can cause symptoms such as heartburn, chest pain, an unpleasant sour taste in your mouth, and swallowing problems (dysphagia). You should see your GP if you have frequent and severe symptoms of GORD. What causes a hiatus hernia? It’s not exactly clear what causes hiatus hernia, but it may be the result of the diaphragm becoming weak with age, or pressure on the abdomen. Hiatus hernia can sometimes occur in newborn babies if the stomach or diaphragm doesn’t develop properly. Who’s affected Hiatus hernia can affect anyone, but it’s more common in people who are: over 50 years of age overweight pregnant It’s estimated that a third of people over 50 have a hiatus hernia. There’s also a rare type of hiatus hernia that affects newborn babies, which is


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It’s estimated that a third of people over 50 have a hiatus hernia. There’s also a rare type of hiatus hernia that affects newborn babies, which is caused by a congenital defect of the stomach or diaphragm. Congenital means that it is present from birth. Types of hiatus hernia There are 2 main types of hiatus hernia. They are: sliding hiatus hernias – hernias that move up and down, in and out of the chest area (more than 80% of hiatus hernias are of this type) para-oesophageal hiatus hernias – also called rolling hiatus hernias, where part of the stomach pushes up through the hole in the diaphragm next to the oesophagus (about 5 to 15% of hiatus hernias are of this type) These pages mainly focus on sliding hiatus hernias. They can usually be diagnosed using an X-ray or an endoscopy, where a long, thin flexible tube with a light and video camera at one end is used to examine the inside of the body. Read more about diagnosing a hiatus hernia. Treating a hiatus hernia Treatment for a


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camera at one end is used to examine the inside of the body. Read more about diagnosing a hiatus hernia. Treating a hiatus hernia Treatment for a sliding hiatus hernia usually focuses on relieving the symptoms of GORD, such as heartburn. Lifestyle changes and medication are the preferred treatments. Surgery is usually only recommended as an alternative to long-term medication or if other treatments haven’t worked. Lifestyle advice may include: eating smaller, more frequent meals, rather than 3 large meals a day avoiding lying down (including going to bed) for 3 hours after eating or drinking removing any foods or drinks from your diet that make your symptoms worse If a hiatus hernia isn’t causing any noticeable problems, it doesn’t usually need to be treated. Surgery is used to repair a para-oesophageal hiatus hernia if there’s a risk of serious complications. Read more about treating a hiatus hernia. Further problems It’s rare for a hiatus hernia to cause complications, but long-term


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serious complications. Read more about treating a hiatus hernia. Further problems It’s rare for a hiatus hernia to cause complications, but long-term damage to the oesophagus caused by leaking stomach acid can lead to ulcers, scarring and changes to the cells of the oesophagus, which can increase your risk of oesophageal cancer. Read more about the complications of a hiatus hernia. Diagnosing hiatus hernia A hiatus hernia can usually be diagnosed after a gastroscopy or X-ray. Gastroscopy A gastroscopy is a procedure where the inside of your body is examined using a gastroscope (a long, thin flexible tube with a light and video camera at one end), which sends images to an external monitor. The gastroscope will be inserted into your mouth and down your throat, and will be used to help identify any problems. The procedure may be carried out using a local anaesthetic or a sedative to help you relax. Barium meal X-ray The barium meal X-ray, also called the barium swallow test, is an


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out using a local anaesthetic or a sedative to help you relax. Barium meal X-ray The barium meal X-ray, also called the barium swallow test, is an effective way of identifying a hiatus hernia. As part of the test, you’ll be asked to drink some barium solution. Barium is a non-toxic chemical that shows up clearly on an X-ray. Once the barium moves down into your digestive system, a series of X-rays will be taken to identify any problems. If you need to have a barium meal X-ray, you won’t be able to eat or drink anything for at least 6 hours before the procedure, so that your stomach and duodenum (the top of the small intestine) are empty. You may be given an injection to relax the muscles in your digestive system. You’ll be given a white, chalky liquid containing barium to drink while lying down. This will allow the specialist to see your stomach on an X-ray monitor more easily, as well as any ulcers or abnormal growths. Your bed may be tipped slightly during the test, so that the


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your stomach on an X-ray monitor more easily, as well as any ulcers or abnormal growths. Your bed may be tipped slightly during the test, so that the barium fills all the areas of your stomach. A barium swallow usually takes about 15 minutes to perform. Afterwards, you’ll be able to eat and drink as normal, although you may need to drink more water to help flush the barium out of your system. You may feel slightly sick after a barium meal X-ray and the barium may cause constipation. Your stools may also be white for a few days afterwards, as the barium passes through your system. Treating hiatus hernia Treatment for a hiatus hernia is usually only necessary if it’s causing problems. In most cases, people with a hiatus hernia only experience problems if the hernia causes gastro-oesophageal reflux disease (GORD). GORD can cause symptoms such as heartburn and an unpleasant taste in your mouth. Lifestyle changes and medication are the preferred treatments, although surgery may be used as


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as heartburn and an unpleasant taste in your mouth. Lifestyle changes and medication are the preferred treatments, although surgery may be used as an alternative to long-term medication, or if other treatments are ineffective. Lifestyle changes There are several things you can do yourself to help relieve symptoms of GORD caused by a hiatus hernia. These include: eating smaller, more frequent meals, rather than three large meals a day avoiding lying down (including going to bed) for at least 3 hours after eating or drinking avoiding drinking during the night removing certain foods from your diet if you think they make your symptoms worse avoiding alcohol, caffeine, chocolate, tomatoes, fatty foods, spicy foods and acidic food or drinks, such as citrus fruit juice, if they make your symptoms worse avoiding bending over or stooping, particularly after eating or drinking raising the head of your bed by around 20cm (8 inches) by placing a piece of wood or blocks under it; don’t use extra


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after eating or drinking raising the head of your bed by around 20cm (8 inches) by placing a piece of wood or blocks under it; don’t use extra pillows, because this may increase pressure on your abdomen If you’re overweight, losing weight may help to reduce the severity and frequency of your symptoms. If you smoke, you should try to give up. Tobacco smoke can irritate your digestive system and may make your symptoms worse. Read about stopping smoking. Medication A number of different medications can be used to treat symptoms of hiatus hernia. These are described below. Antacids Antacid medicines can relieve some of the symptoms of hiatus hernia. They come in liquid or tablet form and can be swallowed or chewed. They help to neutralise stomach acid when they reach the oesophagus and stomach by making it less acidic. However, antacid medicines don’t work for everyone. They’re not a long-term solution if symptoms persist or you’re in extreme discomfort. Antacids shouldn’t be taken at the


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don’t work for everyone. They’re not a long-term solution if symptoms persist or you’re in extreme discomfort. Antacids shouldn’t be taken at the same time as other medicines, because they can stop other medicines from being properly absorbed by your body. They may also damage the special coating on some types of tablets. Ask your GP or pharmacist for advice. Alginates Alginates are an alternative medicine to antacids. They work by producing a protective coating that shields the lining of your stomach and oesophagus from the effects of stomach acid. H2-receptor antagonists In some cases, a medicine known as an H2-receptor antagonist (H2RA) may be recommended if a hiatus hernia is causing GORD. Examples of H2RAs include cimetidine, famotidine (PepcidTwo) and ranitidine. H2RAs block the effects of the chemical histamine, which your body uses to produce stomach acid. H2RAs therefore help to reduce the amount of acid in your stomach. Side effects of H2RAs are uncommon. However, possible


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to produce stomach acid. H2RAs therefore help to reduce the amount of acid in your stomach. Side effects of H2RAs are uncommon. However, possible side effects may include diarrhoea, headaches, tiredness and a rash. Some H2RAs are available over the counter at pharmacies. These types of HR2As are taken in a lower dosage than the ones available on prescription. Ask your GP or pharmacist if you’re not sure whether these medicines are suitable for you. Proton-pump inhibitors (PPIs) Your GP may prescribe a medication called a proton-pump inhibitor (PPI). PPIs work by reducing the amount of acid produced by your stomach. Examples of the PPIs you may be prescribed include omeprazole, lansoprazole, rabeprazole and esomeprazole. Most people tolerate PPIs well and side effects are uncommon. When they do occur, they’re usually mild and can include headaches, diarrhoea, feeling sick or constipation. To minimise any side effects, your GP will prescribe the lowest possible dose of PPIs they think


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headaches, diarrhoea, feeling sick or constipation. To minimise any side effects, your GP will prescribe the lowest possible dose of PPIs they think will be effective. You should let your GP know if the prescribed dose of PPIs doesn’t work. A stronger dose may be needed. Surgery Surgery is usually only recommended for a sliding hiatus hernia (hernias that move up and down, in and out of the chest area) if the problem fails to respond to lifestyle changes and medication. You may also want to consider surgery if you have persistent and troublesome symptoms, but don’t want to take medication on a long-term basis. Prior to surgery, you may need further investigations to check how well the oesophagus moves (manometry) and how much acid is being refluxed (24-hour oesopageal pH studies). Laparoscopic nissen fundoplication (LNF) A procedure called a laparoscopic nissen fundoplication (LNF) is one of the most common surgical techniques used to treat GORD and sliding hiatus hernias. LNF is a


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a laparoscopic nissen fundoplication (LNF) is one of the most common surgical techniques used to treat GORD and sliding hiatus hernias. LNF is a type of keyhole surgery that involves making a series of small cuts in your abdomen. Carbon dioxide gas is used to inflate your abdomen to give the surgeon room to work in. During LNF, the stomach is put back into the correct position and the diaphragm around the lower part of the oesophagus is tightened. This should prevent any acid moving back out of your stomach. LNF is carried out under general anaesthetic, so you won’t feel any pain or discomfort. The surgery takes 60 to 90 minutes to complete. After having LNF, you should be able to leave hospital after you’ve recovered from the effects of the general anaesthetic. This is usually within 2 to 3 days. Depending on the type of job you do, you should be able to return to work within 3 to 6 weeks. For the first 6 weeks after surgery, it’s recommended that you only eat soft food, such as


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you should be able to return to work within 3 to 6 weeks. For the first 6 weeks after surgery, it’s recommended that you only eat soft food, such as mince, mashed potatoes or soup. Avoid eating hard food that could get stuck at the site of the surgery, such as toast, chicken or steak. Common side effects of LNF include difficulties swallowing (dysphagia), belching, bloating and flatulence. These side effects should resolve over the course of a few months. However, in about 1 in 100 cases they can be persistent. In such circumstances, further corrective surgery may be required. Para-oesophageal hiatus hernia If you have a para-oesophageal hiatus hernia, where the stomach pushes up through the hole in the diaphragm next to the oesophagus, surgery may be recommended to reduce the risk of the hernia becoming strangulated (see complications of a hiatus hernia for more information). Complications of hiatus hernia Complications from a hiatus hernia are rare, but they can be serious. Hiatus


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of a hiatus hernia for more information). Complications of hiatus hernia Complications from a hiatus hernia are rare, but they can be serious. Hiatus hernias that slide in and out of the chest area (sliding hiatus hernias) can cause gastro-oesophageal reflux disease (GORD). This is where stomach acid leaks into the oesophagus (gullet). This can damage the oesophagus, increasing the risk of problems. Oesophageal ulcers Damage to the lining of the oesophagus (oesophagitis) caused by stomach acid can lead to the formation of ulcers. The ulcers can bleed, causing pain and making swallowing difficult. Ulcers can usually be successfully treated by controlling the underlying symptoms of GORD. In most cases, over-the-counter medicines called antacids or alginates are used to treat the condition. Read more about treating GORD. Oesophageal stricture Repeated damage to the lining of your oesophagus can lead to the formation of scar tissue. If the scar tissue is allowed to build up, it can cause


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Repeated damage to the lining of your oesophagus can lead to the formation of scar tissue. If the scar tissue is allowed to build up, it can cause your oesophagus to become narrowed. This is known as oesophageal stricture. An oesophageal stricture can make swallowing food difficult and painful. Oesophageal strictures can be treated using a tiny balloon to dilate (widen) the oesophagus. This procedure is usually carried out under a local anaesthetic. Barrett’s oesophagus and cancer Repeated damage to the oesophagus can also lead to changes in the cells lining your lower oesophagus. This is a condition known as Barrett’s oesophagus. Barrett’s oesophagus doesn’t usually cause noticeable symptoms, other than those associated with GORD. However, Barrett’s oesophagus can increase your risk of developing oesophageal cancer. If you have persistent reflux symptoms for more than 3 weeks, you should talk to your GP because you may need some investigations. Strangulated hernia In some cases, a


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reflux symptoms for more than 3 weeks, you should talk to your GP because you may need some investigations. Strangulated hernia In some cases, a hiatus hernia causes part of the stomach to push up next to the oesophagus. This is known as a para-oesophageal hiatus hernia. GORD doesn’t usually occur in these cases, but there’s a risk of the hernia becoming strangulated. Strangulation occurs when the hernia becomes knotted and the blood supply to the area is cut off. Emergency surgery is usually required to correct the problem. Source: NHS 24 - Opens in new browser window Last updated: 29 May 2023 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Don’t 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 Dysphagia (swallowing problems) Stomach ulcer Gastro-oesophageal reflux


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500 characters Send feedback Add this page to Info For Me Also on NHS inform Dysphagia (swallowing problems) Stomach ulcer Gastro-oesophageal reflux disease (GORD) Other health sites British Hernia Centre: the anatomy of hernia 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 © 2025 NHS 24 – v1.1.1.17852


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https://www.nhsinform.scot/illnesses-and-conditions/cardiovascular-disease/risk-factors-for-cardiovascular-disease/high-blood-pressure-hypertension/


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https://www.nhsinform.scot/illnesses-and-conditions/cardiovascular-disease/risk-factors-for-cardiovascular-disease/high-cholesterol/


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High cholesterol | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotland’s Service Directory 0 Home Illnesses and conditions Cardiovascular disease Risk factors for cardiovascular disease High cholesterol High cholesterol Cholesterol is a fatty substance that’s produced in the liver. It’s also in some foods that we eat. The body needs a certain amount of cholesterol to function normally. Cholesterol combines with proteins to be carried around the blood. This combination is known as lipoproteins. There are 2 main types of lipoprotein. High-density lipoprotein (HDL) carries cholesterol away from the cells and back to the liver to be removed. For this reason, HDL is referred to as ‘good cholesterol’ and higher levels of this type are better. Non-HDL lipoproteins are known as ‘bad cholesterol’. This is because it can build up in blood vessel walls if there’s too much. Effects of high cholesterol Non-HDL


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are known as ‘bad cholesterol’. This is because it can build up in blood vessel walls if there’s too much. Effects of high cholesterol Non-HDL lipoproteins can build up in blood vessel walls and cause atherosclerosis. This is a gradual build up of fatty substances that causes a narrowing of the arteries. This affects blood flow and can lead to: heart disease strokes peripheral arterial disease (PAD) Other risk factors for cardiovascular disease include high blood pressure. What are healthy cholesterol levels? This information is just a guide to healthy cholesterol levels. What matters is your overall risk of cardiovascular disease. This is assessed by considering your cholesterol levels alongside other things like: your age whether you smoke whether you have high blood pressure if you have a family history of cardiovascular disease Blood cholesterol is measured in units called millimoles per litre of blood. This is often shortened to mmol/L. A healthy level of: total cholesterol – is


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cholesterol is measured in units called millimoles per litre of blood. This is often shortened to mmol/L. A healthy level of: total cholesterol – is below 5mmol/L HDL (good cholesterol) – is above 1.0mmol/L for men or above 1.2mmol/L for women non-HDL (bad cholesterol) – is below 4mmol/L You should speak to your healthcare professional if you’re worried about your cholesterol level. Causes of high cholesterol There are many things that can influence your chance of developing high cholesterol. Some of these you have control over and some of these you don’t. For example, the chance of developing high cholesterol is increased by certain lifestyle factors. These are sometimes called controllable risk factors. This includes your diet, level of physical activity and smoking habits. Things that influence high cholesterol that you can’t change include: age being male ethnicity There’s also an inherited condition called familial hypercholesterolaemia (FH). An inherited condition means that it


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age being male ethnicity There’s also an inherited condition called familial hypercholesterolaemia (FH). An inherited condition means that it can be passed through families by faulty genes. This can cause high cholesterol even in people who follow a healthy lifestyle. Diagnosing high cholesterol High cholesterol doesn’t usually cause any symptoms on its own. You can have your cholesterol levels checked. Your healthcare professional may recommend that you get your cholesterol levels tested if they think you’re at risk of cardiovascular disease. If you have high cholesterol, your healthcare professional will talk to you about how you can lower it. This might include things like changing your diet or taking medicine. Managing your high cholesterol Lifestyle changes can help to lower your cholesterol level, including: eating a healthy, balanced diet exercising regularly stopping smoking drinking less alcohol The most common medications for high cholesterol are statins. But, there are some


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diet exercising regularly stopping smoking drinking less alcohol The most common medications for high cholesterol are statins. But, there are some other types of medications available. Your healthcare professional will advise if you need these. The British Heart Foundation has some top tips on how to lower your cholesterol. Source: Scottish Government - Opens in new browser window Last updated: 10 February 2025 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Don’t 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 High blood pressure (hypertension) Statins Other health sites British Heart Foundation: High cholesterol British Heart Foundation: Reducing your high cholesterol Heart UK: Eating for lower cholesterol Heart UK: Understanding your cholesterol test results Lab Tests


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Foundation: Reducing your high cholesterol Heart UK: Eating for lower cholesterol Heart UK: Understanding your cholesterol test results Lab Tests Online: Cholesterol test NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats © 2025 NHS 24 – v1.1.1.17852


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Hives | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotland’s Service Directory 0 Home Illnesses and conditions Skin, hair and nails Hives Hives Return to Symptoms Enter age Last Updated: Next Review Date: Review my answers Find your local services Search for a service near you by entering your postcode below. Please input your postcode in the following format: A12 1BC GP Practices Dental Services Pharmacies Opticians Postcode Search NHS inform has more information on this condition. Read more Previous Start guide Review my answers × You told us your credentials were: : You said: Based on the information you gave us, we made the following recommendation: Close Keep a copy View PDF The main symptom of hives (urticaria) is a rash. The rash may: be raised be very itchy be on one part of the body spread over large areas range is size from a few millimetres to the size of a hand change in appearance within 24


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itchy be on one part of the body spread over large areas range is size from a few millimetres to the size of a hand change in appearance within 24 hours The image shows a hives rash on the side of the stomach. The rash is small, circular patches of pink on pale skin.Source: https://dermnetnz.org/ More images of hives Image 1 Image 2 Image 3 Diagnosing hives Hives can usually be diagnosed by examining the distinctive red rash. The pharmacist or GP may also ask you questions to find out what triggered your symptoms. If your symptoms last a while (chronic urticaria), a doctor may arrange for tests to help work out the cause. They’ll also ask about anything that makes your symptoms worse. Treating hives Most hives rashes don’t need treatment. The symptoms are usually mild and often get better within a few days. If necessary, a pharmacist can give you advice about antihistamines to help treat hives. Antihistamines may not be suitable for young children or if you’ve got a long term


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can give you advice about antihistamines to help treat hives. Antihistamines may not be suitable for young children or if you’ve got a long term condition. You should discuss this with the pharmacist. Find your nearest pharmacy Treating severe hives If hives are more severe, your doctor may prescribe: steroid tablets (oral corticosteroids) antihistamines menthol cream to relieve itchiness If hives don’t go away with treatment, a doctor may also refer you to a skin specialist (dermatologist). Phone 999 or go to A&E if you: have swelling in your mouth, eyes, face, lips, tongue, throat, feet or hands are wheezing feel lightheaded or faint get tightness in your chest or throat have trouble breathing or talking have abdominal pain, nausea and vomiting You could be having a serious allergic reaction (anaphylaxis) and may need immediate treatment in hospital. Speak to a GP if: the symptoms don’t improve after 2 days you’re worried about your child’s hives the rash is spreading the symptoms


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in hospital. Speak to a GP if: the symptoms don’t improve after 2 days you’re worried about your child’s hives the rash is spreading the symptoms are severe hives keeps coming back (you may be allergic to something) you also have a high temperature and feel unwell you also have swelling under your skin (this might be angioedema) the symptoms cause distress the symptoms disrupt daily activities Causes of hives Hives occur when histamine and other chemicals are released from under the skin’s surface. This causes the tissues to swell. Histamine can be released for many reasons, including: eating certain foods an insect bite or sting cold – including exposure to cold water or wind heat – including from exercise or eating spicy food emotional stress an infection like a cold having drinks like alcohol or caffeine taking medicines like non-steroidal anti-inflammatory drugs (NSAIDs) or antibiotics a reaction to environmental factors like pollen, dust mites or chemicals an allergic reaction to


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anti-inflammatory drugs (NSAIDs) or antibiotics a reaction to environmental factors like pollen, dust mites or chemicals an allergic reaction to latex scratching or pressing on your skin – like wearing itchy or tight clothing a problem with your immune system water or sunlight (though this is rare) If you can, try to work out what’s causing your hives. This can help to avoid them in the future. Rash self-help guide Complete our self-help guide to check your symptoms and find out what to do next. Complications of hives Complications of hives can include: angioedema – a deeper swelling of tissues psychological and emotional problems like stress and anxiety anaphylaxis – a severe allergic reaction that should be treated as a serious medical emergency Source: NHS 24 - Opens in new browser window Last updated: 29 May 2023 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Don’t include personal information e.g. name, location or any personal


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page? Help us improve NHS inform Thank You Your feedback has been received Don’t 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 Self-help guide: Rash NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats © 2025 NHS 24 – v1.1.1.17852


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https://www.nhsinform.scot/illnesses-and-conditions/cancer/cancer-types-in-children/hodgkin-lymphoma-children/


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Hodgkin lymphoma | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotland’s Service Directory 0 Home Illnesses and conditions Cancer Cancer types in children Hodgkin lymphoma: Children Hodgkin lymphoma: Children Hodgkin lymphoma is a type of blood cancer. It can affect children at any age but is more common in older teenagers and young adults. More children than ever are surviving childhood cancer. There are new and better drugs and treatments, and we can now also work to reduce the after-effects of having had cancer in the past. It’s devastating to hear that your child has cancer. At times it can feel overwhelming, but there are many healthcare professionals and support organisations to help you through this difficult time. Understanding more about the cancer your child has, and the treatments that may be used, can often help parents to cope. Your child’s specialist will give you more detailed information


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your child has, and the treatments that may be used, can often help parents to cope. Your child’s specialist will give you more detailed information and, if you have any questions, it’s important to ask the specialist doctor or nurse who knows your child’s individual situation. What is Hodgkin lymphoma? Hodgkin lymphoma is a type of cancer that occurs in the lymphatic system. There are 2 main types of Hodgkin lymphoma: classical Hodgkin lymphoma, which affects 95% of patients, and Lymphocyte Predominant Hodgkin Lymphoma (LPHL), which only affects 5% of patients. This information is about classical Hodgkin lymphoma, but it includes a short section about LPHL. The lymphatic system The lymphatic system is part of the immune system, the body’s natural defence against infection and disease. The lymphatic system is made up of the bone marrow, thymus, spleen, and lymph nodes (or lymph glands). Lymph nodes are connected by a network of tiny lymphatic vessels that contain lymph fluid.


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marrow, thymus, spleen, and lymph nodes (or lymph glands). Lymph nodes are connected by a network of tiny lymphatic vessels that contain lymph fluid. Lymphomas can start anywhere in the lymphatic system, but Hodgkin Lymphoma is most likely to start in the lymph nodes in the neck. The other areas where lymph nodes are likely to swell are above the collar bone, the armpit, the groin and inside the chest. Glands can swell in these areas as part of the body’s response to infection, not just cancer, which is why a biopsy is needed to diagnose lymphoma. The number of lymph nodes varies from one part of the body to another. In some parts of the body, there are very few lymph nodes, whereas under your arm there may be 20 to 50. There are 2 main types of lymphoma: non-Hodgkin lymphoma (NHL) and Hodgkin lymphoma (HL). Although these are both types of lymphoma, there are differences between them, which means they need different treatment. Causes The exact cause of Hodgkin lymphoma is not known.


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of lymphoma, there are differences between them, which means they need different treatment. Causes The exact cause of Hodgkin lymphoma is not known. In most people that develop Hodgkin lymphoma, no cause is found. However, there is increasing evidence that infections, such as the virus that causes glandular fever, may play a part in the development of Hodgkin lymphoma, especially in childhood. Poor immunity may also be a risk factor for developing the disease. Very rarely, more than one member of a family may develop Hodgkin lymphoma but it is not inherited from parents and you cannot catch it from another person. Signs and symptoms The first sign of Hodgkin lymphoma is usually a painless swelling of 1 gland, or a group of lymph glands, which continues for some weeks or even months. The first glands that are likely to be affected are in the neck or above the collarbone, most often only on 1 side. However, it’s important to remember that children’s glands can also become swollen when


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the neck or above the collarbone, most often only on 1 side. However, it’s important to remember that children’s glands can also become swollen when they have a common infection that causes a sore throat or a cold. If glands in the chest are affected, this can cause a cough or breathlessness. This is caused by the pressure the glands exert on the airways. Sometimes, a child with Hodgkin lymphoma may have a high temperature (fever), night sweats, weight loss or itchy skin. How Hodgkin lymphoma is diagnosed As lymph glands can swell for lots of reasons, a biopsy is carried out to diagnose Hodgkin lymphoma. A biopsy is when a swollen lymph gland is removed and the cells are looked at under a microscope. It’s a small operation which is usually done under a general anaesthetic. Sometimes only a small part of the lymph gland has to be removed, which can be done under a local anaesthetic. If Hodgkin lymphoma is diagnosed after the biopsy, further tests are carried out to find out the exact


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which can be done under a local anaesthetic. If Hodgkin lymphoma is diagnosed after the biopsy, further tests are carried out to find out the exact size and position of the lymphoma, and to see whether it has spread beyond the original area. These tests include X-rays, blood tests, CT, MRI and PET scans. Very often, a bone marrow sample will be taken. This is because the lymphoma cells can spread to the bone marrow as well as to other lymph glands. The tests that are carried out are called staging tests. Any tests and investigations that your child needs will be explained to you. The Children’s Cancer and Leukaemia Group (CCLG) has more information about what the tests and scans involve. Staging The stage of Hodgkin lymphoma describes the size and position of the cancer and whether it has spread. Staging is very important because the type of treatment your child receives will depend on the stage of the disease. The staging system for Hodgkin lymphoma is as follows: stage 1 – only 1


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of treatment your child receives will depend on the stage of the disease. The staging system for Hodgkin lymphoma is as follows: stage 1 – only 1 group of lymph nodes is affected and the lymphoma is only on 1 side of the diaphragm (the sheet of muscle under the lungs that controls breathing) stage 2 – 2 or more groups of lymph nodes are affected, but they are only on 1 side of the diaphragm. stage 3 – the lymphoma is in lymph nodes both above and below the diaphragm stage 4 – the lymphoma has spread outside the lymph nodes to other organs such as the liver, lungs or bone marrow As well as giving each stage a number, doctors also use a letter code – either A, B, or E: A means your child has no symptoms B means your child has 1 or more of the following symptoms: a fever, night sweats or significant weight loss E means that the lymphoma has grown from the lymph gland to extranodal tissue (tissue in places outside the lymph nodes) A number and letter is used in the staging of every child


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grown from the lymph gland to extranodal tissue (tissue in places outside the lymph nodes) A number and letter is used in the staging of every child with Hodgkin lymphoma. This helps the doctor decide on a treatment plan for your child. Treatment Children with Hodgkin lymphoma are usually treated with chemotherapy, but sometimes radiotherapy is also needed. The type and amount of treatment given depend on the stage of the disease when it is diagnosed. Your child’s doctor will discuss the treatment options with you. Chemotherapy This is the use of anti-cancer (cytotoxic) drugs to destroy cancer cells. It is usual for a combination of drugs to be used, which will often be given every few weeks over a number of months. A combination of drugs is used because each chemotherapy drug works in a different way. Using several drugs together increases the effectiveness of the treatment. It also means lower doses of individual drugs can be used, which may reduce the possibility of long-term side


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the effectiveness of the treatment. It also means lower doses of individual drugs can be used, which may reduce the possibility of long-term side effects. Radiotherapy This is used in less than half of people with Hodgkin lymphoma. It treats cancer by using high energy rays that destroy the cancer cells while doing as little harm as possible to normal cells. Side effects of treatment Treatment for Hodgkin lymphoma can cause side effects, and your child’s doctor will discuss these with you before the treatment starts. Any possible side effects will depend on the particular treatment being used and the part of the body that is being treated. Some general side effects of chemotherapy that can occur during treatment include: feeling sick (nausea) and being sick (vomiting) hair loss low blood count which can lead to an increased risk of infection, bruising and bleeding tiredness Changes to your child’s sense of taste and changes in their bowel may also happen. If your child has side


