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cure for lactose intolerance, but limiting your intake of food and drink containing lactose usually helps to control the symptoms. Depending on what dairy products you’re able to eat, you may also require additional calcium and vitamin D supplements to keep your bones strong and healthy. In some cases, your GP may refer you to a dietitian for further advice. In addition to dietary changes, lactase substitutes may also be helpful. These are drops or tablets you can take with your meals or drinks to improve your digestion of lactose. Read more about treating lactose intolerance Complications of lactose intolerance Milk and other dairy products contain calcium, protein and vitamins such as A, B12 and D. Lactose also helps your body absorb a number of other minerals, such as magnesium and zinc. These vitamins and minerals are important for the development of strong, healthy bones. If you’re lactose intolerant, getting the right amount of important vitamins and minerals can prove


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for the development of strong, healthy bones. If you’re lactose intolerant, getting the right amount of important vitamins and minerals can prove difficult. This may lead to unhealthy weight loss and put you at increased risk of developing the following conditions: Osteopenia – where you have a very low bone-mineral density. If osteopenia is not treated, it can develop into osteoporosis. Osteoporosis – where your bones become thin and weak. If you have osteoporosis, your risk of getting fractures and broken bones is increased. Malnutrition – when the food you eat doesn’t give you the nutrients essential for a healthy functioning body. If you’re malnourished, wounds can take longer to heal and you may start to feel tired or depressed. If you’re concerned that dietary restrictions are putting you at risk of complications, you may find it helpful to consult a dietitian. They can advise you on your diet and whether you require food supplements. Your GP should be able to refer you to an


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helpful to consult a dietitian. They can advise you on your diet and whether you require food supplements. Your GP should be able to refer you to an NHS dietitian free of charge. Alternatively, you can contact a private dietician. The British Dietetic Association has information on how to find a private dietitian. Causes of lactose intolerance Lactose intolerance is usually the result of your body not producing enough lactase. Lactase is an enzyme (a protein that causes a chemical reaction to occur) normally produced in your small intestine that’s used to digest lactose. If you have a lactase deficiency, it means your body doesn’t produce enough lactase. Digesting lactose After eating or drinking something containing lactose, it passes down your oesophagus (gullet) into your stomach, where it’s digested. The digested food then passes into your small intestine. The lactase in your small intestine should break lactose down into glucose and galactose (other types of sugar), which are


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into your small intestine. The lactase in your small intestine should break lactose down into glucose and galactose (other types of sugar), which are then absorbed into your bloodstream. If there isn’t enough lactase, the unabsorbed lactose moves through your digestive system to your colon (large intestine). Bacteria in the colon ferment (break down) the lactose, producing fatty acids and gases such as carbon dioxide, hydrogen and methane. The breakdown of the lactose in the colon, and the resulting acids and gases that are produced, cause the symptoms of lactose intolerance such as flatulence and bloating. Types of lactase deficiency The main types of lactase deficiency are outlined below. Primary lactase deficiency Primary lactase deficiency is the most common cause of lactose intolerance worldwide. This type of lactase deficiency is caused by an inherited genetic fault that runs in families. Primary lactase deficiency develops when your lactase production decreases as your diet


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caused by an inherited genetic fault that runs in families. Primary lactase deficiency develops when your lactase production decreases as your diet becomes less reliant on milk and dairy products. This is usually after the age of two, when breastfeeding or bottle-feeding has stopped, although the symptoms may not be noticeable until adulthood. Secondary lactase deficiency Secondary lactase deficiency is a shortage of lactase caused by a problem in your small intestine. It can occur at any age, and may be the result of another condition, surgery to your small intestine, or taking certain medication. Secondary lactase deficiency is the most common cause of lactose intolerance in the UK, particularly in babies and young children. Possible causes of secondary lactase deficiency include: gastroenteritis – an infection of the stomach and intestines coeliac disease – a bowel condition caused by an adverse reaction to a protein called gluten Crohn’s disease – a long-term condition that causes


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coeliac disease – a bowel condition caused by an adverse reaction to a protein called gluten Crohn’s disease – a long-term condition that causes inflammation of the lining of the digestive system ulcerative colitis – a long-term condition that affects the large intestine chemotherapy – a cancer treatment long courses of antibiotics The decrease in the production of lactase in secondary lactase deficiency is sometimes only temporary, but it may be permanent if it’s caused by a long-term condition. It’s also possible to develop secondary lactase deficiency later in life, even without another condition to trigger it. This is because your body’s production of lactase naturally reduces as you get older. Congenital lactase deficiency Congenital lactase deficiency is a rare condition that runs in families and is found in newborn babies. It’s caused by an inherited genetic fault that means affected babies produce very little or no lactase. The genetic mutation responsible for congenital


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caused by an inherited genetic fault that means affected babies produce very little or no lactase. The genetic mutation responsible for congenital lactase deficiency is passed on in an autosomal recessive inheritance pattern. This means both parents must have a copy of the faulty gene to pass on the condition. Developmental lactase deficiency Some babies born prematurely (before the 37th week of pregnancy) have a temporary lactose intolerance because their small intestine wasn’t fully developed by the time they were born. This is known as developmental lactase deficiency and it usually improves as affected babies get older. Diagnosing lactose intolerance It’s important to visit your GP if you think you or your child may have lactose intolerance, as the symptoms can be similar to other conditions. Before seeing your GP, keep a diary of what you eat and drink, and what symptoms you experience. Tell your GP if you notice any patterns, or if there are any foods you seem particularly


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of what you eat and drink, and what symptoms you experience. Tell your GP if you notice any patterns, or if there are any foods you seem particularly sensitive to. Your GP may suggest trying to remove lactose from your diet for two weeks to see if it helps to relieve your symptoms. This will provide further evidence of whether you’re lactose intolerant. Further testing Other tests aren’t usually needed, but your GP may sometimes suggest further tests to: help confirm the diagnosis find out how much lactase (the enzyme used to digest lactose) your body is producing try to determine what might be causing your lactose intolerance Some of the main tests that may be used are described below. Hydrogen breath test A hydrogen breath test is a simple way of determining if you may be lactose intolerant. You’ll be asked to avoid eating or drinking during the night before the test. When you arrive for the test, you’ll be asked to blow up a balloon-like bag. This sample of your breath will be


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during the night before the test. When you arrive for the test, you’ll be asked to blow up a balloon-like bag. This sample of your breath will be tested to find out how much hydrogen is present, measured in parts per million (ppm). You’ll then be given a drink of lactose solution and your breath will be tested every 15 minutes over the next few hours to see if the level of hydrogen changes. If your breath contains a large amount of hydrogen (more than 20ppm above your baseline) after consuming the lactose solution, it’s likely that you’re lactose intolerant. This is because lactose intolerance can cause the bacteria in the colon (large intestine) to produce more hydrogen than normal. Lactose tolerance test In a lactose tolerance test, you’ll be given a drink of lactose solution and a blood sample will be taken from your arm using a needle. The blood will be tested to see how much glucose (blood sugar) it contains. If you’re lactose intolerant, your blood sugar levels will either rise


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The blood will be tested to see how much glucose (blood sugar) it contains. If you’re lactose intolerant, your blood sugar levels will either rise slowly, or not at all. This is because your body is unable to break down the lactose into glucose. Milk tolerance test In a milk tolerance test, you’ll be given a glass of milk (about 500ml) and your blood sugar levels will be tested. If your blood sugar levels don’t rise after drinking the milk, you may be lactose intolerant. Small bowel biopsy A small bowel biopsy is rarely used to diagnose lactose intolerance. However, it may be carried out to see if your symptoms are being caused by another condition, such as coeliac disease. In a small bowel biopsy, a sample of your small intestinal lining is taken using an endoscope (a thin, flexible tube with a light and a tiny cutting tool at the end) that’s passed down your throat. This will be carried out under local anaesthetic, so it won’t hurt. The sample of intestinal lining will be tested to


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that’s passed down your throat. This will be carried out under local anaesthetic, so it won’t hurt. The sample of intestinal lining will be tested to see how much lactase it contains. If it only contains a small amount of lactase, it’s likely you’re lactose intolerant. The sample can also be examined to look for signs of possible underlying conditions such as coeliac disease. Treating lactose intolerance There’s no cure for lactose intolerance, but most people are able to control their symptoms by making changes to their diet. Some cases of lactose intolerance, such as those caused by gastroenteritis, are only temporary and will improve within a few days or weeks. Other cases, such as those caused by an inherited genetic fault or a long-term underlying condition, are likely to be lifelong. Changing your diet In most cases, cutting down on or avoiding sources of lactose and replacing them with lactose-free alternatives is enough to control the symptoms of lactose intolerance. The exact


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or avoiding sources of lactose and replacing them with lactose-free alternatives is enough to control the symptoms of lactose intolerance. The exact changes you need to make to your diet depend on how sensitive you are to lactose. Some people are able to tolerate some lactose in their diet without any problems, whereas others experience symptoms after consuming food containing only a tiny amount of lactose. If you decide to experiment with what you can and can’t eat, make sure to introduce new foods gradually, rather than all at once. This will help you to get used to any foods you might be sensitive to and identify any that cause problems. Eating fewer products containing lactose, or avoiding them completely, can mean you miss out on certain vitamins and minerals in your diet and increase your risk of complications. You’ll also need to make sure you’re getting enough nutrition from either lacto-free foods or dietary supplements. If you or your child are extremely sensitive to


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to make sure you’re getting enough nutrition from either lacto-free foods or dietary supplements. If you or your child are extremely sensitive to lactose, talk to your GP about your diet. Milk products are rich in calcium needed for healthy bones so you may need to have regular bone density checks. You may be referred to a dietitian (an expert in diet and nutrition) who can advise about what foods should be included in your, or your child’s, diet. Sources of lactose Some of the main sources of lactose you may need to cut down on or avoid if you’re lactose intolerant are described below. Milk A major source of lactose is milk, including cow’s milk, goat’s milk and sheep’s milk. Depending on how mild or severe your lactose intolerance is, you may need to change the amount of milk in your diet. For example: you may be able to have milk in your tea or coffee, but not on your cereal some products containing milk, such as milk chocolate, may still be acceptable in small quantities you may


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your tea or coffee, but not on your cereal some products containing milk, such as milk chocolate, may still be acceptable in small quantities you may find that drinking milk as part of a meal, rather than on its own, improves how the lactose is absorbed If even a small amount of milk triggers your symptoms, there are some alternatives you can try, such as soya or rice milk (see below). Dairy products Other dairy products made from milk, such as butter, ice cream and cheese, can also contain high levels of lactose and may need to be avoided if you’re lactose intolerant. Some dairy products however, such as hard cheese and yoghurt, contain lower levels of lactose than milk and other products, so you may still be able to have them. It’s worth experimenting with different foods to find out if there are any dairy products you can eat because they’re a good source of essential nutrients such as calcium. Other foods and drinks As well as milk and dairy products, there are other foods and


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they’re a good source of essential nutrients such as calcium. Other foods and drinks As well as milk and dairy products, there are other foods and drinks that can sometimes contain lactose. These include: salad cream, salad dressing and mayonnaise biscuits chocolate boiled sweets cakes some types of bread and other baked goods some breakfast cereals packets of mixes to make pancakes and biscuits packets of instant potatoes and instant soup some processed meats, such as sliced ham Check the ingredients of all food and drink products carefully, because milk or lactose are often hidden ingredients. The lactose found in some foods won’t necessarily be listed separately on the food label, so you need to check the ingredients list for milk, whey, curds and milk products such as cheese, butter and cream. Some ingredients may sound like they contain lactose when they don’t, such as lactic acid, sodium lactate and cocoa butter. These ingredients don’t need to be avoided if you’re lactose


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contain lactose when they don’t, such as lactic acid, sodium lactate and cocoa butter. These ingredients don’t need to be avoided if you’re lactose intolerant. Medication Some prescription medicines, over-the-counter medicines and complementary medicines may contain a small amount of lactose. While this isn’t usually enough to trigger the symptoms of lactose intolerance in most people, it may cause problems if your intolerance is severe or you’re taking several different medicines. If you need to start taking a new medication, check with your GP or pharmacist in case it contains lactose. Lactose-free foods and drinks There are a number of alternative foods and drinks available in supermarkets to replace the milk and dairy products you need to avoid. Food and drinks that don’t usually contain lactose include: soya milks, yoghurts and some cheeses milks made from rice, oats, almonds, hazelnuts, coconut, quinoa, and potato foods which carry the ‘dairy-free’ or ‘suitable for vegans’ signs


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cheeses milks made from rice, oats, almonds, hazelnuts, coconut, quinoa, and potato foods which carry the ‘dairy-free’ or ‘suitable for vegans’ signs carob bars You can also buy cow’s milk containing additional lactase (the enzyme used to digest lactose). This means you still get the nutritional benefits of the milk, but you’re less likely to experience any symptoms after consuming it. Getting enough calcium If you’re unable to eat most dairy products, you may not be getting enough calcium in your daily diet. Calcium has several important functions, including: helping build strong bones and teeth regulating muscle contractions (including heartbeat) ensuring blood clots normally Therefore, it’s a good idea to choose lactose-free products with added calcium and ensure your diet contains alternative sources of calcium, such as: green leafy vegetables, such as spinach, kale, broccoli, cabbage and okra soya beans tofu nuts bread and anything made with fortified flour fish containing edible


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such as spinach, kale, broccoli, cabbage and okra soya beans tofu nuts bread and anything made with fortified flour fish containing edible bones (for example, sardines, salmon, and pilchards) You can also buy combined calcium and vitamin D supplements from most pharmacists to help maintain good bone health. It’s important to check with your GP or dietitian whether you should be taking supplements, however, as taking excessively high levels of calcium can cause side effects. Lactase substitutes In addition to dietary changes, you may also find it useful to take liquid drops, tablets or capsules that contain lactase substitutes. These are available from most health foods shops. Lactase substitutes replace the lactase your small intestine isn’t producing, which can reduce your symptoms by helping your body break down any lactose in your diet more easily. Lactase substitutes can either be added to milk or taken just before eating a meal containing lactose. Lactose intolerance in children


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more easily. Lactase substitutes can either be added to milk or taken just before eating a meal containing lactose. Lactose intolerance in children If your child is lactose intolerant, they may be able to consume small amounts of lactose without experiencing symptoms. This is quite safe, but you may need to experiment to find out how much they can comfortably eat or drink. If your child is unable to tolerate any lactose, your doctor may refer you to a dietitian for nutritional advice because it’s important for young children to have certain nutrients in their diet to ensure healthy growth and development. In general, the same rules about foods to try or to avoid are similar for children and adults (see above). For babies with lactose intolerance, lactose-free formula milk is available to buy from pharmacies and supermarkets. However, soya formula isn’t recommended for children under six months because it contains hormones that may interfere with your baby’s future physical and sexual


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formula isn’t recommended for children under six months because it contains hormones that may interfere with your baby’s future physical and sexual development. Breastfed babies may benefit from lactase substitute drops to help their bodies digest the lactose in breast milk. For many children, lactose intolerance is only temporary and will improve after a few weeks. After this point it’s safe to gradually reintroduce milk and dairy products into their diet. Complications of lactose intolerance Milk and other dairy products are an important part of a healthy diet. They contain calcium, protein and vitamins such as vitamins A, B12 and D. Lactose is also important because it helps your body absorb a number of other minerals, including magnesium and zinc. These vitamins and minerals are important for the development of strong, healthy bones. If you are lactose intolerant, getting the right amount of important vitamins and minerals can prove difficult. This may lead to unhealthy weight


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If you are lactose intolerant, getting the right amount of important vitamins and minerals can prove difficult. This may lead to unhealthy weight loss and put you at increased risk of developing the following conditions. Osteopenia – where you have a very low bone-mineral density. If osteopenia is not treated, it can develop into osteoporosis. Osteoporosis – where your bones become thin and weak. If you have osteoporosis, your risk of getting fractures and broken bones is increased. Malnutrition – when the food you eat does not give you the nutrients essential for a healthy functioning body. If you are malnourished, wounds can take longer to heal and you may start to feel tired or depressed. If you are concerned that dietary restrictions are putting you at risk of complications, you may find it helpful to consult a dietitian. They can advise you on your diet and whether you require food supplements. Your GP should be able to refer you to an NHS dietitian free of charge. Alternatively,


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you on your diet and whether you require food supplements. Your GP should be able to refer you to an NHS dietitian free of charge. Alternatively, you can contact a private dietician. The British Dietetic Association has information on how to find a private dietitian. 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 Other health sites Allergy UK: Cow's milk allergy Allergy UK: Cow's milk allergy in adults British Dietetic 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 ©


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https://www.nhsinform.scot/illnesses-and-conditions/cancer/cancer-types-in-adults/laryngeal-larynx-cancer/


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Laryngeal (larynx) 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 Laryngeal (larynx) cancer Laryngeal (larynx) cancer About laryngeal cancer Causes of laryngeal cancer Diagnosing laryngeal cancer Treating laryngeal cancer Recovering from laryngeal cancer Preventing laryngeal cancer About laryngeal cancer Laryngeal cancer is a type of cancer that affects the larynx (voice box). The larynx is part of the throat found at the entrance of the windpipe (trachea). It plays an important role in helping you breathe and speak. The condition is more common in people over the age of 60. It’s about 4 times more common in men than women. Symptoms of laryngeal cancer The main symptoms of laryngeal cancer include: a change in your voice, such as sounding hoarse pain when swallowing or difficulty swallowing a lump or swelling


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of laryngeal cancer include: a change in your voice, such as sounding hoarse pain when swallowing or difficulty swallowing a lump or swelling in your neck a long-lasting cough a persistent sore throat or earache in severe cases, difficulty breathing Some people may also experience bad breath, breathlessness, a high-pitched wheezing noise when breathing, unexplained weight loss, or fatigue (extreme tiredness). When to speak to your GP You should speak to your GP if you have had any of the main symptoms for more than 3 weeks. These symptoms are often caused by less serious conditions, such as laryngitis, but it’s a good idea to get them checked out. If necessary, your GP can refer you to a hospital specialist for further tests to confirm or rule out cancer. Read more about diagnosing laryngeal cancer. What causes laryngeal cancer? It’s not clear exactly what causes laryngeal cancer, but your risk of getting the condition is increased by: smoking tobacco regularly drinking large amounts


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clear exactly what causes laryngeal cancer, but your risk of getting the condition is increased by: smoking tobacco regularly drinking large amounts of alcohol having a family history of head and neck cancer having an unhealthy diet exposure to certain chemicals and substances, such as asbestos and coal dust By adopting a healthy lifestyle, including avoiding alcohol and tobacco, you can significantly reduce your chances of developing laryngeal cancer. Read more about the causes of laryngeal cancer and preventing laryngeal cancer. How laryngeal cancer is treated The main treatments for laryngeal cancer are radiotherapy, surgery and chemotherapy. Radiotherapy or surgery to remove the cancerous cells from the larynx can often cure laryngeal cancer if it’s diagnosed early. If the cancer is advanced, a combination of surgery to remove part or all of the larynx, radiotherapy and chemotherapy can be used. If you have surgery to remove your larynx, you’ll no longer be able to speak or


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part or all of the larynx, radiotherapy and chemotherapy can be used. If you have surgery to remove your larynx, you’ll no longer be able to speak or breathe in the usual way. Instead, you will breathe through a permanent hole in your neck (stoma) and you will need additional treatment to help restore your voice. This may include an implant in your throat, or an electrical device you hold against your throat to produce sound. Read more about treating laryngeal cancer and recovering from laryngeal cancer surgery. Causes of laryngeal cancer Laryngeal cancer is caused by changes in the cells of the larynx, although it’s not clear exactly why this happens. All cancers begin with a change in a cell’s DNA. DNA provides our cells with a basic set of instructions, such as when to grow and reproduce. A change in DNA can alter the instructions that control cell growth, which means cells continue to grow instead of stopping when they should. This causes the cells to reproduce in an


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that control cell growth, which means cells continue to grow instead of stopping when they should. This causes the cells to reproduce in an uncontrollable manner, producing a growth of tissue called a tumour. It’s not known why the DNA inside the cells of the larynx is affected in cases of laryngeal cancer. But it appears that exposure to things that can damage the cells and tissue of the larynx increases the risk of cancer developing. What can increase your risk? A number of things can increase your chances of developing laryngeal cancer. Alcohol and tobacco Alcohol and tobacco are the 2 main things that can increase your risk of developing laryngeal cancer. They’re thought to contain chemicals that can damage the cells of the larynx. The more you drink or smoke, the higher your risk of developing laryngeal cancer. People who smoke more than 25 cigarettes a day, or people who have smoked for more than 40 years, have been found to be about 40 times more likely to develop laryngeal


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than 25 cigarettes a day, or people who have smoked for more than 40 years, have been found to be about 40 times more likely to develop laryngeal cancer than people who don’t smoke. Compared to people who don’t drink, people who regularly drink large amounts of alcohol are about 3 times more likely to develop laryngeal cancer. If you drink and smoke, your risk of laryngeal cancer increases even further. By stopping both drinking and smoking, you can significantly reduce your risk of developing the condition. Read more about preventing laryngeal cancer. Family history People who have a first-degree relative (parent, sibling or child) diagnosed with head or neck cancer are thought to be twice as likely to develop laryngeal cancer as someone without a family history. Diet There’s evidence to suggest that a diet high in red meat, processed food and fried food might increase your risk of developing laryngeal cancer. Having a ‘Mediterranean diet’ or a diet containing plenty of fruit and


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food and fried food might increase your risk of developing laryngeal cancer. Having a ‘Mediterranean diet’ or a diet containing plenty of fruit and vegetables may reduce your risk. Read more about preventing laryngeal cancer. Human papilloma virus (HPV) Human papilloma virus (HPV) is the name given to a group of viruses that affect the skin and moist membranes that line the body, such as those in the cervix (neck of the womb), anus, mouth and throat. HPV is known to cause changes in the cells of the cervix, which can lead to cervical cancer. It’s thought the virus may have a similar effect on the cells of the throat. HPV is often spread during sex, including oral sex. Exposure to harmful substances Having a job where you’re exposed to high levels of certain substances may also increase your risk of developing laryngeal cancer. These include: asbestos coal or wood dust paint or diesel fumes nickel sulphuric acid fumes formaldehyde (a chemical used in a wide range of industrial


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include: asbestos coal or wood dust paint or diesel fumes nickel sulphuric acid fumes formaldehyde (a chemical used in a wide range of industrial processes, such as paint manufacturing and cosmetics) isopropyl alcohol (often used as a cleaning solvent) Diagnosing laryngeal cancer If you have symptoms of laryngeal cancer, such as a hoarse voice and pain when swallowing, your GP will ask about your symptoms and recent medical history. They may also examine the inside and outside of your throat for abnormalities, such as lumps and swellings. If laryngeal cancer is suspected, you’ll probably be referred to the ear, nose and throat (ENT) department of your local hospital for further testing. The National Institute for Health and Care Excellence (NICE) recommends that anyone aged 45 or over with persistent unexplained hoarseness or an unexplained lump in their neck should have an appointment with a specialist within 2 weeks. Nasendoscopy A nasendoscopy is a procedure used to get a clear


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lump in their neck should have an appointment with a specialist within 2 weeks. Nasendoscopy A nasendoscopy is a procedure used to get a clear view of your larynx. During the procedure, a small, flexible tube with a light and video camera at one end (endoscope) is inserted into your nostril and passed down the back of your throat. The images from the endoscope are displayed on a monitor. You’ll usually be awake while this is carried out and it may feel uncomfortable. A local anaesthetic spray is sometimes used to numb your nose and throat beforehand, so you don’t feel any pain. Laryngoscopy If it wasn’t possible to get a good view of your larynx during a nasendoscopy, or a possible problem is spotted, you may have a further test called a laryngoscopy. Like a nasendoscopy, this procedure involves using an endoscope to examine your larynx. However, the endoscope used during a laryngoscopy is longer and inserted through the mouth. This allows the larynx to be seen in greater detail. A


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However, the endoscope used during a laryngoscopy is longer and inserted through the mouth. This allows the larynx to be seen in greater detail. A laryngoscopy can be very uncomfortable, so it’s usually carried out under general anaesthetic (where you’re asleep). You should be able to leave hospital as soon as you’ve recovered from the effects of anaesthetic, which is usually the same day or the day after. Biopsy During a nasendoscopy or laryngoscopy, your doctor may use small instruments to remove a sample of cells from your larynx so it can be examined for signs of cancer. This is known as a biopsy. Alternatively, if you have a lump in your neck, a needle and syringe can be used to remove a tissue sample. This is known as fine needle aspiration. Further testing If the results of the biopsy show you have cancer and there’s a risk it may have spread, you’ll probably be referred for further testing to assess how widespread the cancer is. The tests may include: a computerised tomography


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have spread, you’ll probably be referred for further testing to assess how widespread the cancer is. The tests may include: a computerised tomography (CT) scan – a series of X-rays are taken to build up a more detailed three-dimensional picture of your larynx and the surrounding tissue a magnetic resonance imaging (MRI) scan – a strong magnetic field and radio waves are used to produce a more detailed image of your larynx and the surrounding tissue a PET-CT scan – a CT scan is used to take pictures of the inside of your body after you’ve been injected with a mildly radioactive substance that helps to show cancerous areas more clearly an ultrasound scan – high-frequency sound waves are used to check for signs of cancer in the lymph nodes (glands found throughout the body) near the larynx Staging and grading After these tests have been completed, your doctor should be able to tell you the extent of the cancer. This is known as the stage and grade of the cancer. Healthcare professionals


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your doctor should be able to tell you the extent of the cancer. This is known as the stage and grade of the cancer. Healthcare professionals use a system called the TNM system to stage laryngeal cancer. T describes the size of the tumour, N describes whether cancer has spread to the lymph nodes and M gives an indication of whether the cancer has spread to other parts of the body. the T stage is given as a number from 1 to 4 – small tumours confined to 1 part of the larynx are described as T1 tumours and large tumours that have grown into tissues outside the larynx are described as T4 the N stage is given as a number from 0 to 3 – N0 means the lymph nodes are not affected, whereas stages N2 to N3 mean that 1 or more lymph nodes are affected the M stage is given as either M0 or M1 – M0 means the cancer has not spread to other parts of the body and M1 means that it has There are also 3 different grades (1 to 3) used to describe laryngeal cancer. Lower-grade cancers, such as grade 1,


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the body and M1 means that it has There are also 3 different grades (1 to 3) used to describe laryngeal cancer. Lower-grade cancers, such as grade 1, tend to grow more slowly and are less likely to spread. Higher-grade cancers, such as grade 3, grow quickly and are more likely to spread. You can read more about the stages, types and grades of laryngeal cancer on the Cancer Research UK website. Treating laryngeal cancer The treatment for laryngeal cancer largely depends on the size of the cancer. The main treatments are radiotherapy, surgery and chemotherapy. Most hospitals use multidisciplinary teams (MDTs) of specialists that work together to decide the best way to proceed with your treatment. Members of your MDT will probably include a surgeon, a clinical oncologist (a specialist in the non-surgical treatment of cancer), and a specialist cancer nurse who will be responsible for co-ordinating your care. Your cancer team will recommend what they think is the best treatment option, but


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cancer nurse who will be responsible for co-ordinating your care. Your cancer team will recommend what they think is the best treatment option, but the final decision will be yours. Before visiting hospital to discuss your treatment options, you may find it useful to write a list of questions you’d like to ask your care team. For example, you may want to find out the advantages and disadvantages of particular treatments. Your treatment plan Your recommended treatment plan will depend on the stage of the cancer (see diagnosing laryngeal cancer for more information on staging). If you have early-stage laryngeal cancer, it may be possible to remove the cancer using surgery (endoscopic resection) or radiotherapy alone. This may also be the case with slightly larger cancers, although a combination of surgery and radiotherapy is sometimes required. In later-stage laryngeal cancer, more extensive surgery may be needed. Radiotherapy and chemotherapy will probably be used in combination. In


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In later-stage laryngeal cancer, more extensive surgery may be needed. Radiotherapy and chemotherapy will probably be used in combination. In some cases, the entire larynx may have to be removed. A medication called cetuximab may be used in cases where chemotherapy is not suitable. Radiotherapy Radiotherapy uses controlled doses of high-energy radiation to destroy cancerous cells. It can be used as a treatment on its own for early-stage laryngeal cancer, or it can be used after surgery to stop cancerous cells returning. It’s sometimes combined with chemotherapy. The energy beams used during radiotherapy have to be precisely targeted to your larynx. To ensure the beams are directed at the exact area, a special plastic mask will be made to hold your head in the right position. A mould of your face will be taken so that the mask can be made before treatment starts. Radiotherapy is usually given in short daily sessions from Monday to Friday, with a break from treatment at the weekend. The


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before treatment starts. Radiotherapy is usually given in short daily sessions from Monday to Friday, with a break from treatment at the weekend. The course of treatment usually lasts for 3 to 7 weeks. As well as killing cancerous cells, radiotherapy can affect healthy tissue and has a number of side effects, including: sore, red skin (similar to sunburn) mouth ulcers dry mouth loss of taste loss of appetite tiredness feeling sick Your MDT will monitor any side effects and treat them when possible. For example, protective gels can be used to treat mouth ulcers, and medicines are available for a dry mouth. Radiotherapy can sometimes cause your throat tissue to become inflamed. Severe inflammation can cause breathing difficulties. Contact your key worker or visit your local accident and emergency (A&E) department as soon as possible if you have difficulty breathing. Most side effects should pass within a few weeks of treatment finishing. Read more about radiotherapy. Surgery There are 3


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have difficulty breathing. Most side effects should pass within a few weeks of treatment finishing. Read more about radiotherapy. Surgery There are 3 types of surgery that can be used to treat laryngeal cancer. They are: endoscopic resection partial laryngectomy total laryngectomy Endoscopic resection Endoscopic resection can be used in early-stage laryngeal cancer. During the procedure, a surgeon uses a special microscope to get a magnified view of the larynx. This allows them to remove the cancer either with a laser or small surgical instruments. An endoscopic resection is carried out under general anaesthetic, so you will be unconscious during the procedure and won’t feel any pain. Your mouth and throat may feel sore for a few weeks after the operation and there’s a risk of your voice changing as a result of the procedure, which can be permanent. Partial laryngectomy A partial laryngectomy can be used to treat some laryngeal cancers. The operation involves surgically removing the


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be permanent. Partial laryngectomy A partial laryngectomy can be used to treat some laryngeal cancers. The operation involves surgically removing the affected part of your larynx. Some of your vocal cords will be left in place, so you will still be able to talk, but your voice may be quite hoarse or weak. While your larynx is healing, you may find breathing difficult. Your surgeon may need to create a temporary hole in your neck, which will be attached to a tube you can breathe through. This is known as a temporary tracheostomy. Once your larynx has healed, the tube can be removed and the hole will heal, leaving a small scar. This operation is uncommon nowadays, as endoscopic resection is preferred whenever possible. Total laryngectomy A total laryngectomy is usually used to treat advanced laryngeal cancer. The operation involves removing your entire larynx. Nearby lymph nodes (small glands that form part of the immune system) may also need to be removed if the cancer has spread to


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your entire larynx. Nearby lymph nodes (small glands that form part of the immune system) may also need to be removed if the cancer has spread to them. As your vocal cords will be removed, you won’t be able to speak in the usual way after the operation. However, there are several ways to help restore your speech. If you have a total laryngectomy, your surgeon will also need to create a permanent hole in your neck (called a stoma) to help you breathe after the operation. You will be given training on how to keep your stoma clean. Having a stoma can seem daunting and frightening at first, but most people get used to it after a few months. See recovering from laryngeal cancer for more information about speaking after surgery and looking after a stoma. Chemotherapy Chemotherapy uses powerful cancer-killing medicines to damage the DNA of the cancerous cells and stop them reproducing. It may be used to shrink a tumour before surgery or radiotherapy, or in combination with radiotherapy to


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cancerous cells and stop them reproducing. It may be used to shrink a tumour before surgery or radiotherapy, or in combination with radiotherapy to make the radiotherapy more effective. It can also be used to treat laryngeal cancer that’s advanced or has come back after treatment. In this situation, it can relieve symptoms and may slow the cancer’s growth. Chemotherapy medication is usually given as an injection into a vein (intravenously) once every 3 or 4 weeks, for up to 6 months. You may need to stay in hospital for a few days during each treatment or you may just come in for a short visit each time. Chemotherapy can sometimes damage healthy tissue as well as the cancerous tissue. This, unfortunately, means side effects are common, such as: feeling and being sick hair loss loss of appetite diarrhoea sore mouth and mouth ulcers tiredness Chemotherapy can also weaken your immune system, making you more vulnerable to infection and illness. It’s therefore important to report any


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Chemotherapy can also weaken your immune system, making you more vulnerable to infection and illness. It’s therefore important to report any symptoms of potential infection to your MDT, such as a high temperature, chills or a persistent cough. You should also avoid close contact with people known to have an infection. The side effects of chemotherapy should improve after your treatment has finished. Read more about chemotherapy. Cetuximab Cetuximab is a type of medication called biological therapy. These medications target and disrupt the processes that cancerous cells use to grow and reproduce. Cetuximab can be used in combination with radiotherapy to treat more advanced laryngeal cancer, when it’s not possible to use chemotherapy. For example, people with kidney or heart disease, or people with an ongoing infection, may not be able to have chemotherapy, because it could make them very ill. Cetuximab is given slowly through a drip into your vein (intravenously) for up to an hour or


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have chemotherapy, because it could make them very ill. Cetuximab is given slowly through a drip into your vein (intravenously) for up to an hour or more. It’s usually given weekly for up to 7 weeks. Side effects of cetuximab are usually mild and include: rashes feeling sick diarrhoea breathlessness Cetuximab can also trigger allergic reactions in some people, which can cause problems such as a swollen tongue or throat. In a few cases, the reaction can be severe and potentially life-threatening. Most serious reactions occur within a day of treatment starting, so you’ll be closely monitored once your treatment begins. If you have symptoms of a severe reaction, such as a rapid heartbeat or breathing problems, medication can be used to relieve them (such as corticosteroids). Recovering from laryngeal cancer If you’ve had some or all of your larynx removed (laryngectomy), it’s likely that you’ll need to spend 1 or 2 days in an intensive care unit until you’ve recovered. You won’t be able


