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are enlarged blood vessels inside or around the bottom (the rectum and anus). Symptoms include discomfort, itching, bleeding or a lump hanging down outside of the anus. In severe cases, haemorrhoids may lead to bowel incontinence. Problems with the sphincter muscles The sphincter muscles at the bottom of the rectum control the bowel. Bowel incontinence happens if these muscles become weakened or damaged. Childbirth is a common cause of damage to the sphincter muscles and a leading cause of bowel incontinence. During a vaginal birth, the sphincter muscles can become stretched and damaged, particularly as a result of a forceps delivery. Other causes include a large baby, the baby being born with the back of their head facing the mother’s back (occipitoposterior position) and a long labour. Sphincter muscles can also become damaged through injury, or damage from bowel or rectal surgery. Nerve damage Bowel incontinence can also be caused by a problem with the nerves connecting the brain


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injury, or damage from bowel or rectal surgery. Nerve damage Bowel incontinence can also be caused by a problem with the nerves connecting the brain and the rectum. A nerve problem can mean your body is unaware of stools in your rectum, and may make it difficult for you to control your sphincter muscles. Damage to these nerves is related to a number of conditions, including: diabetes multiple sclerosis (a condition of the central nervous system) stroke spina bifida (birth defects that affect the development of the spine and nervous system) An injury to these nerves, such as a spinal injury, can also lead to bowel incontinence. Other health conditions In some cases, bowel incontinence may result from a health condition such as dementia or a severe learning disability that causes the person to lose bowel control. A physical disability can also make it difficult to get to the toilet in time. Diagnosing bowel incontinence Your GP will begin by asking you about the pattern of your symptoms


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make it difficult to get to the toilet in time. Diagnosing bowel incontinence Your GP will begin by asking you about the pattern of your symptoms and other related issues, such as your diet. You may find this embarrassing, but it’s important to answer as honestly and fully as you can to make sure you receive the most suitable treatment. Let your doctor know about: any changes in your bowel habits lasting for more than a few weeks rectal bleeding stomach pains any changes to your diet any medication you’re taking Your GP will usually carry out a physical examination. They’ll look at your anus and the surrounding area to check for damage and carry out a rectal examination, inserting a gloved finger into your bottom. A rectal examination will show whether constipation is the cause, and check for any tumours in your rectum. Your GP may ask you to squeeze your rectum around their finger to assess how well the muscles in your anus are working. Depending on the results, your GP may refer you


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to squeeze your rectum around their finger to assess how well the muscles in your anus are working. Depending on the results, your GP may refer you for further tests. Further tests Endoscopy (sigmoidoscopy) During an endoscopy, the inside of your rectum (and in some cases your lower bowel) is examined using a long, thin flexible tube with a light and video camera at the end (endoscope). Images can also be taken of the inside of your body. The endoscope checks whether there’s any obstruction, damage or inflammation in your rectum. An endoscopy isn’t painful, but it can feel uncomfortable, so you may be given a sedative to relax you. Anal manometry Anal manometry helps to assess how well the muscles and nerves in and around your rectum are working. The test uses a device that looks like a small thermometer with a balloon attached to the end. It’s inserted into your rectum and the balloon is inflated. It may feel unusual, but it’s not uncomfortable or painful. The device is attached to a


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It’s inserted into your rectum and the balloon is inflated. It may feel unusual, but it’s not uncomfortable or painful. The device is attached to a machine, which measures pressure readings taken from the balloon. You’ll be asked to squeeze, relax and push your rectum muscles at certain times. You may also be asked to push the balloon out of your rectum in the same way you push out a stool. The pressure-measuring machine gives an idea of how well your muscles are working. If the balloon is inflated to a relatively large size but you don’t feel any sensation of fullness, it may mean there are problems with the nerves in your rectum. Ultrasound An ultrasound scan can be used to create a detailed picture of the inside of your anus. Ultrasound scans are particularly useful in detecting underlying damage to the sphincter muscles. Defecography Defecography is a test used to study how you pass stools. It can also be useful in detecting signs of obstruction or prolapse that haven’t been