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infection, bruising and bleeding tiredness Changes to your child’s sense of taste and changes in their bowel may also happen. If your child has side effects from the treatment it is important to discuss them with your doctor or nurse. They may be able to help reduce them. Late side effects of treatment The cure rate for Hodgkin lymphoma is very high, which means some children may develop side effects many years after treatment. The chance of developing late side effects depends on where the original tumour was, how far it spread, and the type of treatment your child had. These late side effects can affect the normal organs such as the heart, kidneys and lungs. Following treatment for Hodgkin lymphoma, there is a small increase in the risk of developing another cancer in later life. There is also a chance that fertility may be affected. Teenage boys who are diagnosed after puberty should have the option of sperm banking before treatment starts. In this situation, sperm can be stored


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Teenage boys who are diagnosed after puberty should have the option of sperm banking before treatment starts. In this situation, sperm can be stored for possible use in later years. Your child’s doctor or nurse will explain more about any possible late side effects. Clinical trials Many children have their treatment as part of a clinical research trial. Trials aim to improve our understanding of the best way to treat an illness, usually by comparing the standard treatment with a new or modified version. The aim of treatment for Hodgkin lymphoma is to cure the cancer with the fewest possible short and long-term side effects. This is particularly important in childhood Hodgkin lymphoma where cure rates are high. It’s important to get the balance right between curing the cancer and having the lowest risk of long-term side effects. If appropriate, your child’s medical team will talk to you about taking part in a clinical trial and will answer any questions you may have. Written


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If appropriate, your child’s medical team will talk to you about taking part in a clinical trial and will answer any questions you may have. Written information is often provided to help explain things. Taking part in a research trial is completely voluntary, and you’ll be given plenty of time to decide whether it’s right for your child. Treatment guidelines Sometimes, clinical trials are not available for your child’s tumour. This may be because a recent trial has just finished, or because the tumour is very rare. In these cases, you can expect your doctors and nurses to offer treatment which is agreed to be the most appropriate, using guidelines which have been prepared by experts across the country. The Children’s Cancer and Leukaemia Group (CCLG) is an important organisation which helps to produce these guidelines. Follow-up care About 90% of children who develop Hodgkin lymphoma are cured. When your child completes treatment, they will then go into a follow-up phase, seeing


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About 90% of children who develop Hodgkin lymphoma are cured. When your child completes treatment, they will then go into a follow-up phase, seeing doctors and nurses in out-patient clinics usually for around five years. Clinic visits will be every 3 to 4 months to start with and there will be occasional scans, X-rays, and blood tests done for several years after completing treatment. If the cancer comes back, a different course of treatment can be given. If you have specific concerns about your child’s condition and treatment, it’s best to discuss them with your child’s doctor, who knows the situation. Lymphocyte predominant Hodgkin lymphoma (LPHL) This is a rare type of Hodgkin lymphoma that affects around 5% of patients. LPHL usually grows at a slower rate than classical Hodgkin lymphoma and normally requires less intensive treatment. Young people with LPHL may have a single swollen gland or group of swollen glands in one area only, such as the neck or groin. The swollen gland


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Young people with LPHL may have a single swollen gland or group of swollen glands in one area only, such as the neck or groin. The swollen gland often grows very slowly and may be present for many months before a biopsy and diagnosis happens. The biopsy and staging tests will be carried out as with classical Hodgkin lymphoma. The treatment given will depend on the stage of the disease, but most patients are diagnosed with an early stage of the disease. LPHL is usually treated with surgery or low-dose chemotherapy. It may return many years after treatment, and further treatment may be required, but it is rarely a life-threatening condition. In rare cases, patients have advanced LPHL and receive more intensive chemotherapy. There is also a link between LPHL and developing a more aggressive non-Hodgkin lymphoma. Your feelings As a parent, the fact that your child has cancer is one of the worst situations you can be faced with. You may have many emotions, such as fear, guilt, sadness,


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the fact that your child has cancer is one of the worst situations you can be faced with. You may have many emotions, such as fear, guilt, sadness, anger and uncertainty. These are all normal reactions and are part of the process that many parents go through at such a difficult time. Your child may have a variety of powerful emotions throughout their experience with cancer. Further information and advice if your child has cancer Source: Children's Cancer and Leukaemia Group - 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’t 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 Scottish Cancer Network: Catient information Search for cancer support services near you Enter a place or postcode NHS inform About NHS


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health sites Scottish Cancer Network: Catient 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 © 2025 NHS 24 – v1.1.1.17852


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https://www.nhsinform.scot/illnesses-and-conditions/cancer/cancer-types-in-teenagers-and-young-adults/hodgkin-lymphoma-teenagers-and-young-adults/


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https://www.nhsinform.scot/illnesses-and-conditions/brain-nerves-and-spinal-cord/huntingtons-disease/


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Huntington's disease | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotland’s Service Directory 0 Home Illnesses and conditions Brain, nerves and spinal cord Huntington’s disease Huntington’s disease Huntington’s disease is a condition that damages nerve cells in the brain causing them to stop working properly. It’s passed on (inherited) from a person’s parents. The damage to the brain gets worse over time. It can affect movement, cognition (perception, awareness, thinking, judgement) and mental health. Symptoms of Huntington’s disease People can start to show the symptoms of Huntington’s disease at almost any age. Most will develop problems between the ages of 30 and 50. The condition gradually gets worse for around 10-25 years, until the person dies. Early symptoms Behavioural changes are often the first symptoms of Huntington’s disease. These changes often include: a lack of emotions and not recognising


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Behavioural changes are often the first symptoms of Huntington’s disease. These changes often include: a lack of emotions and not recognising the needs of others periods of aggression, excitement, depression, antisocial behaviour and anger apathy – causing a person to appear lazy or have a lack of interest in hygiene and self care difficulty concentrating on more than one task and handling complex situations irritability and impulsiveness Speak to your GP if: you’re worried you might have early symptoms of Huntington’s disease, especially if there’s a history of the condition in your family Later symptoms Further symptoms of Huntington’s might include: psychiatric problems – some people develop obsessive behaviours, delusional thoughts or behaviours, stubborness, lack of self awareness, or suicidal thoughts uncontrollable movements of the face, jerking, clicking or fidgety movements of the limbs and body difficulty eating because the mouth and throat muscles don’t work properly which


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face, jerking, clicking or fidgety movements of the limbs and body difficulty eating because the mouth and throat muscles don’t work properly which can lead to choking and chest infections communication problems – difficulty putting thoughts into words and slurring of speech sexual problems – a loss of interest in sex or making inappropriate sexual demands balance problems In the later stages of Huntington’s disease, the person will need full nursing care. Death is usually from a secondary cause, like pneumonia or another infection. You might find the palliative care section useful if you’re caring for someone who’s dying, or if you want to plan your end of life care. Juvenile Huntington’s disease Juvenile Huntington’s disease is a rare form of the condition that can occur in people under the age of 20. Common signs include: a rapid decline in school performance changes in handwriting problems with movement, such as slowness, stiffness, tremor or muscle twitching (similar to the


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decline in school performance changes in handwriting problems with movement, such as slowness, stiffness, tremor or muscle twitching (similar to the features of Parkinson’s disease) seizures (fits) Causes of Huntington’s disease Huntington’s disease is caused by a faulty gene. Cells in parts of the brain are very sensitive to the effects of the faulty gene. This makes them function poorly and eventually die. A parent with the Huntington’s disease gene has one good copy of the gene and one faulty copy. This means there’s a: 50% chance that each of their children will develop Huntington’s disease – affected children can pass the gene to children they may have 50% chance that each of their children won’t develop Huntington’s disease – unaffected children can’t pass the gene to children they may have It’s difficult to predict how old a child will be when they develop the condition if they inherit the abnormal gene. In around 3% of cases of Huntington’s disease, there’s no obvious family


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will be when they develop the condition if they inherit the abnormal gene. In around 3% of cases of Huntington’s disease, there’s no obvious family history of the condition. This could be because relatives with the condition died before they were diagnosed with it. In rare cases, it’s due to a new fault in the gene that causes Huntington’s disease. Diagnosing Huntington’s disease If you have symptoms of Huntington’s disease, your GP will refer you to a specialist clinician. The specialist will ask about your symptoms to: see if it’s likely you have Huntington’s disease rule out similar conditions They’ll examine you and test your thinking, eye movements, balance and walking. They’ll find out if you have any involuntary movements, such as chorea (fidgety or jerky movements). Tests to diagnose Huntington’s disease You might have genetic testing to confirm if you have Huntington’s disease if: you’re showing symptoms of the condition and it runs in your family your doctor strongly


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testing to confirm if you have Huntington’s disease if: you’re showing symptoms of the condition and it runs in your family your doctor strongly suspects you have the condition Diagnosis is based on the doctor recognising a number of factors like neurological examination, family history and genetic testing. Genetic test The children of someone with Huntington’s disease can take a genetic test after the age of 18 to see whether they’ve inherited the faulty gene. It’s possible to have the gene change and still be healthy when you’re tested. This is known as “premanifest Huntington’s disease”. If they’ve inherited the faulty gene, they’ll develop Huntington’s disease, but it’s not possible to work out when. You can ask your GP or neurologist for an appointment at a genetic clinic. You’ll receive some counselling and blood samples will be taken. Your DNA from the blood samples will be analysed to see whether you have inherited the faulty gene. Scottish Huntington’s Association has a


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be taken. Your DNA from the blood samples will be analysed to see whether you have inherited the faulty gene. Scottish Huntington’s Association has a national youth service to help and support children and young people who are living within a Huntington’s family. Brain scan In the early stages of Huntington’s disease, there may not be any specific changes on the brain scan. A doctor might use a brain scan if they’re concerned there may be other problems in addition to Huntington’s disease. A brain scan may involve having a computerised tomography (CT scan) or a magnetic resonance imaging (MRI) scan. Getting tested in pregnancy If you’re pregnant and know you have the Huntington’s disease gene, it’s possible for your unborn baby to be tested during pregnancy at 11 weeks. You can discuss this with a genetic counselling team. Preimplantation genetic diagnosis Preimplantation genetic diagnosis can be used when one partner is known to have or is at risk of having the faulty gene. It


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genetic diagnosis Preimplantation genetic diagnosis can be used when one partner is known to have or is at risk of having the faulty gene. It involves having in vitro fertilisation (IVF) treatment. The embryo is genetically tested to make sure it doesn’t have the faulty gene before being implanted into the womb. Should I get tested? Not everyone wants to know if they’ve inherited the faulty gene. It’s a personal choice. Some people say they would rather not know because they want to enjoy their life and they may die of other causes before the condition develops. If you’re considering genetic testing, your GP will refer you to a genetic counsellor first. Treating Huntington’s disease There’s no cure for Huntington’s disease. Medication and therapies can help treat some of the symptoms. Speech and language therapy and occupational therapy, can help with communication and day-to-day living. Regular exercise is also very important. People who are active tend to feel much better physically


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can help with communication and day-to-day living. Regular exercise is also very important. People who are active tend to feel much better physically and mentally than those who don’t. Medication for Huntington’s disease Most of these medications have side effects, like tiredness. It can sometimes be difficult to tell if the side effects are symptoms of the condition or a result of the medication. Antidepressants to treat depression Antidepressants can help improve mood swings and treat depression. Mood stabilisers to treat irritability or mood swings Mood stabilisers may be considered as a treatment for irritability. Some mood stabilizers can’t be used during pregnancy. Medication to suppress involuntary movements Medication can suppress involuntary movements. In the UK, antipsychotic medicines are usually preferred. Antipsychotic medication might help control delusions and violent outbursts, but they can have severe side effects, such as: stiffness and rigidity sedation moving


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medication might help control delusions and violent outbursts, but they can have severe side effects, such as: stiffness and rigidity sedation moving slowly Living with Huntington’s disease Help is available to assist people with Huntington’s disease in their day-to-day life. This might include physiotherapy, occupational therapy and speech therapy. Daily routines such as getting dressed and eating meals can be frustrating and exhausting. The types of help outlined below aim to ease the strain of the condition by improving skills that may deteriorate. Help with communication Speech and language therapy can improve communication skills, and memory. It can help with swallowing problems. Communication aids can sometimes be helpful, as they allow communication without the need for talking. For example, you can point to symbols on a chart to show your mood or whether you’re hungry. The family of someone with Huntington’s disease can try alternative ways of communicating if speech is a


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to show your mood or whether you’re hungry. The family of someone with Huntington’s disease can try alternative ways of communicating if speech is a problem. Help with mealtimes People with Huntington’s disease might need to have a high-calorie diet. A dietitian can help you work out an appropriate diet plan. Food should be easy to chew, swallow and digest. It can be cut into small pieces or puréed to prevent choking. Feeding equipment like special straws and non-slip mats can help. At some point, you might be offered a feeding tube that goes into the stomach. You might want to consider making an advance decision (a living will) or a statement of wishes and preferences. Occupational therapy An occupational therapist (OT) can help with day-to-day activities. Your home can be adapted by social services to make life easier for a person with Huntington’s disease. You might also need to think about wheelchair access. Read more about occupational therapy and how it can help. Physiotherapy A


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Huntington’s disease. You might also need to think about wheelchair access. Read more about occupational therapy and how it can help. Physiotherapy A physiotherapist can help with mobility and balance. It uses a range of treatments, including manipulation, massage, exercise, electrotherapy and hydrotherapy. You may be referred to a physiotherapist through your GP or social services. Current research Research is underway to find disease-modifying medication and new treatments for Huntington’s disease. Progress has been made in identifying potential ways of slowing down or halting the condition by “switching off” the faulty gene that causes Huntington’s disease. Speak to your healthcare professional if you’re interested in taking part in research for Huntington’s disease. Financial information and support It’s worth finding out what benefits you may be entitled to if you have Huntington’s disease, or if you’re looking after someone with the condition. The Scottish Huntington’s


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benefits you may be entitled to if you have Huntington’s disease, or if you’re looking after someone with the condition. The Scottish Huntington’s Association Financial Wellbeing Service provides information, confidential advice and support to people living with Huntington’s disease. You can also contact the Citizens Advice Bureau (CAB) Read more about benefits if you need care, and carers’ benefits Driving A person diagnosed with Huntington’s disease who’s started to experience symptoms should inform the Driver and Vehicle Licensing Agency (DVLA). The condition will affect their ability to drive. The DVLA will write to your doctor, with your permission, to ask for their opinion about your condition. Based on that information, they’ll decide whether you can still drive and for how long before another assessment is needed. There’s no need to tell the DVLA if you’re carrying the faulty gene but haven’t yet developed symptoms. You can view the National Care Framework for Huntington’s


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to tell the DVLA if you’re carrying the faulty gene but haven’t yet developed symptoms. You can view the National Care Framework for Huntington’s Disease on the Scottish Huntington’s Association (SHA) website. The SHA employs Huntington’s Disease (HD) Specialists in many areas of Scotland who work as part of multi-disciplinary teams along with HD Clinical Leads, physiotherapy, occupational therapy and speech therapy. 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’t 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 Scottish Huntington's Association NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions


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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 © 2025 NHS 24 – v1.1.1.17852


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https://www.nhsinform.scot/illnesses-and-conditions/blood-and-lymph/hyperglycaemia-high-blood-sugar/


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Hyperglycaemia (high blood sugar) | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotland’s Service Directory 0 Home Illnesses and conditions Blood and lymph Hyperglycaemia (high blood sugar) Hyperglycaemia (high blood sugar) Hyperglycaemia (high blood sugar) can affect people with type 1 diabetes and type 2 diabetes, as well as pregnant women with gestational diabetes. It can occasionally affect people who don’t have diabetes, but usually only people who are seriously ill, such as those who have recently had a stroke or heart attack, or have a severe infection. Hyperglycaemia shouldn’t be confused with hypoglycaemia, which is when a person’s blood sugar level drops too low. This information focuses on hyperglycaemia in people with diabetes. Is hyperglycaemia serious? The aim of diabetes treatment is to keep blood sugar levels as near to normal as possible. But if you have diabetes, no matter how careful


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serious? The aim of diabetes treatment is to keep blood sugar levels as near to normal as possible. But if you have diabetes, no matter how careful you are, you’re likely to experience hyperglycaemia at some point. It’s important to be able to recognise and treat hyperglycaemia, as it can lead to serious health problems if left untreated. Occasional mild episodes aren’t usually a cause for concern and can be treated quite easily or may return to normal on their own. However, hyperglycaemia can be potentially dangerous if blood sugar levels become very high or stay high for long periods. Very high blood sugar levels can cause life-threatening complications, such as: diabetic ketoacidosis (DKA) – a condition caused by the body needing to break down fat as a source of energy, which can lead to a diabetic coma; this tends to affect people with type 1 diabetes hyperosmolar hyperglycaemic state (HHS) – severe dehydration caused by the body trying to get rid of excess sugar; this tends to


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with type 1 diabetes hyperosmolar hyperglycaemic state (HHS) – severe dehydration caused by the body trying to get rid of excess sugar; this tends to affect people with type 2 diabetes Regularly having high blood sugar levels for long periods of time (over months or years) can result in permanent damage to parts of the body such as the eyes, nerves, kidneys and blood vessels. If you experience hyperglycaemia regularly, speak to your doctor or diabetes care team. You may need to change your treatment or lifestyle to keep your blood sugar levels within a healthy range. Symptoms of hyperglycaemia Symptoms of hyperglycaemia in people with diabetes tend to develop slowly over a few days or weeks. In some cases, there may be no symptoms until the blood sugar level is very high. Symptoms of hyperglycaemia include: increased thirst and a dry mouth needing to pee frequently tiredness blurred vision unintentional weight loss recurrent infections, such as thrush, bladder infections (cystitis)


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needing to pee frequently tiredness blurred vision unintentional weight loss recurrent infections, such as thrush, bladder infections (cystitis) and skin infections Symptoms of hyperglycaemia can also be due to undiagnosed diabetes, so see your GP if this applies to you. You can have a test to check for the condition. What should my blood sugar level be? When you’re first diagnosed with diabetes, your diabetes care team will usually tell you what your blood sugar level is and what you should aim to get it down to. You may be advised to use a testing device to monitor your blood sugar level regularly at home, or you may have an appointment with a nurse or doctor every few months to see what your level is. Target blood sugar levels differ for everyone, but generally speaking: if you monitor yourself at home – a normal target is 4-7mmol/l before eating and under 8.5-9mmol/l two hours after a meal if you’re tested every few months – a normal target is below 48mmol/mol (or 6.5% on the


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before eating and under 8.5-9mmol/l two hours after a meal if you’re tested every few months – a normal target is below 48mmol/mol (or 6.5% on the older measurement scale) What causes high blood sugar? A variety of things can trigger an increase in blood sugar level in people with diabetes, including: stress an illness, such as a cold eating too much, such as snacking between meals a lack of exercise dehydration missing a dose of your diabetes medication, or taking an incorrect dose over-treating an episode of hypoglycaemia (low blood sugar) taking certain medicines, such as steroid medication Occasional episodes of hyperglycaemia can also occur in children and young adults during growth spurts. Treating hyperglycaemia If you’ve been diagnosed with diabetes and you have symptoms of hyperglycaemia, follow the advice your care team has given you to reduce your blood sugar level. If you’re not sure what to do, contact your GP or care team. You may be advised to: change your diet – for


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you to reduce your blood sugar level. If you’re not sure what to do, contact your GP or care team. You may be advised to: change your diet – for example, you may be advised to avoid foods that cause your blood sugar levels to rise, such as cakes or sugary drinks drink plenty of sugar-free fluids – this can help if you’re dehydrated exercise more often – gentle, regular exercise such as walking can often lower your blood sugar level, particularly if it helps you lose weight if you use insulin, adjust your dose – your care team can give you specific advice about how to do this You may also be advised to monitor your blood sugar level more closely, or test your blood or urine for substances called ketones (associated with diabetic ketoacidosis). Until your blood sugar level is back under control, watch out for additional symptoms that could be a sign of a more serious condition (see below). When to get urgent medical attention Contact your diabetes care team immediately if you have a


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be a sign of a more serious condition (see below). When to get urgent medical attention Contact your diabetes care team immediately if you have a high blood sugar level and experience the following symptoms: feeling or being sick abdominal (tummy) pain rapid, deep breathing signs of dehydration, such as a headache, dry skin and a weak, rapid heartbeat difficulty staying awake These symptoms could be a sign of diabetic ketoacidosis or a hyperosmolar hyperglycaemic state (see above) and you may need to be looked after in hospital. How to prevent hyperglycaemia There are simple ways to reduce your risk of severe or prolonged hyperglycaemia: Be careful what you eat – be particularly aware of how snacking and eating sugary foods or carbohydrates can affect your blood sugar level. Stick to your treatment plan – remember to take your insulin or other diabetes medications as recommended by your care team. Be as active as possible – getting regular exercise can help stop your blood sugar level


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other diabetes medications as recommended by your care team. Be as active as possible – getting regular exercise can help stop your blood sugar level rising, but you should check with your doctor first if you’re taking diabetes medication, as some medicines can lead to hypoglycaemia if you exercise too much Take extra care when you’re ill – your care team can provide you with some “sick day rules” that outline what you can do to keep your blood sugar level under control during an illness. Monitor your blood sugar level – your care team may suggest using a device to check your level at home, so you can spot an increase early and take steps to stop it. Source: NHS 24 - Opens in new browser window Last updated: 09 January 2025 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Don’t 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


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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 Hypoglycaemia (low blood sugar)r Type 2 diabetes Other health sites Diabetes.co.uk: Hyperglycaemia Diabetes UK: Hypos 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 © 2025 NHS 24 – v1.1.1.17852


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Hypoglycaemia (low blood sugar) | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotland’s Service Directory 0 Home Illnesses and conditions Blood and lymph Hypoglycaemia (low blood sugar) Hypoglycaemia (low blood sugar) Introduction Symptoms of hypoglycaemia Causes of hypoglycaemia Treating hypoglycaemia Preventing hypoglycaemia Introduction Hypoglycaemia, or a “hypo”, is an abnormally low level of glucose in your blood (less than four millimoles per litre). When your glucose (sugar) level is too low, your body doesn’t have enough energy to carry out its activities. Hypoglycaemia is most commonly associated with diabetes, and mainly occurs if someone with diabetes takes too much insulin, misses a meal or exercises too hard. In rare cases, it’s possible for a person who doesn’t have diabetes to experience hypoglycaemia. It can be triggered by malnutrition, binge drinking or certain conditions, such as


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a person who doesn’t have diabetes to experience hypoglycaemia. It can be triggered by malnutrition, binge drinking or certain conditions, such as Addison’s disease. Read more about the causes of hypoglycaemia Symptoms of hypoglycaemia Most people will have some warning that their blood glucose levels are too low, which gives them time to correct them. Symptoms usually occur when blood sugar levels fall below four millimoles (mmol) per litre. Typical early warning signs are feeling hungry, trembling or shakiness, and sweating. In more severe cases, you may also feel confused and have difficulty concentrating. In very severe cases, a person experiencing hypoglycaemia can lose consciousness. It’s also possible for hypoglycaemia to occur during sleep, which can cause excess sweating, disturbed sleep, and feeling tired and confused upon waking. Read more about the symptoms of hypoglycaemia Correcting hypoglycaemia The immediate treatment for hypoglycaemia is to have some food or drink


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Read more about the symptoms of hypoglycaemia Correcting hypoglycaemia The immediate treatment for hypoglycaemia is to have some food or drink that contains sugar, such as dextrose tablets or fruit juice, to correct your blood glucose levels. After having something sugary, you may need to have a longer-acting “starchy” carbohydrate food, such as a sandwich or a few biscuits. If hypoglycaemia causes a loss of consciousness, an injection of the hormone glucagon can be given to raise blood glucose levels and restore consciousness. This is only if an injection is available and the person giving the injection knows how to use it. You should dial 999 to request an ambulance if: a glucagon injection kit isn’t available there’s nobody trained to give the injection the injection is ineffective after 10 minutes Never try to put food or drink into the mouth of someone who’s drowsy or unconscious as they could choke. This includes some of the high-sugar preparations specifically designed for


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the mouth of someone who’s drowsy or unconscious as they could choke. This includes some of the high-sugar preparations specifically designed for smearing inside the cheek. Read more about treating hypoglycaemia Preventing hypoglycaemia If you have diabetes that requires treatment with insulin, the safest way to avoid hypoglycaemia is to regularly check your blood sugar and learn to recognise the early symptoms. Missing meals or snacks or eating less carbohydrate than planned can increase your risk of hypoglycaemia. You should be careful when drinking alcohol as it can also cause hypoglycaemia, sometimes many hours after drinking. Exercise or activity is another potential cause, and you should have a plan for dealing with this, such as eating carbohydrate before, during or after exercise, or adjusting your insulin dose. You should also make sure you regularly change where you inject insulin as the amount of insulin your body absorbs can differ depending on where it’s injected. Always


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sure you regularly change where you inject insulin as the amount of insulin your body absorbs can differ depending on where it’s injected. Always carry rapid-acting carbohydrate with you, such as glucose tablets, a carton of fruit juice (one that contains sugar), or some sweets in case you feel symptoms coming on or your blood glucose level is low. Make sure your friends and family know about your diabetes and the risk of hypoglycaemia. It may also help to carry some form of identification that lets people know about your condition in an emergency. When hypoglycaemia occurs as the result of an underlying condition other than diabetes, the condition will need to be treated to prevent a further hypo. Read more about preventing hypoglycaemia Symptoms of hypoglycaemia The symptoms of hypoglycaemia usually begin when your blood glucose level drops below four millimoles (mmol) per litre. If you have diabetes, particularly if it’s treated with insulin, you may be advised to use a small


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drops below four millimoles (mmol) per litre. If you have diabetes, particularly if it’s treated with insulin, you may be advised to use a small device called a blood glucose meter to regularly check your blood glucose levels. Symptoms can vary from person to person, and it’s important to be aware of the early warning signs so you can treat them. Signs and symptoms of hypoglycaemia can include: feeling hungry sweating dizziness tiredness (fatigue) blurred vision trembling or shakiness going pale fast pulse or palpitations tingling lips irritability difficulty concentrating confusion disorderly or irrational behaviour, which may be mistaken for drunkenness If hypoglycaemia isn’t treated promptly and your blood glucose levels drop low enough, you may become drowsy or even lose consciousness. Most people with insulin-treated diabetes notice that the symptoms of hypoglycaemia change and become less obvious the longer they live with the condition. For some people, the warning symptoms


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that the symptoms of hypoglycaemia change and become less obvious the longer they live with the condition. For some people, the warning symptoms become greatly reduced, putting them at significant risk of having severe episodes where they’re dependent on others for help. Let your diabetes care team know if you develop this problem as your treatment may need to be changed to reduce the risk. Read more about how hypoglycaemia is treated Hypoglycaemia while sleeping Having a hypo while you’re asleep is known as nocturnal hypoglycaemia. It’s more common in people who treat diabetes with insulin. Although some people find their sleep is disturbed when they experience nocturnal hypoglycaemia, you may only notice the symptoms when you wake up in the morning. The symptoms of nocturnal hypoglycaemia can include: headache – often likened to having a hangover feeling unusually tired in the morning damp sheets or clothing from sweating Causes of hypoglycaemia In most cases, hypoglycaemia affects


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a hangover feeling unusually tired in the morning damp sheets or clothing from sweating Causes of hypoglycaemia In most cases, hypoglycaemia affects people with diabetes, although more rarely it can also occur as a result of other underlying conditions. Hypoglycaemia in people with diabetes Overdose of diabetes medication A common cause of hypoglycaemia is taking too much insulin for your current needs. Insulin is a medication that helps control your blood glucose levels. It’s commonly used to treat type 1 diabetes and is also recommended for some people with type 2 diabetes. A fall in blood glucose levels can also occur after taking too much oral hypoglycaemia medication, such as sulphonylurea, which causes a release of insulin. This medication is often used to lower blood glucose levels in people with type 2 diabetes. Exercise, food and alcohol For people with type 1 diabetes, maintaining the correct blood glucose level involves balancing how much insulin you inject, the amount of


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alcohol For people with type 1 diabetes, maintaining the correct blood glucose level involves balancing how much insulin you inject, the amount of food you eat, and how much energy you burn during exercise. Hypoglycaemia may occur if you’ve taken your dose of insulin as usual, but your carbohydrate intake is lower than normal or has been used up more quickly. This may happen if you delay or miss a meal or snack, don’t eat enough carbohydrate, or exercise more than usual. People with diabetes who’ve drunk too much alcohol, or drank alcohol on an empty stomach, can also get hypoglycaemia. However, it’s not always possible to identify why a particular episode of hypoglycaemia has occurred, and sometimes it happens for no obvious reason. Hypoglycaemia in people without diabetes Hypoglycaemia – even mild cases – is very rare in people who don’t have diabetes. The possible causes are outlined below. Reactive hypoglycaemia People without diabetes can sometimes experience hypoglycaemia if