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larynx removed (laryngectomy), it’s likely that you’ll need to spend 1 or 2 days in an intensive care unit until you’ve recovered. You won’t be able to eat until your throat has healed, which for most people takes at least a week or two. While your throat heals, you’ll need to be fed through a tube that’s passed through your nose and into your stomach. If you’ve had all of your larynx removed (total laryngectomy), you won’t be able to speak normally, because you will no longer have vocal cords. A number of techniques can be used to replicate the functions of your vocal cords although they can take weeks or months to learn. Therefore, it’s likely that you’ll need to use alternative methods of communicating, such as using a pen or paper, during the first few weeks or months after surgery. This can be a frustrating experience – the loss of something you’ve previously taken for granted can be difficult to cope with. Try to prepare yourself for strangers reacting in unpredictable and


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of something you’ve previously taken for granted can be difficult to cope with. Try to prepare yourself for strangers reacting in unpredictable and possibly upsetting ways. Some people who have had a laryngectomy have reported that other people sometimes assume they’re deaf or have a learning difficulty because of their inability to speak. Your emotions The emotional impact of living with a laryngectomy can be significant. Many people report experiencing a rollercoaster effect. For example, you may feel down when laryngeal cancer is diagnosed, then feel up after the cancer has been removed, then feel down again as you try to come to terms with the practicalities of living with a laryngectomy. These emotional changes can sometimes trigger feelings of depression. You may be depressed if you have felt very down during the past month and you no longer take pleasure in doing things you enjoy. Contact your GP or care team for advice if you think you may be depressed. There are a range of


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no longer take pleasure in doing things you enjoy. Contact your GP or care team for advice if you think you may be depressed. There are a range of effective treatments available. The National Association of Laryngectomee Clubs (NALC) is also a useful resource for people trying to come to terms with living with a laryngectomy. NALC is a patient support group that provides advice on all aspects of living with a laryngectomy. Looking after your stoma If you’ve had all of your larynx removed, the surgeon will need to create a permanent hole in your throat through which you will breathe (a stoma). During the first few months after surgery, it’s likely that your stoma will produce a lot of mucus, particularly if you’ve had radiotherapy. Excessive mucus can cause breathing difficulties, so a tube may be attached to your stoma to help you breathe more easily. Once the production of mucus has settled down, the tube can be removed. It’s important to clean your stoma at least once a day,


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breathe more easily. Once the production of mucus has settled down, the tube can be removed. It’s important to clean your stoma at least once a day, otherwise it can become crusty and may become vulnerable to infection. A specialist nurse can teach you how to keep your stoma clean. You’ll be given special filters to place over your stoma that can help keep your stoma moist and free of germs. It’s important to remember that you’ll need to cover your stoma with a tissue when you cough or sneeze, rather than covering your mouth or nose. This is because mucus or saliva will come out of your stoma. Speaking after surgery If your larynx has been completely removed as part of your treatment for laryngeal cancer, you’ll need additional treatment to help restore your voice. Before your laryngectomy, you may meet a speech and language therapist (SLT) to discuss possible treatment options for restoring your voice. An SLT is a healthcare professional who specialises in helping people who have


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(SLT) to discuss possible treatment options for restoring your voice. An SLT is a healthcare professional who specialises in helping people who have difficulties speaking and using language. There are several different treatment options. Voice prosthesis A voice prosthesis is an artificial valve implanted into your neck. When you want to speak, you cover the stoma and breathe out through the valve. The valve produces a noise, which you can use to make words by moving your lips and mouth in the usual way. The voice that’s produced by the valve sounds natural, although it may be lower-pitched than your previous voice. If you choose to have a voice prosthesis, it can be fitted during the surgery to remove your larynx. Oesophageal speech Oesophageal speech is a technique for speaking that your SLT can teach you. It involves learning to push air through your oesophagus (gullet). As the air moves through your oesophagus, it vibrates and makes a noise. You can produce words by moving your


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air through your oesophagus (gullet). As the air moves through your oesophagus, it vibrates and makes a noise. You can produce words by moving your lips and mouth. Some people find it quite easy to learn oesophageal speech, whereas others find it difficult. Regular practice by yourself and with your SLT can help you improve. Electrolarynx An electrolarynx is a small, battery-operated electrical device that vibrates and produces sound. You hold the device under your chin, and as you move your mouth and lips the vibrations translate into spoken words. Your SLT can train you to use it correctly. Preventing laryngeal cancer It’s thought that most laryngeal cancers can be prevented by adopting a healthy lifestyle. Avoiding tobacco products, cutting down on how much alcohol you drink and having a healthy diet are particularly important in reducing your chances of developing the condition. Avoiding tobacco products Using tobacco products increases your chances of developing several different


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your chances of developing the condition. Avoiding tobacco products Using tobacco products increases your chances of developing several different types of cancer, including laryngeal cancer. Tobacco comes in many forms, including: cigarettes pipe tobacco cigars cigarillos snuff (powdered tobacco snorted through the nose) chewing tobacco If you smoke or use other tobacco products, stopping will have both short- and long-term health benefits, including significantly reducing your risk of developing laryngeal cancer. If you decide to stop smoking your free NHS stop smoking service can help you give up. You can also call Quit Your Way Scotland on 0800 84 84 84 for free expert advice and support. If you want to stop smoking, but don’t want to be referred to a stop smoking service, your GP should be able to prescribe medical treatment to help with any withdrawal symptoms you may have. Read more about stopping smoking. Cutting down on alcohol Staying within the recommended guidelines for


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with any withdrawal symptoms you may have. Read more about stopping smoking. Cutting down on alcohol Staying within the recommended guidelines for alcohol consumption will also reduce your risk of developing laryngeal and liver cancers. Studies have found that your risk of developing laryngeal cancer reduces significantly within 5 to 10 years of not drinking, and after 20 to 30 years your risk is about the same as someone who has never drunk alcohol. Contact your GP if you’re finding it difficult to reduce the amount of alcohol you drink. You may need additional treatment, which could include counselling, group work or medication. Read more about treatments for alcohol misuse and tips on cutting down how much you drink. Healthy diet Research shows a diet that contains plenty of fresh fruits and vegetables, particularly tomatoes, citrus fruit (such as oranges, grapefruits and lemons), olive oil and fish oil, may reduce your risk of getting laryngeal cancer. This type of diet is


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fruit (such as oranges, grapefruits and lemons), olive oil and fish oil, may reduce your risk of getting laryngeal cancer. This type of diet is sometimes known as a ‘Mediterranean diet’. Eating plenty of fruit and vegetables each day may help to reduce your chances of developing many types of cancer, including laryngeal cancer. Read about food and diet and healthy eating for more information and advice. 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 Radiotherapy Chemotherapy Other health sites Cancer Research UK: Laryngeal cancer Macmillan Cancer Support: Laryngeal cancer National Association of Laryngectomee Clubs Scottish Cancer Network:


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Cancer Research UK: Laryngeal cancer Macmillan Cancer Support: Laryngeal cancer 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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Laryngitis | 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 Laryngitis Laryngitis Laryngitis is inflammation of the larynx (voice box). In most cases, it gets better without treatment in about a week. Symptoms of laryngitis Symptoms of laryngitis can begin suddenly and usually get worse over a period of 2 to 3 days. Common symptoms of laryngitis include: hoarseness difficulty speaking sore throat mild fever irritating cough a constant need to clear your throat The hoarse voice and speaking difficulties usually get worse each day you’re ill. They may last for up to a week after the other symptoms have gone. In a few cases, the larynx can swell and cause breathing difficulties. This isn’t common in adults but can happen in young children who have smaller, narrower windpipes. Laryngitis is often linked to another illness. For


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This isn’t common in adults but can happen in young children who have smaller, narrower windpipes. Laryngitis is often linked to another illness. For example, a cold, flu, throat infection or tonsillitis. So you might also have other symptoms such as: a headache swollen glands runny nose pain when swallowing feeling tired and achy When to get medical advice Speak to your GP practice if: You or your child: have symptoms that are particularly severe or they last longer than 2 weeks experience breathing difficulties Things you can do to help your symptoms Do drink plenty of water try to rest your voice as much as possible Don’t do not smoke do not spend time in smoky or dusty places Treating the underlying cause If you see your GP, they’ll discuss the possible causes with you and may refer you for tests or to a specialist in hospital. In some cases, it may be possible to treat the underlying cause of laryngitis. For example, if the symptoms are caused by an allergic reaction, you may be


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cases, it may be possible to treat the underlying cause of laryngitis. For example, if the symptoms are caused by an allergic reaction, you may be able to: avoid the thing you’re allergic to take medication to help control your allergy What causes laryngitis In most cases, laryngitis is caused by either: a viral infection – such as a cold or flu irritation to your larynx – for example by straining your voice or reflux In these cases, most of the symptoms usually pass within a week. This is known as acute laryngitis. Laryngitis can occasionally last much longer. This is known as chronic laryngitis. Chronic laryngitis can be caused by: smoking alcohol misuse reflux How to prevent laryngitis As laryngitis is often caused by a common viral infection, such as a cold or flu, it’s not always possible to prevent it. There are things you can reduce your risk of developing the condition. Do avoid smoking make sure you have the flu vaccine every year if you’re eligible wash your hands often,


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your risk of developing the condition. Do avoid smoking make sure you have the flu vaccine every year if you’re eligible wash your hands often, especially before handling food and after using the toilet avoid close contact with people who have respiratory infections, such as a cold or flu – particularly if you’re prone to laryngitis avoid irritants, such as smoke or dust – particularly if you have a cold or other respiratory infection raise your head with pillows when you’re sleeping to protect your larynx from any acid reflux from your stomach during sleep avoid regularly clearing your throat as this can irritate the larynx – try small sips of water instead follow the low-risk drinking guidelines when drinking alcohol avoid shouting or singing loudly or for long periods of time Source: ENT Scotland - Opens in new browser window Last updated: 13 May 2024 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Don’t include personal


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Last updated: 13 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 Common cold Flu Tonsillitis 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/pregnancy-and-childbirth/losing-a-baby/late-miscarriage/


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Late miscarriage | 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 Pregnancy and childbirth Losing a baby Late miscarriage Late miscarriage A late miscarriage happens after 12 weeks and before 24 weeks. Read more about early miscarriage (when you miscarry before 12 weeks) Read more about stillbirth (when your baby dies after 24 weeks or during birth) Phone 999 or go to your nearest A&E if you: have sharp, sudden and intense stomach pains feel very dizzy or faint feel very sick look very pale have vaginal bleeding or spotting, commonly after the pain has started have pain in your shoulder tip have diarrhoea and are vomiting Get medical help if you’re pregnant and: you’re bleeding from your vagina you’ve got strong, cramping pain your waters break you have started to feel your baby move (usually this is from about 16-24 weeks) and the movements have


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got strong, cramping pain your waters break you have started to feel your baby move (usually this is from about 16-24 weeks) and the movements have slowed down or stopped If you’re registered, contact your midwife or local maternity unit. If you’re not registered, contact your GP or NHS 24 on 111. Symptoms of late miscarriage Signs of a late miscarriage can include: vaginal bleeding strong cramping pain a gush or trickle of liquid from your vagina your baby’s movements changing, like slowing down or stopping Experiencing these miscarriage symptoms does not mean that you’re definitely having a late miscarriage. But, you should contact your maternity service if you’re concerned. If you’re not registered yet, contact your GP. If your GP is closed, phone NHS 24 on 111. It’s possible to first discover you’ve lost your baby during an antenatal appointment. This does not mean you missed the symptoms of a miscarriage. Some people have a later miscarriage without experiencing symptoms. Causes


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appointment. This does not mean you missed the symptoms of a miscarriage. Some people have a later miscarriage without experiencing symptoms. Causes of late miscarriage Most of the time there’s no clear reason why a miscarriage happens, but it’s unlikely to be caused by anything you did or did not do. Read more about the causes of a miscarriage What happens during a late miscarriage If you’re experiencing a late miscarriage, you may go into very premature labour. If this doesn’t happen, your doctor or midwife might recommend that your labour is induced (started by a midwife or doctor). If the loss of your baby has been found during a scan or another appointment, you may be offered different options for how you want to proceed. You may be able to: choose to have an induction (to have labour started) as soon as possible choose to delay induction until you’ve gone home and seen family members choose expectant management, where you go home and wait for labour to start naturally Your


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induction until you’ve gone home and seen family members choose expectant management, where you go home and wait for labour to start naturally Your doctor or midwife will support you with the information you need to choose what’s right for you. If you choose expectant management, they’ll make sure you know what to look for and when to attend hospital. They’ll also give you guidance on what to do if labour doesn’t start, and what you can expect your baby to look like when they’re born. Sometimes, you’ll not be able to choose to wait to deliver your baby. This might be the case if: you’re bleeding heavily and continuously you’re showing signs of infection your waters have broken Induction of labour If you’re having an induction you’ll have to go into hospital. The doctor or midwife caring for you will explain what to expect. They can tell you about pain relief and how long labour might take. Induction is usually a 2-stage process. First you’ll be a given a medicine called mifepristone.


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you about pain relief and how long labour might take. Induction is usually a 2-stage process. First you’ll be a given a medicine called mifepristone. This is a tablet that you swallow. After taking this, you may be able to go home and return 36-48 hours later to start labour. This is because it takes 36-48 hours for the mifepristone to work best. When you return, you’ll be given prostaglandin tablets every few hours until you have regular contractions. You will then go through labour, and your baby will be born. Everyone responds differently to induction. For some the labour and birth happens quickly, for others it can take several hours. Think about what emotional support you’ll need. A partner, friend or family member can stay with you throughout. Your doctor or midwife will discuss this with you. Memory making There’s no right or wrong thing to do. It depends on how you (and your partner, if you have one) feel. Your doctor or midwife will discuss your options with you, and can make


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thing to do. It depends on how you (and your partner, if you have one) feel. Your doctor or midwife will discuss your options with you, and can make suggestions about memory making. Take some time to think about it beforehand if you can. You might be unsure about what your baby will look like. The doctor or midwife looking after you can describe your baby. Depending on how far along in your pregnancy you are, you may be able to see and hold them if you want to. You may also ask medical professionals to take a photo for you to look at later in private. It may not be possible to tell the sex of your baby. This is something you can talk about with your doctor or midwife. Some people prefer to think of their baby as one sex or the other. There’s no right or wrong way to approach this. You may also like to invite other family members to spend time with your baby. It is, however, your choice. Whatever you choose, the medical professionals caring for you will support your choices. There is


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time with your baby. It is, however, your choice. Whatever you choose, the medical professionals caring for you will support your choices. There is no formal registration process for babies lost before 24 weeks. However, you can record your loss in the Memorial Book of Pregnancy and Baby Loss Prior to 24 Weeks. What happens to my baby after a late miscarriage If you lose your baby before 24 weeks, there’s no legal requirement to have a burial or cremation. The decision about what happens is a very personal one for you and your loved ones. You’ll be guided through this process by the healthcare professionals looking after you. Some hospitals do offer burials and cremations for babies lost before 24 weeks. This may be a shared cremation, which is when your baby is cremated with other babies rather than alone. You can ask your healthcare professional about the arrangements at your hospital. If you opt for hospital cremation, you’ll be given written information about your options. You may


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about the arrangements at your hospital. If you opt for hospital cremation, you’ll be given written information about your options. You may want to make your own arrangements. Some people choose to use a funeral director or specialist cremation service. Others choose to bury the remains or scatter the ashes at home or somewhere else that is meaningful to them. You might not be ready to decide right now. There’s no rush and those caring for you will help you make decisions at a pace that feels right for you. They should also give you a person to contact in case you change your mind, and let you know how long you have to make any changes. Tests and treatments You may be offered tests for both you and your partner. These will try to find out why you lost your baby. Your doctor or midwife will explain what your test results are, and what they mean for a future pregnancy if you want to get pregnant again. Your doctor or midwife may also offer to carry out a post-mortem on your baby. This


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mean for a future pregnancy if you want to get pregnant again. Your doctor or midwife may also offer to carry out a post-mortem on your baby. This will only be done with your permission. In many cases, tests and a post-mortem are unlikely to explain why you had a miscarriage. But, they may rule out some possibilities and perhaps reassure you if you want to try to get pregnant again in the future. It’s important to remember that most people are likely to have a successful pregnancy in the future, particularly if their test results are normal. Physical recovery from a late miscarriage There are physical changes to your body that you may experience after a late miscarriage. Breastmilk Your breasts may produce milk in the first few days after your miscarriage. It can make them feel very large, tight, painful and tender. To help reduce the amount of milk you produce you could try: applying ice packs (or a bag of frozen peas) covered in a light cloth to your breasts wearing a well-fitting


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of milk you produce you could try: applying ice packs (or a bag of frozen peas) covered in a light cloth to your breasts wearing a well-fitting bra using pain relief like ibuprofen or paracetamol expressing small amounts by hand (just enough to ease the pain, otherwise you’ll encourage the production of more milk) taking a warm shower, which may encourage your milk to leak naturally. You may find it helpful to wear breast pads for the first few days. You may be able to get medication to suppress your milk, though these are not suitable for everyone. Speak to the doctor or midwife treating you if you’d like further information. Some people decide to donate their milk to help other babies. Donated breastmilk helps other babies whose mothers are unable to give breastmilk. Some people find some comfort in being able to help others. Read more about donating breast milk After-pains/stomach cramps It’s common to have after-pains after a late miscarriage. They can feel similar to labour


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more about donating breast milk After-pains/stomach cramps It’s common to have after-pains after a late miscarriage. They can feel similar to labour contractions, cramps or strong period pains. This is your womb contracting back to its normal size and usual location (down inside your pelvis). Painkillers, like paracetamol, can help with this. Vaginal bleeding (lochia) After the miscarriage, you’ll bleed from the vagina. This type of bleeding is called lochia. It’s your body’s way of removing the tissue that formed to help your baby grow. It includes: the lining of your womb blood from where your placenta was attached This bleeding is likely to be heavy for around 2 weeks and then lighter for a further 4-6 weeks. It may have some small lumps or clots in it. The colour will change from red, to pink, to brown. The flow of this bleeding can increase and decrease. Do not worry if you find you have lighter days followed by heavier days. This is normal. During this time, you should use


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can increase and decrease. Do not worry if you find you have lighter days followed by heavier days. This is normal. During this time, you should use external period products (like pads) rather than internal period products (like tampons). This can help to avoid infection. Contact your maternity unit if: you’re filling a large sanitary pad in 1 to 2 hours you’re passing blood clots larger than a £2 coin It’s hard to say when your first normal period will happen. It’s likely it will be about 4 to 6 weeks after your miscarriage. It can sometimes be hard to know whether it’s lochia, or your first period. Sometimes your first period is different than your normal period. This isn’t unusual. There’s no need to be concerned. You may find that your first period reminds you of your miscarriage. Some people find this upsetting, while others find it a welcome sign that they can try to conceive again. If you do find it distressing, there’s support available to help you. Support after a miscarriage


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a welcome sign that they can try to conceive again. If you do find it distressing, there’s support available to help you. Support after a miscarriage There’s no right or wrong way to feel after a miscarriage. You, your partner (if you have one), and other members of your family, may be feeling grief, shock and sadness. You may find it helpful to look for more support from specialist organisations. Read more about support after a miscarriage 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. 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 Causes of miscarriage Early miscarriage Finding support after baby loss Stillbirth Other health sites Memorial Book of Pregnancy and Baby Loss


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inform Causes of miscarriage Early miscarriage Finding support after baby loss Stillbirth Other health sites Memorial Book of Pregnancy and Baby Loss Prior to 24 Weeks Milk Bank Scotland 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/healthy-living/womens-health/later-years-around-50-years-and-over#menopause-and-post-menopause-health


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Later years | 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 Healthy living Women's health Later years (around 50 years and over) Later years (around 50 years and over)In this period of life, some women experience more complex health needs. Mental health Mental health Includes stress, depression, insomnia and eating disorders Mental health self-help guides Self-help guides that use cognitive behavioural therapy (CBT) Mental wellbeing Advice dealing with low mood, anxiety, phobias, stress and where you can get help Menopause and post menopause health Menopause An overview of menopause, including peri and post menopause Early and premature menopause Information about early and premature menopause Signs and symptoms of menopause Information around the symptoms of menopause After the menopause Find out about how things might change when you are postmenopause Menopause and your


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Information around the symptoms of menopause After the menopause Find out about how things might change when you are postmenopause Menopause and your mental wellbeing Information about how menopause can impact your mental wellbeing Treating menopause symptoms Information about the options available to treat symptoms of menopause Hormone replacement therapy (HRT) Information about hormone replacement therapy (HRT) Menopause and the workplace Information on menopause and the workplace Sexual wellbeing, intimacy and menopause Information about sexual wellbeing during and after the menopause Supporting someone through the menopause Find out about how you can support someone through the menopause Menopause videos Videos about menopause including common myths and how to talk to your GP Self-help tool: Menopause and mental wellbeing Help with anxiety, stress, depression, anger, self-esteem and sleep Pharmacy services Women’s health: How your pharmacist can help Your nearest pharmacy can help


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stress, depression, anger, self-esteem and sleep Pharmacy services Women’s health: How your pharmacist can help Your nearest pharmacy can help you with advice, support and treatment for a variety of women’s health symptoms and conditions Periods and menstrual health Periods (menstruation) Information about periods including pain and PMS Choosing period products Information about period products and where to get them Stuck or lost tampon Learn how to remove a stuck tampon yourself and when to get help Periods (menstruation) videos Videos about periods including irregular periods and PMS Delayed start to periods Information about delayed and irregular periods Periods and pregnancy Information about how periods are linked to fertility Period pain (dysmenorrhoea) Information about period pain including ways to help Premenstrual Syndrome (PMS) Information about PMS and PMDD Heavy periods Information about what heavy periods are, what can cause them and when to speak to your doctor


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(PMS) Information about PMS and PMDD Heavy periods Information about what heavy periods are, what can cause them and when to speak to your doctor Irregular periods Information about irregular periods including possible causes and when to speak to your doctor Paused periods Information about why you may have stopped your period Adenomyosis Information about adenomyosis including diagnosis and treatment Endometriosis Learn about endometriosis symptoms and treatments Fibroids Learn about fibroids symptoms and treatments Ovarian cyst Learn about ovarian cyst symptoms and treatments Polycystic ovary syndrome (PCOS) Information about polycystic ovary syndrome (PCOS) symptoms and treatment Self-help tool: Periods and mental wellbeing Help with anxiety, low mood, anger, self-esteem, sleep problems and social anxiety Vaginal health Managing genital symptoms Advice about common genital symptoms including pain, spots and itching Vaginal discharge Learn about vaginal discharge, changes to look


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symptoms Advice about common genital symptoms including pain, spots and itching Vaginal discharge Learn about vaginal discharge, changes to look for, and when to speak to a doctor Thrush Learn about thrush symptoms and treatments Bacterial vaginosis Learn more about bacterial vaginosis symptoms, treatments and how to avoid getting it. Sexual health and contraception Sexual health Information about sexually transmitted infections (STIs) Contraception Find out where to get contraception, how to use it and which types are available Pelvic health Pelvic floor muscles Learn how to exercise your pelvic floor muscles Pelvic organ prolapse Learn about pelvic organ prolapse symptoms and treatments Transvaginal mesh implants Information on transvaginal mesh implants which are used for treating pelvic organ prolapse or stress urinary incontinence Urinary incontinence in women Learn about symptoms and treatments of urinary incontinence in women Urinary tract infection (UTI) Urinary tract


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Urinary incontinence in women Learn about symptoms and treatments of urinary incontinence in women Urinary tract infection (UTI) Urinary tract infections (UTIs) are common infections that affect the bladder, kidneys and connected tubes. Screening Cervical screening Who'll be offered a smear test in Scotland and what happens next if the test finds changes that need further investigation Bowel screening Who'll be offered bowl screening in Scotland and how it's done Breast screening Who'll be offered breast screening in Scotland and how a mammogram is done Long term conditions Cancer Information on different cancer types and advice on living with cancer Chronic pain Information about pain that lasts longer than 12 weeks, or beyond the natural healing time Irritable bowel syndrome (IBS) Learn about irritable bowel syndrome symptoms and treatments Lipoedema Information about lipoedema, a long term (chronic) condition of fat and connective tissue Surgical procedures Mastectomy Information


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Lipoedema Information about lipoedema, a long term (chronic) condition of fat and connective tissue Surgical procedures Mastectomy Information about the mastectomy procedure, including how it's performed Breast and cosmetic implants Learn about breast and cosmetic implants and when they're used Caesarean section (C-section) Information about C-section, including how it's performed and when it might be needed Hysteroscopy Information about hysteroscopy, including how it's carried out and when it may be needed Hysterectomy Information about hysterectomy, including types of hysterectomy and why it may be needed Thyroid Underactive thyroid Learn about underactive thyroid symptoms and treatments Overactive thyroid Learn about overactive thyroid symptoms and treatments Thyroid cancer Learn about thyroid cancer, a rare type of cancer that affects the thyroid gland located at the base of the neck Women's heart health Women’s heart health Heart disease affects women as well as men. It's


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affects the thyroid gland located at the base of the neck Women's heart health Women’s heart health Heart disease affects women as well as men. It's important to know the symptoms of heart disease and when to get help. Medical devices Breast and cosmetic implants Learn about breast and cosmetic implants and when they're used Breast and Cosmetic Implant Registry Learn about the Breast and Cosmetic Implant Registry and why it's useful Essure contraceptive device Essure is a contraceptive medical device that's no longer offered Support after rape or sexual assault Turn to SARCS The NHS Scotland sexual assault self-referral phone service can help to arrange care for you in the days following a rape or sexual assault Where to find support if you’ve been raped or sexually assaulted Support is available from NHS Scotland, Police Scotland, charities and support organisations Supporting someone who has been raped or sexually assaulted Information to help people support someone who has


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charities and support organisations Supporting someone who has been raped or sexually assaulted Information to help people support someone who has experienced sexual violence Vaccines Older adults over 65 Immunisations for older adults over 65 years include the shingles, pneumococcal and flu vaccinations. Find out more about these vaccines, and when and where to get them. 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/leg-cramps/


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Lichen planus | 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 Lichen planus Lichen planus About lichen planus Symptoms of lichen planus Causes of lichen planus Diagnosing lichen planus Treating lichen planus Complications of lichen planus About lichen planus Lichen planus is a non-infectious, itchy rash that can affect many areas of the body. Affected areas can include the: arms, legs and trunk mouth (oral lichen planus) nails and scalp vulva, vagina and penis The exact cause of lichen planus is unknown. However, the condition isn’t infectious and doesn’t usually run in families. It can’t be passed on to other people, including sexual partners. A GP can usually diagnose lichen planus by examining the rash and asking about your symptoms. Oral lichen planus is often diagnosed by a dentist during routine dental check-ups. Lichen


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by examining the rash and asking about your symptoms. Oral lichen planus is often diagnosed by a dentist during routine dental check-ups. Lichen planus is an itchy rash that can occur anywhere on the body.Source: https://dermnetnz.org/ Who’s affected by lichen planus Lichen planus is thought to affect 1-2% of the worldwide population. It’s more common in adults over the age of 40. Lichen planus of the skin affects men and women equally. However, oral lichen planus is more common in women. The mouth is affected in around 50% of all cases of lichen planus (oral lichen planus). Treating lichen planus There’s no single treatment that can cure lichen planus completely. However, treatments are available to help manage the symptoms and make living with it easier. For example, steroid creams or ointments are often used to help relieve the itch and control the rash. Most cases of lichen planus of the skin clear up on their own within 6 to 9 months. The rash rarely lasts longer than 18 months.


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control the rash. Most cases of lichen planus of the skin clear up on their own within 6 to 9 months. The rash rarely lasts longer than 18 months. However, oral lichen planus and lichen planus that affects the genital area may be more persistent. Read more about how lichen planus is treated. Erosive lichen planus Erosive lichen planus is a rare form of lichen planus that can last a long time. It causes painful ulcers to develop in the mouth and in the genital areas of both males and females. In some cases, long-term erosive lichen planus can increase the chance of some types of cancer developing. Read our page on complications of lichen planus for more information about erosive lichen planus. Symptoms of lichen planus The symptoms of lichen planus vary, depending on which area of the body is affected. Areas of the body most commonly affected by the condition include the: skin mouth penis vulva (external female sex organs) and vagina Lichen planus causes symptoms like itchy skin and


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by the condition include the: skin mouth penis vulva (external female sex organs) and vagina Lichen planus causes symptoms like itchy skin and red, slightly raised, bumps.Source: https://dermnetnz.org/ Lichen planus of the skin The symptoms of lichen planus of the skin are: purple-red coloured bumps (papules) that are slightly raised, shiny and have a flat top. The papules usually measure 3-5mm in diameter and may also have irregular white streaks (Wickham’s striae) thicker scaly patches can appear, usually around the ankles – this is known as hypertrophic lichen planus itchy skin Lichen planus of the skin often affects the wrists, ankles and lower back, although other parts of the body can also be affected. Thickened (hypertrophic) lichen planus affects the shins, and ring-shaped lichen planus affects creases in the skin, such as the armpits. After the papules have cleared, the affected area of skin can sometimes become discoloured. Lichen planus of the mouth (oral lichen planus) The


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After the papules have cleared, the affected area of skin can sometimes become discoloured. Lichen planus of the mouth (oral lichen planus) The symptoms of oral lichen planus are: a white pattern on the tongue and inner cheeks red and white patches in the mouth burning and discomfort in the mouth while eating or drinking painful red gums Mild cases of oral lichen planus don’t usually cause any pain or discomfort. Lichen planus of the penis The symptoms of lichen planus of the penis are: purple or white ring-shaped patches on the tip of the penis (glans) bumps (papules) that are flat-topped and shiny a non-itchy rash Lichen planus of the vulva and vagina The symptoms of lichen planus of the vulva and vagina include: soreness, burning and rawness around the vulva the vulva may be covered in white streaks and be a red, pink or pale white colour if the vagina is affected, sexual intercourse can be painful if the outer layers of skin break down, moist, red patches can form scar tissue can


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if the vagina is affected, sexual intercourse can be painful if the outer layers of skin break down, moist, red patches can form scar tissue can form, which distorts the shape of the vagina a sticky yellow or green discharge, which may be bloodstained the opening of the vagina can become narrowed Other areas Lichen planus can sometimes affect other areas, including: the nails – which can become thinner, ridged and grooved, or they may become darker, thicker or raised; they may sometimes shed or stop growing the scalp – red patches can appear around clusters of hair; in some cases, permanent hair loss can occur Causes of lichen planus The cause of lichen planus is unknown. It’s thought to be related to the immune system, or an abnormal response of the immune system to certain medicines. Lichen planus isn’t infectious, doesn’t usually run in families and can’t be passed on to others. Autoimmune reaction The immune system protects your body against illness and infection by producing


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run in families and can’t be passed on to others. Autoimmune reaction The immune system protects your body against illness and infection by producing antibodies (proteins) that attack bacteria and viruses. In people with lichen planus, it’s thought that the immune system becomes overactive, causing an excess amount of proteins to be produced, which inflame the skin. This is known as an autoimmune reaction and causes the symptoms of lichen planus. Reaction to medication A reaction to certain medications is another possible cause of lichen planus. For example: gold injections – these are disease-modifying anti-rheumatic drugs (DMARDs) that are sometimes injected into the muscles of people with arthritis to help reduce inflammation and painful joints antimalarial tablets – these help treat and prevent malaria (a serious tropical disease spread by mosquitoes) Diagnosing lichen planus Lichen planus is often diagnosed by a GP or dentist examining the affected area. Lichen planus of the skin


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by mosquitoes) Diagnosing lichen planus Lichen planus is often diagnosed by a GP or dentist examining the affected area. Lichen planus of the skin Your GP may be able to make a diagnosis based on the characteristic rash. However, lichen planus can be mistaken for other skin conditions, such as eczema, which also causes the skin to become red, flaky and itchy. If your doctor is unable to make a confident diagnosis by examining your skin, they may want to take a small skin sample (biopsy), which will be examined under a microscope. If a skin biopsy is required, you’ll be given a local anaesthetic to numb the affected area so you don’t feel any pain or discomfort during the procedure. Lichen planus of the mouth (oral lichen planus) A dentist or doctor can diagnose oral lichen planus by looking at the inside of your mouth. A biopsy may be recommended to confirm the diagnosis. A sample of mouth tissue will be removed so that it can be examined under a microscope. As with lichen planus of


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to confirm the diagnosis. A sample of mouth tissue will be removed so that it can be examined under a microscope. As with lichen planus of the skin, you’ll be given a local anaesthetic to numb the pain. Treating lichen planus There’s no cure for lichen planus, so treatments aim to ease the symptoms and clear the rash. Mild lichen planus doesn’t require treatment. Self-help Below is some general self-help advice that can help ease your symptoms and prevent them getting worse. Lichen planus of the skin avoid washing with soap or bubble bath – use plain warm water instead wash your hair over a basin to stop affected areas of skin coming into contact with shampoo use an emollient to moisturise your skin Lichen planus of the mouth (oral lichen planus) avoid eating spicy foods and anything acidic, such as fruit juice, because they can irritate oral lichen planus avoid eating sharp food, such as crusty bread avoid drinking alcohol, particularly spirits if areas of your mouth are painful,


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oral lichen planus avoid eating sharp food, such as crusty bread avoid drinking alcohol, particularly spirits if areas of your mouth are painful, stick to soft, bland foods, such as mashed potatoes and porridge if possible, continue to use your usual toothpaste avoid using mouthwashes that contain alcohol because they may be too strong, and keep your mouth as clean as possible visit your dentist regularly to help keep your teeth and gums healthy Lichen planus of the genitals avoid washing with soap or bubble bath – use plain warm water or a soap substitute instead, such as aqueous cream use an emollient, such as petroleum jelly, before and after urinating applying ice packs to the affected areas may soothe itching and swelling (never apply an ice pack directly to your skin – wrap it in a clean tea towel before placing it on your body) women should avoid wearing tights Lichen planus of the skin, hair and nails There are a number of medications and treatments that may be recommended for


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should avoid wearing tights Lichen planus of the skin, hair and nails There are a number of medications and treatments that may be recommended for lichen planus of the skin, hair and nails. These are outlined below. Corticosteroid creams and ointments Corticosteroid creams and ointments contain corticosteroids (artificial hormones) and are used to treat inflammatory skin conditions. They are often referred to as topical corticosteroids. Topical corticosteroids help treat the swelling (inflammation) and redness caused by lichen planus. Strong topical corticosteroids, such as clobetasol propionate, are also effective in reducing any itchiness you may have. Treatment is applied to the red or purple itchy spots, but should be stopped when the colour of the rash changes to brown or grey. This pigment change occurs when the inflammation has settled. Continuing to apply the corticosteroid cream to the brown areas of skin will gradually cause the skin to thin. The side effects of