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Defecography is a test used to study how you pass stools. It can also be useful in detecting signs of obstruction or prolapse that haven’t been discovered during a rectal examination. During this test, a liquid called barium is placed into your rectum. The barium helps make it easier to highlight problems using an X-ray. Once the barium is in place, you’ll be asked to pass stools in the usual way while scans are taken. This test is occasionally carried out using a magnetic resonance imaging (MRI) scanner instead of an X-ray. Treating bowel incontinence Treatment for bowel incontinence depends on underlying cause and the pattern of your symptoms. Trying the least intrusive treatments first, such as dietary changes and exercise programmes, is often recommended. Medication and surgery are usually only considered if other treatments haven’t worked. Continence products You may find it helpful to use continence products until your bowel incontinence is better controlled. Most continence


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worked. Continence products You may find it helpful to use continence products until your bowel incontinence is better controlled. Most continence products are available for free on the NHS. Anal plugs are one way to prevent involuntary soiling. An anal plug is made of foam and designed to be inserted into your bottom. However, they can be uncomfortable and they’re not really a long term solution. If the plug comes into contact with moisture from the bowel, it expands and prevents leakage or soiling. Anal plugs can be worn for up to 12 hours, after which time they are removed using an attached string. Disposable body pads are contoured pads that soak up liquid stools and protect your skin. They can be used in cases of mild bowel incontinence. Single-use silicone inserts, which form a seal around the rectum until your next bowel movement, are also being investigated as a treatment option for moderate to severe bowel incontinence. Your local NHS continence service can offer help and


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are also being investigated as a treatment option for moderate to severe bowel incontinence. Your local NHS continence service can offer help and advice about continence products, and you don’t usually need a referral from your GP to make an appointment. These clinics are staffed by nurses who specialise in continence treatment. When you’re out Wear trousers or skirts that are easy to undo and have elasticated waistbands rather than buttons. Disability Rights UK offers access to 9,000 disabled toilets around the UK with a Radar NKS key. The key costs £4.50 and is only sold to people who require use of toilet facilities due to a disability or health condition. Dietary changes Bowel incontinence associated with diarrhoea or constipation can often be controlled by making changes to your diet. It may be beneficial to keep a food diary to record the effect of your diet on your symptoms. Diarrhoea The National Institute for Health and Care Excellence (NICE) has published dietary advice for


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the effect of your diet on your symptoms. Diarrhoea The National Institute for Health and Care Excellence (NICE) has published dietary advice for managing diarrhoea in cases of irritable bowel syndrome. These guidelines can also be applied to people with diarrhoea associated with bowel incontinence. The advice from NICE includes the following: limit fibre intake from wholegrain breads, bran, cereals, nuts and seeds (except golden linseeds) avoid skin, pips and pith from fruit and vegetables limit fresh and dried fruit to 3 portions a day and fruit juice to 1 small glass a day (make up the recommended ‘5 a day’ with vegetables) limit how often you have fizzy drinks and drinks containing caffeine avoid foods high in fat, such as chips, fast foods and burgers Constipation A high-fibre diet is usually recommended for most people with constipation-associated bowel incontinence. Your GP can tell you if a high-fibre diet is suitable for you. Fibre can soften stools, making them easier to


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bowel incontinence. Your GP can tell you if a high-fibre diet is suitable for you. Fibre can soften stools, making them easier to pass. Foods that are high in fibre include: fruit and vegetables beans wholegrain rice wholewheat pasta wholemeal bread seeds, nuts and oats Drink plenty of fluids because this can help to soften your stools and make them easier to pass. Pelvic floor muscle training Pelvic floor muscle training is a type of exercise programme used to treat cases of bowel incontinence caused by weakness in the pelvic floor muscles. A therapist, usually a physiotherapist or specialist nurse, will teach you a range of exercises. The goal of pelvic floor muscle training is to strengthen any muscles that may have been stretched and weakened. You’ll probably be required to carry out the exercises 3 times a day, for 6 to 8 weeks. After this time, you should notice an improvement in your symptoms. Exercises to try Check with your health professional before trying these at home.