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don’t have diabetes. The possible causes are outlined below. Reactive hypoglycaemia People without diabetes can sometimes experience hypoglycaemia if their pancreas produces too much insulin after a large carbohydrate-based meal. This is known as reactive hypoglycaemia. It’s not clear why this happens, although it’s thought to be more common in people who are overweight or have had gastric bypass surgery. In rare cases, a benign (non-cancerous) tumour in the pancreas may cause an overproduction of insulin, or the tumour itself may use up too much glucose. Other possible causes Other possible causes of hypoglycaemia in people without diabetes are: fasting or malnutrition – where not enough nutrients are consumed for your body to function properly binge drinking or heavy drinking of alcohol Addison’s disease – a disorder of the adrenal glands (two small glands that sit on top of the kidneys) certain medication – hypoglycaemia has been known to occur in people taking quinine (for


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glands (two small glands that sit on top of the kidneys) certain medication – hypoglycaemia has been known to occur in people taking quinine (for malaria), salicylates (for rheumatic disease) and propranolol (for high blood pressure) severe illnesses affecting the liver, kidneys or thyroid gland Treating hypoglycaemia In most cases, you can treat hypoglycaemia yourself when you recognise the symptoms. Treating an episode of hypoglycaemia The immediate treatment for hypoglycaemia is to have some sugary food or drink (about 15 to 20g of rapidly acting carbohydrate) to end the attack. For example, this could be: a glass of fruit juice or non-diet soft drink between three and five dextrose tablets a handful of sweets At first you should avoid fatty foods and drinks, such as chocolate and milk, because they don’t usually contain as much sugar and the sugar they do contain may be absorbed more slowly. After having something sugary, you should have a longer-acting carbohydrate food, such as


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and the sugar they do contain may be absorbed more slowly. After having something sugary, you should have a longer-acting carbohydrate food, such as a few biscuits, a cereal bar, a piece of fruit or a sandwich. It will usually take around 15 minutes to recover from a mild episode of hypoglycaemia. If you have a blood glucose meter, measure your blood sugar again after 15 to 20 minutes. If it’s still too low (below 4mmol), you should have some more sugary food or a drink before testing your levels again in another 15 to 20 minutes. When treating someone else with hypoglycaemia, if the above treatment isn’t effective, you may be able to help them by applying glucose gel (or honey, treacle or jam if glucose gel isn’t available) to the inside of their cheeks, and gently massaging the outside of their cheeks. It may take 10 to 15 minutes before they feel better. This shouldn’t be done if the person is drowsy or unconscious because of the risk of choking. If you have several episodes of


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they feel better. This shouldn’t be done if the person is drowsy or unconscious because of the risk of choking. If you have several episodes of hypoglycaemia a week, you should contact your diabetes care team to find out the underlying cause. Your medication may need to be adjusted, or there may be another condition causing hypoglycaemia that needs to be treated. If a person is unconscious If a person loses consciousness because of severe hypoglycaemia, they need to be put into the recovery position and given an injection of the hormone glucagon (if they have an injection kit). The injection will raise their blood glucose level. The injection should be carried out by a friend or family member who knows what they’re doing, or by a trained healthcare professional. You should dial 999 to request an ambulance if: a glucagon injection kit isn’t available there’s nobody available who’s trained to give the injection the injection is ineffective after 10 minutes Never try to put food or drink


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available there’s nobody available who’s trained to give the injection the injection is ineffective after 10 minutes Never try to put food or drink into the mouth of someone who’s unconscious as they could choke. If you’re able to give a glucagon injection and the person regains consciousness, they should eat some longer-acting carbohydrate food, such as a few biscuits, a cereal bar or a sandwich. You should continue to monitor the person for signs of recurring symptoms in case they need to be treated again. Preventing hypoglycaemia If you have diabetes, sticking to your medication plan and eating regular meals can help prevent hypoglycaemia. It’s also important to monitor your blood glucose levels. Monitoring blood glucose Regularly monitoring your blood glucose levels can help you keep your blood glucose as normal and stable as possible, and will help you spot the signs and symptoms of hypoglycaemia quickly. Your blood glucose level can vary throughout the day, so you may need to


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and will help you spot the signs and symptoms of hypoglycaemia quickly. Your blood glucose level can vary throughout the day, so you may need to check it several times a day, depending on the treatment you’re taking. You can monitor your blood glucose levels using a blood glucose meter, a small device that measures the concentration of glucose in your blood. Read more about living with type 1 diabetes and living with type 2 diabetes Food and alcohol If you have diabetes, strenuous physical activity can lead to hypoglycaemia. Eating extra carbohydrate-based foods before and during exercise can help reduce the chances of this happening. If you’re taking insulin, your doctor may advise you to lower your dose before you do strenuous physical activity. Alcohol can also affect your body’s ability to release glucose. If you have type 1 diabetes, it’s recommended that you drink no more than 2 to 3 units of alcohol a day and eat a snack after drinking alcohol. Spotting the signs As


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1 diabetes, it’s recommended that you drink no more than 2 to 3 units of alcohol a day and eat a snack after drinking alcohol. Spotting the signs As hypoglycaemia can develop suddenly, it’s important to be aware of the symptoms of hypoglycaemia so you can treat it quickly. Tell your family and friends about the signs to look out for and let them know how to treat it. People with diabetes are advised to carry a form of identification with them that states their condition so they can be helped quickly and efficiently. Keep treatment with you If you’re at risk of hypoglycaemia, you should carry sugary food and drink with you at all times to treat mild cases as soon as possible. If you have diabetes, particularly type 1 diabetes, your doctor may recommend medications such as glucose gel to carry with you. This can be used to treat hypoglycaemia that doesn’t respond to normal treatment. If you’re being treated with insulin, you’ll usually be given a kit that contains an injection of a


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that doesn’t respond to normal treatment. If you’re being treated with insulin, you’ll usually be given a kit that contains an injection of a medication called glucagon. Family members or your carer can be trained to carry out the injection, which should be used if you lose consciousness because of severe hypoglycaemia. Preventing hypoglycaemia at night It’s important to avoid recurrent hypoglycaemia during the night (nocturnal hypoglycaemia) as it can reduce the early symptoms of daytime episodes. If you experience nocturnal hypoglycaemia, you can try: keeping something sugary by your bedside having a snack before bedtime, such as biscuits and milk checking your blood glucose levels between 3am and 4am, when hypoglycaemia is most likely to occur Hypoglycaemia and driving As hypoglycaemia can cause confusion, drowsiness, or even unconsciousness, this can present a significant risk to you or other road users. If you have diabetes that requires treatment with insulin, you must: inform


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this can present a significant risk to you or other road users. If you have diabetes that requires treatment with insulin, you must: inform the DVLA and your insurance company test your blood sugar before driving and at regular intervals (at least every two hours) while driving avoid driving if your blood glucose is low avoid driving for 45 minutes after treating hypoglycaemia carry rapid-acting carbohydrates with you in the vehicle at all times If you experience hypoglycaemia while driving, pull over and stop as soon as it’s safe to do so. Remove the keys from the ignition and get out of the driver’s seat before treating hypoglycaemia in the normal way. If you have two or more episodes of hypoglycaemia that require assistance in a 12-month period, it’s a legal requirement to stop driving and inform the DVLA. If you’re a group two driver (you hold a licence to drive buses, coaches or lorries), you’re legally required to stop driving group two vehicles immediately and inform the DVLA


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(you hold a licence to drive buses, coaches or lorries), you’re legally required to stop driving group two vehicles immediately and inform the DVLA if you have a single episode of hypoglycaemia that requires assistance. Inform your diabetes care team if you start having problems recognising hypoglycaemia or you start to have more regular episodes, even if there were warning symptoms and you were able to treat them without assistance. See the GOV.UK website for more information about hypoglycaemia and driving Source: NHS 24 - Opens in new browser window Last updated: 09 January 2025 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Don’t 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 Type 2 diabetes Other health sites Diabetes.co.uk: diabetes and hypoglycaemia Diabetes UK:


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feedback Add this page to Info For Me Also on NHS inform Type 2 diabetes Other health sites Diabetes.co.uk: diabetes and hypoglycaemia Diabetes UK: Hypos 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 © 2025 NHS 24 – v1.1.1.17852


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https://www.nhsinform.scot/illnesses-and-conditions/lungs-and-airways/idiopathic-pulmonary-fibrosis/


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https://www.nhsinform.scot/illnesses-and-conditions/lungs-and-airways/if-your-child-has-cold-or-flu-symptoms/


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If your child has cold or flu symptoms | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotland’s Service Directory 0 Home Illnesses and conditions Lungs and airways If your child has cold or flu symptoms If your child has cold or flu symptoms Viral infections like cold and flu are very common in babies and children and most will make a full recovery without needing treatment. There are some things you can do to help them feel better. Phone 999 or go to A&E if your child: has lips or skin that are turning pale, blue or grey – on brown or black skin this is easier to see on the palms of their hands has severe difficulty breathing – they may make grunting noises or suck their stomach in under their ribcage is breathing fast or stops or pauses is pulling in at their throat area (tracheal tug) or their windpipe is more prominent is limp, floppy or not responding like they normally do – they may find it difficult


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throat area (tracheal tug) or their windpipe is more prominent is limp, floppy or not responding like they normally do – they may find it difficult to focus on you or are more difficult to wake up than usual is less than 3 months old and has a temperature of 38°C (101°F) or above and has not had a vaccination in the past 2 days is less than 3 months old and has a temperature of 36°C (97°F) or less and has not had a vaccination in the past 2 days Always trust your instincts and phone 999 if you think there’s an emergency. Contact your GP practice urgently if your child: is more short of breath than usual has pain when breathing in or coughing is feeling confused, dizzy or lightheaded feels sick or is being sick – for example, they can’t keep food or fluids down is coughing up blood (haemoptysis) has had a dry nappy for 12 hours or more, or is showing other signs of dehydration has a very high or low temperature – for example, they feel either hot or cold to touch or are shivering If


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or is showing other signs of dehydration has a very high or low temperature – for example, they feel either hot or cold to touch or are shivering If your GP practice is closed, phone 111. Cold and flu symptoms in babies The most common cold and flu symptoms in babies are: fever of 37.5°C or above breathlessness rapid breathing cough not taking usual feeds not having their usual wet or dirty nappies Cold and flu symptoms in children The most common cold and flu symptoms in children are: fever of 37.9°C or above breathlessness rapid breathing cough runny nose blocked nose sneezing If your child is alert and playing and behaving normally it’s unlikely that they’re seriously ill. Treatment of cold and flu symptoms There’s no specific treatment for a cold or flu but there are some things you can do to make your child more comfortable. Do use infant paracetamol or ibuprofenonly use over the counter remedies recommended by your pharmacistencourage your child to drink more fluids Don’t try to


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paracetamol or ibuprofenonly use over the counter remedies recommended by your pharmacistencourage your child to drink more fluids Don’t try to reduce your child’s fever by undressing themsponge your child with watergive aspirin to children under 16give honey to babies under 1 Most children will make a full recovery without any medical treatment. Use our self help guide for fever in babies More about fever in children Possible causes of cold and flu symptoms The most common causes of cold and flu symptoms in children are viral infections including: respiratory syncytial virus (RSV) influenza (flu) rhinovirus adenovirus There are several others but these are the most common. Most of the time these viruses don’t lead to serious illness. There are some conditions which can cause cold and flu symptoms and may require further treatment, such as: pneumonia tonsillitis in toddlers and older children Who’s most at risk? Babies and children born with the following health conditions may be more


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pneumonia tonsillitis in toddlers and older children Who’s most at risk? Babies and children born with the following health conditions may be more at risk of serious infection: congenital heart disease where a baby is born with a heart condition babies born with narrowing of the airways or other respiratory disease babies born prematurely Preventing the spread of colds and flu To reduce the risk of getting or spreading cold or flu you should: make sure you wash your hands regularly with soap and warm water clean surfaces (such as your telephone and door handles) regularly to get rid of germs put used tissues in a bin as soon as possible keep your child at home until they’re feeling better (without fever for 24 hours without infant paracetamol or ibuprofen) Source: Scottish Government - Opens in new browser window Last updated: 01 May 2025 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Don’t include personal information e.g. name,


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2025 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Don’t 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 © 2025 NHS 24 – v1.1.1.17852


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Indigestion | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotland’s Service Directory 0 Home Illnesses and conditions Stomach, liver and gastrointestinal tract Indigestion Indigestion About indigestion Symptoms of indigestion Causes of indigestion Diagnosing indigestion Treating indigestion Complications of indigestion About indigestion Indigestion can be pain or discomfort in your upper abdomen (dyspepsia) or burning pain behind the breastbone (heartburn). Dyspepsia and heartburn may occur together or on their own. Symptoms usually appear soon after eating or drinking. Common associated symptoms include: feeling full or bloated feeling sick (nausea) belching bringing up (regurgitating) fluid or food into the gullet (oesophagus) Indigestion is a common problem that affects many people, but in most cases it’s mild and only occurs occasionally. Read more about the symptoms of indigestion. Why it happens


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that affects many people, but in most cases it’s mild and only occurs occasionally. Read more about the symptoms of indigestion. Why it happens Indigestion may be caused by stomach acid coming into contact with the sensitive, protective lining of the digestive system (mucosa). The stomach acid breaks down the lining, leading to irritation and inflammation, which can be painful. The majority of people with indigestion don’t have inflammation in their digestive system. Therefore, their symptoms are thought to be caused by increased sensitivity of the mucosa (to acidity or stretching). In most cases indigestion is related to eating, although it can be triggered by other factors such as smoking, drinking, alcohol, pregnancy, stress or taking certain medications. Read more about the causes of indigestion. Treating indigestion at home Most people are able to treat indigestion with simple changes to their diet and lifestyle, or with a number of different medications, such as antacids. Read


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are able to treat indigestion with simple changes to their diet and lifestyle, or with a number of different medications, such as antacids. Read more about the treatment of indigestion. Very rarely, a serious underlying health condition is the cause of indigestion. If this is suspected, then further investigation such as an endoscopy will be required. When to get professional advice Pharmacy First Scotland: Indigestion treatment from your pharmacyIf you have symptoms of indigestion you can get treatment directly from a pharmacy. Find your local pharmacy on Scotland’s Service Directory.Search for a pharmacy near you Most people will not need to seek medical advice for their indigestion. However, your pharmacist may advise you see your GP if you have recurring indigestion and any of the following apply: you are 55 years old or over you have lost a lot of weight without meaning to you have increasing difficulty swallowing (dysphagia) you have persistent vomiting you have iron deficiency


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lost a lot of weight without meaning to you have increasing difficulty swallowing (dysphagia) you have persistent vomiting you have iron deficiency anaemia you have a lump in your stomach you have blood in your vomit or blood in your stools This is because these symptoms may be a sign of an underlying health condition, such as a stomach ulcer or stomach cancer. You may need to be referred for an endoscopy to rule out any serious cause. An endoscopy is a procedure where the inside of the body is examined using an endoscope (a thin, flexible tube that has a light and camera on one end). Severe indigestion can cause long-term problems with parts of your digestive tract, such as scarring of the oesophagus or the passage from your stomach. Read more about the possible complications of severe indigestion. Symptoms of indigestion The main symptom of indigestion is pain or a feeling of discomfort in your upper abdomen (dyspepsia). People often experience the associated feeling of burning


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of indigestion is pain or a feeling of discomfort in your upper abdomen (dyspepsia). People often experience the associated feeling of burning behind the breastbone (heartburn), but this may occur on its own. These symptoms usually come on soon after eating or drinking, although there can sometimes be a delay between eating a meal and experiencing indigestion. Heartburn is caused by acid that passes from your stomach into your gullet (oesophagus). If you have indigestion, you may also have symptoms such as: feeling uncomfortably full or heavy belching or flatulence(passing wind) bringing food or fluid back up from your stomach (reflux) bloating feeling sick (nausea) vomiting Causes of indigestion Indigestion has a number of different causes, but it’s rarely due to a serious, underlying condition. It’s normal for your stomach to produce acid, but sometimes this acid can irritate the lining of your stomach, the top part of your bowel (duodenum) or your gullet (oesophagus). This


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acid, but sometimes this acid can irritate the lining of your stomach, the top part of your bowel (duodenum) or your gullet (oesophagus). This irritation can be painful and often causes a burning sensation. Indigestion may also be due to the lining of your digestive system being overly sensitive to acid, or the ‘stretching’ caused by eating. Indigestion can also be triggered or made worse by other factors. Medications You may have indigestion if you take certain types of medication. Some medicines, such as nitrates (taken to widen your blood vessels) relax the oesophageal sphincter (ring of muscle between your oesophagus and your stomach), which allows acid to leak back up. Other medicines, such as non-steroidal anti-inflammatory drugs (NSAIDs), can affect your digestive tract and cause indigestion. Do not take NSAIDs, such as aspirin and ibuprofen, if you have stomach problems, such as a stomach ulcer, or have had this in the past. Children under 16 years of age should not take


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and ibuprofen, if you have stomach problems, such as a stomach ulcer, or have had this in the past. Children under 16 years of age should not take aspirin. Never stop taking a prescribed medication unless you are told to do so by your GP or another qualified healthcare professional who is responsible for your care. Obesity If you are very overweight, you are more likely to experience indigestion because of increased pressure inside your stomach (abdomen). The increased pressure, particularly after a large meal, may lead to acid reflux into the oesophagus. Stress or anxiety If you regularly experience feelings of stress or anxiety, this can contribute to symptoms of indigestion. Read some relaxation tips to relieve stress. Hiatus hernia A hernia occurs when an internal part of the body, such as an organ, pushes through a weakness in the surrounding muscle or tissue wall. A hiatus hernia occurs when part of your stomach pushes up into your diaphragm (the sheet of muscle under your


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the surrounding muscle or tissue wall. A hiatus hernia occurs when part of your stomach pushes up into your diaphragm (the sheet of muscle under your lungs). It may partially block refluxed stomach acid clearing from your oesophagus, leading to heartburn. Helicobacter pylori infection Helicobacter infection is very common. It may lead to stomach ulcers or, rarely, stomach cancer. In most cases, however, it does not cause any symptoms at all. Some people may get bouts of indigestion from helicobacter infection and, in these cases, getting rid of the bug with antibiotics (eradication) will help. However, many cases of indigestion are not caused by helicobacter, and in these cases eradication will not get rid of symptoms. Gastro-oesophageal reflux disease (GORD) Gastro-oesophageal reflux disease (GORD) is a common condition and one of the main causes of recurring indigestion. It’s caused by acid reflux, which occurs when the oesophageal sphincter fails to prevent stomach acid from moving


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causes of recurring indigestion. It’s caused by acid reflux, which occurs when the oesophageal sphincter fails to prevent stomach acid from moving back up into your oesophagus. A little bit of acid reflux is normal and rarely cause any symptoms. It becomes GORD when large amounts of reflux occur, and the sensitive lining of your oesophagus may get inflamed by repeated irritation from stomach acid. This can lead to heartburn, the sensation of regurgitation or painful swallowing. Stomach ulcers A stomach ulcer is an open sore that develops on the inside lining of your stomach (a gastric ulcer) or small intestine (a duodenal ulcer). If you have a stomach ulcer, you may have indigestion as a symptom. Stomach ulcers form when stomach acid damages the lining in your stomach or duodenum wall. In most cases, the lining is damaged as a result of an H pylori infection. Stomach cancer In rare cases, recurring bouts of indigestion can be a symptom of stomach cancer. Cancer cells in your stomach


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an H pylori infection. Stomach cancer In rare cases, recurring bouts of indigestion can be a symptom of stomach cancer. Cancer cells in your stomach break down the protective lining, allowing acid to come into contact with your stomach wall. Diagnosing indigestion For most people, indigestion (dyspepsia) is mild and infrequent, and does not require treatment from a healthcare professional. However, if you have indigestion regularly, or if it causes you severe pain or discomfort, see your pharmacist. They will ask about your indigestion symptoms, as well as: any other symptoms you have – which may indicate an underlying health condition any medication you are taking – as some medications can cause indigestion your lifestyle – as some lifestyle factors, such as smoking, drinking alcohol or being overweight, can cause indigestion Depending on the type of indigestion symptoms you have, your pharmacist may recommend you see your GP to investigate your condition further. This is because


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on the type of indigestion symptoms you have, your pharmacist may recommend you see your GP to investigate your condition further. This is because indigestion can sometimes be a symptom of an underlying condition or health problem, such as a Helicobacter pylori (H pylori) bacterial infection. Further investigations Endoscopy You may be referred to hospital to have an endoscopy. An endoscopy is a procedure used to examine the inside of your body using an endoscope – a thin, flexible tube, about the width of your little finger, with a light and a camera on one end. The camera is used to relay images of the inside of your body to a TV monitor. An endoscopy is not often needed to diagnose indigestion, but your GP may suggest that you have one if: they need to examine the inside of your abdomen in more detail you have had treatment for indigestion that has not worked you have any serious symptoms of indigestion Taking certain medicines for indigestion can hide some of the problems that


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that has not worked you have any serious symptoms of indigestion Taking certain medicines for indigestion can hide some of the problems that could otherwise be spotted during an endoscopy. Therefore, for at least two weeks before your endoscopy, you will need to stop taking proton pump inhibitors (PPIs) and H2-receptor antagonists. Read more about treatments for indigestion. Your GP may also recommend changing other medications that may be causing your indigestion. However, only stop taking medication if you are advised to do so by your GP or another healthcare professional responsible for your care. Diagnosing H pylori infection If your GP thinks that your symptoms may be due to an infection with H pylori bacteria, you may need to have a test for it, such as: a stool antigen test – a pea-sized stool (faeces) sample will be tested for H pylori bacteria a breath test a blood test– a blood sample will be tested for antibodies to H pylori bacteria (antibodies are proteins produced by the


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bacteria a breath test a blood test– a blood sample will be tested for antibodies to H pylori bacteria (antibodies are proteins produced by the body to fight infection) Antibiotics and PPIs can affect the results of a urea breath test or a stool antigen test. Therefore, these tests may need to be delayed until two weeks after you last used a PPI, and 4 weeks after you last used an antibiotic. Diagnosing other conditions If your GP thinks that your indigestion symptoms may be caused by another underlying medical condition, you may need to have some further tests to rule this out. For example, abdominal pain and discomfort can also be caused by conditions affecting the bile ducts in your liver. Your bile ducts are a series of tubes that carry bile (fluid used by the digestive system to break down fats) from the liver to the gallbladder (a pouch that holds bile) and the bowel. If your GP thinks that you may have such a condition, they may suggest you have a liver function test, which is


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pouch that holds bile) and the bowel. If your GP thinks that you may have such a condition, they may suggest you have a liver function test, which is a type of blood test used to assess how well your liver is working. You may also need to have an abdominal ultrasound. An ultrasound scan uses high-frequency sound waves to create an image of the inside of your body. Treating indigestion Treatment for indigestion (dyspepsia) will vary, depending on what is causing it and how severe your symptoms are. If you have been diagnosed with an underlying health condition, you may want to read our information on: treating gastro-oesophageal reflux disease (GORD) treating a stomach ulcer Diet and lifestyle changes If you only have indigestion occasionally, you may not need to see your pharmacist or GP for treatment. It may be possible to ease your symptoms by making a few simple changes to your diet and lifestyle, summarised below. Healthy weight Being overweight puts more pressure on your stomach,


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by making a few simple changes to your diet and lifestyle, summarised below. Healthy weight Being overweight puts more pressure on your stomach, making it easier for stomach acid to be pushed back up into your gullet (oesophagus). This is known as acid reflux, and is one of the most common causes of indigestion. If you are overweight or obese, it is important to lose weight safely and steadily through regular exercise and by eating a healthy, balanced diet. Read advice on losing weight. Stop smoking If you smoke, the chemicals you inhale in cigarette smoke may contribute to your indigestion. These chemicals can cause the ring of muscle that separates your oesophagus from your stomach to relax, causing acid reflux. Read more about quitting smoking, or speak to your GP or pharmacist. You can also phone the Quit Your Way Scotland service on 0800 84 84 84. Diet and alcohol Make a note of any particular food or drink that seems to make your indigestion worse, and avoid these if possible.


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0800 84 84 84. Diet and alcohol Make a note of any particular food or drink that seems to make your indigestion worse, and avoid these if possible. This may mean: eating less rich, spicy and fatty foods cutting down on drinks that contain caffeine – such as tea, coffee and cola avoiding or cutting down on alcohol At bedtime If you tend to experience indigestion symptoms at night, avoid eating for three to four hours before you go to bed. Going to bed with a full stomach means there is an increased risk that acid in your stomach will be forced up into your oesophagus while you are lying down. When you go to bed, use a couple of pillows to prop your head and shoulders up or, ideally, raise the head of your bed by a few inches by putting something underneath the mattress. The slight slope that is created should help to prevent stomach acid moving up into your oesophagus while you are asleep. Stress or anxiety If you regularly experience feelings of stress or anxiety, this can contribute


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moving up into your oesophagus while you are asleep. Stress or anxiety If you regularly experience feelings of stress or anxiety, this can contribute to symptoms of indigestion. Read some relaxation tips to relieve stress. Changing current medication Your pharmacist may recommend making changes to your current medication if they think it could be contributing to your indigestion. As long as it is safe to do so, you may need to stop taking certain medications, such as aspirin or ibuprofen. Where required, your pharmacist may advise you see your GP to prescribe an alternative medication that will not cause indigestion. However, never stop taking any medication without consulting your pharmacist or GP first. Immediate indigestion relief If you have indigestion that requires immediate relief, your pharmacist can advise you about the best way to treat this. As well as lifestyle changes and reviewing your current medication, your GP may prescribe or recommend: antacid medicines alginates


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to treat this. As well as lifestyle changes and reviewing your current medication, your GP may prescribe or recommend: antacid medicines alginates Antacids Antacids are a type of medicine that can provide immediate relief for mild to moderate symptoms of indigestion. They work by neutralising the acid in your stomach (making it less acidic), so that it no longer irritates the lining of your digestive system. Antacids are available in tablet and liquid form. You can buy them over the counter from most pharmacies without a prescription. The effect of an antacid only lasts for a few hours at a time, so you may need to take more than one dose. Always follow the instructions on the packet to ensure you do not take too much. It is best to take antacids when you are expecting symptoms of indigestion, or when they start to occur, such as: after meals at bedtime This is because antacids stay in your stomach for longer at these times and have more time to work. For example, if you take an


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meals at bedtime This is because antacids stay in your stomach for longer at these times and have more time to work. For example, if you take an antacid at the same time as eating a meal, it can work for up to three hours. In comparison, if you take an antacid on an empty stomach, it may only work for 20 to 60 minutes. Read more about antacids, including possible interactions with other medicines and side effects. Alginates Some antacids also contain a medicine called an alginate. This helps relieve indigestion caused by acid reflux. Acid reflux occurs when stomach acid leaks back up into your oesophagus and irritates its lining. Alginates form a foam barrier that floats on the surface of your stomach contents, keeping stomach acid in your stomach and away from your oesophagus. Your pharmacist may suggest that you take an antacid that contains an alginate if you experience symptoms of acid reflux or if you have GORD. Take antacids containing alginates after eating, because this helps


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an alginate if you experience symptoms of acid reflux or if you have GORD. Take antacids containing alginates after eating, because this helps the medicine stay in your stomach for longer. If you take alginates on an empty stomach, they will leave your stomach too quickly to be effective. Treating persistent indigestion If you have indigestion that is persistent or recurring, treatment with antacids and alginates may not be effective enough to control your symptoms. Your pharmacist may recommend a different type of medication, which will be prescribed at the lowest possible dose to control your symptoms. Possible medications include: proton pump inhibitors (PPIs) H2-receptor antagonists Your pharmacist may advise you to see your GP who may also test you for the Helicobacter pylori (H pylori) bacteria (see Indigestion – diagnosis) and prescribe treatment for this if necessary. Proton pump inhibitors (PPIs) PPIs restrict the acid produced in your stomach. The medication is taken as


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prescribe treatment for this if necessary. Proton pump inhibitors (PPIs) PPIs restrict the acid produced in your stomach. The medication is taken as tablets and if you are over 18, you can buy some types of PPIs over the counter in pharmacies, but these should only be used for short-term treatment. PPIs may enhance the effect of certain medicines. If you are prescribed a PPI, your progress will be monitored if you are also taking other medicines, such as: warfarin – a medicine that stops the blood clotting phenytoin – a medicine to treat epilepsy If your ingestion is persistent, your pharmacist might advise you to see your GP. If your GP refers you for an endoscopy (a procedure that allows a surgeon to see inside your abdomen), you will need to stop taking a PPI at least 14 days before the procedure. This is because PPIs can hide some of the problems that would otherwise be spotted during the endoscopy. PPIs can sometimes cause side effects. However, they are usually mild and