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has settled. Continuing to apply the corticosteroid cream to the brown areas of skin will gradually cause the skin to thin. The side effects of corticosteroids can vary, depending on the: type and severity of treatment being used how long the treatment is used for nature of the condition being treated Potential side effects of topical corticosteroids can include: redness or burning and stinging of the skin skin rash thinning of the skin (atrophy) stretch marks (striae) contact dermatitis – a condition that causes skin inflammation excessive hair growth (hypertrichosis) lightening of the skin Always check the patient information leaflet that comes with your medicine. Corticosteroid tablets Corticosteroid tablets are sometimes used to treat severe cases of lichen planus, when the symptoms aren’t being effectively controlled with creams or ointments. Possible side effects of corticosteroid tablets used on a short-term basis can include: increased appetite weight gain insomnia fluid


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or ointments. Possible side effects of corticosteroid tablets used on a short-term basis can include: increased appetite weight gain insomnia fluid retention (inability to pass urine) mood changes, such as feeling irritable or anxious Other treatments Other treatments recommended for lichen planus of the skin are outlined below. Antihistamines – these are often used to treat symptoms of allergies, such as itchy skin. If you have lichen planus of the skin that’s causing itchiness, antihistamines may be prescribed to help reduce this. Light treatment – there are 2 types of light treatment: ultraviolet B (UVB) and psoralen plus ultraviolet A (PUVA). UVB is the most commonly used light treatment, but PUVA may be recommended in severe or widespread cases of lichen planus that don’t respond to other types of treatment. Acitretin – this medication is only prescribed by a specialist and is used to treat severe cases of lichen planus. The tablets have some associated side effects and may not


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is only prescribed by a specialist and is used to treat severe cases of lichen planus. The tablets have some associated side effects and may not mix well with other medicines. Your specialist can offer advice. Lichen planus of the mouth (oral lichen planus) Mild cases of oral lichen planus won’t need any treatment. In more severe cases, treatment includes: a mouthwash that contains an anaesthetic to temporarily numb the mouth, which makes eating easier corticosteroid sprays, mouthwashes, pastes and dissolvable lozenges a mouthwash or gel that contains an antiseptic to help prevent the build-up of plaque in your mouth In more severe cases of oral lichen planus, corticosteroid tablets may also be used on a short-term basis. It can be difficult to prevent oral lichen planus, but to keep the lining of your mouth healthy it’s recommended that you: stop smoking (if you smoke) avoid drinking large amounts of alcohol have a healthy, balanced diet, including plenty of fresh fruit and


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that you: stop smoking (if you smoke) avoid drinking large amounts of alcohol have a healthy, balanced diet, including plenty of fresh fruit and vegetables You should also maintain good oral hygiene by cleaning your teeth at least twice a day, and having regular dental check-ups, so that any problems with your teeth or mouth can be identified and treated early. Other treatments If corticosteroids are not effective in treating your symptoms, you may be prescribed a medication that suppresses your immune system to try to limit the autoimmune reaction that’s thought to cause lichen planus. These types of treatments are known as immunomodulating agents. Depending on which area of your body is affected by lichen planus, treatments that may be recommended for you can include: treatments such as tacrolimus topical immunomodulating agents (used to treat lichen planus of the skin) – treatments such as tacrolimus ointment and pimecrolimus cream are rubbed directly onto the skin immunomodulating


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treat lichen planus of the skin) – treatments such as tacrolimus ointment and pimecrolimus cream are rubbed directly onto the skin immunomodulating agents (used to treat lichen planus of the mouth) – these are usually available in the form of tablets or capsules, and can be used to treat severe cases of oral lichen planus These treatments can cause a number of different side effects, which your specialist can discuss with you. You’ll also need to have regular blood tests while taking immunomodulating agents, particularly in the early stages of treatment. Further information and support You can find support and information from organisations like: Changing Faces – a charity for people who have a visible difference or facial disfigurement, who can be contacted on 0300 012 0275 for counselling and advice Complications of lichen planus Complications of lichen planus may include discoloured skin and, in some cases, erosive lichen planus may develop into certain types of cancer. Skin


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Complications of lichen planus may include discoloured skin and, in some cases, erosive lichen planus may develop into certain types of cancer. Skin pigmentation After the lichen planus rash has cleared up, the affected area of skin may be a different colour to what it was originally. There may be a brown or grey mark, which can sometimes last for months. This is known as post-inflammatory hyperpigmentation, and tends to be more noticeable in people with darker skin. Erosive lichen planus Erosive lichen planus is a long-lasting (chronic) form of lichen planus that causes painful ulcers to develop, as well as burning and discomfort in the genital areas of both male and females. Occasionally, in around 2% of cases, long-term cases of erosive lichen planus can develop into certain types of cancer, such as: mouth cancer vulval cancer penile cancer Regularly examining yourself and being aware of any changes that occur will help you to identify any problems at an early stage. Pay close


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cancer Regularly examining yourself and being aware of any changes that occur will help you to identify any problems at an early stage. Pay close attention to ulcerated areas in your mouth or genitals that don’t heal and persist for a long time. Visit your GP immediately if you notice any changes that you’re concerned about. You should also visit your dentist regularly to ensure that your teeth and gums remain healthy, and that any ulcers or patches that form in your mouth are examined and treated promptly. Depending on individual circumstances, dental check-ups for adults are recommended anywhere between every 3 to 24 months. Read more about treating lichen planus, including self-help tips for managing all types of the condition. Source: NHS 24 - Opens in new browser window Last updated: 17 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


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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 ulcer Other health sites Changing Faces NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats © 2025 NHS 24 – v1.1.1.17852


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https://www.nhsinform.scot/illnesses-and-conditions/brain-nerves-and-spinal-cord/muscular-dystrophy/limb-girdle-muscular-dystrophy/


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https://www.nhsinform.scot/healthy-living/womens-health/middle-years-around-25-to-50-years/long-term-conditions/lipoedema/


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Lipoedema | 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 Healthy living Women's health Middle years (around 25 to 50 years) Long term conditions Lipoedema Lipoedema Lipoedema is a long term (chronic) condition of fat and connective tissue which builds up in your legs, hips, bottom and sometimes arms. It affects both sides of the body equally. It’s more common in women and only very rarely affects men. It’s not the same as obesity. For some people, it can have a big impact on daily routine, physical health and emotional wellbeing. Symptoms People with lipoedema usually have a small waist, but large hips and thighs. Their upper body and lower body can be completely different sizes. This makes it difficult to shop for clothes that fit right. Symptoms can include: enlargement of your legs, and in some cases arms, but usually not your feet or hands pain, discomfort, heaviness


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fit right. Symptoms can include: enlargement of your legs, and in some cases arms, but usually not your feet or hands pain, discomfort, heaviness or tenderness affected areas affected areas of your body can bruise easily, sometimes for no obvious reason dimpled legs with a lumpy texture, fat may bulge at the knees swelling that gets worse in the afternoon, evening, after activity or in hot weather spider veins or varicose veins on your legs difficulty walking due to changes in your leg shape, heavy legs, or ‘flat-feet’ Lipoedema can be linked to mental health problems, for example depression, anxiety and disordered eating. Speak to your doctor if you are experiencing any of these symptoms. They’ll be able to give you help and advice on how to manage your symptoms. Other conditions Other health conditions, like lymphoedema, can cause large or swollen legs. Sometimes people with lipoedema can also develop this condition. Causes The exact cause of lipoedema isn’t known but it may be


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large or swollen legs. Sometimes people with lipoedema can also develop this condition. Causes The exact cause of lipoedema isn’t known but it may be caused by changes in your hormones: during puberty when you’re pregnant when you’re going through the menopause when you’re taking the contraceptive pill It’s not caused by being overweight – you can be a healthy weight and still have lipoedema. Lipoedema can run in families so let your doctor know if you think this is the case for you. Treatment and self-management Treatment will depend on your symptoms and how they’re affecting you. If your doctor thinks you have lipoedema they may refer you to a specialist for treatment. Although there’s no cure, there are things which may help. Do maintain a healthy weight by eating a balanced diet – this can also reduce your chances of developing other health conditions such as type 2 diabetes and high cholesteroldrink plenty of watertake part in activities you enjoy to keep active like swimming,


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health conditions such as type 2 diabetes and high cholesteroldrink plenty of watertake part in activities you enjoy to keep active like swimming, dancing, yoga or walkingwear compression garments – tight forms of clothing that help to reduce pain and discomfort, as well as making it easier for you to walklook after your skin – using moisturising cream (emollients) regularly will help to stop your skin drying outmanual lymphatic drainage – a specialist type of massage, which may help to reduce discomfortcounselling or cognitive behavioural therapy (CBT) – if you’re finding it difficult to cope or if it’s affecting your mental health Compression therapy Compression therapy uses special compression garments to help manage symptoms. This can help to reduce pain, inflammation, and fluid build up (oedema). Compression garments are often available on prescription. This can include stockings, socks, leggings, arm sleeves, adjustable wraps and sometimes bandaging. Your doctor, practice nurse


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on prescription. This can include stockings, socks, leggings, arm sleeves, adjustable wraps and sometimes bandaging. Your doctor, practice nurse or specialist will recommend the most suitable type of compression garment for you. They’ll also advise you on how to use it. Further support Lipoedema can affect your quality of life and your mental wellbeing. Talking to someone and getting some extra support can really help. You’re not alone. Talk Lipoedema have lots of help and advice about living well with lipoedema. They can also put you in touch with other people with lipoedema, so you can share your experiences of the condition. Source: Scottish Government Last updated: 07 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


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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 Physical activity guidelines Health benefits of eating well Other health sites Talk Lipoedema: Liposuction for lipoedema Legs Matter: Lipoedema 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/liver-disease/


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Liver 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 Stomach, liver and gastrointestinal tract Liver disease Liver disease There are more than 100 different types of liver disease, which together affect at least 2 million people in the UK. The liver The liver is the second largest organ in the body. It works hard, performing hundreds of complex functions, including: fighting infections and illness removing toxins (poisons), such as alcohol, from the body controlling cholesterol levels helping blood to clot (thicken) releasing bile, a liquid that breaks down fats and aids digestion Liver disease doesn’t usually cause any obvious signs or symptoms until it’s fairly advanced and the liver is damaged. At this stage, possible symptoms can include loss of appetite, weight loss and jaundice. Types of liver disease Listed on this page are some


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damaged. At this stage, possible symptoms can include loss of appetite, weight loss and jaundice. Types of liver disease Listed on this page are some specific types of liver disease. The links provide more detailed information about each type: alcohol-related liver disease – where the liver is damaged after years of alcohol misuse, this can lead to cirrhosis (scarring of the liver) Non-alcoholic fatty liver disease – a build-up of fat within liver cells, usually seen in overweight people or those who are obese hepatitis – which is inflammation (swelling) of the liver caused by a viral infection or exposure to harmful substances such as alcohol haemochromatosis – an inherited disorder where there’s a gradual build-up of iron in the body, usually around the liver primary biliary cirrhosis – a rare, long-term type of liver disease that damages the bile ducts in the liver All types of liver disease can cause cirrhosis (scarring of the liver), not just alcohol-related liver disease.


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damages the bile ducts in the liver All types of liver disease can cause cirrhosis (scarring of the liver), not just alcohol-related liver disease. Significant health problem In the UK, liver disease is on the increase. The 3 main causes of liver disease are: obesity undiagnosed hepatitis infection alcohol misuse These causes of liver disease are all preventable. Do make sure you’re a healthy weight for your heightavoid drinking excessive amounts of alcoholtake the appropriate measures to prevent getting hepatitis, such as getting vaccinated if you’re at risk 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 Alcohol-related liver disease Cirrhosis


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Message Maximum of 500 characters Send feedback Add this page to Info For Me Also on NHS inform Alcohol-related liver disease Cirrhosis Body mass index (BMI) Low-risk drinking guidelines Other health sites British Liver Trust: diet and liver disease 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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Long-term effects of COVID-19 (long COVID) 0 Home Long-term effects of COVID-19 Long-term effects of COVID-19 (long COVID) Information and support if you have ongoing symptoms after coronavirus About long COVID What is long COVID? Information about long COVID including common symptoms and recovery Signs and symptoms of long COVID Information on what the symptoms of long COVID are and when to get help Assessing long COVID symptoms Information on how healthcare professionals assess long COVID Your recovery Information on recovering from long COVID, including returning to work Long COVID patient booklet Information booklet for people who have symptoms that last more than 4 weeks Support for unpaid carers Information for unpaid carers, including if you're looking after someone with long COVID Signs and symptoms Long COVID: Cough Information on ways to help a cough if you have long COVID Long COVID: Fatigue Information on fatigue and how you can conserve energy Long COVID: Breathlessness


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on ways to help a cough if you have long COVID Long COVID: Fatigue Information on fatigue and how you can conserve energy Long COVID: Breathlessness Information on how to ease breathlessness Long COVID: Muscle and joint pain Information on how to manage pain Long COVID: Sleep problems Information on how to improve your sleeping pattern Long COVID: Loss of smell or taste Information on how to help loss of, or change in, smell or taste Long COVID: Anxiety Information on long COVID anxiety and how to manage it Long COVID: Low mood and depression Information on long COVID low mood and depression and how to manage them Long COVID: Brain fog Information on ways to help brain fog if you have long COVID Postural orthostatic tachycardia syndrome (PoTS) Information about PoTS symptoms, causes and treatments Other languages and accessible formats Arabic Information about the long-term effects of coronavirus in Arabic Audio Information about the long-term effects of coronavirus in audio format


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Arabic Information about the long-term effects of coronavirus in Arabic Audio Information about the long-term effects of coronavirus in audio format British Sign Language (BSL) Information about the long-term effects of coronavirus in British Sign Language (BSL) Bengali Information about the long-term effects of coronavirus in Bengali Chinese (simplified) Information about the long-term effects of coronavirus in Chinese (simplified) Chinese (traditional) Information about the long-term effects of coronavirus in Chinese (traditional) Dari Information about the long-term effects of coronavirus in Dari Easy Read Information about the long-term effects of coronavirus in Easy Read format Farsi Information about the long-term effects of coronavirus in Farsi Hindi Information about the long-term effects of coronavirus in Hindi Pashto Information about the long-term effects of coronavirus in Pashto Polish Information about the long-term effects of coronavirus in Polish Punjabi Information


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about the long-term effects of coronavirus in Pashto Polish Information about the long-term effects of coronavirus in Polish Punjabi Information about the long-term effects of coronavirus in Punjabi Romanian Information about the long-term effects of coronavirus in Romanian Russian Information about the long-term effects of coronavirus in Russian Slovak Information about the long-term effects of coronavirus in Slovak Spanish Information about the long-term effects of coronavirus in Spanish Urdu Information about the long-term effects of coronavirus in Urdu 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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Low blood pressure | 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 Low blood pressure Low blood pressure Blood pressure is the pressure of blood in the arteries. The arteries are vessels that carry blood from the heart around the body. There needs to be a certain level of pressure in the arteries to move blood around the body. If your blood pressure is low, you may experience some symptoms. Low blood pressure is when your blood pressure is less than 90/60mmHg. This is also known as hypotension. Symptoms of low blood pressure Most people with low blood pressure won’t have any symptoms, but some may experience: light-headedness or dizziness fainting blurred vision confusion feeling sick general weakness You should speak to your healthcare professional if you have any of these symptoms. Checking your blood pressure To check your blood pressure you


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You should speak to your healthcare professional if you have any of these symptoms. Checking your blood pressure To check your blood pressure you can: ask your pharmacist to do it ask your GP or practice nurse to do it measure it at home using a home blood pressure monitor How to measure your blood pressure at home Watch this video to learn how to measure your blood pressure at home. What causes low blood pressure? There are some things that can contribute to low blood pressure, including: the time of day – blood pressure falls overnight your age – low blood pressure is more likely as you get older feeling relaxed rest cold temperatures being fit and healthy Low blood pressure can also be caused by: pregnancy some medical conditions, like diabetes some medications some heart conditions dehydration Some people get symptoms of low blood pressure after a sudden movement like standing up. This is known as postural orthostatic hypotension. Symptoms of low blood pressure can also happen


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pressure after a sudden movement like standing up. This is known as postural orthostatic hypotension. Symptoms of low blood pressure can also happen after eating. This is known as postprandial hypotension. Treatment for low blood pressure If you’ve got symptoms of low blood pressure, your healthcare professional will try to find out why. This means they can help you to manage the cause of your low blood pressure. They may: consider making changes to any medicines that may be contributing to your low blood pressure suggest making small lifestyle changes suggest making dietary changes, including looking at your salt intake You could also try: standing up slowly, particularly first thing in the morning wearing support stockings to improve circulation and increase blood pressure eating small frequent meals, rather than large ones lying or sitting down after eating avoiding sitting or standing for long periods avoiding changing your posture suddenly stretching before standing up to


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or sitting down after eating avoiding sitting or standing for long periods avoiding changing your posture suddenly stretching before standing up to increase your heart rate and blood flow drinking more water – check with your doctor how much fluid you can drink if you’re on a daily fluid restriction due to a heart condition Source: Scottish Government - Opens in new browser window Last updated: 15 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 Cardiovascular disease High blood pressure (hypertension) Other health sites British Heart Foundation: Low blood pressure 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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pressure 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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Lupus | 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 Immune system Lupus Lupus About lupus Symptoms of lupus Causes of lupus Diagnosing lupus Treating lupus Complications of lupus About lupus Lupus is a complex and poorly understood condition that affects many parts of the body and causes symptoms ranging from mild to life-threatening. Types of lupus There are some types of lupus that just affect the skin – such as discoid lupus erythematosus and subacute cutaneous lupus erythematosus. Some medications can also cause lupus-like side effects. However, the term “lupus” is most often used to describe a more severe form of the condition called systemic lupus erythematosus (SLE), which can affect many parts of the body, including the skin, joints and internal organs. Symptoms range from mild to severe, and many people will have long periods with few or


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of the body, including the skin, joints and internal organs. Symptoms range from mild to severe, and many people will have long periods with few or no symptoms before experiencing a sudden flare-up, where their symptoms are particularly severe. Even mild cases can be distressing and have a considerable impact on a person’s quality of life. The rest of this article will focus on SLE. Signs and symptoms SLE can cause a wide range of symptoms, depending on the areas of the body that are affected. The most common symptoms are: fatigue (extreme tiredness) rashes – particularly on the face, wrists and hands joint pain and swelling As the symptoms of SLE can be similar to a number of other conditions, many of which are more common, it can be difficult to diagnose. If you have persistent or troublesome symptoms that you think could be caused by SLE, you should see your GP so they can try to determine the cause. Read more about the symptoms of lupus and diagnosing lupus. What causes lupus? SLE


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you should see your GP so they can try to determine the cause. Read more about the symptoms of lupus and diagnosing lupus. What causes lupus? SLE is an autoimmune condition, which means it is caused by problems with the immune system. For reasons not yet understood, the immune system in people with SLE starts to attack and inflame healthy cells, tissue and organs. As with other more common autoimmune conditions, such as rheumatoid arthritis, it is thought a combination of genetic and environmental factors may be responsible for triggering SLE in certain people. Read more about the causes of lupus. Who is affected SLE is an uncommon condition where around 90% of cases occur in women. The condition is most common in women of childbearing age (between the ages of 15 and 50), but it can also affect people of other ages. The condition tends to be less common in people of white European origin and more common in those of African, Caribbean or Asian origin. How lupus is treated There is


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to be less common in people of white European origin and more common in those of African, Caribbean or Asian origin. How lupus is treated There is currently no cure for SLE, but there are different medications that can help relieve many of the symptoms and reduce the chances of organ damage. These medications include: hydroxychloroquine – a medicine that has historically been used to treat malaria, but can also help treat some symptoms of SLE corticosteroids – anti-inflammatory medications immunosuppressants – a group of medicines that suppress your immune system With good levels of support from friends, family and healthcare professionals, many people with SLE are able to manage their condition effectively. Read more about treating lupus. Outlook A few decades ago SLE was regarded as a terminal condition, as many people would die of an associated complication within a few years of being diagnosed. As a result of early diagnosis and advances in treatment, however, the outlook for SLE


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associated complication within a few years of being diagnosed. As a result of early diagnosis and advances in treatment, however, the outlook for SLE is now much better. The vast majority of people diagnosed with the condition will have a normal or near-normal life expectancy. However, some people with SLE are still at risk of life-threatening complications as a result of damage to internal organs and tissues, such as heart attack or stroke. SLE, and some of the treatments for it, can also increase your risk of developing potentially serious infections. Read more about the complications of lupus. Symptoms of lupus Symptoms of systemic lupus erythematosus (SLE) can vary widely from person to person. Some people may only experience a few mild symptoms, whereas others may be more severely affected. Even if you usually have mild symptoms, SLE can “flare-up”, with symptoms becoming more severe or new symptoms developing. Main symptoms The 3 main symptoms of SLE are fatigue, joint pain and


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can “flare-up”, with symptoms becoming more severe or new symptoms developing. Main symptoms The 3 main symptoms of SLE are fatigue, joint pain and rashes. Fatigue Fatigue is one of the most common symptoms of SLE. You may feel very tired even though you get plenty of sleep. Carrying out everyday tasks, such as housework or office work, can leave you feeling exhausted. Many people with SLE find that fatigue is the most distressing and disruptive aspect of SLE because it has a negative impact on their work and social life. Joint pain If you have SLE, you are likely to experience joint pain in your hands and feet. You may find the pain changes from one set of joints to another quite quickly, and is usually worse in the morning. Unlike some other conditions that affect the joints, SLE is unlikely to cause your joints to become permanently damaged or deformed. Rashes Many people with SLE develop rashes on their skin – most commonly on the face, wrists and hands. A rash over the cheeks and


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or deformed. Rashes Many people with SLE develop rashes on their skin – most commonly on the face, wrists and hands. A rash over the cheeks and the bridge of the nose is particularly common and is known as a “butterfly rash” or “malar rash”. Rashes caused by SLE may get better after a few days or weeks, but can last longer or even be permanent. Rashes caused by SLE can sometimes be itchy or painful, and they may get worse if they are exposed to sunlight. This is known as “photosensitivity”. Other symptoms SLE can also cause a wide range of symptoms. However, you’re unlikely to have all of the symptoms listed below, and many people with the condition will only experience the main symptoms. Other features of SLE may include: a fever (high temperature) swollen lymph glands (small glands found throughout your body, including in your neck, armpits and groin) recurring mouth ulcers hair loss (alopecia) high blood pressure (hypertension) headaches and migraines stomach (abdominal) pain chest


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and groin) recurring mouth ulcers hair loss (alopecia) high blood pressure (hypertension) headaches and migraines stomach (abdominal) pain chest pain depression dry eyes memory loss seizures (fits) problems thinking clearly and difficulty telling the difference between reality and imagination (psychosis) shortness of breath Raynaud’s phenomenon a condition that limits the blood supply to your hands and feet when it is cold ankle swelling and fluid retention (oedema) When to seek medical advice You should see your GP if you have persistent or troublesome symptoms that you think could be caused by SLE. While it is likely that your symptoms are being caused by a more common condition, it is important to see a doctor for a diagnosis. Read more about diagnosing lupus. Causes of lupus Systemic lupus erythematosus (SLE) is an autoimmune condition, which means it is caused by problems with the immune system. The immune system is the body’s natural defence against illness and infection. When


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which means it is caused by problems with the immune system. The immune system is the body’s natural defence against illness and infection. When the immune system detects the presence of an infectious agent, such as bacteria or a virus, it sends white blood cells and antibodies to attack it. In cases of SLE, antibodies released by the immune system can attack healthy tissue, cells and organs. It’s not clear exactly why this happens, although most experts think SLE has more than one cause. It has been suggested that there may be a number of genetic factors that make people more susceptible to the condition, and that it also takes one or more environmental factors to trigger SLE in those who are susceptible. Possible genetic and environmental factors are discussed in more detail below. Genetic factors Brothers and sisters of people with SLE are much more likely to develop the condition than the population at large. Researchers have identified a number of different genetic mutations that


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are much more likely to develop the condition than the population at large. Researchers have identified a number of different genetic mutations that seem to make people more susceptible to developing SLE. A genetic mutation occurs when normal instructions carried in certain genes become “scrambled”, resulting in the body’s processes not working normally. Most faulty genes are associated with regulating certain functions of the immune system, which may explain why the immune system in people with SLE starts to malfunction. Environmental factors A number of environmental factors may be responsible for triggering SLE in vulnerable individuals, although the evidence for many of these is limited. Possible environmental factors that have been suggested include: exposure to sunlight (ultraviolet light) hormonal changes that occur during a woman’s lifetime, such as during puberty or pregnancy certain infections, such as by the Epstein-Barr virus (EBV) – a common viral infection that doesn’t


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lifetime, such as during puberty or pregnancy certain infections, such as by the Epstein-Barr virus (EBV) – a common viral infection that doesn’t usually cause any symptoms smoking Diagnosing lupus Systemic lupus erythematosus (SLE) can be difficult to diagnose, as it has similar symptoms to several other, far more common, conditions. Diagnosis may also be difficult because symptoms can vary greatly from person to person, and they may change over time. For example, there may be periods where your symptoms are not very noticeable, or times when they flare up and become more severe. For a confident diagnosis of SLE to be made, you will need to have several symptoms of lupus and a number of blood tests may need to be carried out. Blood tests Some of the blood tests that may be carried out are described below. Erythrocyte sedimentation rate (ESR) test A blood test called the erythrocyte sedimentation rate (ESR) test can be used to determine whether there is any inflammation in your body.


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(ESR) test A blood test called the erythrocyte sedimentation rate (ESR) test can be used to determine whether there is any inflammation in your body. This can be useful in diagnosing SLE because the condition can cause many areas of the body to become inflamed (swell), including the joints and internal organs. The test works by measuring how long it takes for red blood cells to fall to the bottom of a test tube. The quicker they fall, the more likely it is that there are high levels of inflammation. Anti-nuclear antibody test An anti-nuclear antibody test checks whether there is a certain type of antibody cell in your blood, known as the anti-nuclear antibody. Approximately 95% of people with SLE have this antibody. However, it is possible to have the anti-nuclear antibody without having SLE, so the anti-nuclear antibody test is not a definitive way of testing for the condition. Other blood tests will also be needed to confirm the diagnosis. Anti-DNA antibody test An anti-DNA test


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definitive way of testing for the condition. Other blood tests will also be needed to confirm the diagnosis. Anti-DNA antibody test An anti-DNA test also checks for a certain type of antibody in your blood, known as the anti-DNA antibody. If you have the anti-DNA antibody, it is highly likely that you have SLE. However, the antibody is only found in around 70% of people with the condition. The level of anti-DNA antibodies increases when SLE is more active, so during a flare-up of symptoms your reading from this test may be greater than normal. Complement level test Complement is a chemical in the blood that forms part of your immune system. The level of this chemical may be tested to check how active your SLE is. The level of complement in your blood decreases when SLE is more active. Other tests Once you have been diagnosed with SLE, you will normally need regular monitoring to see how the condition is affecting your body. If you have SLE it is possible you may develop other


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SLE, you will normally need regular monitoring to see how the condition is affecting your body. If you have SLE it is possible you may develop other conditions, such as kidney problems. Monitoring your condition will allow your doctor to check for these complications and, if necessary, treat them as soon as possible. You may need to have scans, such as an X-ray, ultrasound scan, magnetic resonance imaging (MRI) scan or a computerised tomography (CT) scan to check whether SLE is affecting your internal organs. Read more about the complications of lupus. Treating lupus There is currently no cure for systemic lupus erythematosus (SLE), but treatments that can ease the symptoms and make it easier to live with are available. In most cases, treatment will involve a combination of self-care measures and medication. Protecting yourself from the sun Exposure to sunlight can sometimes make symptoms such as rashes worse, and it’s important to protect your skin when in the sun. This means wearing


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Exposure to sunlight can sometimes make symptoms such as rashes worse, and it’s important to protect your skin when in the sun. This means wearing clothing that covers your skin, a wide-brimmed hat and sunglasses. You will also need to apply sunscreen with a high SPF to prevent sunburn. However, some people with lupus are not sun-sensitive and do not need to take extra precautions. As people get most of their vitamin D as a result of direct sunlight on the skin, there is a risk you may not get enough of this vitamin if you need to avoid sun exposure. This means you may need to make an extra effort to include good sources of vitamin D in your diet to avoid problems such as osteoporosis (weakened bones), and you may be advised to take vitamin D supplements. Non-steroidal anti-inflammatory drugs (NSAIDs) Non-steroidal anti-inflammatory drugs (NSAIDs) are a common painkilling medication that reduces inflammation in the body. If you experience joint or muscle pain as a result of SLE, you


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(NSAIDs) are a common painkilling medication that reduces inflammation in the body. If you experience joint or muscle pain as a result of SLE, you may be prescribed a NSAID to help ease your symptoms. Commonly prescribed NSAIDs for SLE include ibuprofen, naproxen and diclofenac. You can buy some NSAIDs, such as ibuprofen, over the counter. These NSAIDs may be suitable if your joint or muscle pain is mild. For more severe pain, you will need stronger medication prescribed by your GP. NSAIDs may not be suitable for people who have stomach, kidney or liver problems, or have had these problems in the past. They may also be unsuitable for people with asthma. Your GP will advise about which NSAID is right for you. Side effects If taken in high doses or over long periods of time, NSAIDs can damage your stomach lining, which may cause internal bleeding. If you need to take NSAIDs on a long-term basis, your GP will carefully monitor you to check for any problems, and you may be prescribed an


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bleeding. If you need to take NSAIDs on a long-term basis, your GP will carefully monitor you to check for any problems, and you may be prescribed an additional medication called a proton pump inhibitor (PPI) to protect your stomach. Hydroxychloroquine Hydroxychloroquine is a medicine that has been used to treat malaria, but is also effective in treating some of the symptoms of SLE, such as rashes, joint and muscle pain, and fatigue. You will usually have to take hydroxychloroquine for 6 to 12 weeks before you notice any benefit. Most expert doctors recommend people with SLE take hydroxychloroquine on a long-term basis as a way of controlling their symptoms, helping to prevent flare-ups and to prevent development of more serious problems from lupus. Side effects Side effects of hydroxychloroquine are uncommon, but may include indigestion, diarrhoea, headaches and rashes. Hydroxychloroquine may also cause more serious side effects in a small number of people. For example, in rare


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diarrhoea, headaches and rashes. Hydroxychloroquine may also cause more serious side effects in a small number of people. For example, in rare cases, this medicine can cause eye damage. Contact your GP or specialist immediately if you experience vision problems while taking hydroxychloroquine. If your GP or specialist feels it is necessary, you may need regular eye examinations. Corticosteroids Corticosteroids are a type of medicine that help reduce inflammation quickly. They can be very effective in treating symptoms of SLE, but are usually only prescribed if the condition is severe. If you have severe symptoms of SLE, or if you are experiencing a flare-up, you may be given a large dose of corticosteroids to help bring your symptoms under control. As your symptoms ease, your dosage can gradually be reduced. Side effects When prescribing corticosteroids, the lowest effective dosage is always given. This is because high doses or long-term use of corticosteroids can cause side effects.