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some of the problems that would otherwise be spotted during the endoscopy. PPIs can sometimes cause side effects. However, they are usually mild and reversible. These side effects may include: headaches diarrhoea constipation feeling sick (nausea) vomiting flatulence stomach pain dizziness skin rashes H2-receptor antagonists H2-receptor antagonists are another type of medication that your pharmacist or GP may suggest if antacids, alginates and PPIs have not been effective in controlling your indigestion. There are four H2-receptor antagonists: cimetidine famotidine nizatidine ranitidine These medicines work by lowering the acidity level in your stomach. Your GP may prescribe any one of these four H2-receptor antagonists, although ranitidine is available from pharmacies under the Pharmacy First Scotland service. H2-receptor antagonists are usually taken in tablet form. As with PPIs, you will need to stop taking H2-receptor antagonists at least 14 days before having an endoscopy if this


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usually taken in tablet form. As with PPIs, you will need to stop taking H2-receptor antagonists at least 14 days before having an endoscopy if this has been arranged through your GP. This is because they can hide some of the problems that could otherwise be spotted during the endoscopy. Helicobacter pylori (H pylori) infection If your indigestion symptoms are caused by an infection with H pylori bacteria, you will need to have treatment to clear the infection from your stomach. This should help relieve your indigestion, because the H pylori bacteria will no longer be increasing the amount of acid in your stomach. H pylori infection is usually treated using triple therapy (treatment with three different medications). Your GP will prescribe a course of treatment containing: two different antibiotics (medicines to treat infections that are caused by bacteria) a PPI You will need to take these medicines twice a day for seven days. You must follow the dosage instructions closely to ensure


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caused by bacteria) a PPI You will need to take these medicines twice a day for seven days. You must follow the dosage instructions closely to ensure that the triple therapy is effective. In up to 85% of cases, one course of triple therapy is effective in clearing an H pylori infection. However, you may need to have more than one course of treatment if it does not clear the infection the first time. Complications of indigestion In most cases, indigestion (dyspepsia) is mild and only occurs occasionally. However, severe indigestion can cause complications, some of which are outlined below. Oesophageal stricture Indigestion is often caused by acid reflux, which occurs when stomach acid leaks back up into your gullet (oesophagus) and irritates its lining. If this irritation builds up over time, it can cause your oesophagus to become scarred. The scarring can eventually lead to your oesophagus becoming narrow and constricted (known as oesophageal stricture). If you have oesophageal


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The scarring can eventually lead to your oesophagus becoming narrow and constricted (known as oesophageal stricture). If you have oesophageal stricture, you may have symptoms such as: difficulty swallowing (dysphagia) food that becomes lodged in your throat chest pain Oesophageal stricture is often treated using surgery to widen your oesophagus. Pyloric stenosis Like oesophageal stricture, pyloric stenosis is caused by long-term irritation of the lining of your digestive system from stomach acid. Pyloric stenosis occurs when the passage between your stomach and your small intestine (known as the pylorus) becomes scarred and narrowed. This causes vomiting and prevents any food you eat from being properly digested. In most cases, pyloric stenosis is treated using surgery to return the pylorus to its proper width. Barrett’s oesophagus Repeated episodes of gastro-oesophageal reflux disease (GORD) can lead to changes in the cells lining your lower oesophagus. This is a condition known as


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episodes of gastro-oesophageal reflux disease (GORD) can lead to changes in the cells lining your lower oesophagus. This is a condition known as Barrett’s oesophagus. It is estimated that 1 in 10 people with GORD will develop Barrett’s oesophagus. Most cases of Barrett’s oesophagus first develop in people aged 50 to 70 years old. The average age at diagnosis is 62. Barrett’s oesophagus does not usually cause noticeable symptoms other than those associated with GORD. The concern is that Barrett’s oesophagus is a pre-cancerous condition. This means that while changes in the cells are not cancerous, there is a small risk they could develop into cancer in the future. This would then trigger the onset of oesophageal cancer. Source: NHS 24 - Opens in new browser window Last updated: 29 May 2023 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Don’t include personal information e.g. name, location or any personal health conditions. Email


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NHS inform Thank You Your feedback has been received Don’t 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 Stomach ulcer NSAIDs Gastro-oesophageal reflux disease (GORD) Search for a pharmacy near you Enter a place or postcode NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats © 2025 NHS 24 – v1.1.1.17852


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Infertility | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotland’s Service Directory 0 Home Illnesses and conditions Sexual and reproductive Infertility Infertility Infertility is when you are unable to become pregnant. Not all of the information on this page will be relevant for everyone. All couples, including same-sex couples and couples where one or both partners are trans or non-binary, can access NHS fertility services if they meet the treatment access criteria. 80% of women under 40 years of age will naturally become pregnant within a year if they have regular unprotected sex. For some people it can be more difficult. For couples, infertility is when you or your partner are unable to get pregnant after 12 months or more of regular unprotected sex. About 1 in 7 of couples struggle to become pregnant. Not all of these couples require fertility treatment as some couples will get pregnant naturally.


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1 in 7 of couples struggle to become pregnant. Not all of these couples require fertility treatment as some couples will get pregnant naturally. Some couples need extra help to be able to have a baby. For example: drugs to help release eggs IVF/ICSI use of donated eggs or sperm more rarely, treatment with a surrogate Infertility and trying for a baby can bring challenges that might be overwhelming at times. There are charities that provide support, advice and information such as Fertility Alliance and Fertility Network UK. The Human Fertility and Embryology Authority also provides information for patients. What can affect fertility? Fertility is affected by various factors, including: the health of your reproductive organs hormones age (as you age fertility decreases) Lifestyle changes can improve your fertility, such as: maintaining a healthy weight (or BMI) stopping smoking not drinking alcohol reducing stress and anxiety There are things you can do to reduce stress and anxiety such


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weight (or BMI) stopping smoking not drinking alcohol reducing stress and anxiety There are things you can do to reduce stress and anxiety such as: gentle exercise – like going for a walk or cycle eating a healthy, balanced diet trying to get 7 to 8 hours of sleep a night yoga, breathing exercises and meditation Further information about your mental health and wellbeing Causes of infertility Some causes of infertility include: semen quality or no sperm in an ejaculation – this affects about 1 in 3 couples who are seeking fertility treatment lack of ovulation (releasing an egg) or ovulatory dysfunction – a sign of this may be having irregular periods blocked fallopian tubes (the tubes connecting the ovary to the womb) – this prevents the sperm getting to the egg or a fertilised eggs getting to the womb genetics, such as Klinefelters Syndrome Sometimes the causes of infertility are unknown. When to get medical advice Speak to your GP practice if: you’re a couple and you have been trying


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Sometimes the causes of infertility are unknown. When to get medical advice Speak to your GP practice if: you’re a couple and you have been trying for a baby for more than a year (having regular unprotected sex) and have not become pregnant you know that you need donated eggs or sperm to have a baby you’re trying for a baby and are worried about irregular or no periods or have a health condition which affects your periods like endometriosis, PCOS or adenomyosis you’re a woman over 36 years of age and have been trying as a couple for a baby for 6 months Diagnosing infertility You may feel worried about speaking to your GP, but infertility is common and they can provide support. When you speak to your doctor about your fertility they will take a medical history. They may carry out some of the following tests on you and your partner, for example: semen analysis – you’ll produce a semen sample to be analysed by a laboratory hormone analysis – you’ll have a blood test which will then be


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example: semen analysis – you’ll produce a semen sample to be analysed by a laboratory hormone analysis – you’ll have a blood test which will then be sent for analysis Your doctor will discuss your results with you and you can ask any questions that you might have. Treatments for infertility Things you can do There are lifestyle changes that might help improve your fertility, as well as your health and the health of any future pregnancy. Do have a BMI of between 19 and 25 – being underweight or overweight reduces fertility and can also lead to complications in pregnancy quit smoking if you smoke – smoking reduces semen quality and can cause issues in pregnancy avoid passive smoking reduce stress where possible – stress can affect your relationships and sex drive, and in severe cases can affect ovulation and sperm production Don’t do not drink alcohol – it affects sperm quality and can cause significant issues in pregnancy, such as fetal alcohol spectrum disorder do not take


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do not drink alcohol – it affects sperm quality and can cause significant issues in pregnancy, such as fetal alcohol spectrum disorder do not take recreational drugs – these affect fertility and can cause issues in pregnancy Further information about preconception health Treatments from your healthcare professional Your healthcare professional will discuss your treatment options with you and you can ask any questions that you might have. Ovulation induction Ovulation induction uses hormone therapy to help your ovaries to release an egg. It’s often the treatment used for patients with PCOS. Surgery Some people will have surgery to help treat or remove areas of endometriosis. In vitro fertilisation (IVF) For IVF, fertility hormones are used to stimulate the ovaries to produce eggs. The eggs are collected (removed from the body) and mixed with sperm in a laboratory. If an egg is fertilised by the sperm this becomes an embryo which is then transferred into the womb. IVF is carried out


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with sperm in a laboratory. If an egg is fertilised by the sperm this becomes an embryo which is then transferred into the womb. IVF is carried out when the sperm quality is considered to be normal. Intracytoplasmic sperm injection (ICSI) ICSI is like IVF but is used when the sperm is lower quality. The sperm is injected into the egg outside of the body. Surgical Sperm Retrieval (SSR) In some cases, there may not be sperm in the sample. This could be because of a blockage or a genetic problem. Sperm may be collected directly from the testicles (balls) using minor surgery. The sperm is then used with ICSI. Intrauterine insemination (IUI) IUI is a procedure where sperm is introduced directly into the womb using medical equipment. IUI is commonly used by people who are using donated sperm in their treatment. Same sex couples Options can include: using donor sperm with IUI using donor eggs with IVF or ICSI using donor sperm with IVF or ICSI A surrogate may also be needed if neither person


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using donor sperm with IUI using donor eggs with IVF or ICSI using donor sperm with IVF or ICSI A surrogate may also be needed if neither person is able to carry a pregnancy. Non-binary or transgender patients Treatment options are available for all couples, including non-binary or transgender people, as long as they meet the NHS IVF treatment access criteria. Trans and non-binary people who are unable to get pregnant because they’ve had gender reassignment (including surgery) will still be able to access treatment if all other access criteria are met. For more information, visit the HFEA website or contact your GP for a referral to fertility services to discuss options. Treatment on the NHS Not all patients will be eligible for NHS treatments. For example, if you and your partner already have a child together you will not be eligible for IVF or ICSI. Source: Scottish Government - Opens in new browser window Last updated: 22 August 2024 How can we improve this page? Help us improve


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for IVF or ICSI. Source: Scottish Government - Opens in new browser window Last updated: 22 August 2024 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Don’t 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 Periods and pregnancy Planning for pregnancy Miscarriage Other health sites Fertility Network UK: Patient support Miscarriage Association: Fertility problems Held In Our Hearts: Baby loss counselling and peer support Fertility Scotland National Network Human Fertilisation and Embryo Authority British Fertility Society Glasgow Fertility Clinic Edinburgh Fertility Clinic Aberdeen Fertility Clinic Dundee Fertility Clinic The Fertility Alliance NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and


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The Fertility 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 policy Freedom of information (FOI) Accessibility Other languages and formats © 2025 NHS 24 – v1.1.1.17852


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https://www.nhsinform.scot/illnesses-and-conditions/stomach-liver-and-gastrointestinal-tract/inflammatory-bowel-disease-ibd


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Inflammatory bowel disease (IBD) | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotland’s Service Directory 0 Home Illnesses and conditions Stomach, liver and gastrointestinal tract Inflammatory bowel disease (IBD) Inflammatory bowel disease (IBD)Learn about inflammatory bowel disease (IBD) symptoms and treatment, including Crohn’s disease and ulcerative colitis Crohn’s disease Learn about Crohn's disease symptoms and treatments Ulcerative colitis Learn about ulcerative colitis symptoms and treatments 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 © 2025 NHS 24 – v1.1.1.17852


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Ingrown toenail | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotland’s Service Directory 0 Home Illnesses and conditions Skin, hair and nails Ingrown toenail Ingrown toenail An ingrown toenail develops when the sides of the toenail grow into the surrounding skin. Symptoms of ingrown toenail An ingrown toenail often affects the big toe, either on one or both sides. The nail curls and pierces the skin which becomes red, swollen and tender. Other possible symptoms include: pain if pressure is placed on the toe inflammation of the skin at the end of the toe a build-up of fluid (oedema) in the area surrounding the toe an overgrowth of skin around the affected toe (hypertrophy) bleeding white or yellow pus coming from the affected area Infected ingrown toenail. Source: dermnetnz.org Get help from a pharmacist If you have an ingrown toenail, you can ask a pharmacist about: treatments to help ease the pain and


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Source: dermnetnz.org Get help from a pharmacist If you have an ingrown toenail, you can ask a pharmacist about: treatments to help ease the pain and prevent an infection whether you need to see a GP Find your nearest pharmacy Speak to your GP practice if: treating your ingrown toenail at home is not helping your toe is painful and swollen with pus coming out of it you have a very high temperature or you feel hot or shivery you have diabetes and an ingrown toenail – foot problems can be more serious if you have diabetes Causes of an ingrown toenail A number of things can cause an ingrown toenail to develop, including: badly cut toenails – cutting your toenails too short, or cutting the edges, will encourage the skin to fold over your nail and the nail to grow into the skin wearing tight-fitting shoes, socks or tights – this places pressure on the skin around your toenail and the skin may be pierced if it’s pressed on to your toenail sweaty feet – if the skin around your toenails is


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on the skin around your toenail and the skin may be pierced if it’s pressed on to your toenail sweaty feet – if the skin around your toenails is soft, it’s easier for your nail to pierce it and embed itself within it injury – for example, stubbing your toe can sometimes cause an ingrown toenail to develop natural shape of the nail – the sides of curved or fan-shaped toenails are more likely to press into the skin surrounding the nail A fungal nail infection can cause your toenail to thicken or widen. Treatment for ingrown toenails Left untreated, an ingrown toenail can become infected. It’s important that you: Do keep your feet clean by washing them regularly with soap and water change your socks regularly cut your toenails straight across to stop them digging into the surrounding skin gently push the skin away from the nail using a cotton bud (this may be easier after using a small amount of olive oil to soften the skin) wear comfortable shoes that fit properly Surgery for ingrown


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bud (this may be easier after using a small amount of olive oil to soften the skin) wear comfortable shoes that fit properly Surgery for ingrown toenail Surgery may be recommended if your toenail doesn’t improve. Depending on the severity of your symptoms, this may involve removing part or all of your toenail. Partial nail avulsion Partial nail avulsion removes part of your toenail and is the most common operation for treating ingrown toenails. It’s about 98% effective. A local anaesthetic is used to numb your toe and the edges of your toenail are cut away. A chemical called phenol is applied to the affected area to prevent the nail growing back and becoming ingrown in the future. A course of antibiotics may be prescribed if your nail is infected, and any pus will be drained away. Total nail avulsion Total nail avulsion completely removes your toenail. This may be necessary if your nail is thick and pressing into the skin surrounding your toe. After your toenail has been removed,


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your toenail. This may be necessary if your nail is thick and pressing into the skin surrounding your toe. After your toenail has been removed, you’ll have an indentation where your nail used to be. However, it’s perfectly safe for you not to have a toenail. After surgery After toenail surgery, your toe will be wrapped in a sterile bandage. This will help stem any bleeding and prevent infection. Rest your foot and keep it raised for 1 to 2 days after the operation. To help reduce the pain, you may need to take a painkiller like paracetamol. You may also need to wear soft or open-toed shoes for the first few days after surgery. Preventing ingrown toenails Taking care of your feet will help prevent foot problems like ingrown toenails. It’s important to cut your toenails properly (straight across, not at an angle or down the edges). Wash your feet every day, dry them thoroughly and use foot moisturiser. You can also use a foot file or pumice stone to remove hard or dead skin. Wearing


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your feet every day, dry them thoroughly and use foot moisturiser. You can also use a foot file or pumice stone to remove hard or dead skin. Wearing shoes that fit properly will help to ensure your feet remain healthy. You should also change your socks (or tights) every day. Visit your GP practice or a podiatrist as soon as possible if you develop problems with your feet. Source: NHS 24 - Opens in new browser window Last updated: 29 July 2024 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Don’t 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 Looking after your feet 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


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https://www.nhsinform.scot/illnesses-and-conditions/cardiovascular-disease/heart-disease/inherited-heart-conditions/


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Inherited heart conditions | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotland’s Service Directory 0 Home Illnesses and conditions Cardiovascular disease Heart disease Inherited heart conditions Inherited heart conditions Inherited heart conditions, sometimes referred to as inherited cardiac conditions (ICC), are a group of heart conditions that are passed on through families. They affect around 1 in 250 people worldwide and can affect people of all ages. Causes of inherited heart conditions The body has over 20,000 genes. Genes are made up of DNA and are like instructions for the body. There are 2 copies of each gene in your body. One is inherited from your mum and one is from your dad. Inherited heart conditions are caused when there’s a change in one or more of your genes. This is known as a gene variant. If one of your parents has a gene variant, there’s a 50% chance it will be passed on to you


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or more of your genes. This is known as a gene variant. If one of your parents has a gene variant, there’s a 50% chance it will be passed on to you (inherited). If you do inherit the gene variant, there’s also a 50% chance you could pass it on to each of your children. If you do not inherit the gene variant, you can’t pass it on to your children. Most inherited heart conditions follow this pattern. Each person is affected by each gene variant differently. This means you could have a gene variant and not have any symptoms. But, you can still pass the gene variant on to your children and they may have symptoms. If someone in your family is diagnosed with an inherited heart condition, or it’s thought they could have one, it’s important to create a family tree with a healthcare professional. This can help to identify if the same condition is present among more than one family member. If you’re diagnosed with an inherited heart condition, your first-degree family members (parents, siblings


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present among more than one family member. If you’re diagnosed with an inherited heart condition, your first-degree family members (parents, siblings and children) should be assessed for the same condition. Symptoms of inherited heart conditions An inherited heart condition can cause symptoms like: dizzy spells blackouts, faints or fits (seizures) palpitations breathlessness chest pain It’s important to speak to your GP or a healthcare professional if you have had any of these symptoms. An inherited heart condition can also cause cardiac arrest and sudden cardiac death. As some affected people don’t have symptoms, this means that sometimes the first time a family is aware that they’re affected by an inherited heart condition is after a sudden cardiac death. Types of inherited heart conditions There are 3 main groups of inherited heart conditions: Inherited cardiomyopathies Inherited cardiomyopathies affect the heart muscle. Examples include: Hypertrophic Cardiomyopathy (HCM) Dilated


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Inherited cardiomyopathies Inherited cardiomyopathies affect the heart muscle. Examples include: Hypertrophic Cardiomyopathy (HCM) Dilated Cardiomyopathy (DCM) Arrhythmogenic Cardiomyopathy Inherited channelopathies Inherited channelopathies affect the heart’s electrical system and heart rhythm. Examples include: Long QT Syndrome Brugada Syndrome Catecholaminergic Polymorphic Ventricular Tachycardia (CPVT) Inherited Aortopathies Aortopathy can affect the aorta, which is the main artery in the body. Examples include: Marfan Syndrome Loeys-Dietz syndrome Sudden Arrhythmic Death Syndrome (SADS) Sudden Arrhythmic Death Syndrome (SADS) is when someone dies suddenly or unexpectedly with no clear cause. SADS can occur when there’s an abnormal heart rhythm, known as an arrhythmia. This causes a cardiac arrest where the heart stops beating. A cardiac arrest is a medical emergency – find out more about what to do in a heart emergency. Cardiac Risk in the Young (CRY) has information on sudden


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arrest is a medical emergency – find out more about what to do in a heart emergency. Cardiac Risk in the Young (CRY) has information on sudden cardiac death. Testing for inherited heart conditions The process for testing for inherited heart conditions may differ from person to person. It will also be personalised to you and your family’s needs. To begin the process, a specialist will ask questions about you and your family history. They may then refer you for heart tests, which can include: an ECG (electrocardiogram) an echocardiogram a 24 hour heart monitor an exercise tolerance test a cardiac MRI scan Treatments for inherited heart conditions Every inherited heart condition is managed and treated differently. Treatments will be based on your symptoms and any test results. Treatments may include: changes to your lifestyle medication pacemakers or implantable cardioverter defibrillators (ICDs) heart transplantation (in rare cases) Inherited Cardiac Services Scotland Genetic services


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or implantable cardioverter defibrillators (ICDs) heart transplantation (in rare cases) Inherited Cardiac Services Scotland Genetic services in Scotland are managed by specialist hospital doctors in 4 regional centres. These are: Aberdeen – gram.clinicalgenetics@nhs.scot Dundee – tay.clinicalgenetics@nhs.scot Edinburgh – wgh.clinicalgenetics@nhslothian.scot.nhs.uk Glasgow – ggc.wosicc@ggc.scot.nhs.uk These regional services have access to: specialist cardiologists geneticists specialist nursing genetic counselling These cardiac-genetic services link with the other hospitals in their regions. You may need to visit your GP to get a referral to a specialist service. Network for Inherited Cardiac Conditions Scotland (NICCS) The Network for Inherited Cardiac Conditions Scotland (NICCS) is a National Managed Clinical Network (NMCN). It was set up to help coordinate services for people with, or suspected of having, inherited heart conditions. NICCS is part of the NHS. It brings together


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set up to help coordinate services for people with, or suspected of having, inherited heart conditions. NICCS is part of the NHS. It brings together experts from across Scotland and aims to improve services for inherited heart conditions. Those in the network include: heart specialists geneticists genetic counsellors pathologists specialist nurses public representatives other experts The NICCS website has resources for people affected by inherited heart conditions. This includes a patient forum made up of patients, family members and organisations with an interest in inherited heart conditions. If you’d like to find out more about NICCS, visit their website or email nss.niccs@nhs.scot. Further information and support Living with an inherited heart condition can be distressing for those affected and their families. There are many patient organisations and charities that can provide support and further information. This includes: Cardiac Risk in the Young (CRY) British Heart Foundation


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organisations and charities that can provide support and further information. This includes: Cardiac Risk in the Young (CRY) British Heart Foundation Cardiomyopathy UK Life After Cardiac Arrest SADS UK Arrhythmia Alliance UK Cruse Scotland Bereavement Support Sudden Cardiac Arrest UK (SCA UK) Source: Scottish Government - Opens in new browser window Last updated: 20 November 2024 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Don’t 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 Rare conditions Other health sites British Heart Foundation: Inherited heart conditions Marfan Foundation Cardiac Risk in the Young 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


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Insomnia | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotland’s Service Directory 0 Home Illnesses and conditions Mental health Insomnia Insomnia British Sign Language (BSL) Insomnia can mean both: struggling to get to sleep difficulty staying asleep It’s a common problem thought to affect around 1 in 3 people in the UK. It’s particularly common in older adults. Symptoms of insomnia If you have insomnia, you might: find it hard to fall asleep lie awake at night wake up several times during the night wake up early in the morning and not be able to get back to sleep not feel refreshed when you get up feel tired and irritable during the day have difficulty concentrating because you’re tired Sometimes episodes of insomnia can come and go without causing any serious problems. But, some people can have insomnia for months or even years at a time. Persistent insomnia can have an impact on your quality of life.


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problems. But, some people can have insomnia for months or even years at a time. Persistent insomnia can have an impact on your quality of life. It can limit what you’re able to do during the day and affect your mood. It can also lead to relationship problems with friends, family and colleagues. How much sleep do I need? Everyone needs different amounts of sleep. Most adults sleep for 7 to 9 hours a night. Children and babies may sleep for much longer than this, whereas older adults may sleep less. What’s important is whether you feel you get enough sleep, and whether your sleep is good quality. You’re probably not getting enough good-quality sleep if: you always feel tired throughout the day tiredness is affecting your everyday life The Sleep Charity has information to support parents and children. Watch more videos about sleep on Mind to Mind Contact your GP practice if: improving your sleep hygiene has not helped poor sleep quality is affecting your daily life you’re not looking


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to Mind Contact your GP practice if: improving your sleep hygiene has not helped poor sleep quality is affecting your daily life you’re not looking after yourself you’re finding it hard to manage any responsibilities you have Find out how to get urgent help for your mental health Your GP will first try to identify and treat any underlying health condition that may be causing your sleep problems. If it’s possible to identify an underlying cause of your sleeping difficulties, treating this may be enough to return your sleep to normal. What causes insomnia? Insomnia can be triggered by many factors. It’s not always possible to identify a clear cause. The most common causes of insomnia are: stress anxiety depression noise a room that’s too hot or cold an uncomfortable bed alcohol caffeine drugs jet lag shift work If you feel unwell or think your sleep problems could be caused by medication, please speak to your GP or pharmacist.blems could be caused by medication please speak to your GP


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your sleep problems could be caused by medication, please speak to your GP or pharmacist.blems could be caused by medication please speak to your GP or pharmacist. Treatment for insomnia The causes of insomnia vary so treatments can vary from person to person. Try a self-help guide You could try our sleep problems and insomnia self-help guide. It covers topics like: symptoms of a sleep problem causes of sleep problems improving your sleep calming a busy mind Our mental health self-help guides are based on Cognitive Behavioural Therapy (CBT). They’ve proven highly successful in helping people with anxiety and other mental health issues. Start the sleep problems and insomnia self-help guide Try an online CBT course You could try an online course like Sleepio. Sleepio is a digital sleep improvement programme based on Cognitive Behavioural Therapy (CBT.) It’s clinically proven to help address the root causes of poor sleep and insomnia. Sign up for Sleepio Improve your sleep hygiene


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Therapy (CBT.) It’s clinically proven to help address the root causes of poor sleep and insomnia. Sign up for Sleepio Improve your sleep hygiene Insomnia can often be treated by improving your sleep hygiene. To improve your sleep hygiene, you need to look at both your sleep environment and your daily behaviours. Do make sure your bedroom is dark and quiet – use thick blinds, curtains, an eye mask or ear plugs keep your bedroom at a comfortable temperature for sleeping – this should be slightly cooler than your living area make sure your mattress, covers and pillow are comfortable exercise regularly during the day create a relaxing bedtime routine, like taking a bath or listening to gentle music write any worries and ideas down before going to bed, so that you’re more likely to be able to forget them until morning get up at a specific time each day and try to stick to this, even if you feel you’ve not had enough sleep Don’t do not nap during the day do not exercise for at least 4 hours


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each day and try to stick to this, even if you feel you’ve not had enough sleep Don’t do not nap during the day do not exercise for at least 4 hours before going to bed do not drink caffeinated drinks (like tea, coffee or fizzy drinks) for a few hours before going to bed do not drink alcohol or smoke shortly before going to bed do not eat a big meal just before bedtime do not go to bed before you feel tired – it’s better to stay up until you’re ready to fall asleep than to go to bed early and worry about not sleeping do not watch the clock when trying to sleep, as anxiety will only make your insomnia worse do not use your bedroom for anything other than sleeping or sex do not watch television, make phone calls, eat, or work in bed What to do if you’re struggling to fall asleep If you find you can’t fall asleep and you’re growing anxious about it, you should: get up and go to a different room do a relaxing activity, like reading or listening to music try going to sleep again in around


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about it, you should: get up and go to a different room do a relaxing activity, like reading or listening to music try going to sleep again in around 20 minutes, or whenever you feel tired again Psychological therapy If changing your sleeping habits doesn’t help, your GP may refer you for a type of cognitive behavioural therapy (CBT) for people with insomnia. This is called CBT-I. CBT-I aims to change unhelpful thoughts and behaviours that contribute to insomnia. It’s an effective treatment for many people and can have long-lasting results. Medication for insomnia In some circumstances, medication over the counter or on prescription can be used to help with insomnia. Medication can be effective in the short term but it can also cause insomnia to get worse, cause addiction, or other side effects. 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’t include


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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’t 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) British Sign Language (BSL) Add this page to Info For Me Also on NHS inform Insomnia (BSL) Sleep problems and insomnia self-help guide Get help with your mental health Mind to Mind - Sleeping better 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 © 2025 NHS 24 – v1.1.1.17852


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Iron deficiency anaemia | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotland’s Service Directory 0 Home Illnesses and conditions Nutritional Iron deficiency anaemia Iron deficiency anaemia About iron deficiency anaemia Causes of iron deficiency anaemia Diagnosing iron deficiency anaemia Treating iron deficiency anaemia Complications of iron deficiency anaemia About iron deficiency anaemia Iron deficiency anaemia is a condition where a lack of iron in the body leads to a reduction in the number of red blood cells. Iron is used to produce red blood cells, which help store and carry oxygen in the blood. If you have fewer red blood cells than is normal, your organs and tissues won’t get as much oxygen as they usually would. There are several different types of anaemia, and each one has a different cause. Iron deficiency anaemia is the most common type. Other types of anaemia can be caused by a lack of