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corticosteroids, the lowest effective dosage is always given. This is because high doses or long-term use of corticosteroids can cause side effects. These may include: thinning of your bones thinning of your skin weight gain high blood pressure (hypertension) Corticosteroids are a safe and effective form of treatment, provided they are taken correctly and under the supervision of your GP or specialist. They will tailor the steroid dose to your disease activity, to minimise side effects while effectively controlling the condition. Immunosuppressants Immunosuppressants are a type of medicine that suppress your immune system. They can help improve your symptoms of SLE by limiting the damage your immune system causes when it attacks healthy parts of your body. Commonly prescribed immunosuppressant medicines include azathioprine, methotrexate, mycophenolate mofetil and cyclophosphamide. Immunosuppressants are sometimes used in conjunction with corticosteroids (see above) because these


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mycophenolate mofetil and cyclophosphamide. Immunosuppressants are sometimes used in conjunction with corticosteroids (see above) because these medicines may ease your symptoms more effectively when used together. Alternatively, the use of immunosuppressant medication may allow your corticosteroid dose to be reduced. Side effects Immunosuppressant medication is usually only prescribed if you have severe SLE. This is because this type of medication is powerful and can cause side effects such as: loss of appetite vomiting diarrhoea swollen gums bruising or bleeding more easily headache acne extra hair growth weight gain liver damage an increased risk of infection (see below) Methotrexate, mycophenolate mofetil and cyclophosphamide can also cause birth defects if they are taken during pregnancy, so you should use a reliable form of contraception if you are taking these medications and are sexually active. If you are trying to become pregnant, an alternative medication such as


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of contraception if you are taking these medications and are sexually active. If you are trying to become pregnant, an alternative medication such as azathioprine can be used. Tell your GP if a side effect becomes particularly troublesome, as it may mean your dose needs to be adjusted. Infection risk Taking immunosuppressant medication can increase your risk of developing an infection. This is a particularly serious concern for people with SLE, because the organ damage that can occur as a result of the condition means infections are more likely to be life-threatening. It is therefore very important to report any symptoms of a possible infection to your GP immediately. Symptoms of infection may sometimes be similar to a flare up of SLE and include: a fever (high temperature) a cough or breathlessness burning when passing urine or passing blood in your urine diarrhoea You should also try to avoid contact with anyone known to have an infection – even if it is an infection you were


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blood in your urine diarrhoea You should also try to avoid contact with anyone known to have an infection – even if it is an infection you were previously immune to, such as chickenpox or measles. This is because your previous immunity to these conditions will probably be suppressed (lowered). Rituximab Rituximab is a new type of medication used in people with severe SLE that doesn’t respond to other treatments. Rituximab was originally designed to treat certain types of cancer, such as lymphoma, but it has since proved effective in treating a number of autoimmune conditions, such as SLE and rheumatoid arthritis. Rituximab works by locking on to and killing cells called “B-cells”, which produce antibodies responsible for the symptoms of SLE. It is administered directly into your vein over the course of several hours, known as an infusion. Rituximab is not currently licensed for treating SLE in the UK, but your specialist may consider it an appropriate treatment for you. If your doctor


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Rituximab is not currently licensed for treating SLE in the UK, but your specialist may consider it an appropriate treatment for you. If your doctor suggests using rituximab, they should tell you that there are currently some uncertainties about how effective or safe it is in treating SLE. Side effects Common side effects of rituximab include: flu-like symptoms, such as chills and a high temperature dizziness vomiting In rare cases, rituximab can cause a more serious allergy-like reaction. Most reactions occur during or shortly after the treatment is given, so you will be closely monitored once your treatment begins. Belimumab Belimumab is a new medication given to people with active SLE who don’t respond to other treatments. It works by binding to growth factors that are needed for the survival of B-cells. It is given directly into your vein over several hours, known as an infusion. The first 3 doses are given 14 days apart, and the medication is usually given once a month


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into your vein over several hours, known as an infusion. The first 3 doses are given 14 days apart, and the medication is usually given once a month thereafter. Belimumab is licensed for treating SLE in the UK, and there may be instances where your specialist may consider it an appropriate treatment for you. If your doctor suggests using belimumab, they should tell you that there are currently some uncertainties about how effective or safe it is in treating SLE. Side effects Common side effects of belimumab include: flu-like symptoms, such as chills and a high temperature nausea and diarrhoea headache difficulty sleeping (insomnia) a cough, sore throat and blocked or runny nose joint pain increased risk of infections changes in blood pressure In rare cases, belimumab can cause a more serious allergy-like reaction. Most reactions occur during or shortly after the treatment is given, so you will be closely monitored once your treatment begins. Complications of lupus If your symptoms of


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or shortly after the treatment is given, so you will be closely monitored once your treatment begins. Complications of lupus If your symptoms of systemic lupus erythematosus (SLE) are mild or well-controlled, you may find it barely affects your day-to-day life and that you do not have any complications. However, for some people, SLE can be a more serious condition that can cause life-threatening complications. Some of these complications are outlined below. Kidney problems Around 1 in every 3 people with SLE will develop a potentially serious kidney disease called lupus nephritis, which is caused by prolonged inflammation of the kidneys. Lupus nephritis tends to develop relatively early in the course of SLE, usually within five years of diagnosis. Symptoms of lupus nephritis can include: swelling of your feet (oedema) headaches dizziness blood in your urine a frequent need to urinate Lupus nephritis can also cause high blood pressure (hypertension). If left untreated, it can put you


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blood in your urine a frequent need to urinate Lupus nephritis can also cause high blood pressure (hypertension). If left untreated, it can put you at risk of developing life-threatening problems such as a heart attack or stroke. In many cases, lupus nephritis does not cause any noticeable symptoms. However, this does not mean the condition is not dangerous, as the kidneys could still be being damaged. If you have SLE, it is likely you will need to have regular blood tests so the condition of your kidneys can be carefully monitored. If you develop lupus nephritis, it can usually be successfully controlled using immunosuppressants such as mycophenolate mofetil or cyclophosphamide. In a small number of cases, the kidney damage can become severe enough to require treatment with dialysis (where a machine is used to replicates many of the kidneys’ functions) or a kidney transplant. Cardiovascular disease Cardiovascular disease (CVD) is a general term for any type of health condition that


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functions) or a kidney transplant. Cardiovascular disease Cardiovascular disease (CVD) is a general term for any type of health condition that affects the heart and arteries. It is often associated with blood clots and atherosclerosis (hardening and narrowing of the arteries). Examples of CVD include coronary heart disease, angina (chest pain caused by the heart not receiving enough blood), heart attack and stroke. People with SLE are more likely to develop CVD than the general population, because SLE can cause your heart and arteries to become inflamed and damaged. If you have SLE, you can reduce your risk of CVD by making health lifestyle chances, such as: stopping smoking if you smoke eating a healthy, balanced diet low in saturated fat, sugar and salt, and containing at least five portions of fruit and vegetables a day maintaining a healthy weight exercising regularly – at least 150 minutes (two-and-a-half hours) a week of exercise strenuous enough to leave you slightly out of


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a healthy weight exercising regularly – at least 150 minutes (two-and-a-half hours) a week of exercise strenuous enough to leave you slightly out of breath is recommended cutting down on your alcohol consumption Pregnancy complications SLE does not usually affect fertility, but it can increase your risk of experiencing pregnancy complications, such as: pre-eclampsia (a condition that causes high blood pressure during pregnancy) premature delivery miscarriage stillbirth Some children of women with SLE can also be born with heart block (where electrical pulses that control the beating of the heart are disrupted) and rashes. This is known as “neonatal lupus syndrome”. If you have SLE and are thinking of having a baby, it is best to plan this carefully with your doctors if possible. The risk of complications is higher if you become pregnant during periods where your symptoms are particularly severe, so you will usually be advised to try to avoid getting pregnant until your symptoms are


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during periods where your symptoms are particularly severe, so you will usually be advised to try to avoid getting pregnant until your symptoms are better controlled. If you do become pregnant, you will need to be monitored closely by your specialist and by an obstetrician, so they can check for any problems. Source: NHS 24 - Opens in new browser window Last updated: 22 February 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 Arthritis Sjogren's syndrome Other health sites Lupus 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 ©


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Lymphoedema | 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 Lymphoedema Lymphoedema Lymphoedema is a long-term condition that causes swelling in the body’s tissues. It can affect any part of the body, but usually develops in the arms or legs. Lymphoedema is caused by a problem with the lymphatic system. The lymphatic system is a group of vessels and glands around the body. It helps to fight infection and drain excess fluid from tissues. Symptoms of lymphoedema The main symptom of lymphoedema is swelling. At first, the swelling may come and go. It may get worse during the day and better overnight. Without treatment, it can get worse. Other symptoms in an affected body part can include: an aching, heavy feeling difficulty moving skin infections that keep coming back the skin becoming hard and tight folds in the skin wart-like growths


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an aching, heavy feeling difficulty moving skin infections that keep coming back the skin becoming hard and tight folds in the skin wart-like growths on the skin fluid leaking through the skin If you have swelling of one leg more than the other, it’s important to consider other possible causes. For example, deep vein thrombosis (DVT). You should get medical advice if you’re worried about DVT. Speak to your GP practice or care team if you: think you may have lymphoedema develop symptoms of skin infection like redness and a feeling of heat in the skin Diagnosing lymphoedema Your doctor may be able diagnose lymphoedema by: asking about your symptoms and medical history examining the affected body part and measuring to check if it’s enlarged You may be at risk of lymphoedema due to cancer treatment. Your aftercare may include monitoring for the condition. You can talk to your care team if you have any worries. Treatment for lymphoedema The main treatment for lymphoedema is decongestive


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the condition. You can talk to your care team if you have any worries. Treatment for lymphoedema The main treatment for lymphoedema is decongestive lymphatic therapy (DLT). DLT is not a cure, but it can help control the symptoms. There are 4 parts to DLT. These are: compression bandages and garments – move fluid out of the affected limb and prevent more fluid from building up skin care – keeps the skin in good condition and reduces the chances of infection exercises – helps use muscles in the affected limb to improve lymph drainage manual lymphatic drainage (MLD) – a specialised massage that helps the flow of fluid in the lymphatic system and reduces swelling What causes lymphoedema? Primary lymphoedema Primary lymphoedema is caused by changes (mutations) in genes that develop in the lymphatic system. This means that the lymphatic system either: doesn’t develop properly, or doesn’t work as it should Primary lymphoedema usually runs in families. Not every child born to someone with the


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either: doesn’t develop properly, or doesn’t work as it should Primary lymphoedema usually runs in families. Not every child born to someone with the condition will develop it themselves. Secondary lymphoedema Secondary lymphoedema develops in people who previously had a normal lymphatic system. It’s more common than primary lymphoedema. Causes include: cancer treatment – like surgery or radiotherapy infections – like severe cellulitis inflammation – like rheumatoid arthritis or eczema abnormal or damaged veins – like deep vein thrombosis (DVT) or varicose veins obesity trauma and injury to the lymphatic system lack of movement and exercise How to prevent lymphoedema There are things you can do to help reduce your chances of developing lymphoedema, or prevent it getting worse. Do eat a healthy diet maintain a healthy weight exercise regularly How to help prevent infections There are some things that can help reduce your chance of developing skin infections. For example, you should:


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How to help prevent infections There are some things that can help reduce your chance of developing skin infections. For example, you should: treat cuts and scratches immediately with an antiseptic cream use insect repellents to prevent insect bites moisturise the skin daily – speak to your healthcare team to find the right cream for you avoid very hot baths and showers – the heat from saunas, steam rooms and sun beds may also increase swelling use sun cream with a high sun protection factor (SPF) to prevent sunburn wear gloves for gardening and household tasks to avoid cuts, if your upper limbs are affected use anti-fungal powder to prevent fungal infections in your skin or feet, if your lower limbs are affected cut your nails with nail clippers visit a chiropodist for foot and nail care – make sure you tell them you have lymphoedema wear shoes that fit correctly and provide support on the top of your feet, if your lower limbs are affected use an electric razor if you need to shave


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shoes that fit correctly and provide support on the top of your feet, if your lower limbs are affected use an electric razor if you need to shave to reduce the risk of cutting yourself avoid wearing tight-fitting clothes or jewellery Complications of lymphoedema Cellulitis (a bacterial infection of the skin) is a common complication of lymphoedema. The build-up of fluid increases the risk of infection. Living with a long-term condition like lymphoedema can also affect your mental health. Speak to your GP practice if you’re feeling low or lymphoedema is affecting your daily life. Talking to other people who have lymphoedema can help. The Lymphoedema Support Network offers information and advice. They can also put you in touch with a support group in your area. Source: NHS 24 - Opens in new browser window Last updated: 27 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


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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 Breast cancer (female) Radiotherapy Other health sites Lymphoedema Support Network Legs Matter: Oedema and lymphoedema Cancer Research UK: Lymphoedema Macmillan Cancer Support: Lymphoedema Breast Cancer Care: Lymphoedema 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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Malaria | 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 Malaria Malaria About malaria Preventing and treating malaria About malaria Malaria is a serious tropical disease spread by mosquitoes. If it isn’t diagnosed and treated quickly, it can be fatal. A single mosquito bite is all it takes for someone to become infected. Symptoms of malaria It’s important to be aware of the symptoms of malaria if you’re travelling to areas where there’s a high risk of the disease. This means that you can get medical attention quickly. Symptoms are similar to those of flu and usually appear 6 to 30 days after the mosquito bite, but it can sometimes take up to a year for symptoms to start. The initial symptoms of malaria include: a high temperature (fever) headache sweats chills muscle aches or pains vomiting and or diarrhoea These symptoms


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initial symptoms of malaria include: a high temperature (fever) headache sweats chills muscle aches or pains vomiting and or diarrhoea These symptoms can start mild and may be difficult to identify as malaria. When to seek medical attention Malaria is a serious illness that can get worse very quickly. It can be fatal if not treated quickly. The effects of malaria are usually more severe in: babies young children pregnant women older people Phone 111 or go to A&E if: you or your child develop symptoms of malaria during or after a visit to an area where the disease is found, even if it has been several weeks, months or a year after you return from travelling You must tell the healthcare professional that you have been in a country with a risk of malaria, including any brief stopovers. What causes malaria? Malaria is caused by the Plasmodium parasite. The parasite is spread to humans through the bites of infected mosquitoes. There are 5 different types of Plasmodium parasite that cause


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parasite. The parasite is spread to humans through the bites of infected mosquitoes. There are 5 different types of Plasmodium parasite that cause malaria in humans. They are found in different parts of the world (but do overlap in certain areas) and vary in terms of how severe the infection can be. All malaria infections cause the same symptoms and require immediate medical attention. It’s not possible to find out which type of malaria you have from symptoms alone. Types of malaria parasite Plasmodium falciparum – mainly found in Africa, it’s the most common type of malaria parasite and is responsible for most malaria deaths worldwide, though treatment does cure the infection. Plasmodium vivax – mainly found in Asia and South America, this parasite causes milder symptoms but it can stay in the liver for years which can result in symptoms reoccurring if it isn’t treated properly. Plasmodium ovale – fairly uncommon and usually found in West Africa. Plasmodium malariae – this is quite


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reoccurring if it isn’t treated properly. Plasmodium ovale – fairly uncommon and usually found in West Africa. Plasmodium malariae – this is quite rare and usually only found in Africa. Plasmodium knowlesi – this is very rare and found in parts of southeast Asia. How malaria is spread The Plasmodium parasite is spread by mosquitoes. These are known as ‘night-biting’ mosquitoes because they most commonly bite between sunset and sunrise. When a mosquito bites a person already infected with malaria, it becomes infected and spreads the parasite to the next person it bites. Malaria can’t be spread directly from person to person. When an infected mosquito bites, the parasite enters the blood and travels to the liver. In the liver, it develops for days to weeks before re-entering the blood. This is the point where symptoms develop and urgent treatment is required. Although it is very rare, malaria can also be spread from a person with the infection through blood transfusions and sharing


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treatment is required. Although it is very rare, malaria can also be spread from a person with the infection through blood transfusions and sharing needles. Where is malaria found? Malaria is found in tropical and subtropical regions of the world. It is not found in the UK or Europe. The fitfortravel website has more information about the risk of malaria in individual countries. Complications of malaria Malaria is a serious illness that can be fatal if not diagnosed and treated quickly. Severe complications of malaria can occur within hours or days of the first symptoms. This means it is important to seek urgent medical help as soon as possible. Anaemia The destruction of red blood cells by the malaria parasite can cause severe anaemia. Anaemia is a condition where the red blood cells are unable to carry enough oxygen to the body’s muscles and organs. This can leave you feeling drowsy, weak and faint. Cerebral malaria In rare cases, malaria can affect the brain. This is known as


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muscles and organs. This can leave you feeling drowsy, weak and faint. Cerebral malaria In rare cases, malaria can affect the brain. This is known as cerebral malaria which can cause your brain to swell, sometimes leading to permanent brain damage. It can also cause fits (seizures) or coma. Other complications Other complications that can arise as a result of severe malaria include: liver failure and jaundice – yellowing of the skin and whites of the eyes shock – a sudden drop in blood pressure pulmonary oedema – a build-up of fluid in the lungs acute respiratory distress syndrome (ARDS) abnormally low blood sugar – hypoglycaemia kidney failure swelling and rupturing of the spleen dehydration Malaria in pregnancy If you get malaria while pregnant, you and your baby have an increased risk of developing serious complications like: premature birth – birth before 37 weeks of pregnancy low birth weight restricted growth of the baby in the womb stillbirth miscarriage death of the mother


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birth – birth before 37 weeks of pregnancy low birth weight restricted growth of the baby in the womb stillbirth miscarriage death of the mother Pregnant women are advised to avoid travelling to regions with a risk of malaria. Visit your GP, midwife, obstetrician or travel health advisor for a full discussion if you’re pregnant and are thinking of travelling to a high-risk area. Not all antimalarial tablets are safe in pregnancy and it’s important you get specific advice. Preventing and treating malaria If you travel to an area that has malaria, you are at risk of the infection. It’s very important that you take precautions to prevent the disease and get treatment immediately if symptoms do develop. Preventing malaria Malaria can often be avoided using the ABCD approach to prevention, which stands for: Awareness of risk – find out whether you’re at risk of getting malaria Bite prevention – use insect repellent, cover your skin with clothing, and use a mosquito net to avoid mosquito


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you’re at risk of getting malaria Bite prevention – use insect repellent, cover your skin with clothing, and use a mosquito net to avoid mosquito bites Check whether you need to take antimalarial prevention tablets by visiting a travel health clinic – if you do, make sure you take the right antimalarial tablets at the right dose and finish the course Diagnosis – seek immediate medical advice if you have malaria symptoms, including up to a year after you return from travelling Being aware of the risks Check whether you’re travelling to a malaria risk area on the fitfortravel website Visit your local travel clinic for malaria advice as soon as you know that you are travelling to a risk area. If you grew up in a country where malaria is common, any natural protection will be quickly lost when you move. This means you need to protect yourself from infection if you’re now travelling to a risk area, even if that’s where you grew up. Further information about travel health and vaccinations.


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from infection if you’re now travelling to a risk area, even if that’s where you grew up. Further information about travel health and vaccinations. Preventing mosquito bites Avoiding mosquito bites is one of the best ways to prevent malaria. This is particularly important during early evening and at night when mosquitoes bite. There are several steps you can take to avoid being bitten. Do mosquitoes can’t bite through clothing so wear light, loose-fitting clothing that will cover your arms and legsapply insect repellent to all areas of your skin that are not covered by clothing, including your face and neckremember to reapply insect repellent frequentlysleep under a mosquito net that’s been treated with an insecticide, or in a room with effective air conditioning The most effective repellents contain 50% diethyltoluamide (DEET). These are available in: sprays roll-ons sticks creams There’s no evidence to suggest that other remedies protect against malaria, such as homeopathic


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These are available in: sprays roll-ons sticks creams There’s no evidence to suggest that other remedies protect against malaria, such as homeopathic remedies, electronic buzzers, vitamins B1 or B12, garlic, yeast extract spread (Marmite), tea tree oils or bath oils. Further information on mosquito bite prevention is available from the fitfortravel website. Antimalarial tablets Antimalarial tablets can help prevent you from developing a malaria infection. For the best protection, you must also follow mosquito bite prevention advice. You must start taking antimalarial tablets before travel and continue taking them whilst travelling in the risk area. Antimalarial tablets must also be taken for a period of time after you have left the risk area. How long antimalarial tablets should be taken will depend on which tablet is used. Antimalarial tablets don’t stop malaria from entering your body. However, they do stop the infection from developing inside your body and prevent you from getting


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tablets don’t stop malaria from entering your body. However, they do stop the infection from developing inside your body and prevent you from getting ill. If you stop taking your antimalarial tablets early (even when you are back in the UK) you could still become ill with malaria. Taking antimalarial medication You may need to take a short trial course of antimalarial tablets before travelling. This is to check that side effects do not occur and that you do not have an adverse reaction. If you do, alternative antimalarials can be prescribed before you leave. Do make sure you get the right antimalarial tablets before you go – visit a travel health clinic for advice on which is the best antimalarial for youfollow the instructions included with your tablets carefullymake sure you complete the full course of tablets There’s currently no vaccine available that offers protection against malaria. Types of antimalarial medication The type of antimalarial tablets that you will be recommended


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available that offers protection against malaria. Types of antimalarial medication The type of antimalarial tablets that you will be recommended is based on the following information: where you’re going any relevant family medical history your medical history, including any allergies to medication any medication you’re currently taking any problems you’ve had with antimalarial medicines in the past your age whether you’re pregnant If you’ve taken antimalarial medication in the past, don’t assume it’s suitable for future trips. The type of antimalarial that you will need to take depends on which strain of malaria is carried by the mosquitoes in an area. It will also depend on whether they’re resistant to certain types of antimalarial medication. The main types of antimalarials used to prevent malaria are: Atovaquone plus proguanil (also known as Maloff protect or Malarone) Doxycycline (also known as Vibramycin-D) Mefloquine (also known as Lariam) To find out what type of antimalarial


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known as Maloff protect or Malarone) Doxycycline (also known as Vibramycin-D) Mefloquine (also known as Lariam) To find out what type of antimalarial medication is best for you, visit your local travel clinic. Treating malaria If malaria is diagnosed and treated quickly, you should fully recover. Treatment should be started as soon as possible. Treatment begins in a hospital to make sure complications don’t suddenly develop. Treatment is with tablets or capsules. If someone is very ill, treatment will be given through a drip into a vein in the arm (intravenously). Treatment for malaria can leave you feeling very tired and weak for several weeks. The type of medicine and how long you need to take it will depend on: the type of malaria you have the severity of your symptoms whether you took preventative antimalarial tablets your age whether you’re pregnant Source: NHS 24 - Opens in new browser window Last updated: 29 May 2023 How can we improve this page? Help us improve NHS inform


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you’re pregnant 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 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-adults/malignant-brain-tumour-cancerous/


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Malnutrition | 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 Malnutrition Malnutrition Malnutrition means poor nutrition. Most commonly this is caused by not eating enough (undernutrition) or not eating enough of the right food to give your body the nutrients it needs. A balanced diet should provide enough nutrients like calories, protein and vitamins, to keep you healthy. Without this, you may not be getting all the nutrients you need and this can lead to malnutrition. Malnutrition can result in: unplanned weight loss muscle loss a low body mass index (BMI) vitamin and mineral deficiencies This can leave you feeling tired, weak and affect your ability to recover from an illness. Symptoms of malnutrition Malnutrition can be difficult to recognise. It can happen very gradually, which can make it very difficult to spot in the early


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of malnutrition Malnutrition can be difficult to recognise. It can happen very gradually, which can make it very difficult to spot in the early stages. Common signs and symptoms of malnutrition include: loss of appetite and lack of interest in food or fluids unplanned weight loss – this might cause clothing, rings, watches or dentures to become loose tiredness or low energy levels reduced ability to perform everyday tasks like showering, getting dressed or cooking reduced muscle strength – for example, not being able to walk as far or as fast as usual changes in mood which might cause feelings of lethargy and depression poor concentration poor growth in children increased risk of infection, recurrent infections, taking longer to recover and poor wound healing difficulty keeping warm dizziness Speak to your GP if: you have any of the symptoms of malnutrition you notice a drop in weight or you’ve lost weight without trying Conditions that cause malnutrition Sometimes, medical conditions


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of malnutrition you notice a drop in weight or you’ve lost weight without trying Conditions that cause malnutrition Sometimes, medical conditions cause your body to need more nutrients. Some medical conditions can lead to your body being unable to absorb or use nutrients. These may include: cancer and liver disease that can cause a lack of appetite, persistent pain or nausea COPD, pulmonary fibrosis and emphysema, which cause your body to need more nutrients but can reduce your appetite mental health conditions, like depression or schizophrenia, which may affect your ability to look after yourself Crohn’s disease, ulcerative colitis or cystic fibrosis that disrupt your body’s ability to digest food or absorb nutrients burns, fractures and post major surgery, due to increased demand for nutrients dementia – people with dementia may be unable to communicate their needs, may use up a lot of calories pacing or may experience a loss of appetite dysphagia – a condition that makes swallowing


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to communicate their needs, may use up a lot of calories pacing or may experience a loss of appetite dysphagia – a condition that makes swallowing difficult or painful persistent vomiting or diarrhoea Some types and combinations of medication can increase your risk of developing malnutrition. Always check your medicines information and speak to a healthcare professional for advice if you have a concern. Do not stop taking your medication without advice from a healthcare professional. Other causes of malnutrition Physical, social and ageing issues can also cause malnutrition. Physical issues Physical issues can contribute to malnutrition. For example: if your teeth are in a poor condition, if your dentures do not fit, or if you have a sore mouth, eating can be difficult or painful you may lose your appetite as a result of losing your sense of smell and taste you may have a physical disability or other physical impairment that makes it difficult for you to cook or shop for food yourself


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of smell and taste you may have a physical disability or other physical impairment that makes it difficult for you to cook or shop for food yourself Social factors Social issues that can contribute to malnutrition include: living alone and being socially isolated having limited knowledge about nutrition or cooking reduced mobility alcohol or drug use low income or poverty reliance on food banks Ageing As we get older we might become more likely to experience malnutrition. This might be because of how we feel, and physical and social factors. The risk also increases because we’re more likely to have one or more medical conditions as we get older. Diagnosing malnutrition A healthcare professional can assess you for malnutrition using a screening tool like ‘Malnutrition Universal Screening Tool’ (‘MUST’). Screen yourself for malnutrition Treating malnutrition If you’ve lost weight or your appetite is poor, you can make simple changes to your meals, snacks and drinks to help treat


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Treating malnutrition If you’ve lost weight or your appetite is poor, you can make simple changes to your meals, snacks and drinks to help treat malnutrition. Choosing nutrient-dense food and drinks can help improve your calorie intake. This might not be suitable for everyone, especially those with other conditions like dysphagia. Ask your GP, dietitian or nurse for further advice if you’re unsure. You should speak to a healthcare professional if you’ve had to limit the fat and sugar you eat in the past due to a health condition like high cholesterol or diabetes. Ways to increase your calories Try the following ideas to help you to increase the amount of calories and protein in your diet. Do eat ‘little and often’ – 3 small meals a day with 2-3 snacks in-between meals include protein like meat, fish, chicken, eggs, beans or lentils in each meal add high calorie ingredients like full cream milk, cheese, butter, ghee, olive oil and cream to meals and drinks include puddings after your


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meal add high calorie ingredients like full cream milk, cheese, butter, ghee, olive oil and cream to meals and drinks include puddings after your lunch and dinner like creamy yoghurts, custards, rice pudding, milk puddings or ice-cream try ready meals if you don’t feel like cooking choose nourishing milky drinks like malted drinks, hot chocolate, milky coffee and milkshakes choose high sugar drinks like fruit juice, smoothies, fizzy drinks or squash (you can also add egg powder to juice to increase its nutrients) try including 1 pint of full cream milk each day – you can fortify (add extra nutrients to) this by adding 4 tablespoons of dried milk powder – and use this in drinks, cooking, cereals and puddings Don’t do not have drinks just before meals because this can make you feel fuller quicker do not choose low fat, sugar-free, diet foods and drinks – for example skimmed milk If you’re using vegan alternatives to cheese, butter, cream or milk, try to choose the highest calorie


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foods and drinks – for example skimmed milk If you’re using vegan alternatives to cheese, butter, cream or milk, try to choose the highest calorie option. How to add extra nutrients to milk Watch this video to find out how to fortify your milk with milk powder. You can then use this instead of your usual milk. How to add extra nutrients to juice Watch this video to find out how to fortify your juice using egg powder. Easy ways to fortify your food There are ways you can use every day food and drinks to fortify (add extra nutrients to) your food. Butter Add extra butter to: sandwiches or toast mashed potatoes vegetables sauces baked potatoes snacks like pancakes, crumpets and scones biscuits or crackers Sugar, jam and honey Add sugar, jam or honey to: puddings hot drinks milkshakes or smoothies glazed vegetables creamy yogurts fruit porridge or cereal Cream, chocolate spread, peanut butter or nuts Add cream, chocolate spread, peanut butter or nuts to: porridge fruit sauces soups


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porridge or cereal Cream, chocolate spread, peanut butter or nuts Add cream, chocolate spread, peanut butter or nuts to: porridge fruit sauces soups smoothies or milkshakes snacks (toast, pancakes, crumpets, scones, waffles, rice cakes) ice cream or puddings Vegetarian and vegan food If you follow a vegetarian or vegan diet, you can use the following foods to fortify your diet: nut butters vegan cheese vegan cream dairy free milks like oat, soya and nut milks (try to choose the sweetened options that provide the most calories) hemp and pea protein powders avocado plant based spreads Try to choose the highest calorie and protein options available. Snacks Try to eat high calorie and protein snacks like: crackers or oatcakes with cheese, pate, hummus or avocado crumpets, scones and pancakes with butter and jam thick and creamy yoghurts soya yoghurts or desserts milk jelly, chocolate pots and mousses custard, trifle and rice pudding pots dried fruit nuts and seeds cereal bar and flapjacks


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yoghurts or desserts milk jelly, chocolate pots and mousses custard, trifle and rice pudding pots dried fruit nuts and seeds cereal bar and flapjacks mini pork pie, sausage roll, scotch egg and spring rolls chocolate, biscuits, pastries and cakes crisps with dip fruit with chocolate spread or peanut butter Food fortification video Watch this video for ideas of how to add extra nutrients to your food. The British Dietetic Association (BDA) Malnutrition factsheet provides more useful practical advice. Watch this video on Vimeo for more tips on how to fortify your food Oral nutritional supplements Oral nutritional supplements (ONS) are a range of liquid and powder products that help support better nutrition. They contain calories, protein, vitamins and minerals to help increase your intake. They’re designed to be taken alongside your diet and the ‘food first’ advice above to promote progress with your weight. Tube feeding (enteral feeding) Depending on how severe your symptoms are, your


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the ‘food first’ advice above to promote progress with your weight. Tube feeding (enteral feeding) Depending on how severe your symptoms are, your healthcare professional might recommend a “feeding tube”. There are different types of tubes. Which one is best for you depends on your diagnosis and symptoms. The most common types of feeding tube include: nasogastric – through your nose and into your stomach nasojejunal – though your nose and further into your digestive tract percutaneous endoscopic gastrostomy (PEG) – a tube is placed directly into the stomach via your abdomen Depending on your condition alternative routes of nutrition may be considered. Source: The Scottish Dietetic Prescribing Support Group - Opens in new browser window Last updated: 10 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


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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 Alzheimer's disease Depression Cancer Dysphagia (swallowing problems) Dementia COPD Crohn's disease Ulcerative colitis Cystic fibrosis Liver disease Other health sites Age UK Macmillan Cancer Support: Information and support Alzheimer Scotland 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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Measles | 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 Measles Measles Measles is a viral infection that spreads very easily. It’s unpleasant and can sometimes have serious complications. Having the measles, mumps and rubella (MMR) vaccine is the best way to prevent it. Anyone can get measles if they haven’t been vaccinated or they haven’t had it before. People usually recover from measles 7 to 10 days after symptoms appear. Symptoms of measles The first symptoms of measles develop around 10 days after you’re infected. These can include: cold-like symptoms, such as a runny nose, sneezing, and a cough sore, red eyes that may be sensitive to light watery eyes swollen eyes a high temperature (fever), which may reach around 40°C (104°F) small greyish-white spots in the mouth aches and pains loss of appetite tiredness,


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a high temperature (fever), which may reach around 40°C (104°F) small greyish-white spots in the mouth aches and pains loss of appetite tiredness, irritability and a general lack of energy The measles rash appears around 2 to 4 days after the initial symptoms and normally fades after about a week. The rash: is made up of small red-brown, flat or slightly raised spots that may join together into larger blotchy patches – it may be harder to see on brown and black skin usually first appears on the head or neck, before spreading outwards to the rest of the body is not usually itchy Measles rash Go to A&E or phone 999 if: You think you or your child have measles and: have a seizure (fit) have severe difficulty breathing – you’re gasping, choking or not able to get words out (babies may make grunting noises or their stomach may suck under their ribcage) are unable to stay awake – cannot keep their eyes open for more than a few seconds suddenly become confused – your child may be very


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their ribcage) are unable to stay awake – cannot keep their eyes open for more than a few seconds suddenly become confused – your child may be very unsettled, behaving differently, or crying non-stop your child is limp, floppy or not responding normally – their head may fall to the side, backwards or forwards, or they may find it difficult to lift their head and focus on your face a rash that does not fade when you press a glass against it a stiff neck, or find light uncomfortable or painful Phone your GP urgently if: You think you or your child may have measles and: your child is under 1 year old and has come into contact with someone who has measles you’ve been in close contact with someone who has measles and you’re pregnant or have a weakened immune system you or your child have a high temperature you or your child have difficulty breathing – you may feel more short of breath than usual your baby or young child is not feeding well, or taking less feeds or fluids than usual you or


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– you may feel more short of breath than usual your baby or young child is not feeding well, or taking less feeds or fluids than usual you or your child are peeing less than usual (or your baby has fewer wet nappies) you or your child feels very unwell, or you’re worried something is seriously wrong If your GP is closed, phone 111. You should phone your GP first before visiting. They can make arrangements to reduce the risk of spreading the infection to others. Who’s at higher risk of measles? You might be more at risk of having measles, or of experiencing complications from measles, if you’re: under 12 months old have a weakened immune system (even if you’ve been immunised against measles) pregnant Is measles serious? Measles can be unpleasant, but will usually pass in about 7 to 10 days without causing any further problems. Once you’ve had measles, your body builds up resistance (immunity) to the virus. It’s highly unlikely you’ll get it again. However, measles can lead to serious


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had measles, your body builds up resistance (immunity) to the virus. It’s highly unlikely you’ll get it again. However, measles can lead to serious and potentially life-threatening complications in some people. These include infections of the lungs (pneumonia) and brain (encephalitis). How measles is spread The measles virus is contained in tiny droplets that come out of the nose and mouth when an infected person breathes, coughs or sneezes. You can easily catch measles by breathing in these droplets from the air. Or, if the droplets have settled on a surface, by touching the surface and then placing your hands near your nose or mouth. The virus can survive on surfaces for a few hours. People with measles are infectious from when the symptoms develop until about 4 days after the rash first appears. How to prevent spreading measles to others If you have measles: stay off nursery, school or work for at least 4 days from when the rash first appears regularly wash your hands with soap


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others If you have measles: stay off nursery, school or work for at least 4 days from when the rash first appears regularly wash your hands with soap cough or sneeze into tissues and throw used tissues in the bin avoid close contact with anyone who avoid close contact with anyone who hasn’t had 2 doses of the MMR vaccine avoid contact with those who are higher risk of measles, like anyone who is pregnant, who has a weakened immune system, or is under 12 months old How measles can be prevented Measles can be prevented by having the MMR vaccine. This is given in 2 doses as part of the NHS childhood vaccination programme. You can be vaccinated at any age if you haven’t been fully vaccinated before. If the MMR vaccine isn’t suitable for you, a treatment called human normal immunoglobulin (HNIG) can be used if you’re at immediate risk of catching measles. Treatment for measles There are things you can do to help relieve your symptoms. Do take paracetamol or ibuprofen to relieve fever,


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catching measles. Treatment for measles There are things you can do to help relieve your symptoms. Do take paracetamol or ibuprofen to relieve fever, aches and pains – aspirin should not be given to children under 16 years old drink plenty of water to avoid dehydration use damp cotton wool to clean the eyes In severe cases, especially if there are complications, you or your child may need to be admitted to hospital for treatment. Source: NHS 24 - Opens in new browser window Last updated: 11 April 2025 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Don’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 MMR vaccine MMR against measles 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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measles 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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Meningitis | 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 Meningitis Meningitis About meningitis Causes of meningitis Treating meningitis Complications of meningitis Preventing meningitis About meningitis Meningitis is an infection of the protective membranes that surround the brain and spinal cord (meninges). It can affect anyone, but is most common in babies, young children, teenagers and young adults. Meningitis can be very serious if not treated quickly. It can cause life-threatening blood poisoning (septicaemia) and result in permanent damage to the brain or nerves. A number of vaccinations are available that offer some protection against meningitis. Symptoms of meningitis Symptoms of meningitis develop suddenly and can include: a high temperature (fever) over 37.5C (99.5F) being sick a headache a blotchy rash that