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of anaemia, and each one has a different cause. Iron deficiency anaemia is the most common type. Other types of anaemia can be caused by a lack of vitamin B12 or folate in the body – read more about vitamin B12 and folate deficiency anaemia. Symptoms of iron deficiency anaemia Many people with iron deficiency anaemia only have a few symptoms. The severity of the symptoms largely depends on how quickly anaemia develops. You may notice symptoms immediately, or they may develop gradually if your anaemia is caused by a long-term problem, such as a stomach ulcer. The most common symptoms include: tiredness and lack of energy (lethargy) shortness of breath noticeable heartbeats (heart palpitations) a pale complexion Less common symptoms include: headache hearing sounds that come from inside the body, rather than from an outside source (tinnitus) an altered sense of taste feeling itchy a sore or abnormally smooth tongue hair loss a desire to eat non-food items, such as ice, paper or clay


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an altered sense of taste feeling itchy a sore or abnormally smooth tongue hair loss a desire to eat non-food items, such as ice, paper or clay (pica) difficulty swallowing (dysphagia) painful open sores (ulcers) on the corners of your mouth spoon-shaped nails When to see your GP See your GP if you experience symptoms of iron deficiency anaemia. They should be able to diagnose the condition using a simple blood test. Read more about diagnosing iron deficiency anaemia What causes iron deficiency anaemia? There are many things that can lead to a lack of iron in the body. In men and post-menopausal women, the most common cause is bleeding in the stomach and intestines. This can be caused by a stomach ulcer, stomach cancer, bowel cancer, or by taking non-steroidal anti-inflammatory drugs (NSAIDs). In women of reproductive age, heavy periods and pregnancy are the most common causes of iron deficiency anaemia as your body needs extra iron for your baby during pregnancy. Unless you’re


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and pregnancy are the most common causes of iron deficiency anaemia as your body needs extra iron for your baby during pregnancy. Unless you’re pregnant, it’s rare for iron deficiency anaemia to be caused just by a lack of iron in your diet. However, if you do lack dietary iron, it may mean you’re more likely to develop anaemia than if you have one of the problems mentioned above. Read more about the causes of iron deficiency anaemia How iron deficiency anaemia is treated Treatment for iron deficiency anaemia involves taking iron supplements to boost the low levels of iron in your body. This is usually effective, and the condition rarely causes long-term problems. You’ll need to be monitored every few months to check the treatment is working and your iron levels have returned to normal. The underlying cause will need to be treated so you don’t get anaemia again. Increasing the amount of iron in your diet may also be recommended. Good sources of iron include: dark-green leafy


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so you don’t get anaemia again. Increasing the amount of iron in your diet may also be recommended. Good sources of iron include: dark-green leafy vegetables, such as watercress and curly kale iron-fortified cereals or bread brown rice pulses and beans nuts and seeds meat, fish and tofu eggs dried fruit, such as dried apricots, prunes and raisins Read more about treating iron deficiency anaemia Further problems If iron deficiency anaemia is left untreated, it can make you more susceptible to illness and infection, as a lack of iron affects the body’s natural defence system (the immune system). Severe iron deficiency anaemia may increase your risk of developing complications that affect the heart or lungs, such as an abnormally fast heartbeat (tachycardia) or heart failure, where your heart is unable to pump enough blood around your body at the right pressure. Pregnant women with severe or untreated anaemia also have a higher risk of complications before and after birth. Read more


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at the right pressure. Pregnant women with severe or untreated anaemia also have a higher risk of complications before and after birth. Read more about the complications of iron deficiency anaemia Causes of iron deficiency anaemia Iron deficiency anaemia occurs when the body doesn’t have enough iron, leading to the decreased production of red blood cells. Red blood cells carry oxygen around the body. A lack of iron can be caused by several factors. Some of the most common causes of iron deficiency anaemia are outlined below. Monthly periods In women of reproductive age, periods are the most common cause of iron deficiency anaemia. Usually, only women with heavy periods develop iron deficiency anaemia. If you have heavy bleeding over several consecutive menstrual cycles, it’s known as menorrhagia. Pregnancy It’s also very common for women to develop iron deficiency during pregnancy. This is because your body needs extra iron to ensure your baby has a sufficient blood supply and


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women to develop iron deficiency during pregnancy. This is because your body needs extra iron to ensure your baby has a sufficient blood supply and receives necessary oxygen and nutrients. Some pregnant women require an iron supplement, while others may need to increase the amount of iron in their diet. Read more about vitamins and minerals in pregnancy Gastrointestinal blood loss The gastrointestinal tract is the part of the body responsible for digesting food. It contains the stomach and intestines. Bleeding in the gastrointestinal tract is the most common cause of iron deficiency anaemia in men, as well as women who’ve experienced the menopause (when monthly periods stop). Most people with gastrointestinal bleeding don’t notice any obvious blood in their stools and don’t experience any changes in their bowel habits. Some causes of gastrointestinal bleeding are described below. Non-steroidal anti-inflammatory drugs Non-steroidal anti-inflammatory drugs (NSAIDs) can cause bleeding in


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bleeding are described below. Non-steroidal anti-inflammatory drugs Non-steroidal anti-inflammatory drugs (NSAIDs) can cause bleeding in the stomach. Ibuprofen and aspirin are two commonly prescribed NSAIDs. If your GP thinks your medication is causing gastrointestinal bleeding, they can prescribe a less harmful medicine. However, don’t stop taking a medicine you’ve been prescribed unless your GP advises you to. Stomach ulcers The acid in your stomach, which helps your body digest food, can sometimes eat into your stomach lining. When this happens, the acid forms an open sore (an ulcer). This is also known as a stomach ulcer or a peptic ulcer. Stomach ulcers can cause the stomach lining to bleed, which can lead to anaemia. In some cases, the bleeding can cause you to vomit blood or pass blood in your stools. However, if the ulcer bleeds slowly, you may not have any symptoms. Gastrointestinal cancer In a few cases, gastrointestinal bleeding can be caused by cancer, usually stomach


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slowly, you may not have any symptoms. Gastrointestinal cancer In a few cases, gastrointestinal bleeding can be caused by cancer, usually stomach cancer or bowel cancer. When trying to establish the cause of anaemia, your GP will check for possible signs of cancer. If your GP suspects cancer, you’ll be referred to a gastroenterologist (a specialist in treating digestive conditions) for a more thorough examination. This means that if cancer is found, it can be treated as quickly as possible. If you’re 60 years old or over and have iron deficiency anaemia, your GP should refer you to a specialist to rule out bowel cancer. Your appointment with the specialist should be within two weeks of your GP referring you. Angiodysplasia Gastrointestinal bleeding can also be caused by a condition called angiodysplasia. This is the result of abnormal, fragile superficial blood vessels in the gastrointestinal tract, which can cause bleeding. Chronic kidney disease People with chronic kidney disease


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fragile superficial blood vessels in the gastrointestinal tract, which can cause bleeding. Chronic kidney disease People with chronic kidney disease (CKD) often develop iron deficiency anaemia. Most people with CKD who have iron deficiency anaemia will be given iron supplement injections, although daily tablets may be tried first. You can read more about treating anaemia in people with CKD on the National Institute for Health and Care Excellence (NICE) website. Other causes Other conditions or actions that cause blood loss and may lead to iron deficiency anaemia include: inflammatory bowel disease – a condition that causes redness and swelling (inflammation) in the digestive system, such as Crohn’s disease and ulcerative colitis oesophagitis – inflammation of the gullet (oesophagus) caused by stomach acid leaking through it schistosomiasis – an infection caused by parasites, mainly found in sub-Saharan Africa blood donation – donating a large amount of blood may lead to anaemia trauma


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– an infection caused by parasites, mainly found in sub-Saharan Africa blood donation – donating a large amount of blood may lead to anaemia trauma – a serious accident, such as a car crash, may cause you to lose a large amount of blood nosebleeds – having regular nosebleeds may lead to anaemia, although this is rare haematuria (blood in your urine) – but this rarely causes anaemia and may be a symptom of another condition Malabsorption Malabsorption is when your body can’t absorb iron from food, and is another possible cause of iron deficiency anaemia. This may happen if you have coeliac disease, a common digestive condition where a person has an adverse reaction to gluten, or surgery to remove all or part of your stomach (gastrectomy). Lack of iron in your diet Unless you’re pregnant, it’s rare for iron deficiency anaemia to be caused solely by a lack of iron in your diet. However, a lack of dietary iron can increase your risk of developing anaemia if you also have any of the


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solely by a lack of iron in your diet. However, a lack of dietary iron can increase your risk of developing anaemia if you also have any of the conditions mentioned above. Some studies suggest vegetarians or vegans are more at risk of iron deficiency anaemia because of the lack of meat in their diet. If you are vegetarian or vegan, it is possible to gain enough iron by eating other types of food, such as: beans nuts dried fruit, such as dried apricots wholegrains, such as brown rice fortified breakfast cereals soybean flour most dark-green leafy vegetables, such as watercress and curly kale If you’re pregnant, you may need to increase the amount of iron-rich food you consume during pregnancy to help prevent iron deficiency anaemia. Read more about vegetarian and vegan diets Diagnosing iron deficiency anaemia See your GP if you experience symptoms of iron deficiency anaemia, such as tiredness, shortness of breath and heart palpitations. A simple blood test can usually confirm the


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symptoms of iron deficiency anaemia, such as tiredness, shortness of breath and heart palpitations. A simple blood test can usually confirm the diagnosis. Your GP may also carry out a physical examination and ask you a number of questions to help determine the cause of your anaemia. Blood test To diagnose iron deficiency anaemia, a blood sample is taken from a vein in your arm and a full blood count is made. This means all the different types of blood cells in the sample will be measured. If you have anaemia: your levels of haemoglobin – a substance that transports oxygen – will be lower than normal you’ll have fewer red blood cells, which contain haemoglobin, than normal your red blood cells may be smaller and paler than usual Your GP may also test for a substance called ferritin, a protein that stores iron. If your ferritin levels are low, it means there isn’t much iron stored in your body and you may have iron deficiency anaemia. Read more about blood tests Vitamin B12 and folate


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low, it means there isn’t much iron stored in your body and you may have iron deficiency anaemia. Read more about blood tests Vitamin B12 and folate deficiency If your GP thinks your anaemia may be the result of a vitamin B12 and folate deficiency, the levels of these substances may be tested. Folate works with vitamin B12 to help your body produce red blood cells. Vitamin B12 and folate deficiency anaemia is more common in people who are over the age of 75. Finding the cause To determine the underlying cause of your anaemia, your GP may ask questions about your lifestyle and medical history. For example, they may ask you about: your diet – to see what you typically eat and whether this includes any iron-rich foods any medicines you take – to see if you’ve been regularly taking a type of medicine that can cause bleeding from the stomach and intestines (gastrointestinal bleeding), such as ibuprofen or aspirin your menstrual pattern – if you’re a woman, your GP may ask if you’ve been


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and intestines (gastrointestinal bleeding), such as ibuprofen or aspirin your menstrual pattern – if you’re a woman, your GP may ask if you’ve been experiencing particularly heavy periods your family history – you’ll be asked if your immediate family has anaemia or a history of gastrointestinal bleeding or blood disorders Iron deficiency anaemia is common during pregnancy. If you’re pregnant, your GP will usually only look for an alternative cause if a blood test has identified a particularly low haemoglobin level, or if your symptoms or medical history suggest your anaemia may be caused by something else. Physical examination A physical examination will usually only be needed if the cause of your iron anaemia deficiency hasn’t been identified by examining your medical history and asking you about your symptoms. In such cases, your GP may: examine your stomach (abdomen) to check for any physical signs of gastrointestinal bleeding look for signs of heart failure, such as swollen ankles


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examine your stomach (abdomen) to check for any physical signs of gastrointestinal bleeding look for signs of heart failure, such as swollen ankles – heart failure can have some similar symptoms to iron deficiency anaemia Two other possible types of physical examination you may have are explained below. Rectal examination A rectal examination is usually only needed if you’re bleeding from your bottom. It’s a common procedure that can help your GP find out if there’s something in your gastrointestinal tract that’s causing bleeding. Your GP will insert a lubricated gloved finger into your bottom to feel for any abnormalities. A rectal examination isn’t something to be embarrassed about, as it’s a procedure your GP will be used to doing. It shouldn’t cause significant pain, but it may cause some slight discomfort – this will only last for a minute. Pelvic examination Women may have a pelvic examination if their GP thinks heavy menstrual bleeding (menorrhagia) may be the cause of their


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a minute. Pelvic examination Women may have a pelvic examination if their GP thinks heavy menstrual bleeding (menorrhagia) may be the cause of their anaemia. During a pelvic examination, your GP will examine your vulva and labia (external sex organs) for signs of bleeding or infection. They may also examine you internally. This will involve your GP inserting lubricated gloved fingers into your vagina to feel whether your womb (uterus) is tender or enlarged. A pelvic examination won’t be carried out without your consent (permission), and you can choose to have someone with you. Referral to a specialist In some cases, your GP may refer you to a gastroenterologist, a specialist in treating digestive conditions. They’ll carry out a more thorough examination. For example, you may be referred to a gastroenterologist if your GP can’t identify a cause and you have a particularly low haemoglobin level, or if your GP thinks there’s a possibility your symptoms could be caused by stomach cancer


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a cause and you have a particularly low haemoglobin level, or if your GP thinks there’s a possibility your symptoms could be caused by stomach cancer or bowel cancer, although this is unlikely. If you’re a woman with heavy periods, you may be referred to a gynaecologist if you don’t respond to treatment with iron supplements. Treating iron deficiency anaemia Treatment for iron deficiency anaemia usually involves taking iron supplements and changing your diet to increase your iron levels, as well as treating the underlying cause. Iron supplements Your GP will prescribe an iron supplement to restore the iron missing from your body. The most commonly prescribed supplement is ferrous sulphate, which is taken as a tablet, usually twice a day. Some people can experience side effects when taking iron supplements, including: abdominal (tummy) pain constipation or diarrhoea heartburn feeling sick black stools (faeces) These side effects should settle down over time. However, your GP may


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pain constipation or diarrhoea heartburn feeling sick black stools (faeces) These side effects should settle down over time. However, your GP may recommend taking the tablets with food or shortly after eating if you have troublesome side effects. Your GP may also advise you to only take one or two tablets a day, instead of three, if you’re finding side effects difficult to cope with. If you can’t take ferrous sulphate because you get severe side effects, you may be prescribed a different iron supplement called ferrous gluconate. This supplement should cause fewer side effects because it contains a less concentrated dose of iron. However, it may take longer for the iron levels in your body to be restored. In a few cases – for example, if you have chronic kidney disease (CKD) – iron injections may be recommended instead of tablets. As with all medications, it’s important to store iron supplements out of the reach of children. An overdose of iron supplements in a young child can be


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with all medications, it’s important to store iron supplements out of the reach of children. An overdose of iron supplements in a young child can be fatal. Dietary advice If a lack of iron in your diet is thought to be contributing to your iron deficiency anaemia, your GP will tell you how to up your intake. Iron-rich foods include: dark-green leafy vegetables, such as watercress and curly kale iron-fortified cereals or bread brown rice pulses and beans nuts and seeds white and red meat fish tofu eggs dried fruit, such as dried apricots, prunes and raisins Your diet should include foods from all the major food groups to ensure it’s healthy and balanced. In particular, food and drink containing vitamin C are important as vitamin C helps your body absorb iron. However, consuming large amounts of some foods and drinks, as well as certain medicines, may make it harder for your body to absorb iron. These include: tea and coffee calcium – found in dairy products, such as milk antacids and


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may make it harder for your body to absorb iron. These include: tea and coffee calcium – found in dairy products, such as milk antacids and proton pump inhibitors (PPIs) – medications used to relieve indigestion wholegrain cereals – although wholegrains are a good source of iron themselves, they contain phytic acid, which can stop your body absorbing iron from other foods and pills You may be referred to a nutrition specialist called a dietitian if you’re finding it difficult to include iron in your diet. They’ll be able to give you detailed, personalised advice about how you can improve your diet. Treating the underlying cause Your GP will also need to ensure the underlying cause of your anaemia is treated so it doesn’t happen again. For example, if non-steroidal anti-inflammatory drugs (NSAIDs) are causing bleeding in your stomach, your GP may prescribe a different medicine to help minimise the risk of stomach bleeding. Heavy periods can be treated with medication or – in


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your GP may prescribe a different medicine to help minimise the risk of stomach bleeding. Heavy periods can be treated with medication or – in particularly severe cases – surgery. Monitoring Your GP will ask you to return two to four weeks after you’ve started taking iron supplements to check how well you’ve responded to the treatment. You’ll have a blood test to check your haemoglobin levels. If your blood test results show an improvement, you’ll be asked to continue taking iron supplements and return in two to four months for another blood test. Once your haemoglobin levels and red blood cells are normal, your GP will usually recommend continuing to take iron supplements for three months to help build up the iron levels in your body. After this, you should be able to stop taking the supplements, depending on the cause of your iron deficiency anaemia. Your condition will be monitored every three months over the course of a year, and again a year later. Continuing treatment Sometimes


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anaemia. Your condition will be monitored every three months over the course of a year, and again a year later. Continuing treatment Sometimes after a person’s iron levels have been replenished, they start to fall again. This could happen if you don’t get enough iron in your diet, you’re pregnant, or you have consistently heavy periods. In such cases, you may be prescribed an ongoing iron supplement to help stop your anaemia returning. This will usually be a tablet, which you’ll have to take once a day. If treatment is ineffective If your iron levels don’t improve, your GP will ask how regularly you’ve been taking your iron supplements. Some people are put off taking the medication because of the side effects. However, your condition won’t improve if you don’t take the supplements. If you’ve been taking the supplements as prescribed and your iron levels still haven’t improved, your GP may refer you to a specialist for an assessment. Complications of iron deficiency anaemia Iron


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and your iron levels still haven’t improved, your GP may refer you to a specialist for an assessment. Complications of iron deficiency anaemia Iron deficiency anaemia rarely causes serious or long-term complications, although some people with the condition find it affects their daily life. Some common complications are outlined below. Tiredness Iron deficiency anaemia can make you feel tired and lacking in energy (lethargic). This may result in you being less productive at work, and you may find it difficult to stay awake or not feel able to exercise regularly. Increased risk of infections Research has shown iron deficiency anaemia can affect your immune system – the body’s natural defence system. This increases your vulnerability to infection. Heart and lung problems Adults with severe anaemia may be at risk of developing complications that affect their heart or lungs. For example, you may develop tachycardia, which is an abnormally fast heartbeat, or heart failure, where the heart


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that affect their heart or lungs. For example, you may develop tachycardia, which is an abnormally fast heartbeat, or heart failure, where the heart fails to pump enough blood around your body at the right pressure. Pregnancy complications Pregnant women with severe anaemia have an increased risk of developing complications, particularly during and after birth. They may also develop postnatal depression, which some women experience after having a baby. Research suggests babies born to mothers who have untreated anaemia are more likely to: be born prematurely – before the 37th week of pregnancy have a low birth weight have problems with iron levels themselves do less well in mental ability tests Restless legs syndrome Some cases of restless legs syndrome are thought to be caused by iron deficiency anaemia. Doctors often refer to this as secondary restless legs syndrome. Restless legs syndrome is a common condition that affects the nervous system, and causes an overwhelming,


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this as secondary restless legs syndrome. Restless legs syndrome is a common condition that affects the nervous system, and causes an overwhelming, irresistible urge to move the legs. It also causes an unpleasant feeling in the feet, calves and thighs. Restless legs syndrome caused by iron deficiency anaemia can usually be treated with iron supplements. Source: NHS 24 - Opens in new browser window Last updated: 21 February 2025 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Don’t 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 Vitamin B12 or folate deficiency anaemia Stomach ulcer Other health sites NICE: Heavy menstrual bleeding NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy


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bleeding 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 © 2025 NHS 24 – v1.1.1.17852


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https://www.nhsinform.scot/illnesses-and-conditions/stomach-liver-and-gastrointestinal-tract/irritable-bowel-syndrome-ibs/


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Irritable bowel syndrome (IBS) | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotland’s Service Directory 0 Home Illnesses and conditions Stomach, liver and gastrointestinal tract Irritable bowel syndrome (IBS) Irritable bowel syndrome (IBS) Learn about what IBS is and how it can be managed What is IBS? Irritable bowel syndrome (IBS) is a common, long-term condition of the digestive system. The condition is often lifelong, although the symptoms may change over time. With the right strategies, IBS can be successfully managed. IBS does not pose a serious threat to your physical health and does not increase your chances of developing cancer or other bowel-related conditions. The exact cause of IBS is unknown. Many causes have been suggested but none have been proven to lead to IBS. IBS symptoms The symptoms of IBS vary between individuals and affect some people more severely than others. Symptoms can become


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to lead to IBS. IBS symptoms The symptoms of IBS vary between individuals and affect some people more severely than others. Symptoms can become worse, often during times of stress or after eating certain foods. You may find some of the symptoms of IBS ease after going to the toilet and moving your bowels. Main symptoms The most common symptoms of IBS are: abdominal (stomach) pain and cramping, which may be relieved by moving your bowels a change in your bowel habits – such as diarrhoea, constipation or sometimes both bloating and swelling of your stomach excessive wind (flatulence) occasionally experiencing an urgent need to move your bowels Less common syptoms Other less common symptoms may also be experienced, such as: lack of energy (lethargy) feeling sick heartburn The symptoms of IBS can also have a significant impact on a person’s day-to-day life and, as a result, some people may experience symptoms of low mood and stress. See your GP if: you think you have IBS type symptoms, so


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life and, as a result, some people may experience symptoms of low mood and stress. See your GP if: you think you have IBS type symptoms, so they can try to identify the cause you’re feeling anxious or experiencing a change in your mood as this can worsen IBS symptoms See your GP urgently if: You have other symptoms, including: a change in your bowel habits that has lasted for more than 6 weeks, especially if you are over 50 years of age unexplained weight loss a swelling or lump in your stomach or back passage bleeding from your back passage These can sometimes be a sign of a potentially more serious condition. You should also tell your GP if you have these symptoms and a family history of bowel cancer or ovarian cancer. Diagnosing IBS There are no specific tests for IBS. Many cases can be diagnosed based on your symptom history and your GP will undertake some routine blood and stool tests to rule out other conditions. As the symptoms of IBS are similar to other conditions such as


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GP will undertake some routine blood and stool tests to rule out other conditions. As the symptoms of IBS are similar to other conditions such as coeliac disease and inflammatory bowel disease, it is important to rule these out. It is important not to make any dietary changes until these tests have been done. This is particularly important for the blood test for coeliac disease as the result can be affected by your diet. Private allergy testing (for example hair sampling) is not a reliable way to test for allergies or intolerances. If you are concerned, please talk to your GP. Managing irritable bowel syndrome (IBS) Learn about things that can help IBS symptoms IBS and your mental health Learn about the link between IBS and mental health and what can help Irritable bowel syndrome (IBS) (BSL) What IBS is and how it’s treated in British Sign Language (BSL) NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions


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Language (BSL) 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 © 2025 NHS 24 – v1.1.1.17852


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Itchy bottom | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotland’s Service Directory 0 Home Illnesses and conditions Skin, hair and nails Itchy bottom Itchy bottom Itchy bottom is a strong urge to scratch the skin around your bottom (anus). The anus is the opening at the lower end of the digestive system, where solid waste leaves your body. Causes of itchy bottom The cause of itchy bottom isn’t always known. If it gets better quickly without treatment, it may be the result of a short term issue. For example, sweating more in hot weather. It’s rare for an itchy bottom alone to be a sign of something more serious. If an itchy bottom lasts longer, you may be able to get an idea of the cause from other symptoms you have. But, you should not self-diagnose. Speak to your GP if you’re worried. An itchy bottom that’s worse at night can be caused by threadworms. This is often the case for children. You can’t


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to your GP if you’re worried. An itchy bottom that’s worse at night can be caused by threadworms. This is often the case for children. You can’t take medicine for threadworms if you’re: pregnant breastfeeding a child under 2 This means you should speak to a GP, midwife or health visitor instead. Conditions with itchy bottom Sometimes an itchy bottom can be a symptom of another problem or condition. This includes: skin conditions like eczema or psoriasis – if you have itching elsewhere on the body too threadworms (especially in children) – symptoms will get worse at night and there will be worms in poo (they look like bits of thread) haemorrhoids (piles) – swellings in and around the anus, as well as pain and blood when pooing bowel incontinence or diarrhoea – can cause poo leaking or pooing you can not control sexually transmitted infection (STI) like genital warts – can cause sores, swelling and irritation ringworm – can cause sores, swelling and irritation Some long-term medications


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(STI) like genital warts – can cause sores, swelling and irritation ringworm – can cause sores, swelling and irritation Some long-term medications can also cause an itchy bottom. For example, steroid creams or peppermint oil. When to get help A pharmacist can often help to treat an itchy bottom. You can ask if they have a private area to discuss your symptoms. They can suggest treatments like: creams and ointments to relieve itching medication if the symptoms are caused by threadworms Find your nearest pharmacy Speak to your GP if: You have an itchy bottom that: doesn’t get better after 3 to 4 days keeps coming back makes you anxious or depressed affects your sleep is painful is accompanied by other symptoms, like itching elsewhere on your body You should also speak to a GP if your itchy bottom is caused by an underlying condition like piles. What to expect at your GP appointment Your GP might need to check your bottom (a rectal examination) to help find out what’s causing your


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like piles. What to expect at your GP appointment Your GP might need to check your bottom (a rectal examination) to help find out what’s causing your itching. You may feel awkward, but this is nothing to be embarrassed or worried about. It’s one of the most common examinations GPs carry out. At your appointment, your GP may ask: whether you use creams, powders or soaps around your bottom how long you have had the itching whether the itching gets worse at night or after eating certain foods if you have any other symptoms Your GP will decide on the best treatment for you depending on what’s causing your symptoms. They may suggest: things you can do yourself to ease an itchy bottom a stronger medication, cream or ointment How to ease an itchy bottom yourself Do use soft toilet tissue bath or shower daily have shorter, cooler showers and baths keep your bottom clean and dry wear loose-fitting cotton underwear change your underwear daily only put underwear on when your bottom is completely


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keep your bottom clean and dry wear loose-fitting cotton underwear change your underwear daily only put underwear on when your bottom is completely dry use a light duvet at night so you don’t get too hot gently wash and dry your bottom after pooing and before bed keep your fingernails short to stop your skin from being damaged by scratching wear cotton gloves while sleeping to avoid damaging the skin if you scratch wear stockings instead of tights eat foods with fibre (fruit, vegetables and wholegrains) to help produce regular, solid poo Don’t do not wear tight clothing do not use scented soaps, bubble bath or perfumes do not use scented powders near your bottom do not scratch if you can do not eat food or drink that makes your itching worse, for example caffeine, alcohol, citrus fruit or spicy foods Source: NHS 24 - Opens in new browser window Last updated: 13 January 2025 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Don’t include


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window Last updated: 13 January 2025 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Don’t 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 © 2025 NHS 24 – v1.1.1.17852


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Itchy skin | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotland’s Service Directory 0 Home Illnesses and conditions Skin, hair and nails Itchy skin Itchy skinItching is an unpleasant sensation that compels a person to scratch the affected area. Learn about causes and treatments of itching. About itchy skin Common causes of itchy skin, how to ease it and when to see your GP Causes of itchy skin Common causes of itchy skin, including allergies, skin conditions and other conditions Treatments for itchy skin The types of treatments available to help itchy skin 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 © 2025 NHS 24 – v1.1.1.17852


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https://www.nhsinform.scot/illnesses-and-conditions/muscle-bone-and-joints/conditions-that-can-affect-multiple-parts-of-the-body/joint-hypermobility/


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Joint hypermobility | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotland’s Service Directory 0 Home Illnesses and conditions Muscle, bone and joints Conditions that can affect multiple parts of the body Joint hypermobility Joint hypermobility About joint hypermobility Diagnosing and treating joint hypermobility Joint hypermobility means that some or all of a person’s joints have an unusually large range of movement. People with hypermobility are very supple. This means they’re able to move their limbs into positions others find impossible. Some people also refer to this as having loose joints or being double-jointed. Symptoms of joint hypermobility Many people with hypermobile joints don’t have any problems. For some people the extra flexibility may be a benefit. For example ballet dancers or gymnasts. But, some people with joint hypermobility can have symptoms like: pain and stiffness in the joints and


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For example ballet dancers or gymnasts. But, some people with joint hypermobility can have symptoms like: pain and stiffness in the joints and muscles clicking joints joints that dislocate (come out of the correct position) easily fatigue (extreme tiredness) recurrent injuries – like sprains digestive problems – like constipation and irritable bowel syndrome (IBS) dizziness and fainting thin or stretchy skin If you have these symptoms with hypermobility, this could be a sign of: hypermobile Ehlers Danlos Syndrome (hEDS) Hypermobility Spectrum Disorder (HSD) A person with hEDS or HSD may also have some other symptoms related to stretchiness in the connective tissues throughout their body. The severity can differ from one person to another. Digestive system problems hEDS or HSD can cause symptoms that affect your digestive system. This is because the connective tissue within your digestive system is more stretchy. This makes squeezing food either more difficult or quicker causing a


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is because the connective tissue within your digestive system is more stretchy. This makes squeezing food either more difficult or quicker causing a range of problems including: gastro-oesophageal reflux disease (GORD) gastroparesis – where the stomach has difficulty emptying its contents into the small bowel which can cause bloating and nausea constipation irritable bowel syndrome (IBS) Postural orthostatic tachycardia syndrome (POTS) hEDS or HSD can also cause abnormalities in the part of your nervous system that controls bodily functions you do not actively think about. These are things like your heart beating. This is known as your autonomic nervous system. These abnormalities can cause problems when you stand up or sit in the same position for a while. Your blood pressure can drop to low levels, making you feel sick, dizzy and sweaty. You may also faint. In some people, these abnormalities can lead to postural orthostatic tachycardia syndrome (POTS). POTS causes your pulse rate


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You may also faint. In some people, these abnormalities can lead to postural orthostatic tachycardia syndrome (POTS). POTS causes your pulse rate to increase rapidly within a few minutes of standing up. You may also experience: dizziness or fainting headaches tummy upsets sweating a sensation of anxiety purple puffy fingers and feet a pounding or fluttering heart beat (heart palpitations) Other problems People with hEDS or HSD may have other related conditions and further symptoms, including: stress incontinence – when urine leaks out when your bladder is under pressure hernias – where an internal part of the body, like an organ, pushes through a weakness in the muscle or surrounding tissue wall in women, pelvic organ prolapse – where the organs inside the pelvis slip down from their normal position varicose veins – swollen and enlarged veins, usually blue or dark purple flat feet – where the inner part of your feet (the arch) is not raised off the ground when you stand headaches


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veins, usually blue or dark purple flat feet – where the inner part of your feet (the arch) is not raised off the ground when you stand headaches drooping eyelids a tendency to bruise easily and develop stretch marks thin or stretchy skin Diagnosing joint hypermobility Your healthcare professional may use the Beighton score if they think you have joint hypermobility. This score can be used as a quick test to assess the range of movement in some of your joints. But, this cannot be used to confirm a diagnosis, because it’s important to look at all the joints and take into account a persons symptoms. The Beighton score does not include all the joints for example shoulders and hips. Your healthcare professional may also carry out blood tests and X-rays to rule out other conditions linked with joint pains like rheumatoid arthritis. The Beighton score The Beighton score consists of a series of 5 tests, the results of which can add up to a total of 9 points. The score is worked out as


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Beighton score The Beighton score consists of a series of 5 tests, the results of which can add up to a total of 9 points. The score is worked out as follows: 1 point if you can place your palms on the ground while standing with your legs straight 1 point for each elbow that bends backwards 1 point for each knee that bends backwards 1 point for each thumb that touches the forearm when bent backwards 1 point for each little finger that bends backwards beyond 90 degrees If your Beighton score is 4 or more, it’s likely that you have joint hypermobility. A person with hEDS or HSD may also have a number of other symptoms related to weaknesses in the connective tissues throughout their body. Causes of joint hypermobility Joint hypermobility is often hereditary (runs in families). One of the main causes is thought to be linked to changes in a type of protein called collagen. Collagen is found throughout the body. For example, its found in: skin ligaments (the tough bands of connective tissue


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of protein called collagen. Collagen is found throughout the body. For example, its found in: skin ligaments (the tough bands of connective tissue that link 2 bones together at a joint) If collagen is more stretchy and lax than it should be then the ligaments, tendons and muscles around the joints allow a greater range of movement. This means they also sometimes cannot keep the joints stable. There is no genetic test currently available for hEDS or HSD. It’s likely that more than one gene is involved. There are genetic tests for rarer forms of EDS. More information is available on the Ehlers-Danlos Support UK website. Treating joint hypermobility You won’t need treatment of your joint hypermobility if doesn’t cause any problems. But, you may need treatment and support if you have hEDS or HSD. These can cause a wide range of symptoms, including joint pain and digestive problems. Things you can do If you’re experiencing symptoms, there are some things you can do yourself that can help.


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joint pain and digestive problems. Things you can do If you’re experiencing symptoms, there are some things you can do yourself that can help. These include: eating a healthy diet and maintaining a healthy weight which can help improve your joint strength, reducing the strain on them trying to have good sleep routine (sleep hygiene) staying as active as you can, but sticking to low-impact exercises, like swimming, cycling, pilates or tai chi to reduce strain on your joints. wearing comfortable and supportive footwear to support your ankles using heat or ice can be a helpful pain treatment Our information on soft tissue injury can help your recovery if you have an injury to your soft tissues such as your muscles, tendons, joint or ligaments If doing exercises that have a specific focus on increasing flexibility such as yoga, be careful not to over stretch hypermobile areas. If you’re struggling with any of your symptoms you should contact your healthcare professional. There are also


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not to over stretch hypermobile areas. If you’re struggling with any of your symptoms you should contact your healthcare professional. There are also support groups you can contact that will offer support for people with hEDS or HSD: Hypermobility Syndromes Association Ehlers-Danlos Support UK Physiotherapy and exercise Physiotherapy can help people with hypermobile joints in many ways. For example, it may help to: reduce pain improve muscle strength and fitness improve posture improve your sense of your body’s position and movement (proprioception) correct the movement of individual joints It’s helpful to have a physiotherapist with knowledge of hEDS or HSD, as some physiotherapy treatments can make symptoms worse. A wide range of physiotherapy techniques can be used. You may be advised to follow an exercise programme that includes: strength and balance training special stretching techniques advice about pacing Pacing involves balancing periods of activity with periods of rest. It


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and balance training special stretching techniques advice about pacing Pacing involves balancing periods of activity with periods of rest. It means not overdoing it or pushing yourself beyond your limits. If you do push yourself too hard, you could slow your long-term progress. Occupational therapy Occupational therapy aims to help you overcome difficulties in your everyday life caused by having hEDS or HSD. This may involve teaching you alternative ways of carrying out a certain task. For example, an occupational therapist can give you advice about: reducing the strain on your joints while using a computer getting dressed suggest ways to adapt your home to make moving around easier like if using stairs is a problem You may also be able to get equipment to make some tasks easier. For example, special grips can make holding a pen easier and help improve handwriting. Podiatry Flat feet can be a problem for some people with hEDS or HSD. Flat feet is where someone has no arch in the inner


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help improve handwriting. Podiatry Flat feet can be a problem for some people with hEDS or HSD. Flat feet is where someone has no arch in the inner part of their feet. This can put a strain on nearby muscles and ligaments (tissue that connects bones together at a joint). If you have problems with your feet, a podiatrist (a foot specialist) can recommend footwear for both indoors and outdoors. These will support the foot arches and can help with foot, knee, hip and back pain. They can recommend footwear and insoles if necessary. Painkillers Medication can be used to manage the pain associated with hEDS or HSD. Painkillers available over the counter from pharmacies, like paracetamol, can sometimes help. Your GP can also prescribe a medicine that contains both paracetamol and codeine, which is a stronger type of painkiller. Liquid paracetamol (like Calpol) may be helpful for children with hEDS or HSD. Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen may help in some


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(like Calpol) may be helpful for children with hEDS or HSD. Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen may help in some cases. Painkillers and NSAIDs are also available as gels or sprays that can be applied directly onto painful joints. Always check the patient information leaflet that comes with over-the-counter medication. This is so you’re sure its suitable for you before you take it. Some people with hEDS or HSD may find pain medication is not effective for them. Some people with hEDS or HSD have said that local anaesthetic has not had any effect on them. If you are having a procedure that requires local anaesthetic, you may want to discuss this with your doctor or dentist beforehand. Pain management If painkillers are not helping to reduce your pain, you may benefit from being referred to a pain specialist at a pain clinic. Staff at the clinic will be able to provide further advice and treatment. For example, some people with hEDS or HSD benefit from


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at a pain clinic. Staff at the clinic will be able to provide further advice and treatment. For example, some people with hEDS or HSD benefit from cognitive behavioural therapy (CBT). CBT is a pain management programme that may help when painkillers are not working. Pain specialists may also give you stronger medication used to treat nerve (neuropathic) pain. These drugs should only be continued if there are clear benefits. This type of pain is often called chronic pain. 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’t 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


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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 © 2025 NHS 24 – v1.1.1.17852


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Kaposi's sarcoma | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotland’s Service Directory 0 Home Illnesses and conditions Cancer Cancer types in adults Kaposi’s sarcoma Kaposi’s sarcoma Kaposi’s sarcoma is a rare type of cancer caused by a virus. It can affect the skin and internal organs. It’s mainly seen in people with a poorly controlled or severe HIV infection. It can also affect some people who have a weakened immune system for another reason, as well as people who have a genetic vulnerability to the virus. Signs and symptoms The most common initial symptom is the appearance of small, painless, flat and discoloured patches on the skin or inside the mouth. They’re usually red or purple and look similar to bruises. Over time, the patches may grow into lumps known as nodules and may merge into each other. Internal organs can also be affected, including the lymph nodes, lungs and the digestive system,


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known as nodules and may merge into each other. Internal organs can also be affected, including the lymph nodes, lungs and the digestive system, which can cause symptoms such as: uncomfortable swelling in the arms or legs (lymphoedema) breathlessness, coughing up blood and chest pain nausea, vomiting, stomach pain and diarrhoea The rate at which symptoms progress depends on the type of Kaposi’s sarcoma you have. Most types get worse quickly in a matter of weeks or months without treatment, but some progress very slowly over many years. When to seek medical advice You should speak to your GP if you have any worrying symptoms you think could be caused by Kaposi’s sarcoma. If you have HIV, you can also contact your local HIV clinic if you have any concerns. Your doctor will ask about your symptoms and examine your skin to look for the characteristic discoloured patches. If they suspect Kaposi’s sarcoma, they will refer you for further tests to confirm the diagnosis. These tests may


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characteristic discoloured patches. If they suspect Kaposi’s sarcoma, they will refer you for further tests to confirm the diagnosis. These tests may include: an HIV test – a blood test to confirm whether or not you have HIV (if you haven’t already been diagnosed with the condition) a skin biopsy – where a small sample of cells is removed from an affected area of skin and checked for Kaposi’s sarcoma cells an endoscopy – where a thin, flexible tube called an endoscope is passed down your throat to see if your lungs or digestive system are affected a computerised tomography (CT) scan to see if your lymph nodes or other parts of your body are affected What causes Kaposi’s sarcoma? Kaposi’s sarcoma is caused by a virus called the human herpesvirus 8 (HHV-8), also known as the Kaposi’s sarcoma-associated herpesvirus (KSHV). This virus is thought to be spread during sex, through saliva, or from a mother to her baby during birth. HHV-8 is a relatively common virus and the vast majority of


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to be spread during sex, through saliva, or from a mother to her baby during birth. HHV-8 is a relatively common virus and the vast majority of people who have it will not develop Kaposi’s sarcoma. It only seems to cause cancer in some people with a weakened immune system and in some people who have a genetic vulnerability to the virus. A weakened immune system allows the HHV-8 virus to multiply to high levels in the blood, which increases the chance it will cause Kaposi’s sarcoma. The virus appears to alter the genetic instructions that control cell growth. This means some cells reproduce uncontrollably and form lumps of tissue known as tumours. Types of Kaposi’s sarcoma and their treatment There are 4 main types of Kaposi’s sarcoma. These types affect different groups of people and are treated in different ways. HIV-related Kaposi’s sarcoma Although it’s not as common as it used to be, Kaposi’s sarcoma is still one of the main types of cancer to affect people with HIV. HIV-related


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Although it’s not as common as it used to be, Kaposi’s sarcoma is still one of the main types of cancer to affect people with HIV. HIV-related Kaposi’s sarcoma can progress very quickly if not treated. However, it can usually be controlled by taking HIV medication – known as combination antiretroviral therapy (cART) – to prevent HIV multiplying and allow the immune system to recover. The immune system can then reduce the levels of HHV-8 in the body. Read more about treating HIV. Some people may also require treatment with radiotherapy (where high-energy rays are used to destroy cancer cells) or chemotherapy (where powerful medications are used to destroy cancer cells), depending on the site and extent of the cancer and what symptoms it’s causing. Classic Kaposi’s sarcoma Classic Kaposi’s sarcoma mainly affects middle-aged and elderly men of Mediterranean or Ashkenazi Jewish descent. Ashkenazi Jews are descended from Jewish communities that lived in central and eastern Europe. Most


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men of Mediterranean or Ashkenazi Jewish descent. Ashkenazi Jews are descended from Jewish communities that lived in central and eastern Europe. Most Jewish people in the UK are Ashkenazi Jews. It’s thought people who develop classic Kaposi’s sarcoma were born with a genetic vulnerability to the HHV-8 virus. Unlike the other types of Kaposi’s sarcoma, the symptoms of classic Kaposi’s sarcoma progress very slowly over many years and are usually limited to the skin. Immediate treatment isn’t usually required because, in many cases, the condition doesn’t affect life expectancy. You’ll usually be monitored carefully and only treated if the symptoms get significantly worse. Radiotherapy is often used if treatment is required, although small skin patches or nodules may be removed using minor surgery or cryotherapy (freezing). Transplant-related Kaposi’s sarcoma Transplant-related Kaposi’s sarcoma is a rare complication of an organ transplant. It occurs because the immunosuppressant


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Kaposi’s sarcoma Transplant-related Kaposi’s sarcoma is a rare complication of an organ transplant. It occurs because the immunosuppressant medication used to weaken the immune system and help prevent the body rejecting the new organ can allow a previous HHV-8 infection to reactivate, which means levels of the virus increase as it starts multiplying again. Transplant-related Kaposi’s sarcoma can be aggressive and usually needs to be treated quickly. It’s normally treated by reducing or stopping the immunosuppressants, if this is possible. If this is unsuccessful, radiotherapy or chemotherapy may be used. Endemic African Kaposi’s sarcoma Endemic African Kaposi’s sarcoma is common in parts of Africa and is one of the most widespread types of cancer in that region. Although this type of Kaposi’s sarcoma is classified separately from HIV-related Kaposi’s sarcoma, many cases may actually result from an undiagnosed HIV infection. All suspected cases therefore must have an HIV test, as the


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Kaposi’s sarcoma, many cases may actually result from an undiagnosed HIV infection. All suspected cases therefore must have an HIV test, as the most effective treatment in these cases is HIV medication. In cases not caused by HIV infection, this type of Kaposi’s sarcoma may be the result of a genetic vulnerability to HHV-8. These cases are usually treated with chemotherapy, although sometimes radiotherapy may be used. Outlook With proper treatment, Kaposi’s sarcoma can usually be controlled for many years. Deaths from the condition are uncommon in the UK. The discoloured patches of skin will often shrink and fade with treatment, although they may not ever disappear completely. A complete cure for any type of Kaposi’s sarcoma isn’t always possible, and there’s a chance the condition could recur in the future. If you think this is happening, contact your HIV clinic, hospital specialist or GP as soon as possible. Source: NHS 24 - Opens in new browser window Last updated: 14 October 2024


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contact your HIV clinic, hospital specialist or GP as soon as possible. Source: NHS 24 - Opens in new browser window Last updated: 14 October 2024 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Don’t 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 Cancer Research UK: Kaposi's sarcoma Macmillan Cancer Support: Kaposi's sarcoma 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 © 2025 NHS 24 – v1.1.1.17852


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Kidney cancer | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotland’s Service Directory 0 Home Illnesses and conditions Cancer Cancer types in adults Kidney cancer Kidney cancer About kidney cancer Symptoms of kidney cancer Causes and risk factors of kidney cancer Diagnosing kidney cancer Treating kidney cancer Preventing kidney cancer About kidney cancer Kidney cancer is the eighth most common cancer in adults in the UK. Signs and symptoms of kidney cancer can include: blood in your urine a constant pain in your side, just below the ribs a lump or swelling in the kidney area (on either side of the body) Speak to your GP as soon as possible if you experience any of these symptoms. They will examine you and may refer you to a specialist clinic for further tests. In around half of all cases of kidney cancer, there are no symptoms, and the condition is detected during tests for other unrelated conditions.


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In around half of all cases of kidney cancer, there are no symptoms, and the condition is detected during tests for other unrelated conditions. Read more about the symptoms of kidney cancer and diagnosing kidney cancer. The kidneys and cancer The kidneys are 2 bean-shaped organs located on either side of the body, just underneath the ribcage. Their main role is to filter out waste products from the blood, in addition to producing urine. Only 1 of the kidneys is usually affected by cancer. The human body is made up of billions of cells, which normally grow and multiply in an orderly way, with new cells being created only when and where they’re needed. In cancer, this orderly process goes wrong and cells begin to grow and multiply uncontrollably. Exactly what triggers this growth is unknown. However, there are certain risk factors that can increase the chances of the condition developing, such as smoking and obesity. Kidney cancer most frequently affects people over 50 years of age and


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increase the chances of the condition developing, such as smoking and obesity. Kidney cancer most frequently affects people over 50 years of age and is more common among men. Read more about the causes of kidney cancer. Types of kidney cancer Many different types of cancer can affect the kidneys. The most common type is renal cell carcinoma (RCC), which accounts for more than 80% of all kidney cancers. Rarer types of kidney cancer include: transitional cell cancer – develops in the lining of the kidneys and usually affects men who are 50 years of age or over Wilms’ tumour – a rare type of kidney cancer that affects children This topic focuses on RCC. Read the Cancer Research UK website for more information about transitional cell cancer and Wilms’ tumour. Treating kidney cancer The earlier kidney cancer is diagnosed, the easier it is to treat. How it’s treated will depend on the size and spread of the cancer. Surgery to remove the cancerous cells is usually the first course of action.


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How it’s treated will depend on the size and spread of the cancer. Surgery to remove the cancerous cells is usually the first course of action. Unlike most other cancers, chemotherapy isn’t very effective at treating kidney cancer. However, non-surgical treatments are available, such as radiotherapy or targeted therapies. These are most commonly used in the more advanced stages of kidney cancer, when the cancer has spread beyond the kidney. Read more about treating kidney cancer. Preventing kidney cancer As the causes of kidney cancer aren’t fully understood, it’s not possible to fully prevent it. However, leading a healthy lifestyle may reduce the chances of developing the condition. A combination of a healthy diet and regular exercise will help to avoid becoming overweight or obese, which is a significant risk factor for kidney cancer. If you’re overweight or obese, you can lose weight and maintain a healthy weight by combining regular exercise with a calorie-controlled diet. Read


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If you’re overweight or obese, you can lose weight and maintain a healthy weight by combining regular exercise with a calorie-controlled diet. Read more about treating obesity. Symptoms of kidney cancer Most cases of kidney cancer don’t cause any symptoms in the early stages. The most common symptoms of mid- to advanced-stage kidney cancer are: blood in your urine (haematuria) – the amount of blood is usually high enough to change the colour of your urine to a reddish or dark brown colour a persistent pain in your side, just below the ribs a lump or swelling in the area of your kidneys (on either side of the body) However, in around half of all cases, the cancer causes no symptoms and is only detected during a routine ultrasound scan. Less common symptoms of kidney cancer include: extreme tiredness (fatigue) or anaemia unintentional weight loss a high temperature of 38C (100.4F) or above night sweats a general sense of feeling unwell swelling of the veins in the testicles (in men)


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loss a high temperature of 38C (100.4F) or above night sweats a general sense of feeling unwell swelling of the veins in the testicles (in men) loss of appetite high blood pressure (hypertension) When to seek medical advice Speak to your GP immediately if you have pain or a swelling or lump in your kidney area (on either side of your body, just below your ribcage). You should also speak to your GP if you have blood in your urine. Although it’s highly unlikely to be caused by kidney cancer, it could be a symptom of a less serious condition that still requires treatment, such as a kidney stone or bladder stone. Causes and risk factors of kidney cancer The exact cause of kidney cancer is unknown, but there are risk factors that can increase the chances of developing the condition. The 3 main risk factors for kidney cancer are: obesity smoking family history and genetics Obesity Obesity is a significant risk factor for kidney cancer. There’s a strong link between someone’s body mass index


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family history and genetics Obesity Obesity is a significant risk factor for kidney cancer. There’s a strong link between someone’s body mass index (BMI) and their risk of developing kidney cancer. Read more about how BMI is calculated, and work out your BMI. A BMI score of 25 or above has been shown to increase a person’s chances of developing kidney cancer. Those with a BMI score of 30 or above are at particularly high risk. This may be because overweight or obese people, particularly women, have higher levels of a hormone called oestrogen in their body. It’s thought that excess levels of oestrogen may stimulate the growth of cancerous cells. Cases of kidney cancer have been increasing over the last 40 years, which has been linked to rising obesity levels. Smoking Smoking is also a significant risk factor for developing kidney cancer, and the more you smoke the greater the risk. For example, research has shown that if you regularly smoke 10 cigarettes a day, you’re one-and-a-half


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and the more you smoke the greater the risk. For example, research has shown that if you regularly smoke 10 cigarettes a day, you’re one-and-a-half times more likely to develop kidney cancer compared to a non-smoker. This increases to twice as likely if you smoke 20 or more cigarettes a day. It’s not clear why smoking increases your chances of developing kidney cancer. Family history and genetics If you have a close family member (parents, brothers, sisters or a child) who’s been diagnosed with kidney cancer, you’re about twice as likely to develop kidney cancer yourself. Examples of inherited genetic conditions and syndromes that increase your risk of developing kidney cancer include: tuberous sclerosis – a rare genetic condition that causes multiple non-cancerous (benign) tumours to grow in the body; it’s autosomal dominant, which means you only have to inherit the faulty gene from one parent to get it; about 1 in every 100 people with tuberous sclerosis will develop kidney cancer


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you only have to inherit the faulty gene from one parent to get it; about 1 in every 100 people with tuberous sclerosis will develop kidney cancer hereditary papillary kidney cancer – a rare form of cancer caused by faulty genes inherited from your parents; it’s autosomal dominant and causes small, slow-growing, cancerous tumours to develop in the kidneys, which can sometimes spread hereditary leiomyomatosis and renal cell carcinoma (HLRCC) – a rare, autosomal dominant form of cancer, where cancerous tumours develop from smooth muscle tissue (leiomyomatas); people with HLRCC have a 10 to 16% increased risk of developing kidney cancer Von Hippel-Lindau syndrome – a rare genetic syndrome that causes small non-cancerous tumours to develop inside the nervous system; VHL is also autosomal dominant and about 4 out of 10 people who have it develop kidney cancer Birt-Hogg-Dubé syndrome – an inherited syndrome that causes non-cancerous tumours to develop in the hair follicles of the skin; they


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kidney cancer Birt-Hogg-Dubé syndrome – an inherited syndrome that causes non-cancerous tumours to develop in the hair follicles of the skin; they usually occur on the face, neck and torso Other possible risk factors There are also a number of other possible risk factors for developing kidney cancer, including: mild painkillers – some mild painkillers have been linked to an increased risk of developing kidney cancer; NSAIDs, such as ibuprofen, may slightly increase the risk, although occasional use or low doses are unlikely to be harmful kidney disease – if you have kidney failure and need to have regular dialysis (treatment to replicate the functions of the kidneys), your risk of developing kidney cysts and kidney cancer is increased high blood pressure (hypertension) – high blood pressure is a known risk factor for kidney disease, and you’re up to twice as likely to develop kidney cancer if you have raised blood pressure Diagnosing kidney cancer In many cases, kidney cancer is


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and you’re up to twice as likely to develop kidney cancer if you have raised blood pressure Diagnosing kidney cancer In many cases, kidney cancer is diagnosed after routine scans and check-ups, as the condition doesn’t always have obvious symptoms. You should speak to your GP if you have any symptoms of kidney cancer, such as blood in your urine or a constant pain below your ribs. Your GP will examine you and, if they think your symptoms need further assessment, refer you to a specialist urologist (a doctor who specialises in conditions that affect the urinary tract). If you notice blood in your urine, your GP will usually carry out a blood test and take a urine sample. The results will help rule out other possible causes, such as infection or kidney stones. In 2015, the National Institute for Health and Care Excellence (NICE) published guidelines to help GPs recognise the signs and symptoms of renal (kidney) cancer and refer people for the right tests faster. To find out if you


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guidelines to help GPs recognise the signs and symptoms of renal (kidney) cancer and refer people for the right tests faster. To find out if you should be referred for further tests for suspected kidney cancer, read the NICE 2015 guidelines on Suspected Cancer: Recognition and Referral. If you need to be referred urgently, you’ll usually be seen within 2 weeks. Further tests If your GP refers you to a hospital specialist, further tests will help determine whether you have kidney cancer. Ultrasound scan An ultrasound scan uses high-frequency sound waves to create an image of an organ in the body. It can often detect changes in the shape of the kidney that might be caused by a cancerous tumour. An ultrasound scan may be needed if the cause of the blood in your urine can’t be found. Computerised tomography scan You may also be referred for a computerised tomography (CT) scan. During a CT scan, a series of detailed images of the inside of your body are taken and put together by a


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for a computerised tomography (CT) scan. During a CT scan, a series of detailed images of the inside of your body are taken and put together by a computer. If you have a CT scan, you may be given a special dye to drink, or it may be injected. The dye makes the results of the CT scan clearer. Image-guided biopsy In some cases of kidney cancer, an image-guided biopsy is carried out. It’s a minor surgical procedure performed under local anaesthetic. This means you’ll be awake during the procedure, but the area surrounding the affected kidney will be numbed, so that you don’t feel anything. During an image-guided biopsy, a radiologist or surgeon will use an ultrasound or CT scan to guide a needle through your skin and into your kidney. A small tissue sample will be removed from your kidney and examined under a microscope to check for cancerous cells. Magnetic resonance imaging (MRI) scan You may also need to have a magnetic resonance imaging (MRI) scan, which can be used to produce


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cells. Magnetic resonance imaging (MRI) scan You may also need to have a magnetic resonance imaging (MRI) scan, which can be used to produce detailed images of your kidneys. The images can help identify a tumour and determine its size. Cystoscopy A cystoscopy is a medical procedure that uses an instrument called a cystoscope to examine the inside of your bladder and urinary system. This procedure doesn’t look at the kidneys, but it can rule out or confirm whether any bleeding is coming from problems in the bladder. Intravenous pyelogram (IVP) An intravenous pyelogram (IVP) test involves injecting a dye into your bloodstream. X-rays are taken after a short time, with the dye highlighting any growths present in the kidneys. Staging and grading If kidney cancer is confirmed, it’s usually possible to determine its grade and stage. The stage describes how far the cancer has spread, and the grade describes how aggressive the cancer is and how quickly it’s likely to spread. Both the stage


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describes how far the cancer has spread, and the grade describes how aggressive the cancer is and how quickly it’s likely to spread. Both the stage and grade of your kidney cancer will help determine your recommended treatment and the likelihood of achieving a cure. Healthcare professionals use the TNM system to stage kidney cancer: T – indicates how large the tumour has grown (a tumour is a lump of cancerous tissue) N – indicates whether nearby lymph nodes are affected (lymph nodes are small, oval-shaped glands found throughout the body, which help protect against infection) M – indicates whether the cancer has spread to another part of the body (M stands for metastases, which is the medical term for cancer that has spread) The stages of tumour size are: T1a – where the tumour is less than 4cm (about 1.6 inches) in diameter T1b – where the tumour is 4 to 7cm (about 1.6-2.8 inches) in diameter T2 – where the tumour is larger than 7cm (2.8 inches) in diameter, but hasn’t spread out of


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the tumour is 4 to 7cm (about 1.6-2.8 inches) in diameter T2 – where the tumour is larger than 7cm (2.8 inches) in diameter, but hasn’t spread out of the kidney T3a – where the tumour has spread into the adrenal gland or the layer of fat surrounding the kidney T3b – where the tumour has spread into the renal vein (the vein that carries blood back from the kidney to the heart) or into the vena cava (the vein that carries blood back from the top half of the body) T3c – where the tumour has spread past the diaphragm (the sheet of muscle that separates the top part of the abdomen from the bottom part) T4 – where the tumour has spread beyond the tough layer of tissue that surrounds and protects the kidney There are 3 lymph node stages: N0 – where no lymph nodes have been affected N1 – where there are cancer cells in 1 lymph node N2 – where there are cancer cells in 2 or more lymph nodes M0 means that the cancer hasn’t spread to another part of the body. M1 means that the cancer has spread.