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Symptoms of meningitis develop suddenly and can include: a high temperature (fever) over 37.5C (99.5F) being sick a headache a blotchy rash that doesn’t fade when a glass is rolled over it (this won’t always develop) a stiff neck a dislike of bright lights drowsiness or unresponsiveness seizures (fits) These symptoms can appear in any order and some may not appear. When to get medical help You should get medical advice as soon as possible if you’re concerned that you or your child could have meningitis. Trust your instincts and don’t wait until a rash develops. Phone 999 for an ambulance or go to your nearest accident and emergency (A&E) department immediately if you think you or your child might be seriously ill. Phone 111 or your GP practice for advice if you’re not sure if it’s anything serious or you think you may have been exposed to someone with meningitis. How meningitis is spread Meningitis is usually caused by a bacterial or viral infection. Bacterial meningitis is rarer but


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someone with meningitis. How meningitis is spread Meningitis is usually caused by a bacterial or viral infection. Bacterial meningitis is rarer but more serious than viral meningitis. Infections that cause meningitis can be spread through: sneezing coughing kissing sharing utensils, cutlery and toothbrushes Meningitis is usually caught from people who carry these viruses or bacteria in their nose or throat but aren’t ill themselves. It can also be caught from someone with meningitis, but this is less common. Read more about the causes of meningitis Vaccinations against meningitis Vaccinations offer some protection against certain causes of meningitis. These include the: meningitis B vaccine – offered to babies aged 8 weeks, followed by a second dose at 16 weeks, and a booster at 1 year 6-in-1 vaccine – offered to babies at 8, 12 and 16 weeks of age pneumococcal vaccine – offered to babies at 12 weeks and between 12 and 13 months old meningitis C vaccine – offered at 12 weeks of age, 1


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of age pneumococcal vaccine – offered to babies at 12 weeks and between 12 and 13 months old meningitis C vaccine – offered at 12 weeks of age, 1 year MMR vaccine – offered to babies at 1 year and a second dose at 3 years and 4 months meningitis ACWY vaccine – offered to teenagers who are in S3 (around 14 years of age) at school. Young people who are in S4-S6 and missed the opportunity to get immunised last year, may also get the vaccine at school this year Read more about the meningitis vaccinations Treatments for meningitis People with suspected meningitis will usually have tests in hospital to confirm the diagnosis and check whether the condition is the result of a viral or bacterial infection. Bacterial meningitis usually needs to be treated in hospital for at least a week. Treatments include: antibiotics given directly into a vein fluids given directly into a vein oxygen through a face mask Viral meningitis tends to get better on its own within 7 to 10 days and can often be


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fluids given directly into a vein oxygen through a face mask Viral meningitis tends to get better on its own within 7 to 10 days and can often be treated at home. Getting plenty of rest and taking painkillers and anti-sickness medication can help relieve the symptoms in the meantime. Read more about how meningitis is treated Outlook for meningitis Viral meningitis will usually get better on its own and rarely causes any long-term problems. Most people with bacterial meningitis who are treated quickly will also make a full recovery, although some are left with serious, long-term problems. These can include: hearing loss or vision loss, which may be partial or total problems with memory and concentration recurrent seizures (epilepsy) co-ordination, movement and balance problems loss of limbs – amputation of affected limbs is sometimes necessary Overall, it’s estimated that up to 1 in every 10 cases of bacterial meningitis is fatal. Read more about the complications of meningitis Causes


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Overall, it’s estimated that up to 1 in every 10 cases of bacterial meningitis is fatal. Read more about the complications of meningitis Causes of meningitis Meningitis is usually caused by a viral or bacterial infection. Viral meningitis is the most common and least serious type. Bacterial meningitis is rare but can be very serious if not treated. Several different viruses and bacteria can cause meningitis, including: meningococcal bacteria – there are several different types, called A, B, C, W, X, Y and Z pneumococcal bacteria Haemophilus influenzae type b (Hib) bacteria enteroviruses – viruses that usually only cause a mild stomach infection the mumps virus the herpes simplex virus – a virus that usually causes cold sores or genital herpes A number of meningitis vaccinations provide protection against many of the infections that can cause meningitis. How meningitis is spread The viruses and bacteria that cause meningitis can be spread through: sneezing coughing kissing sharing


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cause meningitis. How meningitis is spread The viruses and bacteria that cause meningitis can be spread through: sneezing coughing kissing sharing utensils, cutlery and toothbrushes The infection is usually spread by people who carry these viruses or bacteria in their nose or throat, but aren’t ill themselves. The infection can also be spread by someone with meningitis, although this is less common. It’s possible to get meningitis more than once. Who’s most at risk? Anyone can potentially get meningitis, but it’s more common in: babies and young children teenagers and young adults elderly people people with a weak immune system – for example, those with HIV and those having chemotherapy You can reduce the risk of getting meningitis by ensuring all your vaccinations are up-to-date. Read more about meningitis vaccinations Treating meningitis People with suspected meningitis will usually need to have tests in hospital and may need to stay in hospital for treatment. Tests in hospital


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People with suspected meningitis will usually need to have tests in hospital and may need to stay in hospital for treatment. Tests in hospital Several tests may be carried out to confirm the diagnosis and check whether the condition is the result of a viral or bacterial infection. These tests may include: a physical examination to look for symptoms of meningitis a blood test to check for bacteria or viruses a lumbar puncture – where a sample of fluid is taken from the spine and checked for bacteria or viruses a computerised tomography (CT) scan to check for any problems with the brain, such as swelling As bacterial meningitis can be very serious, treatment with antibiotics will usually start before the diagnosis is confirmed and will be stopped later on if tests show the condition is being caused by a virus. Treatment in hospital Treatment in hospital is recommended in all cases of bacterial meningitis, as the condition can cause serious problems and requires close monitoring. Severe


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in hospital is recommended in all cases of bacterial meningitis, as the condition can cause serious problems and requires close monitoring. Severe viral meningitis may also be treated in hospital. Treatments include: antibiotics given directly into a vein fluids given directly into a vein to prevent dehydration oxygen through a face mask if there are any breathing difficulties steroid medication to help reduce any swelling around the brain, in some cases People with meningitis may need to stay in hospital for a few days, and in certain cases, treatment may be needed for several weeks. Even after going home, it may be a while before you feel completely back to normal. Additional treatment and long-term support may also be required if any complications of meningitis occur, such as hearing loss. Treatment at home You’ll usually be able to go home from hospital if you or your child has mild meningitis and tests show it’s being caused by a viral infection. This type of meningitis will


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to go home from hospital if you or your child has mild meningitis and tests show it’s being caused by a viral infection. This type of meningitis will normally get better on its own without causing any serious problems. Most people feel better within 7 to 10 days. In the meantime, it can help to: get plenty of rest take painkillers for a headache or general aches take anti-emetic (anti-sickness) medicine for any vomiting Preventing the spread of infection The risk of someone with meningitis spreading the infection to others is generally low. But if someone is thought to be at high risk of infection, they may be given a dose of antibiotics as a precautionary measure. This may include anyone who has been in prolonged close contact with someone who developed meningitis, such as: people living in the same house pupils sharing a dormitory a boyfriend or girlfriend People who have only had brief contact with someone who developed meningitis won’t usually need to take antibiotics.


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a boyfriend or girlfriend People who have only had brief contact with someone who developed meningitis won’t usually need to take antibiotics. Complications of meningitis Most people make a full recovery from meningitis, but it can sometimes cause serious, long-term problems and can be life threatening. This is why it’s so important to get medical help as soon as possible if you think you or your child has symptoms of meningitis, and why meningitis vaccinations are offered to certain groups. It’s estimated up to 1 person in every 2 or 3 who survives bacterial meningitis is left with 1 or more permanent problems. Complications are much rarer after viral meningitis. Main complications Some of the most common complications associated with meningitis are: hearing loss, which may be partial or total – people who have had meningitis will usually have a hearing test after a few weeks to check for any problems recurrent seizures (epilepsy) problems with memory and concentration co-ordination,


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have a hearing test after a few weeks to check for any problems recurrent seizures (epilepsy) problems with memory and concentration co-ordination, movement and balance problems learning difficulties and behavioural problems vision loss, which may be partial or total loss of limbs – amputation is sometimes necessary to stop the infection spreading through the body and remove damaged tissue bone and joint problems, such as arthritis kidney problems Overall, it’s estimated up to 1 in every 10 cases of bacterial meningitis is fatal. Treatment and support Additional treatment and long-term support may be required if you or your child experience complications of meningitis. For example: cochlear implants, which are small devices that are inserted into the ears to improve hearing, may be needed in cases of severe hearing loss – read more about treatment for hearing loss prosthetic limbs and rehabilitation support may help if it was necessary to amputate any limbs – read more about


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about treatment for hearing loss prosthetic limbs and rehabilitation support may help if it was necessary to amputate any limbs – read more about recovering after an amputation counselling and psychological support may help if the trauma of having meningitis causes problems such as disturbed sleep, bedwetting, or fear of doctors and hospitals You may also find it useful to get in touch with organisations such as the Meningitis Research Foundation or Meningitis Now for support and advice about life after meningitis. Preventing meningitis Meningitis can be caused by a number of different infections, so several vaccinations offer some protection against it. Children should receive most of these as part of the NHS vaccination schedule. Speak to your GP if you’re not sure whether your or your child’s vaccinations are up-to-date. Meningitis B vaccine The meningitis B vaccine offers protection against meningococcal group B bacteria, which are a common cause of meningitis in young children in


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The meningitis B vaccine offers protection against meningococcal group B bacteria, which are a common cause of meningitis in young children in the UK. The vaccine is recommended for babies aged 8 weeks, followed by a second dose at 16 weeks, and a booster at one year. 6-in-1 vaccine The 6-in-1 vaccine, also known as the DTaP/IPV/Hib/HepB vaccine, offers protection against diphtheria, tetanus, whooping cough, polio, Haemophilus influenzae type b (Hib) and hepatitis B. Hib are a type of bacteria that can cause meningitis. The vaccine is given on three separate occasions when babies are 8, 12 and 16 weeks old. More about the 6-in-1 vaccine Pneumococcal vaccine The pneumococcal vaccine offers protection against serious infections caused by pneumococcal bacteria, including meningitis. Babies receive the pneumococcal vaccine as 2 separate injections, at 12 weeks and between 12 and 13 months old. More about the pneumococcal vaccine Hib/Men C vaccine The meningitis C vaccine offers protection


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at 12 weeks and between 12 and 13 months old. More about the pneumococcal vaccine Hib/Men C vaccine The meningitis C vaccine offers protection against a type of bacteria – meningococcal group C bacteria – that can cause meningitis. Babies are offered a combined Hib/Men C vaccine at 1 year of age. Teenagers and first-time university students are also offered vaccination against meningococcal group C bacteria as part of the combined meningitis ACWY vaccine. More about the Hib/Men C vaccine MMR vaccine The MMR vaccine offers protection against measles, mumps and rubella. Meningitis can sometimes occur as a complication of these infections. The vaccine is usually given to babies at 1 year of age. They’ll then have a second dose when they’re 3 years and 4 months old. More about the MMR vaccine Meningitis ACWY vaccine The meningitis ACWY vaccines offers protection against 4 types of bacteria that can cause meningitis – meningococcal groups A, C, W and Y. Young people who are in S3 (around


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offers protection against 4 types of bacteria that can cause meningitis – meningococcal groups A, C, W and Y. Young people who are in S3 (around 14 years of age) at school are advised to have the vaccination. Young people who are in S4 to S6 and missed the opportunity to get immunised last year, may also get the vaccine at school this year. More about the meningitis ACWY vaccine Source: NHS 24 - Opens in new browser window Last updated: 15 June 2023 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Don’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 Sepsis Other health sites Brain and Spine Foundation: Meningitis Meningitis Now Meningitis Research Foundation NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool


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Now Meningitis Research 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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Mesothelioma | 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 Mesothelioma Mesothelioma Mesothelioma is a type of cancer that develops in the lining that covers the outer surface of some of the body’s organs. It’s usually linked to asbestos exposure. Mesothelioma mainly affects the lining of the lungs (pleural mesothelioma), although it can also affect the lining of the tummy (peritoneal mesothelioma), heart or testicles. Most cases are diagnosed in people aged 60 to 80 and men are affected more commonly than women. Unfortunately, it’s rarely possible to cure mesothelioma, although treatment can help control the symptoms. Symptoms of mesothelioma The symptoms of mesothelioma tend to develop gradually over time. They typically don’t appear until several decades after exposure to asbestos. Symptoms of mesothelioma in the


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tend to develop gradually over time. They typically don’t appear until several decades after exposure to asbestos. Symptoms of mesothelioma in the lining of the lungs include: chest pain shortness of breath fatigue (extreme tiredness) a high temperature (fever) and sweating, particularly at night a persistent cough loss of appetite and unexplained weight loss clubbed (swollen) fingertips Symptoms of mesothelioma in the lining of the tummy include: tummy pain or swelling feeling or being sick loss of appetite and unexplained weight loss diarrhoea or constipation Speak to your GP if you have any persistent or worrying symptoms. Tell them about any exposure to asbestos you may have had in the past. What causes mesothelioma? Mesothelioma is almost always caused by exposure to asbestos, a group of minerals made of microscopic fibres that used to be widely used in construction. These tiny fibres can easily get in the lungs, where they get stuck, damaging the lungs over time. It usually


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used to be widely used in construction. These tiny fibres can easily get in the lungs, where they get stuck, damaging the lungs over time. It usually takes a while for this to cause any obvious problems, with mesothelioma typically developing more than 20 years after exposure to asbestos. The use of asbestos was completely banned in 1999, so the risk of exposure is much lower nowadays. However, materials containing asbestos are still found in many older buildings. How mesothelioma is diagnosed If your GP suspects mesothelioma, they will refer you to a hospital specialist for some tests. A number of different tests may need to be carried out, including: an X-ray of your chest or tummy a computerised tomography (CT) scan – a number of X-ray images are taken to create a detailed image of the inside of the body fluid drainage – if there’s a build-up of fluid around the lungs or in the tummy, a sample may be removed using a needle inserted through the skin so the fluid can be analysed a


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a build-up of fluid around the lungs or in the tummy, a sample may be removed using a needle inserted through the skin so the fluid can be analysed a thoracoscopy or laparoscopy – the inside of your chest or tummy is examined with a long, thin camera that’s inserted through a small cut (incision) under sedation or anaesthetic; a sample of tissue (biopsy) may be removed so it can be analysed These tests can help diagnose mesothelioma and show how far it has spread. Treatments for mesothelioma The best treatment for mesothelioma depends on several factors, including how far the cancer has spread and your general health. As mesothelioma is often diagnosed at an advanced stage, treatment is usually focused on controlling the symptoms and prolonging life for as long as possible. This is known as palliative or supportive care. Possible treatments include: chemotherapy – this is the main treatment for mesothelioma and involves using medicine to help shrink the cancer radiotherapy – this


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include: chemotherapy – this is the main treatment for mesothelioma and involves using medicine to help shrink the cancer radiotherapy – this involves using high-energy radiation to kill cancer cells and it may be used to slow the cancer down and keep it under control surgery – an operation to remove the cancerous area can be done if mesothelioma is detected at a very early stage, although it’s not clear whether surgery is helpful You’ll also probably have treatment for your individual symptoms to help you feel as comfortable as possible. For example, regularly draining fluid from your chest may help your breathing and strong painkillers may help relieve your pain. Sometimes, a procedure is carried out to stop the fluid coming back again by making the outside of the lungs stick to the inside of your chest (pleurodesis), or a tube is put in your chest to drain the fluid regularly at home. Your doctors should discuss these treatments with you. Source: NHS 24 - Opens in new browser


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put in your chest to drain the fluid regularly at home. Your doctors should discuss these treatments with you. 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 Asbestosis Other health sites Asthma and Lung UK: Mesothelioma Cancer Research UK: Mesothelioma Macmillan Cancer Support: Mesothelioma Mesothelioma UK 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


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https://www.nhsinform.scot/illnesses-and-conditions/muscle-bone-and-joints/arm-shoulder-and-hand-problems-and-conditions/metacarpal-fracture-of-the-hand/


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https://www.nhsinform.scot/illnesses-and-conditions/ears-nose-and-throat/middle-ear-infection-otitis-media/


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Middle ear infection (otitis media) | 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 Middle ear infection (otitis media) Middle ear infection (otitis media) Otitis media is an infection of the middle ear. It causes inflammation (redness and swelling) and a build-up of fluid behind the eardrum. Anyone can develop a middle ear infection, but they’re most common in young children. You do not always need to see a GP as most ear infections get better on their own within 3 to 5 days. Symptoms of a middle ear infection The main symptoms of a middle ear infection include: earache a high temperature (fever) being sick a lack of energy slight hearing loss – if the middle ear becomes filled with fluid In some cases, a hole may develop in the eardrum (perforated eardrum) and pus may run out of the ear. The earache, which is caused by the


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with fluid In some cases, a hole may develop in the eardrum (perforated eardrum) and pus may run out of the ear. The earache, which is caused by the build-up of fluid stretching the eardrum, then resolves. Signs in young children Young children and babies with an ear infection may also: rub or pull their ear not react to some sounds be irritable or restless be off their food keep losing their balance When to get medical advice Speak to your GP practice if: You or your child has: symptoms that do not improve within 2 or 3 days regular ear infections a lot of pain a discharge of pus or fluid from the ear an underlying health condition, such as cystic fibrosis or congenital heart disease, which could make complications more likely If your GP practice is closed, phone 111. Treatment for middle ear infections Most ear infections get better on their own within 3 to 5 days and do not need any specific treatment. If needed, paracetamol or ibuprofen can be used to relieve pain and a high


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on their own within 3 to 5 days and do not need any specific treatment. If needed, paracetamol or ibuprofen can be used to relieve pain and a high temperature. Always read the leaflet that comes with your medicine before taking it. Follow the recommended dosage instructions. If you’re not sure which treatments are suitable for you or your child, speak to a pharmacist for advice. Placing a warm cloth over the affected ear may also help relieve pain. Antibiotics are not usually used to treat middle ear infections. What causes middle ear infections? Most middle ear infections occur when an infection, such as a cold, leads to a build-up of mucus in the middle ear. This causes the Eustachian tube (a thin tube that runs from the middle ear to the back of the nose) to become swollen or blocked. The mucus can’t drain away properly, making it easier for an infection to spread into the middle ear. An enlarged adenoid (soft tissue at the back of the throat) can also block the Eustachian tube.


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for an infection to spread into the middle ear. An enlarged adenoid (soft tissue at the back of the throat) can also block the Eustachian tube. The adenoid can be removed if it often causes ear infections. Middle ear infections are more common in younger children because: the Eustachian tube is smaller in children than in adults a child’s adenoids are relatively larger than an adults Certain conditions can also increase the risk of middle ear infections, including: having a cleft palate having Down’s syndrome Can middle ear infections be prevented? It’s not possible to prevent middle ear infections. There are some things you can do that may reduce your child’s risk of developing one. Do make sure your child is up-to-date with their routine vaccinations – particularly the pneumococcal vaccine and the DTaP/IPV/Hib/HepB (6-in-1) vaccine if possible, feed your baby with breast milk rather than formula milk Don’t do not expose your child to smoky environments (passive smoking) do not give


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possible, feed your baby with breast milk rather than formula milk Don’t do not expose your child to smoky environments (passive smoking) do not give your child a dummy once they’re older than 12 months old do not feed your child while they’re lying flat on their back Children who go to nursery or school can pick up infections from other children who are unwell. Complications of middle ear infections Complications of middle ear infections are fairly rare, but can be serious. Most complications are the result of the infection spreading to another part of the ear or head. Rarely, infections can leave a perforation or hole in the eardrum. If complications do develop, they often need to be treated immediately with antibiotics in hospital. Source: ENT Scotland - Opens in new browser window Last updated: 02 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


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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 Earache Self-help guide: Earache Other health sites Royal National Institute for Deaf People (RNID) Family Lives 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/injuries/head-and-neck-injuries/minor-head-injury/


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https://www.nhsinform.scot/illnesses-and-conditions/pregnancy-and-childbirth/losing-a-baby/miscarriage/


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Miscarriage | 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 Pregnancy and childbirth Losing a baby Miscarriage Miscarriage A miscarriage is the loss of a pregnancy before 24 weeks. About 1 in 5 pregnancies miscarry. Since many miscarriages aren’t recorded the figure might be higher. For many people who have a pregnancy or baby loss, the word ‘miscarriage’ doesn’t properly express the impact of their loss. Symptoms of miscarriage Miscarriage symptoms can be varied. Some people have very clear symptoms, while others may experience none at all. Miscarriage signs can change, depending on whether you’re having an early miscarriage or a late miscarriage. Phone 999 or go to your nearest A&E if you’re pregnant and you: have sharp, sudden and intense stomach pains feel very dizzy or faint feel very sick look very pale have vaginal bleeding or spotting,


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and you: have sharp, sudden and intense stomach pains feel very dizzy or faint feel very sick look very pale have vaginal bleeding or spotting, commonly after the pain has started have pain in your shoulder tip have diarrhoea and are vomiting Get medical help if you’re pregnant and: you’re bleeding from your vagina you’ve got strong, cramping pain your waters break you have started to feel your baby move (usually this is from about 16-24 weeks) and the movements have slowed down or stopped Before 12 weeks, contact your GP or your local early pregnancy unit. If your GP is closed, phone 111. 12 weeks or after, contact your local maternity service. If you’re not registered with the maternity service, contact your GP or NHS 24 on 111. Early miscarriages An early miscarriage happens in the first 12 weeks of pregnancy. Most women who miscarry do so in the first 12 weeks of their pregnancy. Many women have a miscarriage before they even know they’re pregnant. If this happens it can feel like


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so in the first 12 weeks of their pregnancy. Many women have a miscarriage before they even know they’re pregnant. If this happens it can feel like a late period with heavy bleeding. Read more about early miscarriages Late miscarriages A late miscarriage happens after 12 weeks and before 24 weeks. Read more about late miscarriages What causes a miscarriage? Most of the time there’s no clear reason why a miscarriage happens. It’s unlikely to be caused by anything you did or did not do. Read more about the causes of a miscarriage Making difficult decisions If you’re having a miscarriage, your doctor, nurse or midwife will: talk to you about what will happen next help you, and your partner if you have one, decide what you’d like to do You may have difficult decisions to make at this time. Your emotions may also feel overwhelming. Take your time. Your doctor, nurse or midwife can help. There are also organisations that can support you and your family. Read more about getting support after


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Your doctor, nurse or midwife can help. There are also organisations that can support you and your family. Read more about getting support after a miscarriage After a miscarriage Depending on your circumstances and stage of pregnancy, you may be able to see or hold your baby. The doctor, nurse or midwife treating you will discuss this with you. Some parents decide they don’t want to see their baby. Others choose not to for faith or cultural reasons. This is a decision only you can make. It can be very hard when you’re feeling overwhelmed. Whatever you decide is okay. If you’re worried about what your baby looks like, your doctor or midwife can describe them to help you decide. Physical wellbeing after a miscarriage After a miscarriage, it’s likely you’ll have some bleeding for a week or two. Some people continue to have other symptoms as well as bleeding after a miscarriage. This can mean that some of the pregnancy tissue is still in your uterus (womb). You may need medicine or a


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as well as bleeding after a miscarriage. This can mean that some of the pregnancy tissue is still in your uterus (womb). You may need medicine or a short operation to treat this. If you’re worried about seeking treatment, ask a family member or friend to come with you. Having support is important at this difficult time. Read more about supporting someone who’s lost a baby Working after a miscarriage You may wish to take time off work after a miscarriage. The time you take off is a personal decision and may depend on: how far along your pregnancy was before you miscarried the policies of your workplace Read more about working after a miscarriage Recurrent miscarriages Most people go on to have a successful pregnancy and a healthy baby after a miscarriage. But unfortunately, some people have repeated miscarriages. If you’ve had 1 or 2 miscarriages, you’re no more likely than anyone else to have another miscarriage. But, if you’ve had 3 or more miscarriages, you may wish to speak to your


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you’re no more likely than anyone else to have another miscarriage. But, if you’ve had 3 or more miscarriages, you may wish to speak to your doctor, nurse or midwife for further advice. Read more about recurrent miscarriages 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. 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 Causes of miscarriage Early miscarriage Early Pregnancy Units (EPU) Finding support after baby loss Late miscarriage Recurrent miscarriage Supporting someone who's lost a baby Working after losing a baby 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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https://www.nhsinform.scot/illnesses-and-conditions/pregnancy-and-childbirth/losing-a-baby/molar-pregnancy/


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


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Motor neurone disease (MND) | 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 Motor neurone disease (MND) Motor neurone disease (MND) Motor neurone disease (MND) is a rare condition that progressively damages parts of the nervous system. This leads to muscle weakness, often with visible wasting. Amyotrophic lateral sclerosis (ALS) is the most common form of MND. MND happens when specialist nerve cells in the brain and spinal cord, called motor neurones, stop working properly and die prematurely. This is known as neurodegeneration. Motor neurones control muscle activity like: gripping walking speaking swallowing breathing As MND progresses, it can become more difficult to do some or all of these activities. Symptoms of motor neurone disease The symptoms of MND start gradually over weeks and months. They tend to appear on


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some or all of these activities. Symptoms of motor neurone disease The symptoms of MND start gradually over weeks and months. They tend to appear on one side of the body first and get progressively worse. Speak to your GP if: you have early symptoms of MND Being referred to a specialist as early as possible can help you access the right support. There are usually 3 stages of symptoms. Early symptoms Sometimes the early symptoms are mistaken for similar conditions that also affect the nervous system. Limb-onset disease In about two-thirds of people with MND, the first symptoms are in the arm or leg. This is sometimes called limb-onset disease. The symptoms include: a weakened grip, which can cause problems picking up or holding objects weakness at the shoulder, making lifting your arm above your head difficult tripping up over your foot because of weakness at your ankle or hip These symptoms are usually painless. You might also experience widespread twitching of the muscles


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your foot because of weakness at your ankle or hip These symptoms are usually painless. You might also experience widespread twitching of the muscles (fasciculations) or muscle cramps. You might also see wasting of the muscles with significant weight loss. Bulbar-onset disease In 1 out of 4 cases, the first MND symptoms will affect the muscles used for speaking and swallowing. These problems might initially affect the muscles used for speech and swallowing. Increasingly slurred speech (dysarthria) is usually the first sign of this type of MND. It might be misdiagnosed as a stroke. As the condition progresses, it may become increasingly difficult to swallow (dysphagia). This might be misdiagnosed as a blockage in the throat. Respiratory-onset disease In rare cases, MND starts by affecting the lungs, rather than affecting them at the end of the condition. This is called respiratory-onset disease. In some cases the initial symptoms like breathing difficulties and shortness of breath are


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the condition. This is called respiratory-onset disease. In some cases the initial symptoms like breathing difficulties and shortness of breath are more obvious. You might suffer from a lack of sleep and a headache in the morning. This might be because your body isn’t getting rid of the carbon dioxide you normally breathe out. Advanced symptoms As MND becomes more advanced, more parts and functions of the body are affected. This can make you more likely to experience infections, like chest infections, which can cause your condition to get worse quicker. Muscular symptoms The limbs will become weaker. The muscles in the limbs may become thinner. As a result, the person will find it increasingly difficult to move the affected limbs. The limbs may also become stiff. This is known as spasticity. Both muscle wasting and stiffness can also cause joint aches and pains. Speaking and swallowing difficulties Speaking and swallowing can become increasingly difficult as MND progresses. Choking


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joint aches and pains. Speaking and swallowing difficulties Speaking and swallowing can become increasingly difficult as MND progresses. Choking episodes can be distressing but they aren’t usually the cause of death. Saliva problems Reduced swallowing can cause excess saliva. This can cause drooling. Thicker saliva can sometimes be difficult to clear from the chest or throat. This is because the muscles that control coughing become weak. Excessive yawning Some people with MND have episodes of uncontrollable excessive yawning. This can happen even when they’re not tired. It can sometimes cause jaw pain. Emotional changes MND can cause changes in your ability to control your emotions. This is more likely when there’s weakness in the muscles that control speech and swallowing. One of the most common signs is when a person has episodes of sudden uncontrollable crying or, more rarely, laughter. This is sometimes called emotional lability or emotionality. Changes to mental abilities


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of sudden uncontrollable crying or, more rarely, laughter. This is sometimes called emotional lability or emotionality. Changes to mental abilities Sometimes, people with MND have significant difficulties with: concentration planning communication behavioural changes. This is where the condition is causing a type of dementia (usually frontotemporal dementia). Up to 15% of people with MND develop more profound frontotemporal dementia. This usually happens soon after, or sometimes before, their first muscle-related symptoms. Someone with MND might not be aware that there are problems with their behaviour or personality. Breathing difficulties Breathing might become less efficient as the nerves and muscles that help control the lungs become more damaged. This might mean you feel short of breath after doing every day tasks like walking up the stairs. Over time, you might become even more out of breath when you’re resting. Shortness of breath can become a problem at night. Some people find


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stairs. Over time, you might become even more out of breath when you’re resting. Shortness of breath can become a problem at night. Some people find it difficult to breathe when they’re lying down. Others might wake in the night because they feel breathless. As breathlessness increases, breathing support can help reduce this symptom. This is usually given by non-invasive ventilatory (NIV) support. It can be useful at night to improve your sleep quality. This can help reduce drowsiness during the day. End-stage symptoms As MND progresses to its final phase, you might experience: increasing body paralysis, which means you’ll need help with most daily activities significant shortness of breath Eventually, non-invasive breathing assistance won’t be enough to make up for the loss of normal lung function. At this stage, more medication can help to reduce symptoms of breathlessness and anxiety related to it. Most people with MND become increasingly drowsy before falling into a deep sleep,


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to reduce symptoms of breathlessness and anxiety related to it. Most people with MND become increasingly drowsy before falling into a deep sleep, where they usually die peacefully. Secondary symptoms Some people with MND have other symptoms that aren’t directly caused by the condition, but are related to the stress of living with it. These might include depression, insomnia and anxiety. Causes of motor neurone disease MND occurs when specialist nerve cells (motor neurones) in the brain and spinal cord progressively fail. It’s not clear why this happens. Genetic causes One known cause of MND is an error in your genes with 20% of cases linked to genetic causes. Half of genetic cases will be in people who have a family history of MND. The other half of genetic cases will occur in those without a family history. Having a family history of frontotemporal dementia can also increase the risk of inheriting MND. The error in the gene affects the cells ability to perform normally and survive.


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dementia can also increase the risk of inheriting MND. The error in the gene affects the cells ability to perform normally and survive. If you have a genetic form of MND, there’s a chance that you could pass the risk of developing MND on to your child. The risk of them developing the condition can be affected by many factors like age. Not everyone who has the genetic mutation will develop MND in their lifetime. Typically, the longer you live, the more likely you are to develop the condition. If you have a parent with MND with no other family history of the disease, you’re at a slight increased risk of MND of about 1.4%. The risk to the general population of MND is about 0.3%. Other possible causes of motor neurone disease It’s unclear why the motor neurones begin to lose function. Most experts believe that it’s a combination of factors that affect either the motor neurones or the cells that support them. There are some theories involving different cell processes including: Aggregates


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affect either the motor neurones or the cells that support them. There are some theories involving different cell processes including: Aggregates and RNA processing Aggregates are abnormal clumps of protein that develop inside motor neurones. They’re found in nearly all cases of MND and may disrupt the normal working of the motor neurones. It can also be a marker that the cell is under stress. The protein TDP-43 is most commonly found in these aggregates. This is a protein involved in the processing of the genetic instructions for the cell through a molecule known as RNA. Mutations in the gene (TARDBP) coding for this protein can be a cause of genetic cases of MND. Cell transport disruption All cells have transport systems that move nutrients and other chemicals into the cell and waste products out of the cell. Research suggests that the transport systems in motor neurones become disrupted. Over time, toxic waste can build up in cells as a natural by-product of normal cell activity


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transport systems in motor neurones become disrupted. Over time, toxic waste can build up in cells as a natural by-product of normal cell activity and aging. The body gets rid of the toxic waste by waste disposal systems that can be affected by ageing and the environment. Glial cells Glial cells surround and support motor neurones and provide them with nutrients. When they don’t work properly the motor neurones no longer receive the support and nutrition they need to function normally. Their involvement in MND is still being researched. Glutamate Nerve cells use special “messenger chemicals” called neurotransmitters to pass information between cells. One of the neurotransmitters is called glutamate. It excites neurones and one theory is that too much activity through this causes damage to the neurones. Riluzole, a drug used to treat MND reduces the level of neuronal activity by blocking the action of Glutamate. Mitochondria Mitochondria are the “batteries” of cells. They provide the


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reduces the level of neuronal activity by blocking the action of Glutamate. Mitochondria Mitochondria are the “batteries” of cells. They provide the energy that a cell needs to carry out its normal function. Mitochondria in the motor neurones of people with MND might not function properly. Diagnosing motor neurone disease Speak to your GP if you experience the initial symptoms of MND. After hearing about your symptoms and an initial exam, your GP might refer you to a neurologist (a doctor who specialises in conditions affecting the brain and nervous system). Diagnosing MND can be difficult during the early stages. This is because many of the first symptoms can be caused by other more common health conditions like: a trapped nerve – wear and tear of the bones in the spine can sometimes cause nerves to become trapped under the spine peripheral neuropathy – where part of the nervous system is damaged by another condition, like type 2 diabetes swallowing difficulties caused by narrowing


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neuropathy – where part of the nervous system is damaged by another condition, like type 2 diabetes swallowing difficulties caused by narrowing or inflammation of the gullet speech difficulties due to problems with the voice box damage to the brain by stroke or other neurological conditions like multiple sclerosis (MS) in younger people Initial testing MND is usually diagnosed by a neurologist based on the symptoms and a physical examination. There’s no single test for MND. Various tests might be used to rule out other possible causes of the your symptoms. Tests might include: blood tests – these can be used for several reasons, like checking that organs are working, or to look for a marker of muscle damage (creatinine kinase) magnetic resonance imaging (MRI) scan – to give a detailed picture of your brain and spinal cord electromyography (EMG) – measures the electrical activity in your muscles, which shows how well your motor neurones are working and connecting to the muscles nerve


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(EMG) – measures the electrical activity in your muscles, which shows how well your motor neurones are working and connecting to the muscles nerve conduction test – similar to an EMG but measures how quickly your nerves can conduct an electrical signal lumbar puncture – a sample of spinal fluid might be tested to exclude an inflammatory or nerve condition caused by an infection muscle biopsy – in rare cases, a small sample of muscle might be removed for testing to determine whether the problem lies in the muscles Gene tests can be used to support the diagnosis in some individuals. They might provide an explanation of why they’ve developed the disorder. Your GP can give you more information about specialists who can help with genetic testing. Confirming the diagnosis There are many reasons why there may be delays in diagnosis. The initial symptoms might not appear to be serious. Or symptoms might not be recognised as being related to the nervous system so a neurologist isn’t consulted


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symptoms might not appear to be serious. Or symptoms might not be recognised as being related to the nervous system so a neurologist isn’t consulted at first. Sometimes, the diagnosis of MND is clear without the need for further tests. Confirming a diagnosis can sometimes be time-consuming even for an experienced neurologist. They might need a period of observation to be sure, particularly in cases where the condition progresses slowly. MND can only be diagnosed if the symptoms are clearly getting worse (progressive). Receiving the diagnosis Being told you have MND can be devastating and the news can be difficult to take in at first. After you’re diagnosed you should be provided with contact details of an MND care specialist. These are healthcare professionals with specialist experience caring for people with MND. They’ll be able to give you (and your family) extra support after the diagnosis and during your time with the illness. Talking to a counsellor or a trained clinical


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to give you (and your family) extra support after the diagnosis and during your time with the illness. Talking to a counsellor or a trained clinical psychologist might help with feelings of depression and anxiety. It’s not unusual to have thoughts of taking your own life, although very few people with MND go on to do this. You should discuss these thoughts with your doctor. Taking antidepressants or medicines to reduce anxiety may help. Your care team will be able to tell you about this. Treating motor neurone disease Although there’s no cure for MND, there are treatments available to help relieve the symptoms. A team of healthcare professionals will work together to help care for you. This multidisciplinary team typically includes: a neurologist and an MND care specialist a specialist in breathing (respiratory specialist) physiotherapists to advise on mobility aids occupational therapists to assess the need for adaptations to living environments speech and language therapist to


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to advise on mobility aids occupational therapists to assess the need for adaptations to living environments speech and language therapist to provide help with communication and swallowing dieticians to support nutrition As the conditions advances, you might also need palliative care. Riluzole Riluzole is the only licensed medication in the UK that’s shown a survival benefit for people with MND. Riluzole is thought to slow down the damage to the motor neurone cells by reducing their sensitivity to the nerve transmitter glutamate. In medical research, riluzole extended survival by 2 to 3 months on average. Side effects of riluzole are usually mild and can include nausea, tiredness and, less commonly, a rapid heartbeat. Very rarely, riluzole has been known to cause liver damage. If you’re prescribed riluzole you’ll need to have blood tests for the first few months to check your liver is working properly. If you’ve had significant liver disease, riluzole may not be suitable for you.