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are cancer cells in 2 or more lymph nodes M0 means that the cancer hasn’t spread to another part of the body. M1 means that the cancer has spread. Kidney cancer is graded using a scale of one to four. The higher the grade, the more aggressive the cancer. Coping with cancer Being diagnosed with cancer can be very distressing, particularly if it’s incurable. The news can often be difficult to take in and comprehend. After cancer has been diagnosed, you may find that talking to a counsellor or psychiatrist helps you deal with feelings of depression and anxiety. Antidepressants may also be used to help you through this process. Read more about coping with a cancer diagnosis. More information can be found on our pages about living with cancer. Treating kidney cancer The treatment of kidney cancer depends on the size and spread of the cancer. Surgery is the most common first course of action, with the aim of removing the cancer cells. Unlike most other cancers, chemotherapy isn’t very


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Surgery is the most common first course of action, with the aim of removing the cancer cells. Unlike most other cancers, chemotherapy isn’t very effective in treating kidney cancer. However, there are non-surgical treatments available, such as radiotherapy or targeted drug therapies. The main treatments for kidney cancer include: nephrectomy embolisation radiotherapy targeted therapies immunotherapy Your treatment plan You can expect to be cared for by a multidisciplinary team, often comprising a specialist cancer surgeon, an oncologist (who specialises in radiotherapy and chemotherapy), a radiologist, a nephrologist (a kidney specialist) and a specialist nurse. You’ll be given a key worker, usually the specialist nurse, who will be responsible for coordinating your care. Your team will recommend what they think is the best treatment option, but the final decision will be yours. When deciding what treatment is best for you, your doctors will consider: the stage and grade of your


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option, but the final decision will be yours. When deciding what treatment is best for you, your doctors will consider: the stage and grade of your cancer (how big it is and how far it’s spread) your age and general health If the cancer hasn’t spread out of your kidney (T1 or T2 kidney cancer), it can usually be cured by removing some or all of the kidney. If the cancer has spread out of your kidney (T3 or T4 kidney cancer), a complete cure may not be possible. However, it should be possible to slow the cancer’s progression and treat any symptoms. Surgical treatments Nephrectomy A nephrectomy is an operation to remove a kidney. If the tumour is less than 4cm (1.5 inches) in diameter, it may only be necessary to remove some of your kidney. This is known as a partial nephrectomy. A partial nephrectomy may also be required if your remaining kidney is in poor health. If the tumour is more than 4cm in diameter, your entire kidney will need to be removed. Even if the cancer has spread


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kidney is in poor health. If the tumour is more than 4cm in diameter, your entire kidney will need to be removed. Even if the cancer has spread beyond your kidney, you may still benefit from having your kidney removed. Removing the kidney can help resolve the pain, and make other types of non-surgical treatment more effective. It’s possible to live a normal life with only 1 kidney, because the other kidney will be able to compensate. During a nephrectomy, the surgeon may also remove nearby lymph nodes to make sure the cancer hasn’t spread beyond the kidney. There are 2 ways that both a partial and open nephrectomy can be performed They are an: open nephrectomy – where the kidney is removed through a large incision in your abdomen (stomach) laparoscopic or keyhole nephrectomy – where a series of smaller incisions are made in your abdomen, and the kidney is removed using small surgical instruments Both techniques have advantages and disadvantages. A laparoscopic nephrectomy has a


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and the kidney is removed using small surgical instruments Both techniques have advantages and disadvantages. A laparoscopic nephrectomy has a considerably quicker recovery time than an open nephrectomy. However, the procedure requires surgeons with specialised training, so you may have to wait longer to receive treatment than you would if you decided to have an open nephrectomy. Some types of kidney cancer, where the tumour is located in the centre of the kidney, may not be suitable for a laparoscopic nephrectomy. One of the main disadvantages of an open nephrectomy is that it’s a major surgical procedure that can place a considerable strain on the body. This means it may not be suitable for people who are particularly frail or unwell. You should discuss the pros and cons of both procedures with your surgical team. Embolisation If you’re unable to have a nephrectomy, you may benefit from an alternative operation known as embolisation. During embolisation, the surgeon will insert a


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unable to have a nephrectomy, you may benefit from an alternative operation known as embolisation. During embolisation, the surgeon will insert a small tube called a catheter into your groin, then use X-ray images to guide the catheter into the blood supply of your kidney. A substance will then be injected through the catheter to block the blood supply to your kidney. By blocking blood supply to the kidney, any tumours that are present will become starved of oxygen and nutrients, causing them to shrink. Non-surgical treatments for advanced kidney cancer Kidney cancer is one of the few types of cancer that’s less responsive to chemotherapy (where powerful medication is used to kill cancerous cells). However, a number of clinical trials are underway that are looking at new combinations of chemotherapy medications that appear to be benefiting some people. There are also a number of different non-surgical treatments that can slow the spread of the cancer and help control its symptoms.


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some people. There are also a number of different non-surgical treatments that can slow the spread of the cancer and help control its symptoms. Radiotherapy Radiotherapy can’t usually cure kidney cancer, but it can slow down its progress and help reduce pain. You should only need a few minutes of radiotherapy every day, for a number of days. When radiotherapy is used to control the symptoms of cancer rather than cure it, the side effects tend to be mild. Possible side effects may include fatigue (tiredness), nausea and vomiting. Cryotherapy Cryotherapy involves killing cancer cells by freezing them. It may be used if a person isn’t fit enough for surgery, or if their tumour is small. Cryotherapy is usually classed as either percutaneous (where needles are passed through the skin) or laparoscopic (where needles are placed directly into the kidney through a small incision). Side effects include bleeding around the kidney and injury to the tube that carries urine from the kidney to the


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kidney through a small incision). Side effects include bleeding around the kidney and injury to the tube that carries urine from the kidney to the bladder (the ureter). Radiofrequency ablation Radiofrequency ablation (RFA) uses heat generated by radio waves to kill cancer cells. This is a percutaneous treatment, meaning no incision is needed. This treatment is only available at specialist centres. It’s mainly used if you’re not strong enough for surgery or your kidney cancer is in the early stages. RFA can’t be used if the cancer is too close to other organs, such as the bowel. Side effects include bleeding in the treatment area, a collection of blood (haematoma) near the kidney, and problems passing urine due to the narrowing of the tube that joins the kidney to the bladder (the ureter). Targeted therapies A number of new medicines have been developed for the treatment of kidney cancer. These are: sunitinib pazopanib axitinib sorafenib temsirolimus everolimus bevacizumab These


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have been developed for the treatment of kidney cancer. These are: sunitinib pazopanib axitinib sorafenib temsirolimus everolimus bevacizumab These medicines are sometimes referred to as targeted therapies because they’re designed to target and interrupt the functions needed by cancer to grow and spread. At present, only sunitinib, pazopanib and axitinib have been recommended by the National Institute for Health and Care Excellence (NICE). They’re available on the NHS for people who are still relatively healthy and have advanced kidney cancer, or kidney cancer that’s spread to other parts of their body. Sorafenib, temsirolimus, everolimus and bevacizumab aren’t currently recommended by NICE. Sunitinib Sunitinib is the most commonly prescribed treatment for kidney cancer. It’s a type of medication known as a tyrosine kinase inhibitor. Tyrosine kinase is an enzyme (protein) that helps cancer cells to grow. Sunitinib works by blocking protein kinase, stopping cancer from growing.


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Tyrosine kinase is an enzyme (protein) that helps cancer cells to grow. Sunitinib works by blocking protein kinase, stopping cancer from growing. Sunitinib is taken as a capsule with or without food. You take it once a day for 4 weeks before having a 2-week break. This 6-week cycle is repeated for as long as the treatment is effective. It’s very important that you take sunitinib in the exact dosage that’s been prescribed for you. Never stop taking medication for cancer without first consulting your specialist. Common side effects of sunitinib include: nausea diarrhoea high blood pressure (hypertension) hair discolouration mouth soreness skin discolouration skin rashes or blisters The Cancer Research UK website has more information about sunitinib and its side effects. Pazopanib Like sunitinib, pazopanib is a tyrosine kinase inhibitor that can be used to slow down or stop the growth of cancer cells in the kidneys. It also prevents cancer cells from developing blood vessels, which they


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can be used to slow down or stop the growth of cancer cells in the kidneys. It also prevents cancer cells from developing blood vessels, which they need to grow. Pazopanib is taken as a tablet once a day with a glass of water. You should take it about the same time each day, either at least an hour before eating or 2 hours afterwards. It’s important that you take it in the exact dosage that your specialist has prescribed for you. Common side effects of pazopanib include: nausea diarrhoea high blood pressure hair discolouration abnormal liver function The Cancer Research UK website has more information about pazopanib. Axitinib Axitinib may be recommended for treating advanced kidney cancer if sunitinib and/or pazopanib have stopped working or haven’t been effective. Like sunitinib and pazopanib, axitinib is a tyrosine kinase inhibitor that blocks tyrosine kinase and stops cancer growing. Axitinib is taken as a tablet with a glass of water twice a day, about 12 hours apart. Your


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that blocks tyrosine kinase and stops cancer growing. Axitinib is taken as a tablet with a glass of water twice a day, about 12 hours apart. Your specialist may start you on a low dose which, depending on how you feel, may be increased after 2 weeks. It’s very important that you take the exact dose that’s been prescribed for you. Common side effects of axitinib include: diarrhoea nausea and vomiting loss of appetite tiredness a decrease in thyroid hormone level (hypothyroidism) headaches weight loss loss of fertility The Cancer Research UK website has more information about axitinib. Sorafenib Sorafenib is another tyrosine kinase inhibitor that blocks the protein, tyrosine kinase, which encourages cancer cells to grow. It also prevents cancer cells from developing blood vessels which they need to grow. Sorafenib is taken as a tablet twice a day (at the same time each day) with a glass of water. It can also be taken with a meal, but make sure the food is low-fat, because high-fat foods


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a day (at the same time each day) with a glass of water. It can also be taken with a meal, but make sure the food is low-fat, because high-fat foods make it less effective. Again, it’s very important that you take sorafenib as instructed by your doctor at the exact dosage prescribed for you. Common side effects of sorafenib include: diarrhoea fatigue nausea and vomiting hair thinning (in around one in four people) increased risk of bleeding – such as nosebleeds or bleeding gums loss of fertility flushed skin The Cancer Research UK website has more information about sorafenib. Temsirolimus Temsirolimus is sometimes used to treat advanced kidney cancer. It’s a type of medication known as an mTOR inhibitor, which blocks a protein called mTOR, that’s usually active in cancer cells, making them reproduce and multiply. Temsirolimus also prevents blood vessels from developing, which cancer cells need to grow. Temsirolimus is a liquid that’s delivered directly into the bloodstream, either


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blood vessels from developing, which cancer cells need to grow. Temsirolimus is a liquid that’s delivered directly into the bloodstream, either through a tube that’s put into a vein in your arm (catheter), or a tube into a large vein in your chest (a central line). The treatment takes 30 to 60 minutes and you have it once a week in hospital. Before each dose, an antihistamine is usually given to prevent an allergic reaction. Common side effects of temsirolimus include: red, dry, itchy skin nausea and vomiting lack of appetite diarrhoea a sore mouth or mouth ulcers sleeping problems loss of fertility Everolimus Everolimus is a medication for advanced kidney cancer that’s returned during or following treatment. It stops some of the signals produced within cells that make them grow and divide. Everolimus prevents the mTOR protein from working properly, which plays an important role in the growth of cancer cells. Everolimus is taken as a tablet once a day at the same time each day. It


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properly, which plays an important role in the growth of cancer cells. Everolimus is taken as a tablet once a day at the same time each day. It should be swallowed whole with a glass of water, rather than being chewed or crushed. It can be taken with or without food. It’s very important that everolimus is taken using the exact dosage and method prescribed. Common side effects of everolimus include: a sore mouth tiredness a rash or itchy, dry skin loss of appetite nausea and vomiting a lack of periods in women (this may be temporary) loss of fertility The Cancer Research UK website has more information about everolimus. Immunotherapy As well as medications that prevent, disrupt and slow down the growth and development of kidney cancer (kinase and mTOR inhibitors), there are also treatments that work by encouraging the immune system to attack cancer cells. This type of treatment is known as immunotherapy. Bevacizumab is a medication that’s given intravenously (into a vein, through a


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attack cancer cells. This type of treatment is known as immunotherapy. Bevacizumab is a medication that’s given intravenously (into a vein, through a drip). It blocks a protein called endothelial growth factor (VEGF), which helps cancer to grow. Bevacizumab is usually used in combination with an immunotherapy treatment called interferon. Interferon is taken as an injection just under the skin (subcutaneously), three times a week. It encourages your immune system to attack and destroy the cancer cells. Another medication called aldesleukin is sometimes used to treat kidney cancer that’s spread. It’s similar to a natural protein the body produces called interleukin-2 (IL-2), which is part of the immune system. IL-2 activates lymphocytes (a type of white blood cell), which fight illnesses and infections. Aldesleukin works in a number of ways. It interferes with how cancer cells grow and multiply, it stimulates the immune system into attacking cancer cells, and it makes cancer cells send


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It interferes with how cancer cells grow and multiply, it stimulates the immune system into attacking cancer cells, and it makes cancer cells send out chemicals that attract immune system cells. Like interferon, aldesleukin is usually given as a subcutaneous injection. Immunotherapy treatments are now rarely used to treat advanced kidney cancer. This is because targeted therapies tend to be more effective in controlling the condition, and immunotherapy can sometimes cause serious side effects. The Cancer Research UK website has more information about treatments for advanced kidney cancer. Preventing kidney cancer As the causes of kidney cancer aren’t fully understood, it’s not possible to completely prevent it. However, leading a healthy lifestyle may help reduce your chances of developing the condition. Read about the causes of kidney cancer. Combining a healthy diet and regular exercise will help you avoid becoming overweight or obese, which are both significant risk factors for


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cancer. Combining a healthy diet and regular exercise will help you avoid becoming overweight or obese, which are both significant risk factors for kidney cancer. If you’re overweight or obese, you can lose weight and maintain a healthy weight by combining regular physical activity with a calorie-controlled diet. Read more about healthy weight loss and treating obesity. Diet A low-fat, high-fibre diet that includes whole grains and plenty of fresh fruit and vegetables (at least 5 portions a day) is recommended for a healthy heart. You should also limit the amount of salt in your diet to no more than 6g (0.2oz or 1 teaspoon) a day. Too much salt will increase your blood pressure. Avoid eating foods high in saturated fat because it will increase your cholesterol level. High-fat foods include: meat pies sausages and fatty cuts of meat butter ghee – a type of clarified butter often used in Indian cooking lard cream hard cheese cakes and biscuits foods that contain coconut or palm oil


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ghee – a type of clarified butter often used in Indian cooking lard cream hard cheese cakes and biscuits foods that contain coconut or palm oil There’s some evidence that eating a diet that has plenty of oily fish (at least 1 portion a week) may help reduce the risk of kidney cancer. Examples of oily fish include: salmon mackerel sardines trout herring Oily fish also contains vitamin D, which can reduce the risk of some cancers. You can also get vitamin D from sunlight or by taking supplements. Exercise It’s recommended that adults should do a minimum of 150 minutes (2 hours and 30 minutes) of moderate-intensity aerobic activity, such as cycling or brisk walking, every week. The exercise should be strenuous enough to increase your heart rate and you should feel slightly out of breath afterwards. Examples of activities you could incorporate into your exercise programme include: brisk walking hill climbing running cycling swimming If you find it difficult to do 150 minutes of exercise a


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into your exercise programme include: brisk walking hill climbing running cycling swimming If you find it difficult to do 150 minutes of exercise a week, start at a level you feel comfortable with. However, you should visit your GP for a health check if you’ve never exercised before or you’re returning to exercise after a long period of time. Read more about exercise and its benefits. Giving up smoking If you smoke, giving up is the most effective way of preventing kidney cancer, as well as a number of other serious health conditions, such as stroke, heart attack and lung cancer. Your GP can help if you want to stop smoking, by giving you information and advice, and prescribing medication. Our stopping smoking pages have useful information and advice about giving up smoking. Alternatively, you can call Quit Your Way Scotland on 0800 84 84 84. Read more about giving up smoking. Alcohol There’s evidence to suggest that drinking a moderate amount of alcohol, such as 4 to 5 glasses of


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84 84. Read more about giving up smoking. Alcohol There’s evidence to suggest that drinking a moderate amount of alcohol, such as 4 to 5 glasses of wine a month, will help reduce your risk of developing kidney cancer. The reasons for this aren’t fully understood. However, you shouldn’t exceed the recommended limits for alcohol, because excessive drinking will place you at risk of developing liver disease, liver cancer, and high blood pressure (hypertension). Read more about drinking and alcohol and alcohol units. 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’t 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 Chronic kidney disease Radiotherapy Other health sites Kidney Cancer UK Kidney


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Send feedback Add this page to Info For Me Also on NHS inform Chronic kidney disease Radiotherapy Other health sites Kidney Cancer UK Kidney Research UK Macmillan Cancer Support: Kidney cancer Macmillan Cancer Support: Chemotherapy National Kidney Federation UK Kidney Association 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 © 2025 NHS 24 – v1.1.1.17852


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Kidney infection | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotland’s Service Directory 0 Home Illnesses and conditions Kidneys, bladder and prostate Kidney infection Kidney infection About kidney infections Symptoms of kidney infections Causes of kidney infections Diagnosing kidney infections Treating kidney infections Complications of kidney infections Preventing kidney infections About kidney infections A kidney infection (pyelonephritis) is a painful and unpleasant illness caused by bacteria travelling from your bladder into one or both of your kidneys. It’s more serious than cystitis, a common infection of the bladder that makes urinating painful. If treated promptly, a kidney infection doesn’t cause serious harm, but will make you feel very unwell. If a kidney infection isn’t treated, it can get worse and cause permanent kidney damage. Symptoms of a kidney infection often come on within a few


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If a kidney infection isn’t treated, it can get worse and cause permanent kidney damage. Symptoms of a kidney infection often come on within a few hours. You can feel feverish, shivery, sick and have a pain in your back or side. Read more about the symptoms of a kidney infection When to see your GP See your GP if you have a fever and persistent tummy, lower back or genital pain, or if you notice a change to your usual pattern of urination. Most kidney infections need prompt treatment with antibiotics to stop the infection from damaging the kidneys or spreading to the bloodstream. You may also need painkillers. If you’re especially vulnerable to the effects of an infection, for example, if you have a pre-existing health condition or are pregnant, you may be admitted to hospital and treated with antibiotics through an intravenous drip. After taking antibiotics, you should feel completely better after about 2 weeks. In rare cases, a kidney infection can cause further problems. These


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After taking antibiotics, you should feel completely better after about 2 weeks. In rare cases, a kidney infection can cause further problems. These include blood poisoning (sepsis) and a build-up of pus in the kidney called an abscess. Read more about treating a kidney infection and the complications of a kidney infection What causes a kidney infection? A kidney infection usually happens when bacteria – often a type called E. coli – gets into the urethra (the tube which carries urine out of the body) and travels up through the bladder and into the kidneys. Read more about the causes of a kidney infection Who’s at risk? Kidney infections are relatively rare. It’s estimated that one in every 830 people develops a kidney infection each year in the UK. They can happen at any age, but are much more common in women. In fact, women are 6 times more likely to get a kidney infection than men. This is because a woman’s urethra is shorter, making it easier for bacteria to reach the kidneys.


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more likely to get a kidney infection than men. This is because a woman’s urethra is shorter, making it easier for bacteria to reach the kidneys. Younger women are most at risk because they tend to be more sexually active, and having frequent sex increases the chances of getting a kidney infection. Younger children are also vulnerable to developing kidney infections because they may be born with an abnormality of the urinary tract or have a condition called vesico-ureteric reflux, where there is a backflow of urine from the bladder up to the kidneys. Can kidney infections be prevented? You can reduce your chances of developing a kidney infection by keeping your bladder and urethra free from bacteria. This can include drinking plenty of fluids, keeping your genitals clean and treating any constipation. Read more about preventing a kidney infection Symptoms of kidney infections The symptoms of a kidney infection usually develop quite quickly over a few hours or days. Common symptoms


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infection Symptoms of kidney infections The symptoms of a kidney infection usually develop quite quickly over a few hours or days. Common symptoms include: pain and discomfort in your side, lower back or around your genitals high temperature (it may reach 39.5C or 103.1F) shivering or chills feeling very weak or tired loss of appetite feeling sick or being sick diarrhoea You may have other symptoms if you also have cystitis or urethritis (an infection of the urethra). These additional symptoms may include: pain or a burning sensation during urination need to urinate frequently or urgently feeling that you’re unable to urinate fully blood in your urine cloudy or foul smelling urine pain in your lower abdomen Children Children with a kidney infection may also have additional symptoms, such as: a lack of energy irritability poor feeding and/or vomiting not growing at the expected rate abdominal pain jaundice (yellowing of the skin and whites of the eyes) blood in the urine unpleasant


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and/or vomiting not growing at the expected rate abdominal pain jaundice (yellowing of the skin and whites of the eyes) blood in the urine unpleasant smelling urine bedwetting When to seek medical advice Contact your GP if you have a high temperature, persistent pain, or if you notice a change to your usual pattern of urination. Contact your GP immediately if you think your child may have a kidney infection. If you have blood in your urine, you should always see your GP so the cause can be investigated. Kidney infections require prompt treatment with antibiotics to help relieve symptoms and prevent complications developing. Your GP can carry out some simple tests to help diagnose a kidney infection. See diagnosing kidney infections for more information Causes of kidney infections A kidney infection happens when bacteria infects your kidneys. The bacteria are usually a type called E. coli, which live in your bowel. The bacteria get in through the opening of the urethra and move upwards


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The bacteria are usually a type called E. coli, which live in your bowel. The bacteria get in through the opening of the urethra and move upwards through your urinary tract, first infecting your bladder and then your kidneys. It’s thought the bacteria can get into your urinary tract by accidentally spreading from your anus to your urethra. This can happen if you wipe your bottom after going to the toilet and the soiled toilet paper comes into contact with your genitals. It can also happen during sex. In rare cases, a kidney infection can develop if bacteria or fungi infect the skin and the infection spreads through your bloodstream into your kidney. However, this type of infection usually only occurs in people with weakened immune systems. Who’s most likely to get a kidney infection? Women and children are most at risk of developing a kidney infection, as well as other urinary tract infections (UTIs) such as cystitis. In women, the urethra is closer to the anus than in men, making it


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infection, as well as other urinary tract infections (UTIs) such as cystitis. In women, the urethra is closer to the anus than in men, making it easier for bacteria from the anus to enter the urethra accidentally. The female urethra is also much shorter than the male urethra (which runs through the penis). This makes it easier for bacteria to reach the bladder and move into the kidneys. Other factors can also put you more at risk of developing a kidney infection, including: having a condition that blocks, or obstructs, your urinary tract, such as kidney stones or an enlarged prostate – children with constipation can also be at an increased risk being born with an abnormality in your urinary tract having a condition that prevents you emptying your bladder fully, such as an injury to your spinal cord – this can allow bacteria in your bladder to multiply and spread having a weakened immune system – for example, due to type 2 diabetes or as a side effect of chemotherapy having an


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bladder to multiply and spread having a weakened immune system – for example, due to type 2 diabetes or as a side effect of chemotherapy having an infection of the prostate gland called prostatitis – the infection can spread from the prostate gland into the kidneys having a urinary catheter (a thin, flexible tube inserted into your bladder to drain away urine) being female and sexually active – sexual intercourse can irritate the urethra and allow bacteria to travel into your bladder being a man who has anal sex – bacteria can travel up the urethra into the bladder being pregnant – this can cause physical changes that slow the flow of urine out of your body and make it easier for bacteria to spread to the kidneys having undergone female genital mutilation (FGM) – an illegal practice where a woman’s genitals are deliberately cut or changed for cultural, religious and social reasons Diagnosing kidney infections To work out if you have a kidney infection, your GP will ask you about your


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for cultural, religious and social reasons Diagnosing kidney infections To work out if you have a kidney infection, your GP will ask you about your symptoms and your recent medical history. They will usually also assess your general health by taking your temperature and measuring your blood pressure. Urine test A urine test can help to establish whether you have a urinary tract infection (UTI). The test involves taking a small sample of urine and checking it to see if there are any bacteria in it. You’ll be given a container and told how to collect the urine, which you can do in the surgery or at home. If you do it at home, you’ll need to label the container, seal it in a plastic bag and store it in the fridge. Ideally, hand it in to the surgery within four hours. A urine test can’t tell whether the infection – if you have one – is in your kidneys or another part of your urinary system, such as your bladder. For your GP to be confident you have a kidney infection, you need to have a


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kidneys or another part of your urinary system, such as your bladder. For your GP to be confident you have a kidney infection, you need to have a positive urine test plus certain symptoms, such as a fever or a pain in your side. Hospital scans You may be referred to hospital for further testing if: your symptoms fail to respond to treatment with antibiotics your symptoms suddenly get worse you have additional symptoms that aren’t usually associated with a kidney infection you’re at risk of complications of a kidney infection Children with recurrent UTIs will also be referred to hospital for further testing. In these circumstances, scans can check your urinary tract for signs of problems. This may include: a computer tomography (CT) scan – where a scanner takes a series of X-rays and a computer is used to assemble them into a detailed image of your urinary tract an ultrasound scan – which uses sound waves to build an image of the inside of your body an isotope scan – where a dye is


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image of your urinary tract an ultrasound scan – which uses sound waves to build an image of the inside of your body an isotope scan – where a dye is injected into the bloodstream and a series of X-rays are taken Read more about treating a kidney infection Treating kidney infections Most people with a kidney infection can be treated at home with a course of antibiotics, and possibly painkillers as well. See your GP if you have a fever and persistent tummy, lower back or genital pain, or if you notice a change to your usual pattern of urination. All children with symptoms of a urinary tract infection (UTI) or kidney infection, including cystitis, should see their GP or out-of-hours emergency service. Medication Antibiotics If you’re being treated at home, you’ll usually be prescribed a course of antibiotic tablets or capsules that lasts between 7 and 14 days. For most people – apart from pregnant women – antibiotics called ciprofloxacin or Co-amoxiclav are recommended. However, other


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between 7 and 14 days. For most people – apart from pregnant women – antibiotics called ciprofloxacin or Co-amoxiclav are recommended. However, other antibiotics may also be used. Common side effects of ciprofloxacin include feeling sick and diarrhoea. Co-amoxiclav can make the contraceptive pill and contraceptive patches less effective, so you may need to use another form of contraception during the course of treatment. A 14-day course of an antibiotic called cefalexin is recommended for pregnant women. Usually, you’ll start to feel better quite soon after treatment starts and you should feel completely better after about 2 weeks. If your symptoms show no sign of improvement 24 hours after treatment starts, contact your GP for advice. Painkillers Taking a painkiller such as paracetamol should help relieve symptoms of pain and a high temperature. However, non-steroidal anti-inflammatories (NSAIDs) such as ibuprofen aren’t usually recommended to relieve pain during a kidney infection.