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for the first few months to check your liver is working properly. If you’ve had significant liver disease, riluzole may not be suitable for you. Treating symptoms There are treatments available that can help relieve many of the symptoms of MND and improve your quality of life. Muscle cramps Physiotherapy can help muscle cramps. In some cases, a medication called quinine can help treat muscle cramps too. They often improve later in the condition. Quinine can cause side effects like: hearing and vision problems tinnitus – the perception of noise in one ear, both ears or inside the head vertigo – a sensation that you, or the environment around you, is moving Quinine will usually only be used if the potential benefits are thought to outweigh the risks. Muscle stiffness Muscle stiffness, also known as spasticity, can be treated using medication like baclofen. This helps to help relax the muscles. Side effects can include increased weakness or tiredness. Drooling Medication is available to


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like baclofen. This helps to help relax the muscles. Side effects can include increased weakness or tiredness. Drooling Medication is available to treat drooling of saliva. One option is a hyoscine hydrobromide skin patch. Alternative medicines used to control drooling include: amitriptyline atropine eye drops applied to the tongue glycopyrronium botulinum toxin injections into the glands that produce saliva Communication difficulties Not everyone with MND will have significant speech problems. There are ways to help people who find it hard to communicate. A speech and language therapist can teach you techniques to make your voice as clear as possible. As the disease progresses, you may need assistive technology to help you communicate. A range of communication aids is available. Your therapist will be able to tell you about the most effective communication aids for you. Swallowing difficulties Not everyone with MND will have significant swallowing problems (dysphagia). For those that


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communication aids for you. Swallowing difficulties Not everyone with MND will have significant swallowing problems (dysphagia). For those that do, it can prevent normal eating and drinking. This can lead to you feeling more tired. If food or fluid goes down the wrong way into the lungs it can cause chest infections (called aspiration). One common treatment for dysphagia is a feeding tube known as a gastrostomy tube. The tube is surgically implanted into your stomach through a small cut on the surface of the stomach. It shouldn’t restrict your daily activities. You can continue to bathe and swim if you wish. Ideally you should have the tube inserted before you become too frail. This is so you can get the best out of it and to give yourself the best chance of recovering from the procedure. If you have thick secretions (fluids) you can’t cough up yourself, medicine like carbocisteine and acetylcysteine might help. Breathing difficulties As MND progresses, the muscles that help you


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cough up yourself, medicine like carbocisteine and acetylcysteine might help. Breathing difficulties As MND progresses, the muscles that help you breathe will become weaker. Your breathing will become increasingly shallow, with a weaker cough. Breathing difficulties usually develop gradually. They’re sometimes the first sign of MND, although this is rare. It’s important to discuss breathing problems with your GP before they occur. Your GP or neurologist should be able to refer you to a respiratory (breathing) specialist or a palliative care specialist, depending on your needs. You might benefit from non-invasive mechanical ventilation (NIV) to support your breathing. Room air (not oxygen) is sucked into a small box. It’s filtered and then gently pumped into the lungs through a face mask or nasal tube each time you take a breath. NIV may not be suitable for everyone with MND. Your healthcare team will be able to discuss the options available to you. Advance decision making Many people


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not be suitable for everyone with MND. Your healthcare team will be able to discuss the options available to you. Advance decision making Many people with MND draw up an advance decision (sometimes called an advanced directive). This is where you decide your treatment preferences in advance in case you can’t communicate your decisions later because you’re too ill. Issues that can be covered by an advance decision include: whether you want to be treated at home, in a hospice or in a hospital once you reach the final stages of MND the type of medication you’d be willing to take in certain circumstances whether you’d be willing to consider a feeding tube if you were no longer able to swallow food and liquid if you have respiratory failure (loss of lung function), whether you wish to have artificial resuscitation, like having a permanent breathing tube inserted into your throat (known as a tracheostomy) whether you’d be willing to donate any of your organs after you die (the brain and


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breathing tube inserted into your throat (known as a tracheostomy) whether you’d be willing to donate any of your organs after you die (the brain and spinal cord of people with MND are very important for ongoing research) Your care team will be able to provide you with more information and advice about making an advance decision. Read more about end of life care Research and drug trials You might be given the opportunity to take part in research, including drug trials. Your MND care specialist and neurology consultant can provide further information on this. Advice for carers Caring for someone with MND can be both physically and emotionally demanding. It’s likely you’ll need a wide range of support. For information and advice about all aspects of caring, visit Care Information Scotland Source: Scottish Government - Opens in new browser window Last updated: 03 June 2024 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: 03 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. 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: Motor neurone disease Motor Neurone Disease Scotland My Name'5 Doddie 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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Mouth ulcer | 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 Mouth Mouth ulcer Mouth ulcer Mouth ulcers are painful sores that appear in the mouth. They’re uncomfortable but they’re usually harmless. Most clear up by themselves within 1 to 2 weeks. Mouth ulcers are common and can usually be managed at home, without seeing your dentist or GP. What does a mouth ulcer look like? Mouth ulcers are usually round or oval sores that commonly appear inside the mouth on the: cheeks lips tongue They can be white, red, yellow or grey in colour and swollen. You may have more than one mouth ulcer at a time and they may spread or grow. Mouth ulcers shouldn’t be confused with cold sores, which are small blisters that develop on the lips or around the mouth. Cold sores often begin with a tingling, itching or burning sensation around your mouth. When to get help


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develop on the lips or around the mouth. Cold sores often begin with a tingling, itching or burning sensation around your mouth. When to get help Speak to a pharmacist if: you have a mouth ulcer They can give you advice and treatment. If you have a dental problem you should always phone your dentist first. If you’re not registered with any dental practice then you should read our advice on dental emergencies. Your pharmacist may advise that you see your GP or dentist if: your mouth ulcer has lasted 3 weeks you keep getting mouth ulcers the mouth ulcer grows bigger than usual or is near the back of your throat your mouth ulcer becomes more painful or red – this could be a sign of a bacterial infection, which may need treatment with antibiotics Mouth ulcers are also a possible symptom of hand, foot and mouth disease. Speak to your GP or phone 111 if you’re unsure. How to treat mouth ulcers Most mouth ulcers clear up by themselves within 1 to 2 weeks without treatment. However, treatment


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111 if you’re unsure. How to treat mouth ulcers Most mouth ulcers clear up by themselves within 1 to 2 weeks without treatment. However, treatment can help to reduce swelling and ease any discomfort. This may help if you keep getting mouth ulcers or your mouth ulcer affects eating and drinking. Self care There are things you can do to speed up healing. Do use a soft toothbrush to brush your teeth drink cool drinks through a straw eat softer foods get regular dental check-ups eat a healthy, balanced diet try to reduce stress and anxiety Don’t do not eat very spicy, salty or acidic food do not eat rough, crunchy food, such as toast or crisps do not drink very hot or acidic drinks, such as fruit juice do not use chewing gum do not use toothpaste containing sodium lauryl sulphate Pharmacy medicines You can get several types of mouth ulcer treatment from a pharmacy. Speak to your pharmacist about the best treatment for you. Treatment from a dentist or GP A GP or dentist may prescribe


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treatment from a pharmacy. Speak to your pharmacist about the best treatment for you. Treatment from a dentist or GP A GP or dentist may prescribe stronger medicine to treat severe, persistent or infected mouth ulcers. Possible treatments include: steroid mouth spray or steroid tablets that dissolve in your mouth painkilling gels, ointments, sprays or tablets mouthwashes to kill or remove any germs in your mouth What causes mouth ulcers? In many cases, the reason for mouth ulcers is unclear. Most single mouth ulcers are caused by damage to the lining inside of the mouth. For example: accidentally biting the inside of your cheek or a sharp tooth poorly fitting dentures hard food a faulty filling It’s not always clear what causes mouth ulcers that keep returning, but triggers are thought to include: stress and anxiety hormonal changes – some women develop mouth ulcers during their monthly period eating certain foods – such as chocolate, spicy foods, coffee, peanuts, almonds,


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– some women develop mouth ulcers during their monthly period eating certain foods – such as chocolate, spicy foods, coffee, peanuts, almonds, strawberries, cheese, tomatoes and wheat flour toothpaste containing sodium lauryl sulphate stopping smoking – when you first stop smoking, you may develop mouth ulcers Your genes are also thought to have a role. Around 40% of people who keep getting mouth ulcers report that it runs in their family. Medical conditions Mouth ulcers can sometimes be caused by certain medical conditions, such as: viral infections – including the cold sore virus, chickenpox, and hand, foot and mouth disease vitamin B12 or iron deficiency crohn’s disease – a long-term condition that causes inflammation of the lining of the digestive system coeliac disease – a common digestive condition where a person has an adverse reaction to gluten reactive arthritis – a condition that causes inflammation in various places in the body, usually as a reaction to an infection


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reaction to gluten reactive arthritis – a condition that causes inflammation in various places in the body, usually as a reaction to an infection weakened immune system – for example, due to HIV or lupus behçet’s disease – a rare and poorly understood condition that also causes swelling of the blood vessels Medications and treatments Mouth ulcers can sometimes be caused by certain medications or treatments, such as: non-steroidal anti-inflammatory drugs (NSAIDs) – such as ibuprofen nicorandil – a medication sometimes used to treat angina beta-blockers – used to treat conditions such as angina, high blood pressure and abnormal heart rhythms a side effect of chemotherapy or radiotherapy – this is known as mucositis Is it mouth cancer? In a few cases, a long-lasting mouth ulcer can be a sign of mouth cancer. If mouth cancer is detected early, the chances of a complete recovery are good. Regular dental check-ups are the best way to detect the early signs. Source: NHS 24 - Opens in new


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the chances of a complete recovery are good. Regular dental check-ups are the best way to detect the early signs. Source: NHS 24 - Opens in new browser window Last updated: 23 March 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 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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https://www.nhsinform.scot/illnesses-and-conditions/brain-nerves-and-spinal-cord/multiple-sclerosis-ms/


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Multiple sclerosis (MS) | 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 Multiple sclerosis (MS) Multiple sclerosis (MS) Multiple sclerosis (MS) is a condition that affects the brain and/or spinal cord. It can cause symptoms like problems with vision, arm or leg movement, sensation or balance. It’s a lifelong condition that can sometimes cause serious disability. In many cases, it’s possible to treat symptoms. Average life expectancy is slightly reduced for people with MS. MS Society estimates that there are more than 130,000 people diagnosed with MS in the UK. It’s often diagnosed in people in their 20s and 30s, although it can develop at any age. It’s about two to three times more common in women than men. Symptoms of multiple sclerosis Multiple sclerosis (MS) can cause a wide range of symptoms and can affect any part


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more common in women than men. Symptoms of multiple sclerosis Multiple sclerosis (MS) can cause a wide range of symptoms and can affect any part of the body. It affects everyone differently. The symptoms are unpredictable. Some people’s symptoms develop and worsen over time, while for others, they come and go. Periods when symptoms get worse are known as relapses. Periods when symptoms improve or disappear are known as remissions. Some of the most common symptoms include: Muscle spasms, stiffness and weakness MS can cause your muscles to: feel weak become stiff and resistant to movement (spasticity) contract tightly and painfully (spasm) Vision problems In around 1 in 4 cases of MS, the first noticeable symptom is a problem with one of your eyes (optic neuritis). You may experience: some temporary loss of vision in the affected eye, usually lasting for days to weeks colour blindness eye pain, which is usually worse when moving the eye flashes of light when moving the eye You might


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lasting for days to weeks colour blindness eye pain, which is usually worse when moving the eye flashes of light when moving the eye You might also experience double vision or involuntary eye movements, which can make it seem as though objects are jumping around. Abnormal sensations You might have persistent numbness or tingling in different parts of your body which can last a few days to weeks. Mobility problems MS can make walking and moving around difficult, particularly if you also have muscle weakness and spasticity. You may experience: clumsiness difficulty with balance and co-ordination (ataxia) shaking of the limbs (tremor) dizziness and vertigo, which can make it feel as though everything around you is spinning Pain Some people with MS experience pain which can take two forms. Pain caused by MS itself (neuropathic pain) This is pain caused by damage to the nervous system, and can include: stabbing pains in the face stabbing sensations in the torso (body) and limbs feeling


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is pain caused by damage to the nervous system, and can include: stabbing pains in the face stabbing sensations in the torso (body) and limbs feeling like you’re burning pins and needles feeling like you’re being hugged or squeezed Muscle spasms can sometimes be painful. Musculoskeletal pain This can be back, neck and joint pain particularly if you have problems walking or moving around. Bladder problems Bladder problems are common in MS. They may include: having to pee more often having a sudden, urgent need to pee, which can lead to unintentionally passing urine (urge incontinence) difficulty emptying the bladder completely having to get up during the night to pee recurrent urinary tract infections These problems can also have a range of causes other than MS. Bowel problems Many people with MS also have problems with their bowel function. Constipation is the most common problem. You may find passing stools (poo) difficult and pass them much less than normal. Bowel incontinence is


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Constipation is the most common problem. You may find passing stools (poo) difficult and pass them much less than normal. Bowel incontinence is less common, but is often linked to constipation. If a poo becomes stuck, it can irritate the wall of the bowel, causing it to produce more fluid and mucus that can leak out of your bottom. Some of these problems aren’t specific to MS and can be the result of medications. Sexual problems MS can have an effect on sexual function. For women, problems include difficulty reaching orgasm. They might experience decreased vaginal lubrication and sensation. Men with MS might find it hard to get or maintain an erection (erectile dysfunction). They may also find it takes a lot longer to ejaculate when having sex or masturbating. They might lose the ability to ejaculate altogether. Both men and women with MS may find they’re less interested in sex than they were before. This could be directly related to MS, a mood disorder like depression, or it could be


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may find they’re less interested in sex than they were before. This could be directly related to MS, a mood disorder like depression, or it could be the result of living with the condition. Speech and swallowing difficulties Some people with MS have difficulty chewing or swallowing (dysphagia) at some point. They might also slur their speech or be difficult to understand (dysarthria). Fatigue Feeling fatigued is a common and troublesome symptom of MS. It can cause an overwhelming sense of exhaustion that means it’s a struggle to carry out simple tasks. Fatigue tends to get worse: towards the end of each day in hot weather after exercising during illness Mental health issues Many people with MS experience periods of depression. It’s unclear if this is directly caused by MS, or is due to the stress of having to live with a long-term condition, or both. Anxiety can also be a problem for people with MS, possibly due to the unpredictable nature of the condition. In rare cases, people with


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or both. Anxiety can also be a problem for people with MS, possibly due to the unpredictable nature of the condition. In rare cases, people with MS can experience rapid and severe mood swings. Problems with thinking, learning and planning Some people with MS have problems with thinking, learning and planning. This is known as cognitive dysfunction and can include: problems learning and remembering new things although long-term memory is usually unaffected slowness in processing lots of information or multi-tasking a shortened attention span getting stuck on words problems with understanding and processing visual information, such as reading a map difficulty with planning and problem solving – people often report that they know what they want to do, but can’t grasp how to do it problems with reasoning, such as mathematical laws or solving puzzles Many of these problems aren’t specific to MS. They can be caused by other conditions, including depression and anxiety or medication. Speak


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puzzles Many of these problems aren’t specific to MS. They can be caused by other conditions, including depression and anxiety or medication. Speak to your GP if: you think you have symptoms of MS The symptoms can be similar to several other conditions, so they’re not necessarily caused by MS. What happens when someone has multiple sclerosis MS is an autoimmune condition. This means your immune system mistakes part of your body for a foreign substance and attacks it. In the case of MS, it attacks the myelin sheath in the brain and/or spinal cord. This is the layer that surrounds your nerves, protecting them and helping electrical signals travel from the brain to the rest of the body. The attacks cause the myelin sheath to become inflamed in small patches (plaques or lesions). This can be seen on a magnetic resonance imaging (MRI) scan. These patches of inflammation can disrupt the messages travelling along the nerves. It can slow them down, jumble them, send them the wrong way, or


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These patches of inflammation can disrupt the messages travelling along the nerves. It can slow them down, jumble them, send them the wrong way, or stop them from getting through completely. This disruption leads to the symptoms and signs of MS. When the inflammation goes away, it can leave behind scarring of the myelin sheath (sclerosis). These attacks, particularly if frequent and repeated, can lead to permanent damage. What causes multiple sclerosis? Exactly why someone develops multiple sclerosis (MS) isn’t known. It’s not caused by anything you’ve done and it’s not clear if you can prevent it. It’s likely to be partly caused by genes you inherit from your parents and partly by outside factors that may trigger the condition. Some of the factors that might cause MS include: Your genes MS isn’t directly inherited, but if you’re related to someone with the condition you’re more likely to develop it. The chance of a sibling or child of someone with MS also developing it is around


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to someone with the condition you’re more likely to develop it. The chance of a sibling or child of someone with MS also developing it is around 2-3%. Lack of sunlight and vitamin D MS is more common in countries far from the equator. This could mean that a lack of sunlight and low vitamin D levels may play a role in the condition. It’s not clear whether vitamin D supplements can help prevent MS. Smoking People who smoke are about twice as likely to develop MS compared to those who don’t smoke. Viral infections Infections, particularly those caused by the Epstein-Barr virus, (responsible for glandular fever), might trigger the immune system, leading to MS in some people. More research will help us understand why MS occurs and whether it can be prevented or not. Diagnosing multiple sclerosis It can be hard to tell if you have multiple sclerosis (MS) because some of the symptoms are like other conditions. You may need to rule out other possible causes of your symptoms first. If your GP


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(MS) because some of the symptoms are like other conditions. You may need to rule out other possible causes of your symptoms first. If your GP thinks you could have MS, you should see a neurologist (a specialist in conditions of the nervous system) for a specialist assessment. Some of the tests you may need to confirm MS are: neurological examination magnetic resonance imaging (MRI) scan lumbar puncture blood test Types of multiple sclerosis Once you have a diagnosis of MS, your neurologist might be able to identify which type of MS you have – either relapsing remitting MS or primary progressive MS. This will largely be based on: the pattern of your symptoms – like whether you experience periods when your symptoms get worse (relapses) then improve (remissions), or whether they get steadily worse (progress) the results of an MRI scan It can take some time to find out which type of MS you have because the symptoms are so varied. It can take a few years to make an accurate diagnosis of


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can take some time to find out which type of MS you have because the symptoms are so varied. It can take a few years to make an accurate diagnosis of progressive MS, as the condition usually worsens slowly. Treating multiple sclerosis Phone your specialist MS nurse or GP if: you think you’re having a relapse Treatment with disease-modifying therapies Although there isn’t a cure for MS, there are medicines that can help to reduce the number and severity of relapses in some people. These are called disease-modifying therapies or disease modifying drugs. These reduce the amount of damage and scarring to the myelin sheath (layer surrounding your nerves), associated with MS relapses. These treatments reduce the chances of developing progressive symptoms of MS. They might also help to slow worsening disability in MS. Disease-modifying therapies are not suitable for everyone with MS. They’re only prescribed to those with either: relapsing remitting MS secondary progressive MS who meet


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are not suitable for everyone with MS. They’re only prescribed to those with either: relapsing remitting MS secondary progressive MS who meet certain criteria, like the number of relapses they’ve had primary progressive MS who meet certain criteria like new lesions found by an MRI scan People without relapses are less likely to benefit from the treatments and could still experience side effects from them. Treatment of a relapse of multiple sclerosis Sometimes an infection can cause a flare up of symptoms rather than a relapse, so your nurse or GP will check for other possible causes. Treatment for a relapse might involve a five-day course of steroid tablets taken at home. Steroids can help speed up your recovery from a relapse. They don’t prevent further relapses or stop MS getting worse over time. Steroids are only given for a short period of time to avoid possible steroid side effects. The side effects could include infection, mood disturbance, stomach ulceration, osteoporosis (weak


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of time to avoid possible steroid side effects. The side effects could include infection, mood disturbance, stomach ulceration, osteoporosis (weak bones), weight gain and diabetes. Not using steroids more than three times a year (if possible) will help to reduce the risk of side effects. Treatment for multiple sclerosis symptoms There are different treatments available for MS symptoms. Fatigue Your healthcare professional should give you advice about ways to manage fatigue. This might include exercise, keeping healthy sleep patterns and energy-saving techniques. Your healthcare professional might suggest avoiding medications that can worsen fatigue. Specialist fatigue management courses or therapy, such as cognitive behavioural therapy (CBT), might also help. Visual problems MS-related visual problems will often improve on their own, usually within a few weeks. If your symptoms are particularly severe, your healthcare professional might prescribe steroids. If you have problems with


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within a few weeks. If your symptoms are particularly severe, your healthcare professional might prescribe steroids. If you have problems with involuntary eye movements, medication like gabapentin can sometimes help. Some people with double vision need help from ophthalmologists (eye specialists). Muscle spasms and stiffness Physiotherapy can help improve muscle spasms and stiffness. Techniques such as stretching exercises can help if your movement is restricted. If your muscle spasms are more severe, you may be prescribed a medicine that can relax your muscles. This will usually be either baclofen, gabapentin or tizanidine. These medicines all have side effects. You might experience dizziness, weakness, nausea and diarrhoea. Discuss which of these would be best for you with your specialist MS nurse. Mobility problems Mobility problems are often the result of muscle spasms and spasticity. Muscle weakness, or problems with balance or dizziness can also cause mobility problems. If you


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are often the result of muscle spasms and spasticity. Muscle weakness, or problems with balance or dizziness can also cause mobility problems. If you have problems with mobility, your healthcare professional might suggest: an exercise programme supervised by a physiotherapist special exercises called vestibular rehabilitation, if you have problems with balance medication for dizziness or tremors mobility aids, such as a walking stick, or a wheelchair home adaptations such as stair lifts or railings An occupational therapist can carry out an assessment of your home and suggest adaptations. Musculoskeletal pain Living with MS can cause stresses and strains to the muscles and joints in your body. A physiotherapist might be able to help with this pain by suggesting exercises or better seating positions. If your pain is more severe, you may be prescribed painkillers. Or, you might have a transcutaneous electrical nerve stimulation (TENS) machine that stimulates your nerves. Neuropathic


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be prescribed painkillers. Or, you might have a transcutaneous electrical nerve stimulation (TENS) machine that stimulates your nerves. Neuropathic pain Neuropathic pain is caused by damage to your nerves and is usually sharp and stabbing. It can also occur in the form of extreme skin sensitivity, or a burning sensation. This type of pain can be treated using neuropathic painkillers. Problems with thinking, learning and memory Your MS healthcare professionals can assess your thinking, learning and memory problems and suggest ways to manage them. Emotional problems People with MS who have depression or anxiety can be treated with antidepressants or therapy, such as CBT. If you have emotional outbursts, such as laughing or crying for no clear reason, you should be assessed by a specialist. They may suggest treatment with an antidepressant. Bladder problems Medication might help if you have an overactive bladder or need to pee frequently during the night. If you find it difficult to


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Bladder problems Medication might help if you have an overactive bladder or need to pee frequently during the night. If you find it difficult to empty your bladder, advice from a continence nurse or physiotherapist can help. Hand-held external stimulators can help some people to start peeing or to empty the bladder. Sometimes a catheter can empty the bladder when needed. You might be taught how to do intermittent self catheterisation (ISC). In rare cases, people with MS may need a long-term catheter to keep the bladder emptying safely. You might be referred to a continence adviser or urologist, for specialist treatment and advice. Read more about treating urinary incontinence. Bowel problems It might be possible to treat mild to moderate constipation by changing your diet or taking laxatives. More severe constipation may need to be treated with suppositories, which are inserted into your bottom, or an enema. During an enema, liquid medication is rinsed through your bottom and large


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with suppositories, which are inserted into your bottom, or an enema. During an enema, liquid medication is rinsed through your bottom and large bowel, which softens and flushes out your stools. Anti diarrhoea medication or pelvic floor exercises might help bowel incontinence. Sexual problems If you experience problems with less interest in sex or difficulty reaching orgasm, relationship counselling or seeing a sex therapist might help. If you have MS and find it hard to get or maintain an erection (erectile dysfunction) you may be prescribed medication to increase the blood flow to the penis. Speech and swallowing difficulties A speech and language therapist can help you find ways to overcome problems with speech and swallowing. For example, they can offer advice about foods that are easy to swallow. They might recommend exercises to strengthen the muscles used in speech and swallowing. Complementary and alternative therapies for MS Some people with MS find that complementary


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to strengthen the muscles used in speech and swallowing. Complementary and alternative therapies for MS Some people with MS find that complementary therapies help them feel better. Complementary treatments and therapies claim to ease symptoms, although scientific evidence is often not clear about how effective they are. Many people think that complementary treatments have no harmful effects. However, people can experience problems. It’s not a good idea to use them as an alternative to medicines prescribed by your doctor. If you’re considering an alternative treatment, it’s important to let your doctor know. Clinical trials Clinical trials have helped to improve the treatments available for MS. Speak to your care team if you’re interested in taking part in a clinical trial. Support for living with multiple sclerosis Coming to terms with a long-term condition like MS can put a strain on you, your family and your friends. Be honest about how you feel and let your family and friends know


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long-term condition like MS can put a strain on you, your family and your friends. Be honest about how you feel and let your family and friends know what they can do to help. If you have any questions, your MS nurse or GP can help and will let you know what support is available. If you find it difficult to look after yourself, your local authority may be able to provide you with some help. Ask for a care and support needs assessment. For more information, read about assessing your care and support needs. Having a baby Being diagnosed with MS shouldn’t affect your ability to have children. Women with MS can have a normal pregnancy, deliver a healthy baby and breastfeed. Some of the medications prescribed for MS aren’t suitable for taking during pregnancy or breastfeeding and might affect fertility in males and females. If you’re considering starting a family, discuss it with your healthcare team. Having a baby doesn’t affect the long-term course of MS. Relapses can be less common in


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starting a family, discuss it with your healthcare team. Having a baby doesn’t affect the long-term course of MS. Relapses can be less common in pregnancy, but they can be more common in the months after giving birth. Money and financial support If you have to stop work or work part-time because of your MS, you may find it hard to cope financially. You might be able to get financial support. Driving If you have MS, you must tell the Driver and Vehicle Licensing Agency (DVLA) and inform your insurance company. You might be able to continue driving, but you’ll be asked to complete a form providing more information about your condition. You’ll be asked for details of your doctors and specialists. The DVLA will use this to decide whether you’re fit to drive. 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,


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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 Other health sites Brain and Spine Foundation: Multiple sclerosis MS Trust MS Society Revive MS Support Neurological Alliance of Scotland 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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Mumps | 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 Mumps Mumps Mumps is an infection that spreads easily. It used to be common in children before the introduction of the measles, mumps and rubella (MMR) vaccine. Mumps usually clears within 1 or 2 weeks. Symptoms of mumps The symptoms of mumps usually develop 14 to 25 days after you’re infected. Mumps causes painful swellings at the side of the face under the ears (the parotid glands). It gives a distinctive ‘hamster face’ appearance. Other symptoms of mumps can include: headaches joint pain feeling sick dry mouth mild stomach (abdominal) pain feeling tired loss of appetite a high temperature (fever) of 38°C (100.4°F), or above These may develop a few days before the swelling of the parotid glands. Sometimes, mumps doesn’t cause any noticeable symptoms. Phone your GP if:


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These may develop a few days before the swelling of the parotid glands. Sometimes, mumps doesn’t cause any noticeable symptoms. Phone your GP if: you think you or your child might have mumps you’ve been in close contact with someone who has mumps and you’re pregnant, and haven’t been fully vaccinated Mumps is not usually serious, but it has similar symptoms to more serious types of infection, such as glandular fever and tonsillitis. You should phone your GP first before visiting. They can make arrangements to reduce the risk of spreading the infection to others. Diagnosing mumps Your GP can usually make a diagnosis after: seeing and feeling the swelling looking at the position of the tonsils in the mouth checking your temperature to see if it’s higher than normal If your GP suspects mumps, they should notify your local health protection team (HPT). Who’s affected? Most cases of mumps occur in people aged between 17 and 34 who have not received 2 doses of the MMR vaccine. Once you’ve


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team (HPT). Who’s affected? Most cases of mumps occur in people aged between 17 and 34 who have not received 2 doses of the MMR vaccine. Once you’ve had mumps, your body builds up resistance (immunity) to the virus. It’s highly unlikely you’ll get it again. How mumps is spread The mumps virus is contained in tiny droplets that come out of the nose and mouth when an infected person coughs or sneezes. You can easily catch mumps by breathing in these droplets. Or, if the droplets have settled on a surface, by touching the surface and then placing your hands near your nose or mouth. A person is most contagious a few days before the symptoms develop and for a few days afterwards. How to prevent spreading mumps to others If you have mumps: stay off school or work for at least 5 days after your symptoms first develop regularly wash your hands with soap use and dispose of tissues when you sneeze avoid close contact with anyone who isn’t fully vaccinated How mumps can be prevented Mumps can be


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soap use and dispose of tissues when you sneeze avoid close contact with anyone who isn’t fully vaccinated How mumps can be prevented Mumps can be prevented by having the MMR vaccine. This is given in 2 doses as part of the NHS childhood vaccination programme. You can be vaccinated at any age if you haven’t been fully vaccinated before. Treatment for mumps There are things you can do to help relieve your symptoms. Do get plenty of bed rest drink plenty of water to avoid dehydration use pain relief such as paracetamol or ibuprofen – aspirin shouldn’t be given to children under 16 apply a warm or cool compress to the swollen glands to help relieve pain eat foods that don’t need a lot of chewing, such as soup, mashed potatoes and scrambled eggs Complications of mumps Mumps usually passes without causing serious damage to a person’s health. Serious complications are rare. However, mumps can lead to viral meningitis if the virus moves into the outer layer of the brain. Other complications


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Serious complications are rare. However, mumps can lead to viral meningitis if the virus moves into the outer layer of the brain. Other complications include swelling of the testicles in males or the ovaries in females if the affected person has gone through puberty. About 1 in 20 cases of mumps lead to acute pancreatitis. This is usually mild, but you may be admitted to hospital so your body functions can be supported until your pancreas recovers. About 1 in 20 people with mumps experience some temporary hearing loss, but permanent loss of hearing is rare. Source: NHS 24 - Opens in new browser window Last updated: 27 June 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 MMR vaccine NHS inform About NHS inform


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Message Maximum of 500 characters Send feedback Add this page to Info For Me Also on NHS inform MMR vaccine NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats © 2025 NHS 24 – v1.1.1.17852


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Muscular dystrophy (MD) | 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 Muscular dystrophy Muscular dystrophyMuscular dystrophy (MD) refers to a group of inherited genetic muscle conditions Becker muscular dystrophy Read about Becker muscular dystrophy symptoms, diagnosis and treatment Congenital muscular dystrophy (CMD) Read about congenital muscular dystrophy, it's symptoms and treatment options Duchenne muscular dystrophy (DMD) Read about Duchenne muscular dystrophy (DMD) symptoms and treatment Emery-Dreifuss muscular dystrophy Emery-Dreifuss muscular dystrophy symptoms, diagnosis and treatment Facioscapulohumeral muscular dystrophy (FSHD) Read about facioscapulohumeral muscular dystrophy (FSHD) Limb girdle muscular dystrophy Limb girdle muscular dystrophy symptoms, diagnosis and treatment Muscular dystrophy


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muscular dystrophy (FSHD) Limb girdle muscular dystrophy Limb girdle muscular dystrophy symptoms, diagnosis and treatment Muscular dystrophy Muscular dystrophy (MD) symptoms, causes, types and treatments Myotonic dystrophy Learn about myotonic dystrophy symptoms and treatments Oculopharyngeal muscular dystrophy (OPMD) Read about oculopharyngeal muscular dystrophy (OPMD) 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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Myasthenia gravis | 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 Myasthenia gravis Myasthenia gravis Myasthenia gravis is a long term (chronic) condition that causes muscle weakness and fatigue. It’s a rare condition that commonly affects the muscles that control the eyes and eyelids. It can also affect the face, speaking, chewing, swallowing and other parts of the body. It can affect people at any age, but is most often found in women under 40 and men over 60. There are other rarer types of myasthenia which you can read about on myaware. If you drive, you must inform the DVLA that you have myasthenia gravis. Symptoms of myasthenia gravis The first symptoms of myasthenia gravis are often droopy eyelids or double vision. It usually affects the eyes first and may spread to other parts of the body. It can take weeks,


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gravis are often droopy eyelids or double vision. It usually affects the eyes first and may spread to other parts of the body. It can take weeks, months or years for symptoms to develop in other parts of the body. The severity of the symptoms is different for each person. It’s likely that your symptoms will tend to get worse when you’re tired. The symptoms might improve after resting. Symptoms can include: Eyes You might experience droopy eyelids affecting one or both eyes, and double vision. In some people, only the eye muscles are affected (ocular myasthenia). In most people, the symptoms will spread to affect other parts of the body over time. Swallowing, speaking and breathing You might experience: slurred speech difficulty swallowing difficulty making facial expressions like smiling problems with chewing a change in your voice choking or accidentally inhaling food which can cause chest infections shortness of breath Limbs and neck The muscle weakness might spread to other parts


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or accidentally inhaling food which can cause chest infections shortness of breath Limbs and neck The muscle weakness might spread to other parts of the body like your arms, legs and neck. You might experience: weakness in your arms, legs, neck or other parts of your body difficulty holding your head up aching muscles problems with tasks like climbing stairs or washing your hair Myasthenic crisis Some people can experience severe breathing and swallowing difficulties, which require immediate hospital treatment. This is called a myasthenic crisis. It’s possible for patients to experience a myasthenic crisis before they know they have myasthenia gravis. Phone 999 for an ambulance if: you’re experiencing severe breathing or swallowing problems You might need emergency hospital treatment. You should avoid activities that could become dangerous if you experience sudden weakness, like swimming alone. Diagnosing myasthenia gravis It can be difficult to diagnose myasthenia gravis. Your doctor


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if you experience sudden weakness, like swimming alone. Diagnosing myasthenia gravis It can be difficult to diagnose myasthenia gravis. Your doctor will ask about your medical history and symptoms. You might need several tests to rule out other causes of your symptoms before you can be diagnosed with myasthenia gravis. Blood test A blood test will look for a high level of antibodies (made by your immune system) which might be causing myasthenia gravis. You might be offered another blood test at a later date if your initial blood test is normal but you continue to experience worsening symptoms. Electromyography You might have electromyography (an EMG) to test your nerves and muscles. During electromyography, you’ll have small needles inserted into your muscles to measure their electric activity. These are usually inserted around your eyes, forehead or arms. The test will measure the signals from the nerves to the muscles. If the test detects a disruption in the signals, this might be a


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forehead or arms. The test will measure the signals from the nerves to the muscles. If the test detects a disruption in the signals, this might be a sign of myasthenia gravis. Scans You might have a computerised tomography (CT) scan to check if the thymus gland in your chest is bigger than expected or has grown abnormally (a thymoma). The thymus gland is part of your immune system. Problems with the thymus gland like inflammation (swelling), can be linked to myasthenia gravis. An magnetic resonance imaging (MRI) scan might be used to check if your symptoms are being caused by an issue in your brain. Treating myasthenia gravis There are treatments available that can help reduce the affects of your symptoms. If your symptoms get worse following certain triggers, you should try to avoid those triggers as much as possible. Triggers might include: stress tiredness infections medicines surgery Treatment might include: Medicine Pyridostigmine Sometimes myasthenia gravis can be treated with


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stress tiredness infections medicines surgery Treatment might include: Medicine Pyridostigmine Sometimes myasthenia gravis can be treated with pyridostigmine alone. It works by temporarily improving the nerve to muscle transmission to help muscle strength. It can reduce muscle weakness and for some people this is the only medication they need to control the condition. It’s effects do not last long and it needs to be taken periodically throughout the day to give the best results. Side effects can include stomach upset, diarrhoea and drooling. Steroids You might be advised to take steroid tablets like prednisolone if pyridostigmine isn’t helping. Steroid tablets work by reducing the activity of your immune system to stop it attacking the communication between your nerves and muscles. It’s likely you’ll be advised to take the tablets every other day. You’re likely to start at a low dose which will be built up quickly. This might gradually be reduced once your symptoms are under control.


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other day. You’re likely to start at a low dose which will be built up quickly. This might gradually be reduced once your symptoms are under control. It’s important that you do not stop your steroids suddenly, as this can make you very ill. Using steroids long term can cause side effects including osteoporosis (weak bones), weight gain, infection and diabetes. Read more about the side effects of steroids Immunosuppressants Immunosuppressants work by reducing the activity of your immune system. Your healthcare team might suggest taking immunosuppressants if: steroids aren’t controlling your symptoms you need a high dose of steroids to control your symptoms Commonly used immunosuppressants include azathioprine, mycophenolate mofetil and methotrexate. You’ll need to take the tablets every day and it can take at least 9 months to feel the full effect. You’ll be advised to take steroids at first. Immunosuppressants night cause side effects like: loss of appetite and tiredness feeling sick


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effect. You’ll be advised to take steroids at first. Immunosuppressants night cause side effects like: loss of appetite and tiredness feeling sick increased risk of infections You’ll have regular blood tests to check the the medicine isn’t causing any harm. You might be able to stop taking immunosuppressants if they keep your symptoms under control over a few years. Surgery Your healthcare team might recommend surgery to remove the thymus gland (thymectomy). Symptoms should improve within the first few months after surgery and can continue to improve for up to 2 years. Surgery can reduce: the dose of steroids the need to take other immunosuppressants the chances of needing to go to hospital because of worsening symptoms Surgery might not help myasthenia symptoms in someone that has a thymoma. Your healthcare team might still recommend having your thymus gland removed because it can cause problems if it keeps growing. Your thymectomy will usually be carried out through keyhole surgery.


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your thymus gland removed because it can cause problems if it keeps growing. Your thymectomy will usually be carried out through keyhole surgery. The thymus is removed using surgical instruments inserted through small cuts (incisions) in the chest. Plasma exchange and IVIG Plasma exchange and IVIG (intravenous immunoglobulin) can offer a quick improvement (within a few days) for people with myasthenia gravis who are particularly unwell or are having a myasthenic crisis. Plasma exchange is an emergency treatment that removes antibodies from your own blood. This treatment is given in hospital and the benefits can last around 6 weeks. IVIG treatment involves an injection of normal antibodies from donated blood to temporarily change the way your immune system works. The two treatments are similar and your healthcare team will decide which is the best option for you. Although the benefits only last a few weeks, it can give time for the longer term treatments to take effect and help improve


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the best option for you. Although the benefits only last a few weeks, it can give time for the longer term treatments to take effect and help improve symptoms. You might find that, during pregnancy or after having a baby, your myasthenia gravis worsens. If you’re planning a pregnancy or become pregnant, you should speak to your healthcare team. Don’t stop taking your medications without first speaking to your healthcare professional. Source: Scottish Government - Opens in new browser window Last updated: 14 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. Email Address e.g. you@example.com Message Maximum of 500 characters Send feedback Add this page to Info For Me Other health sites Myaware NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and


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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/brain-nerves-and-spinal-cord/muscular-dystrophy/myotonic-dystrophy/


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https://www.nhsinform.scot/illnesses-and-conditions/cancer/cancer-types-in-adults/nasal-and-sinus-cancer/


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Nasal and sinus 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 Nasal and sinus cancer Nasal and sinus cancer Nasal and sinus cancer affects the nasal cavity (the space behind your nose) and the sinuses (small, air-filled cavities inside your nose, cheekbones and forehead). It’s a rare type of cancer that most often affects men aged 50 to 60. Nasal and sinus cancer is different to cancer in the area where the nose and throat connect. This is called nasopharyngeal cancer. Symptoms of nasal and sinus cancer The most common symptoms of nasal and sinus cancer are: a persistent blocked nose, which usually only affects 1 side nosebleeds mucus draining from the nose, which may be blood-stained a decreased sense of smell These symptoms can be similar to more common and less serious conditions, such as a cold or


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which may be blood-stained a decreased sense of smell These symptoms can be similar to more common and less serious conditions, such as a cold or sinusitis. At a later stage, symptoms can include: pain or numbness in the face swollen glands in the neck partial loss of vision or double vision a bulging or persistently watering eye a lump or growth on your face, nose or roof of your mouth When to speak to your GP Speak to your GP if you notice any unusual or persistent symptoms. They’re very unlikely to be caused by nasal or sinus cancer, but are worth getting checked out. If your GP thinks you might need some tests to determine what’s causing your symptoms, you’ll usually be referred to an ear, nose and throat (ENT) consultant in hospital. Tests you may have include: a nasal endoscopy – where a long, thin, flexible tube attached to a light source is inserted into your nose to examine the area a computerised tomography (CT) scan and a magnetic resonance imaging (MRI) scan a biopsy


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light source is inserted into your nose to examine the area a computerised tomography (CT) scan and a magnetic resonance imaging (MRI) scan a biopsy (where a small sample of tissue is removed and examined) – this may be done during an endoscopy or using a needle Who’s at risk of nasal and sinus cancer Several factors are known to increase the risk of developing nasal and sinus cancer, including: your gender – men are more likely to develop nasal and sinus cancer than women prolonged exposure to certain substances through your work, including wood dust, leather dust, nickel, chromium and formaldehyde smoking – the more you smoke, the higher your risk of developing several types of cancer, including nasal and sinus cancer human papilloma virus (HPV) – a group of viruses that affect the skin and moist membranes, such as the mouth and throat Treatments for nasal and sinus cancer The best treatment depends on several factors, including how far the cancer has spread and your general health.


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Treatments for nasal and sinus cancer The best treatment depends on several factors, including how far the cancer has spread and your general health. Treatment may include: surgery to remove a tumour – which can be performed using surgical incisions (open surgery) or as keyhole surgery through the nose (endoscopic microsurgery) radiotherapy – where high-energy radiation is used to kill the cancerous cells, shrink a tumour before surgery, or destroy small amounts of a tumour that may be left after surgery chemotherapy – where medicine is used to help shrink or slow down the growth of a tumour, or to reduce the risk of the cancer returning after surgery Your treatment will be organised by a head and neck cancer multidisciplinary team (MDT), who will discuss the treatment options with you. A combination of treatments will often be recommended. 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


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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 Nasopharyngeal cancer Other health sites Cancer Research UK: Nasal and paranasal sinus cancer Macmillan Cancer Support: Nasal and sinus cancer 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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https://www.nhsinform.scot/illnesses-and-conditions/cancer/cancer-types-in-adults/nasopharyngeal-cancer/


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Neck injury | 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 Injuries Head and neck injuries Neck injury Neck injury A neck injury can be caused by smaller injuries such as a muscle strain or by a larger injury such as a fall from a height. You may have also hurt your head if you have had a neck injury. Read more about Minor head injuries or Severe head injuries Symptoms of a neck injury Neck injuries often cause pain. Other symptoms of a neck injury may include: neck stiffness difficulty turning your neck muscle spasms headaches nausea (feeling sick) dizziness blurred vision Phone 999 if you or someone else has a neck injury and: is unresponsive has severe neck pain or cannot move their head has fallen from a height, like 5 or more stairs Go to A&E if you or someone else has a neck injury and: is intoxicated due to alcohol or recreational drugs


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from a height, like 5 or more stairs Go to A&E if you or someone else has a neck injury and: is intoxicated due to alcohol or recreational drugs they are a child or vulnerable person with a neck injury that wasn’t accidental, for example if someone else has hurt them on purpose Find your nearest A&E Call 111 if: You have experienced a neck injury and new onset or significant worsening of the following symptoms: severe neck pain a history of spinal problems like osteoporosis or rheumatoid arthritis changes to bladder and bowel function e.g. urgency, frequency, difficulty passing urine, leaking, incontinence changes to feeling around the bottom and/or genitals or sexual dysfunction e.g. recent inability to have an orgasm or erection numbness or weakness in your arms or legs clumsy hands e.g. dropping things, struggling with handwriting, buttons or zips you also feel generally unwell Treating a neck injury Most people who experience a minor neck injury are able to manage their symptoms


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or zips you also feel generally unwell Treating a neck injury Most people who experience a minor neck injury are able to manage their symptoms at home. There are a number of things you can do to help manage it. More information on how you can manage ​neck problems. Whiplash Read information for people who’ve been diagnosed with whiplash. Source: NHS 24 MSK Clinical Advisory Group - 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 Neck problems Whiplash Minor head injury Severe head injury 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


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https://www.nhsinform.scot/illnesses-and-conditions/muscle-bone-and-joints/neck-and-back-problems-and-conditions/neck-problems/


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


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Neuroblastoma: Children | 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 Neuroblastoma: Children Neuroblastoma: Children Most children who have neuroblastoma are younger than 5 years old. It’s the most common solid tumour in children that occurs outside of the brain and makes up 8% of the total number of children’s cancers. 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


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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 your child’s individual situation. Neuroblastoma develops from the cells left behind from a baby’s development in the womb. The cells that it develops from are called neuroblasts. ‘Neuro’ means nerve ‘Blast’ means cells in early development ‘Oma’ means a group of cells, or a tumour Neuroblastoma can occur anywhere in the body. The site of origin is either in 1 of the 2 adrenal glands situated in the abdomen (tummy) or in nerve tissue that runs alongside the spinal cord, in the neck, chest, abdomen or pelvis. The adrenal glands are specialised glands that are found above the right and left kidney. The adrenal glands normally release hormones to maintain blood pressure, and


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are specialised glands that are found above the right and left kidney. The adrenal glands normally release hormones to maintain blood pressure, and enable us to respond to stress. In some cases, neuroblastoma can spread to tissues beyond the original site such as the bone marrow, bone, lymph nodes, liver, and skin. Causes As with most cancers, the cause of neuroblastoma is unknown. It is not infectious and cannot be passed on to other people. Signs and symptoms The symptoms vary, depending on where your child’s neuroblastoma tumour is: if the tumour is in the abdomen, your child’s tummy may be swollen and they may complain of constipation or have difficulty passing urine (peeing) if the tumour affects the chest area, your child may be breathless and have difficulty swallowing if the tumour occurs in the neck, it’s often visible as a lump and occasionally affects breathing and swallowing occasionally, there are deposits of neuroblastoma in the skin that appear as small, blue-coloured


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and occasionally affects breathing and swallowing occasionally, there are deposits of neuroblastoma in the skin that appear as small, blue-coloured lumps if the tumour is pressing on the spinal cord, children may have weakness in the legs and walk unsteadily – if your child is not yet walking, you may notice reduced leg movements; they may also have constipation or difficulty passing urine (peeing) your child may be found to have high blood pressure very rarely, children may have jerky eye and muscle movements, and general unsteadiness associated with the neuroblastoma There are often symptoms of tiredness, being pale, loss of appetite, weight loss, bone pain and generalised discomfort. How is neuroblastoma diagnosed? A variety of tests and investigations will be needed to diagnose neuroblastoma. These include a biopsy of the tumour, blood and bone marrow tests, X-rays, CT or MRI scans, and a special nuclear medicine scan called an MIBG scan. These tests are carried out to confirm the


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and bone marrow tests, X-rays, CT or MRI scans, and a special nuclear medicine scan called an MIBG scan. These tests are carried out to confirm the diagnosis of neuroblastoma, and to find the exact position of the original site of neuroblastoma within the body and to see whether it has spread. This process is known as staging. A specific type of urine test will also be done. Nearly all children with neuroblastoma (9 out of 10) will have substances called vanillylmandelic acid (VMA), or homovanillic acid (HVA), in their urine. Measuring the VMA and HVA in the urine can help to confirm the diagnosis. Your child will also have their VMA and HVA levels checked during and after treatment. The levels of these substances will fall if the treatment is working. As these chemicals are produced by the tumour cells, and can be used to measure tumour activity, they are sometimes known as tumour markers. Most children will have an MIBG (meta-iodo-benzyl guanidine) scan. MIBG is a substance that’s


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activity, they are sometimes known as tumour markers. Most children will have an MIBG (meta-iodo-benzyl guanidine) scan. MIBG is a substance that’s taken up by neuroblastoma cells. It’s given by injection into the blood stream. Attaching a small amount of radioactive iodine to the MIBG enables any neuroblastoma tissue to be seen by a radiation scanner. Sometimes MIBG can be used as a treatment. Biopsy A small sample of cells (a biopsy) is usually taken from the tumour during an operation under a general anaesthetic. These cells are then examined under a microscope. Other tests collectively referred to as tumour biology, look at the chromosomes and ‘biological markers’ in the tumour cells. One of these ‘markers’ is called MYCN. The presence of a certain amount of MYCN in the cells (known as MYCN amplification) can suggest that the neuroblastoma may be a more aggressive type. In this situation, the treatment needs to be more intensive. Staging The ‘stage’ of a cancer is a term used to


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may be a more aggressive type. In this situation, the treatment needs to be more intensive. Staging The ‘stage’ of a cancer is a term used to describe its size and whether it has spread beyond its original site. Knowing the particular type and stage of the cancer helps the doctors to decide on the best treatment for your child. Stage 1 The cancer is contained within 1 area of the body (localised) and there’s no evidence of it having spread. It can be completely removed by surgery, or there may be very small (microscopic) amounts of tumour left. Stage 2A The cancer is localised and has not begun to spread, but cannot be completely removed by surgery. Stage 2B The cancer is localised and has begun to spread into nearby lymph nodes. Stage 3 The cancer has spread into surrounding organs and structures, but has not spread to distant areas of the body. Stage 4 The cancer has spread to distant lymph nodes, bone, bone marrow, liver, skin or other organs. Stage 4S (also called special


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of the body. Stage 4 The cancer has spread to distant lymph nodes, bone, bone marrow, liver, skin or other organs. Stage 4S (also called special neuroblastoma) This stage of neuroblastoma is found in children under 1 year old. The cancer is localised (as in stage 1, 2A or 2B) and has begun to spread to the liver, skin or bone marrow. A newer staging system has been developed by the International Neuroblastoma Risk Group (INRG). This system is now widely used. It looks at whether or not certain ‘image-defined risk factors’ are present in a neuroblastoma tumour before treatment. These risk factors can be detected by scans and help doctors understand the extent of the disease. Your doctor can explain more about this. Stage L1 The tumour is localised and has not spread into important areas (vital structures) nearby. It can be removed by surgery. Stage L2 The tumour is localised but has ‘image-defined risk factors’ and can’t be safely removed by surgery. Stage M The tumour has spread to


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Stage L2 The tumour is localised but has ‘image-defined risk factors’ and can’t be safely removed by surgery. Stage M The tumour has spread to other parts of the body. Stage MS The tumour has spread to the skin, liver and/or the bone marrow in children younger than 18 months old. If the cancer has spread to distant parts of the body, this is known as secondary or metastatic cancer. If the cancer comes back after initial treatment, this is known as recurrent or relapsed cancer. Treatment The treatment of neuroblastoma depends on the age of the child, the size and position of the tumour, the tumour biology (including the MYCN status) and whether the neuroblastoma has spread. Surgery For tumours that have not spread (localised tumours), the treatment is usually surgery. If the tumour is at an early stage and there is no evidence that it has spread to the lymph nodes or any other parts of the body, an operation to remove the tumour, or as much of it as possible, will be undertaken. If the


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spread to the lymph nodes or any other parts of the body, an operation to remove the tumour, or as much of it as possible, will be undertaken. If the tumour is, at first, too large or in too difficult a position to remove safely, chemotherapy will be given to shrink it before surgery. A cure is usually possible for children with localised tumours. However, if a localised tumour is classed as ‘high-risk’, due to the tumour biology results, additional treatment with chemotherapy and usually radiotherapy will be needed. Chemotherapy If the tumour has already spread by the time of diagnosis, or is indicated as being high-risk by the tumour biology result, intensive chemotherapy is needed. Chemotherapy is the use of anti-cancer drugs to destroy cancer cells. It’s usually given as an infusion into a vein. Your child will have a semi-permanent cannula called a central venous line inserted under a general anaesthetic to minimise the distress caused by intravenous injections. Your child’s


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cannula called a central venous line inserted under a general anaesthetic to minimise the distress caused by intravenous injections. Your child’s specialist will discuss with you the type and amount of chemotherapy needed. High-dose chemotherapy with stem cell rescue If the neuroblastoma has spread to several parts of the body, or is high-risk with MYCN amplification, high dose chemotherapy with peripheral blood stem cell rescue is used after the initial courses of chemotherapy. High-dose chemotherapy will wipe out any remaining neuroblastoma cells but will also wipe out the body’s bone marrow, where blood cells are made. To prevent the problems this causes, stem cells (blood cells at their earliest stages of development) are collected from your child through a drip before the chemotherapy is given. These stem cells are then frozen and stored until required. After the high-dose chemotherapy, the stem cells are given back to your child through a drip. They make their way into the bone


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until required. After the high-dose chemotherapy, the stem cells are given back to your child through a drip. They make their way into the bone marrow, where they grow and develop into mature blood cells over a period of 14 to 21 days. Monoclonal antibody treatment Monoclonal antibodies can destroy some types of cancer cells while causing little harm to normal cells. In the UK, patients with high-risk neuroblastoma treated in the (SIOPEN) European high-risk clinical trial receive immunotherapy with a monoclonal antibody called anti-GD2 after their high dose therapy. There is good evidence from a clinical trial (research study) carried out in America, which was first reported on in 2009, that this may be a promising therapy when given alongside standard treatment for neuroblastoma. The anti GD2 is either given on its own or with cytokines. It is not yet a standard treatment for patients with neuroblastoma as it has very unpleasant side effects, the benefits need to be fully proven and


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It is not yet a standard treatment for patients with neuroblastoma as it has very unpleasant side effects, the benefits need to be fully proven and the best way to administer it needs to be established. It is therefore currently only available to patients in the UK who are being treated within a clinical trial. Your child’s specialist will be able to tell you much more about this treatment. Radiotherapy External beam radiotherapy may be given if the neuroblastoma is high-risk, or has spread to several parts of the body. This uses high-energy rays to destroy the cancer cells, while doing as little harm as possible to normal cells. External beam radiotherapy is given from a machine outside the body. Internal radiotherapy may sometimes be given using radioactive MIBG. Radioactive MIBG is similar to the MIBG used in an investigation to diagnose neuroblastoma, but uses higher doses of radioactivity to kill the cancer cells. Younger children Children under 18 months old with neuroblastoma


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neuroblastoma, but uses higher doses of radioactivity to kill the cancer cells. Younger children Children under 18 months old with neuroblastoma often have ‘low-risk’ tumours, and as long as there is no MYCN amplification, their outlook is excellent. Most children in this age group are cured. Children with Stage 4S disease almost always get better with very little treatment or none at all. These tumours either regress spontaneously or after chemotherapy, which is only given if there are symptoms from the tumour. They disappear completely or develop into a non-cancerous (benign) tumour, called a ganglioneuroma. Many of these children, after their initial diagnostic tests and staging investigations, will just need careful monitoring for some years. Ganglioneuromas are usually harmless and will not cause any problems and do not need any treatment. Side effects of chemotherapy treatment Chemotherapy often causes side effects, and your child’s doctor will discuss this with you before the


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Side effects of chemotherapy treatment Chemotherapy often causes side effects, and your child’s doctor will discuss this with you before the treatment starts. The side effects will depend upon the actual drugs being given. Immediate side effects can include: feeling sick (nausea) and being sick (vomiting) diarrhoea weight loss hair loss increased risk of infection bruising and bleeding tiredness Late side effects A small number of children may develop late side effects, sometimes many years after treatment. These include a change in the way the heart and kidneys work, hearing problems, fertility problems, a possible reduction in bone growth if radiotherapy has been given, and a slightly increased risk of developing another cancer in later life. Your child’s doctor or nurse will talk to you 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


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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 organise many trials for children’s cancer. Children in the UK with neuroblastoma can take part in national and European studies. The European research group is called SIOPEN. 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 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


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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 Follow-up after treatment usually involves regular visits to the hospital outpatients department, with scans and urine tests as necessary. For children who have had chemotherapy and/or radiotherapy, more specialised tests may also be carried our. For example, hearing tests, kidney and heart function tests, and checking hormone levels. These will be repeated until your child is grown up. 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 their situation in detail. Your feelings As a parent, the fact


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condition and treatment, it’s best to discuss them with your child’s doctor, who knows their 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 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


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https://www.nhsinform.scot/illnesses-and-conditions/cancer/cancer-types-in-adults/neuroendocrine-tumours/


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https://www.nhsinform.scot/illnesses-and-conditions/stomach-liver-and-gastrointestinal-tract/non-alcoholic-fatty-liver-disease-nafld/


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Non-alcoholic fatty liver disease (NAFLD) | 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 Non-alcoholic fatty liver disease (NAFLD) Non-alcoholic fatty liver disease (NAFLD) Non-alcoholic fatty liver disease (NAFLD) is the term for a range of conditions caused by a build-up of fat in the liver. It’s usually seen in people who are overweight or obese. A healthy liver should contain little or no fat. It’s estimated that up to 1 in every 3 people in the UK has early stages of NAFLD where there are small amounts of fat in their liver. Early-stage NAFLD doesn’t usually cause any harm, but it can lead to serious liver damage, including cirrhosis, if it gets worse. Having high levels of fat in your liver is also associated with an increased risk of problems such as diabetes, heart attacks and strokes. If detected


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high levels of fat in your liver is also associated with an increased risk of problems such as diabetes, heart attacks and strokes. If detected and managed at an early stage, it’s possible to stop NAFLD getting worse and reduce the amount of fat in your liver. Stages of NAFLD NAFLD develops in 4 main stages. Most people will only ever develop the first stage, usually without realising it. In small number of cases it can progress and eventually lead to liver damage if not detected and managed. The main stages of NAFLD are: simple fatty liver (steatosis) – a largely harmless build-up of fat in the liver cells that may only be diagnosed during tests carried out for another reason non-alcoholic steatohepatitis (NASH)– a more serious form of NAFLD, where the liver has become inflamed; this is estimated to affect up to 5% of the UK population fibrosis – where persistent inflammation causes scar tissue around the liver and nearby blood vessels, but the liver is still able to function


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fibrosis – where persistent inflammation causes scar tissue around the liver and nearby blood vessels, but the liver is still able to function normally cirrhosis – the most severe stage, occurring after years of inflammation, where the liver shrinks and becomes scarred and lumpy; this damage is permanent and can lead to liver failure (where your liver stops working properly) and liver cancer It can take years for fibrosis or cirrhosis to develop. It’s important to make lifestyle changes to prevent the disease from getting worse. Am I at risk of NAFLD? You’re at an increased risk of NAFLD if you: are obese or overweight – particularly if you have a lot of fat around your waist (an ‘apple-like’ body shape) have type 2 diabetes have high blood pressure have high cholesterol are over the age of 50 smoke However, NAFLD has been diagnosed in people without any of these risk factors, including young children. Although it’s very similar to alcohol-related liver disease (ARLD), NAFLD isn’t


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people without any of these risk factors, including young children. Although it’s very similar to alcohol-related liver disease (ARLD), NAFLD isn’t caused by drinking too much alcohol. Symptoms of NAFLD There aren’t usually any symptoms of NAFLD in the early stages. You probably won’t know you have it unless it’s diagnosed during tests carried out for another reason. Occasionally, people with NASH or fibrosis (more advanced stages of the disease) may experience: a dull or aching pain in the top right of the tummy (over the lower right side of the ribs) fatigue (extreme tiredness) unexplained weight loss weakness If cirrhosis (the most advanced stage) develops, you can get more severe symptoms such as yellowing of the skin and the whites of the eyes (jaundice), itchy skin, and swelling in the legs, ankles, feet or tummy. Read more about the symptoms of cirrhosis. How NAFLD is diagnosed NAFLD is often diagnosed after a blood test called a liver function test produces an abnormal result


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symptoms of cirrhosis. How NAFLD is diagnosed NAFLD is often diagnosed after a blood test called a liver function test produces an abnormal result and other liver conditions, such as hepatitis, are ruled out. However, blood tests don’t always pick up NAFLD. The condition may also be spotted during an ultrasound scan of your tummy. This is a type of scan where sound waves are used to create an image of the inside of your body. If you’re diagnosed with NAFLD, further tests may be needed to determine which stage you have. This may involve a special blood test or having another type of ultrasound scan (Fibroscan). Some people may also need a small sample of liver tissue (biopsy) taken using a needle to have it analysed in a laboratory. Treatment for NAFLD Most people with NAFLD won’t develop any serious problems, but if you’re diagnosed with the condition it’s a good idea to take steps to stop it getting any worse. There’s currently no specific medication for NAFLD, but making healthy


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the condition it’s a good idea to take steps to stop it getting any worse. There’s currently no specific medication for NAFLD, but making healthy lifestyle choices can help and treatment may be recommended for associated conditions (high blood pressure, diabetes and cholesterol) or complications. You may be advised to have regular appointments with your doctor to check your liver function and look for signs of any new problems. Healthy diet and lifestyle Adopting a healthy lifestyle is the main way of managing NAFLD. The following can all help. Lose weight – you should aim for a BMI of 18.5-24.9. Losing more than 10% of your weight can remove some fat from the liver and improve NASH if you have it. Eat a healthy diet – try to have a balanced diet high in fruits, vegetables, protein and carbohydrates, but low in fat, sugar and salt. Eating smaller portions of food can help too. Exercise regularly – aim to do at least 150 minutes of moderate-intensity activity, such as walking or


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Eating smaller portions of food can help too. Exercise regularly – aim to do at least 150 minutes of moderate-intensity activity, such as walking or cycling, a week. All types of exercise can help improve NAFLD, even if you don’t lose weight. Stop smoking – if you smoke, stopping can help reduce your risk of problems such as heart attacks and strokes. NAFLD isn’t caused by alcohol, but drinking may make the condition worse. It’s therefore advisable to cut down or stop drinking alcohol. Read some tips on cutting down on alcohol. Medication There isn’t currently any medication that can treat NAFLD, but various medicines can be useful in managing the problems associated with the condition. For example, your doctor may recommend medication to treat high blood pressure, treat high cholesterol, treat type 2 diabetes and/or treat obesity. Liver transplant If you develop severe cirrhosis and your liver stops working properly, you may need to be put on the waiting list for a liver transplant.


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transplant If you develop severe cirrhosis and your liver stops working properly, you may need to be put on the waiting list for a liver transplant. For adults, the average waiting time for a liver transplant is 145 days for transplants from recently deceased donors. Alternatively, it may be possible to have a transplant using a section of liver removed from a living donor. As the liver can regenerate itself, both the transplanted section and the remaining section of the donor’s liver are able to regrow to a normal size. Read more about liver transplants. 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 NHS inform About NHS inform Editorial policy Contact us Webchat


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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/cancer/cancer-types-in-adults/non-hodgkin-lymphoma/


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


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Non-Hodgkin lymphoma: Children | 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 Non-Hodgkin lymphoma: Children Non-Hodgkin lymphoma: Children Non-Hodgkin lymphoma is a type of blood cancer. It’s more common in boys than girls. 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 and 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. If you have any questions it’s


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that may be used can often help parents to cope. Your child’s specialist will give you more detailed information. If you have any questions it’s important to ask the specialist doctor or nurse who knows your child’s individual situation. The lymphatic system is part of the immune system, the body’s natural defence against infection and disease. This is a complex system made up of the bone marrow, thymus, spleen, and lymph nodes throughout the body. The lymph nodes are connected by a network of tiny lymphatic vessels. Lymph nodes are also known as lymph glands, and the ones that you’re most likely to notice are those in the neck, armpit and groin. The number of lymph nodes varies from one part of the body to another. In some parts there are very few, whereas under your arm there may be 20 to 50 nodes. Cancers that start in the lymphatic system are called lymphomas. There are 2 main types of lymphoma: Hodgkin lymphoma non-Hodgkin lymphoma (NHL) Although they’re both types of lymphoma,


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system are called lymphomas. There are 2 main types of lymphoma: Hodgkin lymphoma non-Hodgkin lymphoma (NHL) Although they’re both types of lymphoma, there are differences between them, which means they need different treatment. There are 2 main types of NHL. B-cell NHL usually involves the lymph nodes in the abdomen and intestines, but may involve nodes in the head and neck. T-cell NHL usually affects lymph nodes in the chest. Occasionally, NHL can develop in unusual places outside the lymph nodes. This is called extranodal lymphoma. Causes We don’t know what causes NHL but there is research going on all the time to try to find out. It’s important to remember that nothing you have done has caused the cancer. Signs and symptoms The first sign of NHL is usually a lump somewhere in the body, which is caused by swollen lymph nodes. This can cause different symptoms, depending on where the swollen lymph nodes are. If glands in the abdomen are affected, this may cause a feeling of being


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cause different symptoms, depending on where the swollen lymph nodes are. If glands in the abdomen are affected, this may cause a feeling of being full after meals and some stomach pain. Other symptoms of NHL include a high temperature (fever), tiredness, weight loss, and loss of appetite. In a few children, lymphoma cells may be found in the bone marrow or in the fluid around the spinal cord (cerebrospinal fluid). How it’s diagnosed A variety of tests and investigations may be needed to diagnose NHL. Part, or all, of a swollen lymph gland, may be removed so that the cells can be examined in the laboratory (biopsy). This involves a small operation that is usually done under a general anaesthetic. Tests such as X-rays, ultrasound scans, MRI scans, CT scans, blood tests and bone marrow samples may be carried out to find out the extent of the disease. This is known as staging. Any tests and investigations that your child needs will be explained to you. The Children’s Cancer and Leukaemia


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disease. This is known as staging. 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 a cancer is a term used to describe its size and whether it has spread beyond its original site. The type of treatment your child receives depends on the stage of the disease. Stage 1 One group of lymph nodes is affected, or there’s a single extranodal tumour. Stage 2 Two or more groups of nodes are affected, or there is a single extranodal tumour that has spread to nearby lymph nodes, or there are two single extranodal tumours, but only on one side of the diaphragm (the sheet of muscle under the lungs, which plays a large part in our breathing). Stage 3 There’s lymphoma on both sides of the diaphragm (either in two or more groups of nodes) or there are two single extranodal tumours or the lymphoma is affecting the chest. Stage 4 The lymphoma has


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(either in two or more groups of nodes) or there are two single extranodal tumours or the lymphoma is affecting the chest. Stage 4 The lymphoma has spread beyond the lymph nodes to other organs of the body such as the bone marrow or nervous system. Treatment Treatment for NHL has a very good success rate and many people are cured. Chemotherapy is the most important treatment for children with NHL. Chemotherapy is the use of anti-cancer (cytotoxic) drugs to destroy cancer cells. It’s common for a combination of drugs to be used and treatment may last a number of months or years. The treatment will be planned according to your child’s particular type of NHL and the stage of the disease. B-cell NHL is treated with 4 to 8 courses of intensive chemotherapy. T-cell NHL is treated for about 2 years. Your child’s doctor will discuss the treatment options with you. NHL can sometimes affect the brain and spinal cord. To stop this, chemotherapy may be injected directly into the fluid around the


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options with you. NHL can sometimes affect the brain and spinal cord. To stop this, chemotherapy may be injected directly into the fluid around the spinal cord. This is called intrathecal chemotherapy. Very rarely, radiotherapy is also necessary. Radiotherapy treats cancer by using high-energy rays to destroy the cancer cells, while doing as little harm as possible to normal cells. High-dose chemotherapy with a bone marrow transplant is sometimes used (again very rarely) if the NHL comes back (recurs) after initial treatment. Side effects of treatment Treatment for NHL can cause different side effects, and your child’s doctor will discuss these with you before the treatment starts. Any possible side effects will depend on the part of the body that’s being treated and what treatment is being used. Some children have just a few side effects, while others experience more. Side effects can include: feeling sick (nausea) and vomiting a sore mouth temporary hair loss a low blood count


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while others experience more. Side effects can include: feeling sick (nausea) and vomiting a sore mouth temporary hair loss a low blood count leading to an increased risk of infection, bruising and bleeding (sometimes blood and/or platelet transfusions are needed) tiredness diarrhoea Late side effects Months or years later some children will develop late side effects from the treatment they have had. These include a possible reduction in bone growth, a change in the way the heart, lungs and kidneys work, and a small increase in the risk of developing another cancer in later life. After treatment with chemotherapy, some children – particularly boys – may become infertile. Older boys, and their parents, should be aware of the option of sperm banking. In this situation, sperm can be stored for possible use in later years. Your child’s doctor or nurse will talk to you about any possible late side effects and will keep a close eye on possible long-term side effects in follow-up clinics.