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However, non-steroidal anti-inflammatories (NSAIDs) such as ibuprofen aren’t usually recommended to relieve pain during a kidney infection. This is because they may increase the risk of further kidney problems. Self-help tips If you have a kidney infection, try not to ‘hover’ over the toilet seat when you go to the loo, because it can result in your bladder not being fully emptied. It’s also important to drink plenty of fluids, because this will help prevent dehydration and will help to flush out the bacteria from your kidneys. Aim to drink enough so that you’re frequently passing pale-coloured urine. Make sure that you get plenty of rest. A kidney infection can be physically draining, even if you’re normally healthy and strong. It may take up to two weeks before you’re fit enough to return to work. Treatment at hospital Your GP may refer you to hospital if you have an underlying problem with your urinary tract, which makes you vulnerable to kidney infections. It’s standard practice


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you to hospital if you have an underlying problem with your urinary tract, which makes you vulnerable to kidney infections. It’s standard practice to further investigate all men with a kidney infection simply because the condition is much rarer in men. Only women who have had 2 or more kidney infections tend to be referred. Most children with a kidney infection will be treated in hospital. Hospital treatment may also be needed if: you’re severely dehydrated you’re unable to swallow or keep down any fluids or medications you have additional symptoms that suggest you may have blood poisoning, such as a rapid heartbeat and losing consciousness you’re pregnant and you also have a high temperature you’re particularly frail and your general health is poor your symptoms fail to improve within 24 hours of starting treatment with antibiotics you have a weakened immune system you have a foreign body inside your urinary tract, such as a kidney stone or a urinary catheter you have diabetes you’re


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a weakened immune system you have a foreign body inside your urinary tract, such as a kidney stone or a urinary catheter you have diabetes you’re over the age of 65 you have an underlying condition that affects the way your kidneys work, such as polycystic kidney disease or chronic kidney disease If you’re admitted to hospital with a kidney infection, you’ll probably be attached to a drip so you can be given fluids to help keep you hydrated. Antibiotics can also be given through the drip. You’ll have regular blood and urine tests to monitor your health and how effectively the antibiotics are fighting off the infection. Most people respond well to treatment. As long as there are no complications, they’re usually well enough to leave hospital within three to seven days. Treatment will usually switch to tablets or capsules after you stop receiving antibiotics through a drip. Complications of kidney infections Most kidney infections are treated successfully without complications, although


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antibiotics through a drip. Complications of kidney infections Most kidney infections are treated successfully without complications, although some people may develop further problems. Complications of a kidney infection are rare, but you’re more likely to develop them if you: are a child are over 65 are pregnant have diabetes, chronic kidney disease or sickle cell anaemia have had a kidney transplant (particularly in the first three months after the transplant) have a weakened immune system developed the kidney infection while in hospital Kidney abscess A kidney abscess is a rare, but serious, complication of a kidney infection, where pus develops inside the tissue of the kidney. You’re thought to be most at risk of developing a kidney abscess if you have diabetes. The symptoms of a kidney abscess are similar to those of a kidney infection. The most common are: a high temperature of 38C (100.4F) or above chills abdominal pain loss of appetite pain when passing urine Kidney abscesses


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The most common are: a high temperature of 38C (100.4F) or above chills abdominal pain loss of appetite pain when passing urine Kidney abscesses are potentially serious because the bacteria inside the abscess can spread to other parts of your body, such as your bloodstream or lungs, and can be fatal. Smaller abscesses can usually be treated with antibiotics through a drip. Surgery is usually required for larger abscesses. This involves draining the pus out of the abscess using a needle that’s inserted into the kidney. Blood poisoning Blood poisoning (also called sepsis) is another rare, but potentially fatal, complication of a kidney infection. It happens when bacteria spreads from the kidneys into the bloodstream. Once bacteria are in your blood, the infection can spread to any part of your body, including all of the major organs. In someone with a kidney infection, the symptoms of blood poisoning include: low blood pressure, which makes you feel dizzy when you stand up confusion or


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with a kidney infection, the symptoms of blood poisoning include: low blood pressure, which makes you feel dizzy when you stand up confusion or disorientation excessive sweating uncontrollable shaking or shivering high temperature or lower body temperature than usual (under 36C, or 96.8F) pale skin rapid heartbeat breathlessness Blood poisoning is a medical emergency that usually requires admission to a hospital intensive care unit (ICU) while antibiotics are used to fight the infection. If you’re taking certain medications for diabetes, such as metformin or angiotensin-converting enzyme (ACE) inhibitors, they may be temporarily withdrawn until you recover. This is because they can cause kidney damage during an episode of blood poisoning. Severe infection Another rare, but potentially fatal, complication of a kidney infection is a condition called emphysematous pyelonephritis (EPN). EPN is a severe infection, where the tissues of the kidneys are rapidly destroyed and the bacteria


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called emphysematous pyelonephritis (EPN). EPN is a severe infection, where the tissues of the kidneys are rapidly destroyed and the bacteria causing the infection begin to release a toxic gas, which builds up inside the kidneys. The exact cause of EPN is unclear, but almost all cases are in people with diabetes. The usual treatment is emergency surgery to remove some, or all, of the affected kidney. It’s possible to live a full and active life with only one kidney. Kidney failure In very rare cases, a kidney infection can cause severe kidney damage that results in kidney failure. This is when the kidneys stop working properly. Kidney failure is potentially fatal, but it can be treated with dialysis or a kidney transplant. Other problems A kidney infection can also cause other complications, including high blood pressure (hypertension) or premature labour or birth. Preventing kidney infections The best way to prevent a kidney infection is to keep your bladder and urethra free from


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or premature labour or birth. Preventing kidney infections The best way to prevent a kidney infection is to keep your bladder and urethra free from bacteria. These self-help tips explain how you can do this. Drink plenty of liquids Drinking plenty of liquids, particularly water, will help to wash bacteria from your bladder and urinary tract. Drinking cranberry juice or taking cranberry extracts may also help prevent urinary tract infections (UTIs). However, you should avoid cranberry juice or extracts if you’re taking warfarin, a medicine used to prevent blood clots. Cranberry juice can make the effects of warfarin more potent, so there’s a risk of excessive bleeding. Toilet tips To help keep your urinary tract free from bacteria: go to the toilet as soon as you feel the need to urinate, rather than holding it in wipe from front to back after going to the toilet practice good hygiene by washing your genitals every day and before having sex empty your bladder after having sex if you’re


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going to the toilet practice good hygiene by washing your genitals every day and before having sex empty your bladder after having sex if you’re a woman, avoid ‘hovering’ over a toilet seat as this position can often leave urine behind in the bladder Treat constipation Constipation can increase your chances of developing a urinary tract infection (UTI), so try to treat any constipation promptly. Recommended treatments for constipation include: increasing the amount of fibre in your diet to 20g to 30g of fibre a day using a mild laxative on a short-term basis drinking plenty of fluids See your GP if your symptoms don’t improve after 14 days (or 7 days for children with constipation). Read more about treating constipation Be careful with contraceptives If you keep getting UTIs (more than 3 a year is considered high), avoid using spermicide-coated condoms or diaphragms. This is because spermicide can stimulate the production of bacteria. Stick to lubricated condoms without spermicide,


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condoms or diaphragms. This is because spermicide can stimulate the production of bacteria. Stick to lubricated condoms without spermicide, because unlubricated ones can irritate the urethra and make it more vulnerable to infection. Source: NHS 24 - Opens in new browser window Last updated: 26 March 2025 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Don’t 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 Kidney stones Cystitis Urinary tract infection (UTI) in children 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 © 2025 NHS 24 – v1.1.1.17852


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Kidney stones | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotland’s Service Directory 0 Home Illnesses and conditions Kidneys, bladder and prostate Kidney stones Kidney stones About kidney stones Symptoms of kidney stones Causes of kidney stones Diagnosing kidney stones Treating kidney stones Preventing kidney stones About kidney stones Kidney stones can develop in one or both kidneys and most often affect people aged 30 to 60. They’re quite common, with around 3 in 20 men and up to 2 in 20 women developing them at some stage of their lives. The medical term for kidney stones is nephrolithiasis, and if they cause severe pain it’s known as renal colic. Symptoms of kidney stones Small kidney stones may go undetected and be passed out painlessly in the urine. But it’s fairly common for a stone to block part of the urinary system, such as the: ureter – the tube connecting the kidney to the bladder urethra –


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But it’s fairly common for a stone to block part of the urinary system, such as the: ureter – the tube connecting the kidney to the bladder urethra – the tube urine passes through on its way out of the body A blockage can cause severe pain in the abdomen or groin and sometimes causes a urinary tract infection (UTI). Read more about the symptoms of kidney stones. What causes kidney stones? The waste products in the blood can occasionally form crystals that collect inside the kidneys. Over time, the crystals may build up to form a hard stone-like lump. This is more likely to happen if you don’t drink enough fluids, if you’re taking some types of medication, or if you have a medical condition that raises the levels of certain substances in your urine. Read more about the causes of kidney stones. After a kidney stone has formed, your body will try to pass it out when you go to the toilet (in the urine). This means it will often travel through the urinary system (the kidneys, kidney tubes


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try to pass it out when you go to the toilet (in the urine). This means it will often travel through the urinary system (the kidneys, kidney tubes and bladder). Treating and preventing kidney stones Most kidney stones are small enough to be passed in your urine, and it may be possible to treat the symptoms at home with medication. Larger stones may need to be broken up using ultrasound or laser energy. Occasionally, keyhole surgery may be needed to remove very large kidney stones directly. Read more about treating kidney stones. It’s estimated that up to half of all people who have had kidney stones will experience them again within the following 5 years. To avoid getting kidney stones, make sure you drink plenty of water every day so you don’t become dehydrated. It’s very important to keep your urine diluted (clear) to prevent waste products forming into kidney stones. Read more about preventing kidney stones. Symptoms of kidney stones Very small kidney stones are unlikely to cause


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forming into kidney stones. Read more about preventing kidney stones. Symptoms of kidney stones Very small kidney stones are unlikely to cause many symptoms. It may even go undetected and pass out painlessly when you urinate. Symptoms usually occur if the kidney stone: gets stuck in your kidney starts to travel down the ureter (the tube that attaches each kidney to the bladder) – the ureter is narrow and kidney stones can cause pain as they try to pass through causes an infection In these cases, the symptoms of kidney stones can include: a persistent ache in the lower back, which is sometimes also felt in the groin – men may have pain in their testicles and scrotum periods of intense pain in the back or side of your abdomen, or occasionally in your groin, which may last for minutes or hours feeling restless and unable to lie still nausea (feeling sick) needing to urinate more often than normal pain when you urinate (dysuria) blood in your urine (haematuria) – this may be caused by the


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(feeling sick) needing to urinate more often than normal pain when you urinate (dysuria) blood in your urine (haematuria) – this may be caused by the stone scratching the kidney or ureter Blocked ureter and kidney infection A kidney stone that blocks the ureter can lead to a kidney infection. This is because waste products are unable to pass the blockage, which may cause a build-up of bacteria. The symptoms of a kidney infection are similar to symptoms of kidney stones, but may also include: a high temperature (fever) of 38C (100.4F) or over chills and shivering feeling very weak or tired diarrhoea cloudy and bad-smelling urine Read more about kidney infections. Causes of kidney stones Kidney stones are usually formed following a build-up of certain chemicals in the body. This build-up may be any of the following: calcium ammonia uric acid – a waste product produced when the body breaks down food to use as energy cysteine – an amino acid that helps to build protein Certain medical


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acid – a waste product produced when the body breaks down food to use as energy cysteine – an amino acid that helps to build protein Certain medical conditions can lead to an unusually high level of these substances in your urine. You’re also more likely to develop kidney stones if you don’t drink enough fluids. Recurrent kidney stones Some people are particularly likely to keep on developing kidney stones, including people who: eat a high-protein, low-fibre diet are inactive or bed-bound have a family history of kidney stones have had several kidney or urinary infections have had a kidney stone before, particularly if it was before you were 25 have only one fully working kidney have had an intestinal bypass (surgery on your digestive system), or a condition affecting the small intestine, such as Crohn’s disease Medication There’s evidence to suggest that certain medications may increase your risk of developing recurrent kidney stones. These include: aspirin antacids diuretics (used


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to suggest that certain medications may increase your risk of developing recurrent kidney stones. These include: aspirin antacids diuretics (used to reduce fluid build-up) certain antibiotics certain antiretroviral medication (used to treat HIV) certain anti-epileptic medication Types of kidney stones Kidney stones can develop for a number of reasons. Calcium stones Calcium stones are the most common type of kidney stone and form if there’s too much calcium in the urine, which can be due to: an inherited condition called hypercalcuria, which leads to large amounts of calcium in urine an overactive parathyroid gland (the parathyroid glands help to regulate the amount of calcium in your body) kidney disease a rare condition called sarcoidosis some cancers Calcium stones are usually either large and smooth or spiky and rough. Struvite stones Struvite stones are often caused by infections, and they most commonly occur after a urinary tract infection that’s lasted a long time. Struvite


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Struvite stones are often caused by infections, and they most commonly occur after a urinary tract infection that’s lasted a long time. Struvite stones are more common in women than men. Uric acid stones Uric acid stones can form if there’s a large amount of acid in your urine. They may be caused by: eating a high-protein diet that includes lots of meat a condition such as gout that prevents the body breaking down certain chemicals an inherited condition that causes higher than normal levels of acid in the body chemotherapy Cystine stones Cystine stones are the rarest type of kidney stone. They’re caused by an inherited condition called cystinuria, which affects the amount of acid that is passed in your urine. Diagnosing kidney stones Your GP will usually be able to diagnose kidney stones from your symptoms and medical history. It will be particularly easy if you’ve had kidney stones before. You may be given tests, including: urine tests to check for infections and pieces of stones an


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particularly easy if you’ve had kidney stones before. You may be given tests, including: urine tests to check for infections and pieces of stones an examination of any stones that you pass in your urine blood tests to check that your kidneys are working properly, and to also check the levels of substances that could cause kidney stones, such as calcium You can collect a kidney stone by urinating through some gauze or a stocking. Having a kidney stone to analyse will make a diagnosis easier, and may help your GP determine which treatment method will be of most benefit to you. If you have severe pain that isn’t controlled by painkillers, or if you have a high temperature as well as pain, you may be referred to a urologist (a specialist in treating urinary problems). Imaging tests If you’re referred to hospital for an imaging test, a number of different techniques may be used. Imaging tests can help confirm the diagnosis, or identify precisely where a kidney stone is. These tests


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number of different techniques may be used. Imaging tests can help confirm the diagnosis, or identify precisely where a kidney stone is. These tests include: a computerised tomography (CT) scan – where a series of X-rays at slightly different angles are taken and a computer is used to put the images together X-ray – an imaging technique that uses high-energy radiation to highlight abnormalities in body tissue an ultrasound scan – uses high-frequency sound waves to create an image of the inside of your body an intravenous urogram (IVU) or intravenous pyelogram (IVP) – a dye that shows up on X-ray is injected into a vein in your arm; the X-ray image highlights any blockages as the kidneys filter the dye out of your blood and into your urine CT scans are now often used because they’re thought to be more accurate. IVUs were previously the preferred imaging method. The imaging technique you have may depend on what’s available at your local hospital. Treating kidney stones Most kidney


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preferred imaging method. The imaging technique you have may depend on what’s available at your local hospital. Treating kidney stones Most kidney stones are small enough (less than 4mm in diameter) to be passed out in your urine and can probably be treated at home. But even small kidney stones can be painful, although this usually only lasts a couple of days and disappears when the stone has been passed. Medication If you are in severe pain, your GP can give you pain relief by injection. A second dose can be given after half an hour if you’re still experiencing pain. Medication can also be injected to treat the symptoms of nausea (feeling sick) and vomiting. This is called an anti-emetic (anti-sickness) medication. You may also be given a prescription for painkillers, anti-emetics, or both, to take at home. Self care You may be advised to wait until you pass your kidney stone when you go to the toilet, and to try to collect it from your urine. You can do this by filtering your urine


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to wait until you pass your kidney stone when you go to the toilet, and to try to collect it from your urine. You can do this by filtering your urine through gauze or a stocking. Give the stone to your GP so that they can have it analysed to help determine any further treatment you may need. You should drink enough water to make your urine colourless. If your urine is yellow or brown, you’re not drinking enough. Admission to hospital If your kidney stone has moved into your ureter (the tube that carries waste products from the kidneys to the bladder), and it’s causing severe pain, your GP may admit you to hospital for treatment. This may be necessary if: you’re at an increased risk of your kidneys failing (for example, because you only have one kidney) your symptoms don’t improve within an hour of being given painkillers or anti-sickness medication you’re dehydrated and vomiting too much to keep fluids down you’re pregnant you’re over 60 years of age Treating large kidney stones If a


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medication you’re dehydrated and vomiting too much to keep fluids down you’re pregnant you’re over 60 years of age Treating large kidney stones If a kidney stone is too big to be passed naturally – 6mm to 7mm (about 0.23in to 0.27in) in diameter or larger – you may need treatment to remove it another way. This could include: extracorporeal shock wave lithotripsy (ESWL) ureteroscopy percutaneous nephrolithotomy (PCNL) open surgery The type of treatment you have will depend on the size and location of your stones. Extracorporeal shock wave lithotripsy (ESWL) ESWL is the most common way of treating kidney stones that can’t be passed in the urine. It involves using ultrasound (high-frequency sound waves) to pinpoint where a kidney stone is. Ultrasound shock waves are then sent to the stone from a machine to break it into smaller pieces, so it can be passed in your urine. ESWL can be an uncomfortable form of treatment, so it’s usually carried out after giving painkilling medication. You


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it can be passed in your urine. ESWL can be an uncomfortable form of treatment, so it’s usually carried out after giving painkilling medication. You may need more than one session of ESWL to successfully treat your kidney stones. ESWL is up to 99% effective for stones up to 20mm (0.8in) in diameter. Ureteroscopy If a kidney stone is stuck in the ureter, you may need to have a ureteroscopy, which is also sometimes known as retrograde intrarenal surgery (RIRS). It involves passing a long, thin telescope called a ureteroscope through your urethra (the tube urine passes through on its way out of the body) and into your bladder. It’s then passed up into your ureter to where the stone is stuck. The surgeon may either try to gently remove the stone using another instrument, or they may use laser energy to break it up into small pieces so that it can be passed naturally in your urine. Ureteroscopy is carried out under general anaesthetic (where you’re unconscious), so you shouldn’t drive or


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it can be passed naturally in your urine. Ureteroscopy is carried out under general anaesthetic (where you’re unconscious), so you shouldn’t drive or operate machinery for up to 48 hours after the procedure. For stones up to 15mm (0.6in), a ureteroscopy is effective in 50% to 80% of cases. A plastic tube called a stent may need to be temporarily inserted inside you to allow the stone fragments to drain into the bladder. Percutaneous nephrolithotomy (PCNL) PCNL is an alternative procedure that may be used for larger stones. It may also be used if ESWL isn’t suitable – for example, because the person being treated is obese. PCNL involves using a thin telescopic instrument called a nephroscope. A small incision is made in your back and the nephroscope is passed through it and into your kidney. The stone is either pulled out or broken into smaller pieces using a laser or pneumatic energy. PCNL is always carried out under general anaesthetic, so you shouldn’t drive or operate machinery for


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pieces using a laser or pneumatic energy. PCNL is always carried out under general anaesthetic, so you shouldn’t drive or operate machinery for up to 48 hours after the procedure. PCNL is 86% effective for stones that are 21mm to 30mm (0.8in to 1.2in) in diameter. Open surgery Nowadays, open surgery for kidney stones is rare. Less than 1% of cases require this type of surgery. It’s only usually used if there’s a very large stone or abnormal anatomy. During open surgery, an incision will be made in your back so that your surgeon is able to access your ureter and kidney. The kidney stone can then be removed. Treating uric acid stones If you have a uric acid stone, you may be advised to drink around 3 litres (just over 5 pints) of water each day to try to dissolve it. Uric acid stones are much softer than other types of kidney stone, and they can be made smaller if they’re exposed to alkaline fluids. You may need to take some medication to make your urine more alkaline before the uric


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they can be made smaller if they’re exposed to alkaline fluids. You may need to take some medication to make your urine more alkaline before the uric acid stone starts to dissolve. Complications of treatment Complications can occur following the treatment of large kidney stones. Your surgeon should explain these to you before you have the procedure. Possible complications will depend on the type of treatment you have and the size and position of your stones. Complications could include: sepsis – an infection that spreads through the blood, causing symptoms throughout the whole body a blocked ureter – caused by stone fragments; the ureter is the tube that attaches the kidney to the bladder an injury to the ureter a urinary tract infection bleeding during surgery pain It’s estimated that 5% to 9% of people may experience complications after having a ureteroscopy. Preventing kidney stones The best way of preventing kidney stones is to make sure you drink plenty of water each day to avoid


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having a ureteroscopy. Preventing kidney stones The best way of preventing kidney stones is to make sure you drink plenty of water each day to avoid becoming dehydrated. Keeping your urine diluted helps to stop waste products getting too concentrated and forming stones. You can tell how diluted your urine is by looking at its colour. The darker your urine is, the more concentrated it is. Your urine is usually a dark yellow colour in the morning because it contains a build-up of waste products that your body has produced overnight. Drinks such as tea, coffee and fruit juice can count towards your fluid intake, but water is the healthiest option and is best for preventing kidney stones developing. You should also make sure you drink more when it’s hot or when you’re exercising, to replenish fluids lost through sweating. Read more about preventing dehydration. Diet If your kidney stone is caused by too much calcium, you may be advised to reduce the amount of oxalates in your diet.


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preventing dehydration. Diet If your kidney stone is caused by too much calcium, you may be advised to reduce the amount of oxalates in your diet. Oxalates prevent calcium being absorbed by your body, and can accumulate in your kidney to form a stone. Foods that contain oxalates include: beetroot asparagus rhubarb chocolate berries leeks parsley celery almonds, peanuts and cashew nuts soy products grains, such as oatmeal, wheat germ and wholewheat Don’t reduce the amount of calcium in your diet unless your GP advises you to. This is because calcium is very important for maintaining healthy bones and teeth. To avoid developing a uric acid stone, you should reduce the amount of meat, poultry and fish in your diet. You may also be prescribed medication to change the levels of acid or alkaline in your urine. Medication If you have a kidney stone, medication will usually be prescribed for pain relief or to prevent infections developing. However, some medication may need to be reviewed by


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stone, medication will usually be prescribed for pain relief or to prevent infections developing. However, some medication may need to be reviewed by your GP if it’s thought to be causing your kidney stone. The type of medication your GP prescribes will depend on the type of kidney stone you have. For example, if you have: calcium stones – you may be prescribed a diuretic medication if they are caused by hypercalcuria (an inherited condition) struvite stones – you may be prescribed antibiotics to help prevent a urinary tract infection or kidney infection, which are the main causes of struvite stones uric acid stones – you may be prescribed allopurinol (a medication used to lower uric acid levels) and medication to help alkalise your urine cystine stones – you may be prescribed medication to lower levels of cystine in your urine Source: NHS 24 - Opens in new browser window Last updated: 26 March 2025 How can we improve this page? Help us improve NHS inform Thank You Your feedback has


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NHS 24 - Opens in new browser window Last updated: 26 March 2025 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Don’t 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 Kidney infection Chronic kidney disease Other health sites Lab Tests Online UK: PTH National Kidney Federation Kidney Research UK UK Kidney 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 © 2025 NHS 24 – v1.1.1.17852


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Labyrinthitis | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotland’s Service Directory 0 Home Illnesses and conditions Ears, nose and throat Labyrinthitis Labyrinthitis Labyrinthitis is an inner ear infection. It causes the labyrinth inside your ear to become inflamed, affecting your hearing and balance. Labyrinthitis usually starts suddenly and can be worrying. You should seek medical advice straight away. What is the labyrinth? The labyrinth is the innermost part of the ear. It contains 2 parts: the cochlea – this sends sounds to the brain so you can hear the vestibular system – a complex set of fluid-filled tubes that affect your balance The labyrinth usually becomes inflamed either because of: a viral infection, such as a cold or flu (viral labyrinthitis) a bacterial infection, which is much less common (bacterial labyrinthitis) Symptoms of labyrinthitis The most common symptoms of labyrinthitis are:


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a bacterial infection, which is much less common (bacterial labyrinthitis) Symptoms of labyrinthitis The most common symptoms of labyrinthitis are: vertigo (dizziness) – the sensation that you, or the environment around you, is moving hearing loss (from mild to total loss of hearing) a feeling of pressure inside your ear(s) ringing or humming in your ear(s) (tinnitus) feeling sick (nausea) or being sick mild headaches Certain things can make the dizziness worse, including: colds or illness, or anything that makes you feel generally unwell the dark tiredness or jetlag being on your period Avoid driving, using tools and machinery, or working at heights if you’re feeling dizzy. When to get medical advice Speak to your GP practice if: you have symptoms of labyrinthitis your symptoms are getting worse Diagnosing labyrinthitis Your GP may: ask about your symptoms check your medical history carry out a physical examination – you may be asked to move your head or body and they can check your


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about your symptoms check your medical history carry out a physical examination – you may be asked to move your head or body and they can check your ears for signs of inflammation and infection test your hearing – labyrinthitis is more likely if you have hearing loss check your eyes – if they’re flickering uncontrollably your balancing system may not be working properly Treating labyrinthitis You’ll usually have already seen your GP about labyrinthitis symptoms and may have started some treatment. There are things you can also do during this time to help manage your symptoms at home. Things you can do to help your symptoms Do drink plenty of water to avoid becoming dehydrated – it’s best to drink little and often lie still in a dark room if you feel very dizzy lie in a comfortable position (on your side is often best) try to get enough sleep – tiredness can make symptoms worse try to reduce noise and anything that causes stress from your surroundings avoid alcohol avoid bright lights


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– tiredness can make symptoms worse try to reduce noise and anything that causes stress from your surroundings avoid alcohol avoid bright lights Treatments from your doctor If your symptoms are particularly severe, your GP may prescribe: prochlorperazine – can help with dizziness and sickness antiemetic – can help if you’re feeling sick and vomiting corticosteroids – can help by reducing inflammation Vestibular rehabilitation therapy (VRT) A small number of people experience dizziness and vertigo for months or years. This is known as chronic labyrinthitis. Chronic labyrinthitis requires a treatment called vestibular rehabilitation therapy (VRT). VRT is usually supervised by a physiotherapist. You can ask your GP to refer you or you can pay for private treatment. If you see a private physiotherapist, make sure they are fully qualified and a member of a recognised body. For example, the Chartered Society of Physiotherapy (CSP). Not all physiotherapists have training in VRT. You should


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a member of a recognised body. For example, the Chartered Society of Physiotherapy (CSP). Not all physiotherapists have training in VRT. You should tell them that you need this type of treatment before making an appointment. Who can get labyrinthitis? Most cases of viral labyrinthitis occur in adults aged 30 to 60 years old. Viral labyrinthitis is quite common in adults. Other types of ear infections are usually more common in children. Bacterial labyrinthitis is much less common. Younger children under 2 years old are more vulnerable to developing bacterial labyrinthitis. Vestibular neuronitis Many people diagnosed with labyrinthitis only experience the balance symptoms without hearing loss. This is known as vestibular neuronitis rather than labyrinthitis. Both names are often used to describe the same diagnosis. Source: ENT Scotland - Opens in new browser window Last updated: 20 May 2024 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been


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- Opens in new browser window Last updated: 20 May 2024 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Don’t 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 Meningitis Hearing loss Vertigo 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 © 2025 NHS 24 – v1.1.1.17852


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Lactose intolerance | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotland’s Service Directory 0 Home Illnesses and conditions Nutritional Lactose intolerance Lactose intolerance About lactose intolerance Causes of lactose intolerance Diagnosing lactose intolerance Treating lactose intolerance Complications of lactose intolerance About lactose intolerance Lactose intolerance is a common digestive problem where the body is unable to digest lactose, a type of sugar mainly found in milk and dairy products. Symptoms of lactose intolerance usually develop within a few hours of consuming food or drink that contains lactose. They may include: flatulence (wind) diarrhoea bloated stomach stomach cramps and pains stomach rumbling feeling sick The severity of your symptoms and when they appear depends on the amount of lactose you’ve consumed. Some people may still be able to drink a small glass of milk without


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symptoms and when they appear depends on the amount of lactose you’ve consumed. Some people may still be able to drink a small glass of milk without triggering any symptoms, while others may not even be able to have milk in their tea or coffee. When to seek medical advice The symptoms of lactose intolerance can be similar to several other conditions, so it’s important to see your GP for a diagnosis before removing milk and dairy products from your diet. For example, the symptoms above can also be caused by: irritable bowel syndrome (IBS) – a long-term disorder that affects the digestive system milk protein intolerance – an adverse reaction to the protein in milk from cows (not the same as a milk allergy) If your GP thinks you have lactose intolerance, they may suggest avoiding foods and drinks containing lactose for two weeks to see if your symptoms improve. Read more about diagnosing lactose intolerance What causes lactose intolerance? The body digests lactose using a substance


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if your symptoms improve. Read more about diagnosing lactose intolerance What causes lactose intolerance? The body digests lactose using a substance called lactase. This breaks down lactose into two sugars called glucose and galactose, which can be easily absorbed into the bloodstream. People with lactose intolerance don’t produce enough lactase, so lactose stays in the digestive system where it’s fermented by bacteria. This leads to the production of various gases, which cause the symptoms associated with lactose intolerance. Depending on the underlying reason why the body isn’t producing enough lactase, lactose intolerance may be temporary or permanent. Most cases that develop in adults are inherited and tend to be lifelong, but cases in young children are often caused by an infection in the digestive system and may only last for a few weeks. Read more about the causes of lactose intolerance Who’s affected? In the UK, lactose intolerance is more common in people of Asian or


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a few weeks. Read more about the causes of lactose intolerance Who’s affected? In the UK, lactose intolerance is more common in people of Asian or African-Caribbean descent. Lactose intolerance can develop at any age. Many cases first develop in people aged 20 to 40, although babies and young children can also be affected. Is it an allergy? Lactose intolerance isn’t the same as a milk or dairy allergy. Food allergies are caused by your immune system reacting to a certain type of food. This causes symptoms such as a rash, wheezing and itching. If you’re allergic to something, even a tiny particle can be enough to trigger a reaction, while most people with lactose intolerance can still consume small amounts of lactose without experiencing any problems (although this varies from person to person). Treating lactose intolerance There’s no cure for lactose intolerance, but limiting your intake of food and drink containing lactose usually helps to control the symptoms. Depending on what