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or nurse will talk to you about any possible late side effects and will keep a close eye on possible long-term side effects in follow-up clinics. Clinical trials Many children have their treatment as part of a clinical research trial. Cancer research trials are carried out to try to find new and better treatments for cancer. Clinical trials mean there are now better results for curing children’s cancers compared with just a few years ago. 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 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


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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 Once treatment has finished, the doctors will monitor your child closely with regular appointments in the hospital outpatient department. 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


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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: 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


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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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Nosebleed | 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 Nosebleed Nosebleed Nosebleeds are not usually a sign of anything serious. You can often treat them at home. During a nosebleed, blood flows from one or both nostrils. It can be heavy or light. It can last from a few seconds to 15 minutes or more. How to stop a nosebleed To stop a nosebleed: Sit down at a table, lean forward and firmly pinch the soft part of your nose, just above your nostrils, for at least 10 to 15 minutes. Lean forward and breathe through your mouth. Spit out any blood that collects in your throat or mouth into a bowl. Do not swallow any blood. Place an ice pack or bag of frozen vegetables covered by a towel on your forehead or back of your neck. Stay upright or seated, rather than lying down, to reduce the blood pressure in the blood vessels of your


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on your forehead or back of your neck. Stay upright or seated, rather than lying down, to reduce the blood pressure in the blood vessels of your nose and help reduce further bleeding. If the bleeding eventually stops, you won’t usually need to seek medical advice. But in some cases you may need further treatment from your GP or in hospital. When to get medical advice Go to A&E or phone 999 if: the bleeding continues for longer than 20 minutes the bleeding is heavy and you’ve lost a lot of blood you’re having difficulty breathing you’re feeling weak or dizzy you swallow a large amount of blood that makes you vomit the nosebleed developed after a serious injury, such as a car crash Speak to your GP practice if: you’re taking a blood-thinning medicine (anticoagulant) such as warfarin you have a condition that means your blood cannot clot properly, such as haemophilia you have symptoms of anaemia such as heart palpitations, shortness of breath and a pale complexion a child under 2 has a


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such as haemophilia you have symptoms of anaemia such as heart palpitations, shortness of breath and a pale complexion a child under 2 has a nosebleed you have nosebleeds that come and go regularly If your GP practice is closed, phone 111. What causes nosebleeds? There are delicate blood vessels in your nose that can become damaged and bleed quite easily. Common causes of nosebleeds include: picking your nose blowing your nose very hard recently drinking alcohol a minor injury to your nose changes in humidity or temperature causing the inside of the nose to become dry and cracked Occasionally, bleeding can come from the blood vessels deeper within the nose. This can be caused by a blow to the head, recent nasal surgery or hardened arteries (atherosclerosis). Who gets nosebleeds? Nosebleeds are fairly common. Most people will get them every now and again. Anyone can get a nosebleed, but they most often affect: children aged between 2 and 10 elderly people pregnant women people who take


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now and again. Anyone can get a nosebleed, but they most often affect: children aged between 2 and 10 elderly people pregnant women people who take blood thinning medication such as aspirin or anticoagulants, such as warfarin people with blood clotting disorders, such as haemophilia Preventing nosebleeds There are things you can do to prevent nosebleeds. Do avoid picking your nose and keep your fingernails shortblow your nose as little as possible and only very gentlykeep your home humidifiedwear a head guard during activities in which your nose or head could get injuredalways follow the instructions that come with nasal decongestants – overusing these can cause nosebleeds Talk to your GP if you often get nosebleeds and aren’t able to prevent them. Treatment for nosebleeds If you see your GP or go to hospital with a nosebleed, you’ll be assessed to find out how serious your condition is and what’s likely to have caused it. This may involve: looking inside your nose measuring your


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be assessed to find out how serious your condition is and what’s likely to have caused it. This may involve: looking inside your nose measuring your pulse and blood pressure carrying out blood tests asking about any other symptoms you have If needed, your doctor will discuss additional treatments with you. For example, ointments for your nose, cautery to seal blood vessels in your nose or nasal packing may be required. Source: ENT Scotland - Opens in new browser window Last updated: 14 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 High blood pressure (hypertension) Iron deficiency anaemia First aid Other health sites St John Ambulance: Nosebleeds NHS inform About NHS inform Editorial policy Contact us


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Iron deficiency anaemia First aid Other health sites St John Ambulance: Nosebleeds 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/mental-health/obsessive-compulsive-disorder-ocd/


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Obsessive compulsive disorder (OCD) | 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 Obsessive compulsive disorder (OCD) Obsessive compulsive disorder (OCD) bsessive compulsive disorder (OCD) is a mental health condition. It causes you to have obsessive thoughts and carry out compulsive activity. This can be distressing and can have a big impact on your life. Treatment can help you keep it under control. Symptoms of OCD OCD affects people in different ways. It usually causes a particular pattern of thought and behaviour. This pattern has 4 main steps: Obsession – where an intrusive, distressing thought, image or urge repeatedly enters your mind. Anxiety – the obsession causes a feeling of intense anxiety or distress. Compulsion – repetitive behaviours or mental acts that you feel driven to perform although you may recognise them as


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of intense anxiety or distress. Compulsion – repetitive behaviours or mental acts that you feel driven to perform although you may recognise them as senseless or pointless. Temporary relief – the compulsive behaviour brings temporary relief, but the obsession and anxiety return, causing the cycle to begin again. Speak to your GP practice if: obsessive thoughts and compulsive behaviours are 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 Obsessive thoughts Almost everyone has unpleasant or unwanted thoughts at some point in their life. This might be a concern that you’ve forgotten to lock the door or that you might get a disease from touching other people. It could be sudden unwelcome violent or offensive mental images. Most people are able to put these types of thoughts and concerns into context. They can then carry on with their day-to-day life. They do


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images. Most people are able to put these types of thoughts and concerns into context. They can then carry on with their day-to-day life. They do not repeatedly think about worries they recognise as senseless or excessive. If you have persistent and unwanted thoughts that dominate your thinking, you may have developed an obsession. Some common obsessions that affect people with OCD include: fear of deliberately harming yourself or others – for example, fear you may attack someone, even though this isn’t in your nature fear of harming yourself or others by accident – for example, a fear you may set the house on fire by leaving the cooker on fear of contamination by disease, infection or an unpleasant substance a need for symmetry or orderliness – for example, you may feel the need to ensure all the tins in your cupboard face the same way Compulsive behaviour Compulsions happen as a way of trying to reduce or prevent the harm of the obsessive thought. However, this behaviour is either


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Compulsive behaviour Compulsions happen as a way of trying to reduce or prevent the harm of the obsessive thought. However, this behaviour is either excessive or not connected at all. For example, a person who fears that they’ll become contaminated with dirt and germs may wash their hands repeatedly. Or someone with a fear of causing harm to their family may have the urge to repeat an action many times to try to ‘neutralise’ the thought of harm. This type of compulsive behaviour is particularly common in children with OCD. Most people with OCD realise that such compulsive behaviour is irrational. They might know it makes no logical sense, but they cannot stop acting on their compulsion. Not all compulsive behaviours will be obvious to other people. Conditions related to OCD Some people with OCD may also have or develop other mental health problems, including: depression eating disorders generalised anxiety disorder a hoarding disorder People with OCD and severe depression might also


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problems, including: depression eating disorders generalised anxiety disorder a hoarding disorder People with OCD and severe depression might also have suicidal feelings. What causes OCD? The exact cause of OCD is not known. There are some factors that could make a person more likely to have OCD. These factors might include: genetics life events personality traits chemical differences in the brain Diagnosing OCD Diagnosis and treatment can help to reduce the impact of OCD on your day-to-day life. You should speak to your GP if you think you have OCD. Many people do not tell their GP about their symptoms because they feel ashamed or embarrassed. They may also try to disguise their symptoms from family and friends. If you have OCD, you should not feel ashamed or embarrassed. Like diabetes or asthma, it’s a long-term health condition, and it’s not your fault you have it. Your GP will probably ask you a series of questions to see if it’s likely you have OCD. If the results of the initial


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not your fault you have it. Your GP will probably ask you a series of questions to see if it’s likely you have OCD. If the results of the initial screening questions suggest you have OCD, the severity of your symptoms will be assessed. Either your GP or a mental health professional will carry out the assessment. It’s important you’re open and honest. Accurate and truthful responses will ensure you receive the most appropriate treatment. If you think someone you know may have OCD, it’s a good idea to: talk to them carefully about your concerns suggest they speak to their GP Treatment for OCD Treatment for OCD depends on the how much the condition is affecting your daily life. The 2 main treatments are: cognitive behavioural therapy (CBT) medication If your OCD has a severe impact on your daily life, you’ll usually be referred to a specialist mental health service. You’ll likely receive a combination of CBT and a course of antidepressants. Children with OCD are usually referred to a


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mental health service. You’ll likely receive a combination of CBT and a course of antidepressants. Children with OCD are usually referred to a healthcare professional with experience of treating OCD in children. It can take several months before a treatment has a noticeable effect. Try a self-help guide for OCD You could try our OCD self-help guide for mild to moderate symptoms of OCD. Start our OCD self-help guide Further treatment You might have specialist treatment if you’ve tried other options and your OCD is still not under control. Most people improve after receiving treatment. OCD Action have online support groups where you can connect with other people with similar experiences. Source: NHS 24 - Opens in new browser window Last updated: 18 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


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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 Obsessive compulsive disorder (OCD) self-help guide Selective serotonin reuptake inhibitors (SSRIs) Depression Anxiety disorders in children Other health sites OCD-UK Choice and Medication: Obsessive compulsive disorder (OCD) OCD Action 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/brain-nerves-and-spinal-cord/muscular-dystrophy/oculopharyngeal-muscular-dystrophy-opmd/


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Oculopharyngeal muscular dystrophy (OPMD) | 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 Muscular dystrophy Oculopharyngeal muscular dystrophy (OPMD) Oculopharyngeal muscular dystrophy (OPMD) Oculopharyngeal muscular dystrophy (OPMD) affects the muscles in the eyes (ocular) and the throat (pharyngeal). Someone with OPMD will usually start to experience symptoms in their 40’s or 50’s. Symptoms of oculopharyngeal muscular dystrophy The symptoms of OPMD are: ptosis or droopy eyelids dysphagia (problems with swallowing) limb weakness in the muscles around the shoulders and hips problems with eye movements Although you might have droopy eyelids, your eyesight (vision) should not be affected. Even when the condition worsens, a person with OPMD could have normal vision if their eyelids are raised. Worsening problems with


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not be affected. Even when the condition worsens, a person with OPMD could have normal vision if their eyelids are raised. Worsening problems with swallowing (dysphagia) can cause problems swallowing fluids including saliva. There’s a danger of aspiration (food, drink or saliva going down the wrong way into the chest instead of the stomach). This increases the risk of chest infections (aspiration pneumonia). Some people with OPMD experience muscle weakness first around the shoulders and then around the hips. This doesn’t usually happen until many years after the initial diagnosis. It’s usually mild but can progress to be more severe. The life expectancy of someone with OPMD is close to normal if it’s managed well. Causes of oculopharyngeal muscular dystrophy OPMD is an autosomal dominant inherited type of MD. If you have a dominant inherited MD, you only need to inherit the altered gene from one parent to be affected. This means, if you have a child with an unaffected partner there’s


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MD, you only need to inherit the altered gene from one parent to be affected. This means, if you have a child with an unaffected partner there’s still a 1 in 2 chance your child will develop the condition. If you have a parent with OPMD you might want to find out if you’re likely to develop the condition. You might want to consider having a genetic test. You’ll be offered counselling if you’re considering genetic testing. If you do find out you have inherited the condition, it’s impossible to predict when you’ll develop symptoms. Diagnosing oculopharyngeal muscular dystrophy A blood test can confirm if you have OPMD. The test identifies the genetic abnormality in the mutated gene. Treating oculopharyngeal muscular dystrophy There is no cure for OPMD. There are treatments available for the the most common OPMD symptoms of ptosis, limb weakness and dysphagia. Treatment for ptosis There’s a minor surgical procedure you can have to lift the eyelids to treat droopy eyelids caused by OPMD.


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and dysphagia. Treatment for ptosis There’s a minor surgical procedure you can have to lift the eyelids to treat droopy eyelids caused by OPMD. The procedure will try to restore your field of vision while still allowing the eyelids to close. Treatment for dysphagia If your dysphagia is mild, it can sometimes be helped by diet and speech therapy. If dysphagia is causing you to lose too much weight, a dietician might suggest you take food supplements. In more severe cases of dysphagia, the upper oesophageal sphincter (gullet) can obstruct weak swallowing. Stretching the muscle or cutting it in a procedure called cricopharyngeal myotomy can help. A botulinum toxin (Botox) injection is a temporary measure that can have a similar effect as the surgical procedure. If your dysphagia is not responding to the initial treatments options like diet, speech therapy and surgical treatments, there’s a risk of aspiration pneumonia. This can be prevented by using a different method of feeding. If this


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speech therapy and surgical treatments, there’s a risk of aspiration pneumonia. This can be prevented by using a different method of feeding. If this is the case, you might have gastrostomy. This involves a minor operation to pass a tube through the front of the abdomen (tummy) directly into the stomach. This might be a PEG (percutaneous gastrostomy) or a RIG (radiographically inserted gastrostomy). A gastrostomy ensures you’re getting enough nutrition and hydration. It reduces the chance of aspiration pneumonia and still allows you to swallow small amounts of food and drink if you’re able to. A PEG or RIG can be hidden under clothes. Limb weakness Physiotherapy and walking aids might help with limb weakness. Occupational therapy can help you to manage your daily activities. Source: Scottish Government - Opens in new browser window Last updated: 12 April 2023 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Don’t include personal


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Last updated: 12 April 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 Muscular dystrophy Becker muscular dystrophy Congenital muscular dystrophy (CMD) Emery-Dreifuss muscular dystrophy Facioscapulohumeral muscular dystrophy (FSHD) Limb girdle muscular dystrophy Myotonic dystrophy Other health sites Muscular Dystrophy 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/cancer/cancer-types-in-adults/oesophageal-cancer/


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Oral thrush in adults | 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 Oral thrush in adults Oral thrush in adults Oral thrush is a fungal infection of the mouth. It’s not contagious and is usually successfully treated with antifungal medication. It’s also called oral candidosis (or candiasis) because it’s caused by a group of yeasts called Candida. Contact your GP practice if: You develop symptoms of oral thrush, which can include: white patches (plaques) in the mouth that can often be wiped off, leaving behind red areas that may bleed slightly loss of taste or an unpleasant taste in the mouth redness inside the mouth and throat cracks at the corners of the mouth a painful, burning sensation in the mouth In some cases, the symptoms of oral thrush can make eating and drinking difficult. If left untreated, the symptoms will


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sensation in the mouth In some cases, the symptoms of oral thrush can make eating and drinking difficult. If left untreated, the symptoms will often persist and your mouth will continue to feel uncomfortable. In severe cases that are left untreated, there is also a risk of the infection spreading further into your body, which can be serious. Your GP will usually be able to diagnose oral thrush simply by examining your mouth. Sometimes they may also recommend blood tests to look for certain conditions associated with oral thrush, such as diabetes and nutritional deficiencies. What causes oral thrush? Low numbers of the fungus Candida are naturally found in the mouth and digestive system of most people. They don’t usually cause any problems, but can lead to oral thrush if they multiply. There are a number of reasons why this may happen, including: taking a course of antibiotics, particularly over a long period or at a high dose taking inhaled corticosteroid medication for asthma wearing


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taking a course of antibiotics, particularly over a long period or at a high dose taking inhaled corticosteroid medication for asthma wearing dentures (false teeth), particularly if they don’t fit properly having poor oral hygiene having a dry mouth, either because of a medical condition or a medication you are taking smoking having chemotherapy or radiotherapy to treat cancer Babies, young children and elderly people are at a particularly high risk of developing oral thrush, as are people with certain underlying conditions, including diabetes, an iron deficiency or vitamin B12 deficiency, an underactive thyroid (hypothyroidism) and HIV. As most people already have Candida fungi living in their mouth, oral thrush is not contagious. This means it cannot be passed to others. Treating oral thrush Oral thrush can usually be successfully treated with antifungal medicines. These usually come in the form of gels or liquid that you apply directly inside your mouth (topical medication),


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treated with antifungal medicines. These usually come in the form of gels or liquid that you apply directly inside your mouth (topical medication), although tablets or capsules are sometimes used. Topical medication will usually need to be used several times a day for around 7 to 14 days. Tablet or capsules are usually taken once daily. These medications don’t often have side effects, although some can cause nausea (feeling sick), vomiting, bloating, abdominal (tummy) pain and diarrhoea. If antibiotics or corticosteroids are thought to be causing your oral thrush, the medicine – or the way it is delivered – may need to be changed or the dosage reduced. Preventing oral thrush There are a number of things you can do to reduce your chances of developing oral thrush. Do rinse your mouth after mealsbrush your teeth twice a day with a toothpaste that contains fluoridefloss regularlyvisit your dentist regularly for check-ups, even if you wear dentures or have no natural teethremove your


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that contains fluoridefloss regularlyvisit your dentist regularly for check-ups, even if you wear dentures or have no natural teethremove your dentures every night and clean them with paste or soap and water before soaking them in a solution of water and denture-cleaning tabletsbrush your gums, tongue and inside your mouth with a soft brush twice a day if you wear dentures or have no or few natural teethvisit your dentist if your dentures do not fit properlystop smoking if you smokerinse your mouth with water and spit it out after using a corticosteroid inhaler, and use a spacer (a plastic cylinder that attaches to the inhaler) when you take your medicineensure that any underlying condition you have, such as diabetes, is well controlled If you have a condition or are receiving treatment that could put you at a high risk of developing oral thrush, your doctor may recommend taking a course of antifungal medication to prevent this happening. Read more about taking care of your oral


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oral thrush, your doctor may recommend taking a course of antifungal medication to prevent this happening. Read more about taking care of your oral health Source: NHS 24 - Opens in new browser window Last updated: 15 June 2023 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Don’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 Antibiotics Corticosteroids Taking care of your oral health Other health sites Diabetes UK Oral Health Foundation: Thrush Oral Health Foundation: Dentures 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/osteoarthritis/


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https://www.nhsinform.scot/illnesses-and-conditions/muscle-bone-and-joints/leg-and-foot-problems-and-conditions/osteoarthritis-of-the-hip/


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Osteoarthritis of the hip | 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 Osteoarthritis of the hip Osteoarthritis of the hip This information may be useful for those who have been diagnosed with osteoarthritis of the hip. People who are experiencing new or ongoing symptoms should contact their healthcare professional. Read about advice on dealing with a hip problem What is Osteoarthritis? Osteoarthritis is a common condition which can affect any joint in the body. When a joint develops osteoarthritis, part of the cartilage thins and the surface becomes rougher (sometimes called wear and tear). This means the joint doesn’t move as smoothly as it should. Read more about osteoarthritis What causes osteoarthritis of the hip? The exact cause of osteoarthritis is unknown, however it’s likely


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as it should. Read more about osteoarthritis What causes osteoarthritis of the hip? The exact cause of osteoarthritis is unknown, however it’s likely that a combination of factors may contribute. The likelihood of developing osteoarthritis in the hip can be increased by normal age related changes a previous injury to the area repetitive activities and physical jobs inheriting certain genetics from your parents being overweight What are the symptoms of osteoarthritis of the hip? These can vary from person to person. People may experience some or all of these symptoms including: pain in or around the hip joint, groin area, buttock or front thigh that can be worse when moving or doing activities. stiffness in the hip, often in the morning or after resting. locking, sticking or grinding of the hip weakness in the buttock muscles. difficulty in daily activities such as walking, going up/down stairs, getting up from a chair or out of a car. How is osteoarthritis of the hip diagnosed In


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in daily activities such as walking, going up/down stairs, getting up from a chair or out of a car. How is osteoarthritis of the hip diagnosed In order for osteoarthritis of the hip to be diagnosed you will need an assessment from a healthcare professional. They’ll initially ask you questions about your hip issue and then carry out a physical examination. This will include checking your range of movement and strength. An x-ray of the hip is sometimes used to help diagnosis. You may sometimes need to have a further examination to rule out other possible health conditions. How is osteoarthritis of the hip treated? While there is no cure for osteoarthritis, the condition can be successfully self-managed in a number of cases. Osteoarthritis of the hip can range in severity; some people can have significant changes shown on an x-ray with mild symptoms and others can have severe symptoms with little physical change. For both cases, and those in between, treatment would begin with the same


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symptoms and others can have severe symptoms with little physical change. For both cases, and those in between, treatment would begin with the same approach. Keeping the joint mobile is the best way to manage your symptoms. You can manage your symptoms by: pacing your activities throughout the day. adapt activities which increase your pain or you find difficult. avoid low seating if possible. wearing supportive footwear with cushioned soles and avoiding high heels. avoiding sitting in one position for long periods. Strengthening muscles around your hip will help manage your symptoms. Read more about exercises for osteoarthritis of the hip Seating Low seating often tends to aggravate the hip. Many people find it difficult to get on and off a sofa or toilet or in and out of bed or a car. It may be useful to increase the height of your seating where possible using cushions or specific products to raise all types of seating. Versus Arthritis have more information on living with arthritis.


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where possible using cushions or specific products to raise all types of seating. Versus Arthritis have more information on living with arthritis. Walking aids/use of handrails When climbing stairs consider using a handrail until your muscles become stronger. If going upstairs lead with the unaffected leg. If going downstairs lead with the affected leg. A walking stick may be beneficial, if using ensure it’s used on the opposite side from your affected leg. If you feel a walking aid would be beneficial you should contact your healthcare professional for advice. Pain treatments Pain medication can help you move more comfortably, which can help your recovery More about taking painkillers Surgery In some cases, surgery may be required if all other treatment options have been tried. If you’re waiting on surgery it’s still important to maintain movement in your hip using the management advice above as this will help your recovery. Read more about what you can do while awaiting hip surgery


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movement in your hip using the management advice above as this will help your recovery. Read more about what you can do while awaiting hip surgery Work Osteoarthritis 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, it’s a good idea to 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


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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 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 osteoarthritis of the hip Hip problems Other health sites Versus Arthritis: Osteoarthritis 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/osteoarthritis-of-the-knee/


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https://www.nhsinform.scot/illnesses-and-conditions/muscle-bone-and-joints/arm-shoulder-and-hand-problems-and-conditions/osteoarthritis-of-the-thumb/


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Osteoarthritis of the thumb | 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 Arm, shoulder and hand problems and conditions Osteoarthritis of the thumb Osteoarthritis of the thumb This information is useful for those who have been diagnosed with OA thumb. People who are experiencing new or ongoing symptoms should contact a healthcare professional for assessment and diagnosis. Read more about self-managing wrist, hand and finger problems What is Osteoarthritis of the thumb? Osteoarthritis (OA) is the most common form of arthritis in the UK, affecting a large proportion of the population. It’s caused by changes in the cartilage that cover the end of the bone within the joint. The cartilage becomes thin and rough, and can make movement of the joint difficult. Osteoarthritis can develop at any age, but usually appears after the


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cartilage becomes thin and rough, and can make movement of the joint difficult. Osteoarthritis can develop at any age, but usually appears after the age of 45. It can also develop after trauma to the thumb or wrist area. It mainly affects the joint at the base of your thumb. It can become painful, swollen and difficult to use if you have OA. Most people will be able to control the symptoms so that it doesn’t interfere with normal activities. Early management can help to prevent further symptoms and joint damage. What are the symptoms of osteoarthritis of the thumb? Symptoms vary from person to person. Common symptoms include: swelling pain loss of movement and strength around the thumb and wrist reduced ability to grip, twist or pinch with the thumb Read more about osteoarthritis How is osteoarthritis of the thumb diagnosed? In order for your thumb problem to be diagnosed you will need an assessment from a healthcare professional. They’ll initially ask you questions about your thumb


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your thumb problem to be diagnosed you will need an assessment from a healthcare professional. They’ll initially ask you questions about your thumb issue and then carry out a physical examination. This may include checking your range of movement and strength. You may sometimes need to have a further examination to rule out other possible health conditions How is osteoarthritis of the thumb treated? It’s important to keep the thumb moving and strong. This may help reduce your pain and any inflammation around the joint. Spreading your activities throughout the day can help make your tasks more manageable. Exercises can help to improve the thumb posture and make it easier to carry out your activities. Versus Arthritis have advice on using certain aids or other tools to help with activities. Thumb grip 52 Thumb circles 1:07 Thumb stretch 37 Palm on table 38 Tip of thumb bend 37 Thumb and finger touch 1:00 Managing pain Pain medication can help you move more comfortably, which can help


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37 Palm on table 38 Tip of thumb bend 37 Thumb and finger touch 1:00 Managing pain Pain medication can help you move more comfortably, which can help your recovery. More about taking painkillers Thumb splint A splint is often advised by your healthcare professional as a first treatment option. The aim of the splint is to support the thumb to reduce pain. This shouldn’t stop you from keeping your thumb mobile during the day. You may sometimes need to use a splint during the day when carrying out repetitive activities, it’s not advised to wear this all the time. You may only need to use this for a few weeks in order to settle the symptoms. 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 base of the thumb joint. Corticosteroids are medicines that help reduce pain and inflammation. They may also be given with a local anaesthetic. Injections may not cure your


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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 Surgery In some cases, surgery may be an option if all other treatment options have been tried. The operation is called a trapeziectomy and involves removing a small bone at the base of the thumb to reduce pain. Work Osteoarthritis 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


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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, or it’s got worse, within 6 weeks of 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: MSK Expert Panel - Opens in new browser window Last updated: 06 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 Wrist, hand and finger problems NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS


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For Me Also on NHS inform Wrist, hand and finger 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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https://www.nhsinform.scot/illnesses-and-conditions/muscle-bone-and-joints/conditions-that-can-affect-multiple-parts-of-the-body/osteoporosis/


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Osteosarcoma | 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 Osteosarcoma Osteosarcoma Osteosarcoma is a type of bone cancer. Osteosarcomas occur more commonly in older children and teenagers and are very rarely seen in children under 5. More children than ever are surviving childhood cancer. There are new and better drugs and treatments. But it remains devastating to hear that your child has cancer, and at times it can feel overwhelming. 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. If you have any questions it’s important to ask the specialist doctor or nurse who knows your


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specialist will give you more detailed information. If you have any questions it’s important to ask the specialist doctor or nurse who knows your child’s individual situation. Osteosarcoma often starts at the end of the long bones, where new bone tissue forms as a young person grows. Any bone in the body can be affected. The most common sites are in the arms and legs, particularly around the knee and shoulder joints. There are several different types of osteosarcoma. Most occur in the centre of the bone. There are also rare subtypes, such as parosteal, periosteal, telangiectatic, and small cell osteosarcoma. Causes There has been a lot of research into the causes of osteosarcoma but, like most childhood cancers, a definite cause is unknown. There are a few risk factors that have been associated with osteosarcoma. Children who have hereditary retinoblastoma (a rare tumour of the eye) have an increased risk of developing osteosarcoma. Children who have previously had radiotherapy and


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retinoblastoma (a rare tumour of the eye) have an increased risk of developing osteosarcoma. Children who have previously had radiotherapy and chemotherapy also have an increased risk of developing osteosarcoma. It is not caused by injuries or damage to the bone, although an injury may draw attention to a bone tumour. Signs and symptoms Pain in the affected bone is the most common symptom. This pain may initially come and go, and then gradually become more severe and constant especially at night. There may also be swelling around the affected bone. Osteosarcoma is sometimes discovered when a bone that has been weakened by cancer breaks after the person has had a minor fall or accident. Some patients may develop a limp if the tumour is in the leg or pelvis. These symptoms can be caused by many things other than cancer. However, any persistent bone pain should be checked by your child’s doctor. Symptoms are often attributed to a sporting injury. How osteosarcoma is diagnosed Usually you


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bone pain should be checked by your child’s doctor. Symptoms are often attributed to a sporting injury. How osteosarcoma is diagnosed Usually you begin by seeing your GP, who will examine your child and may arrange tests or X-rays. If a bone tumour is suspected, the doctor will refer your child directly to a specialist hospital or bone tumour centre for further tests. The doctor at the hospital will take your child’s full medical history. They will then do a physical examination. This will include an examination of the painful bone to check for any swelling or tenderness. Your child will probably have a blood test to check their general health. A variety of tests and investigations may be needed to diagnose osteosarcoma. An X-ray of the painful part of the bone will usually identify a tumour, although sometimes they can be difficult to see. A small piece of the tumour will be removed and looked at under a microscope. This is called a biopsy. It’s a small operation, performed under a


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see. A small piece of the tumour will be removed and looked at under a microscope. This is called a biopsy. It’s a small operation, performed under a general anaesthetic. Other tests are done to check whether the cancer has spread to other parts of the body. These include a chest X-ray, blood tests, a bone scan and an MRI or CT scan. Any tests and investigations that your child needs will be explained to you. Grading Grading refers to the appearance of the cancer cells under the microscope, and gives an idea of how quickly the cancer may develop. Low-grade cancer cells are usually slow-growing and less likely to spread. In high-grade tumours the cells are likely to grow quickly and are more likely to spread. Most osteosarcomas are high-grade, but a type known as parosteal osteosarcoma is usually low-grade. Staging The ‘stage’ of a cancer is a term used to describe its size and whether it has spread beyond its original site. Knowing the particular type and stage of the cancer helps the


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is a term used to describe its size and whether it has spread beyond its original site. Knowing the particular type and stage of the cancer helps the doctors to decide on the most appropriate treatment. Most patients are grouped depending on whether cancer is found in only one part of the body (localised disease), or whether the cancer has spread from one part of the body to another (metastatic disease). A staging system commonly used for osteosarcomas is described below: Stage 1A The cancer is low-grade and is only found within the hard coating of the bone. Stage 1B The cancer is low-grade, extending outside the bone and into the soft tissue spaces that contain nerves and blood vessels. Stage 2A The cancer is high-grade and is completely contained within the hard coating of the bone. Stage 2B The cancer is high-grade and has spread outside the bone and into surrounding soft tissue spaces that contain nerves and blood vessels. Most osteosarcomas are stage 2B. Stage 3 The cancer can be


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the bone and into surrounding soft tissue spaces that contain nerves and blood vessels. Most osteosarcomas are stage 2B. Stage 3 The cancer can be low or high-grade and is either found within the bone or extends outside the bone. The cancer has spread to other parts of the body, or to other bones not directly connected to the bone where the tumour started. If the cancer comes back after initial treatment, this is known as recurrent or relapsed cancer. Treatment Treatment will depend on a number of factors including the size, position, and stage of the tumour. Chemotherapy Chemotherapy is a very important part of treatment for osteosarcoma. Chemotherapy uses anti-cancer (cytotoxic) drugs to destroy cancer cells, and is usually given to shrink the main tumour before surgery. It’s also given after the tumour has been removed by surgery, to help reduce the risk of the cancer coming back (recurring). It’s common for a combination of drugs to be used. Radiotherapy Radiotherapy may


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to help reduce the risk of the cancer coming back (recurring). It’s common for a combination of drugs to be used. Radiotherapy Radiotherapy may occasionally be given. This treats cancer by using high energy rays to destroy the cancer cells, while doing as little harm as possible to normal cells. Surgery The type and extent of surgery depends on the position and size of the tumour in the body. This surgery will need to be carried out at a specialist orthopaedic centre, and your child should be referred to one. Surgery may include removing the whole limb (amputation) or part of the affected bone, which is then replaced by some form of false limb (prosthesis). If only part of the affected bone is removed, this is known as limb-sparing surgery. Most children will be considered for limb-sparing surgery. Amputation Sometimes amputation of the limb is unavoidable if the cancer is affecting the surrounding blood vessels and nerves. After amputation, a false limb will be fitted and will be


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limb is unavoidable if the cancer is affecting the surrounding blood vessels and nerves. After amputation, a false limb will be fitted and will be regularly adjusted as your child grows. False limbs can work very well. It should be possible for your child to join in with normal activities and even sports. Limb-sparing surgery There are 2 ways that limb-sparing surgery may be done: replacing the bone with a prosthesis (a specially designed artificial part) replacing the affected bone with bone taken from another part of the body (bone graft) After this type of surgery, children will usually be able to use their limbs almost normally. However, they are advised not to participate in any contact sports. This is because any damage to the bone graft or prosthesis may require another major operation to repair or replace it. If your child is growing, the limb prosthesis will need to be lengthened as the bone grows. This may mean there are extra short stays in hospital, although some