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After this time, you should notice an improvement in your symptoms. Exercises to try Check with your health professional before trying these at home. First, pretend you’re trying to hold in a bowel movement. You should feel the muscles around your anus tighten. Next, sit, stand, or lie in a comfortable position with your legs slightly apart. Squeeze your pelvic floor muscles for as long as you can, then relax. Repeat 5 times. Squeeze the muscles as hard as you can, then relax. Repeat 5 times. Squeeze the muscles quickly, then relax. Repeat 5 times. If you find these exercises too difficult, try fewer repetitions at first and build them up. If they get too easy, try doing more repetitions. You can do the exercises without anyone knowing about them, so they should be easy to fit into your daily routine. Bowel retraining Bowel retraining is a type of treatment for people with reduced sensation in their rectum as a result of nerve damage, or for those who have recurring episodes of


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is a type of treatment for people with reduced sensation in their rectum as a result of nerve damage, or for those who have recurring episodes of constipation. There are 3 goals in bowel retraining: to improve the consistency of your stools to establish a regular time for you to empty your bowels to find ways of stimulating your bowels to empty themselves Changes to your diet usually improve stool consistency (see above). Establishing a regular time to empty your bowels means finding the most convenient time when you can go to the toilet without being rushed. Ways to stimulate bowel movements can differ from person to person. Some people find a hot drink and meal can help. Others may need to stimulate their anus using their finger. Biofeedback Biofeedback is a type of bowel retraining exercise that involves placing a small electric probe into your bottom. The sensor relays detailed information about the movement and pressure of the muscles in your rectum to an attached computer.


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probe into your bottom. The sensor relays detailed information about the movement and pressure of the muscles in your rectum to an attached computer. You’re then asked to perform a series of exercises designed to improve your bowel function. The sensor checks that you are performing the exercises in the right way. Medication Medication can be used to help treat soft or loose stools or constipation associated with bowel incontinence. Loperamide is a medicine widely used to treat diarrhoea. It works by slowing down the movement of stools through the digestive system, allowing more water to be absorbed from the stools. Loperamide can be prescribed in low doses to be taken regularly over a long period of time. Laxatives are used to treat constipation. They’re a type of medicine that helps you to pass stools. Bulk-forming laxatives are usually recommended. These help your stools to retain fluid. This means they’re less likely to dry out, which can lead to faecal impaction. Enemas or rectal


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recommended. These help your stools to retain fluid. This means they’re less likely to dry out, which can lead to faecal impaction. Enemas or rectal irrigation Rectal irrigation or enemas are used when bowel incontinence is caused by faecal impaction and other treatments have failed to remove the impacted stool from the rectum. These procedures involve a small tube that is placed into your anus. A special solution is then used to wash out your rectum. Surgery Surgery is usually only recommended after all other treatment options have been tried. The main surgical treatments used on the NHS are sphincteroplasty and sacral nerve stimulation. Other treatments – such as tibial nerve stimulation, endoscopic heat therapy and artificial sphincter surgery – can also be used, but their availability on the NHS is limited. An operation called a colostomy is more widely available on the NHS, but it’s only used if other treatments are unsuccessful. Sphincteroplasty A sphincteroplasty is an


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a colostomy is more widely available on the NHS, but it’s only used if other treatments are unsuccessful. Sphincteroplasty A sphincteroplasty is an operation to repair damaged sphincter muscles. The surgeon removes some of the muscle tissue and the muscle edges are overlapped and sewn back together. This provides extra support to the muscles, which makes them stronger. Sacral nerve stimulation Sacral nerve stimulation is a treatment used for people with weakened sphincter muscles. Electrodes are inserted under the skin in the lower back and connected to a pulse generator. The generator releases pulses of electricity that stimulate the sacral nerves, which causes the sphincter and pelvic floor muscles to work more effectively. At first, the pulse generator is located outside your body. If the treatment is effective, the pulse generator will be implanted deep under the skin in your back. The most commonly reported complications of the procedure are infection at the site of surgery and


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be implanted deep under the skin in your back. The most commonly reported complications of the procedure are infection at the site of surgery and technical problems with the pulse generator, which require additional surgery to correct. Read the NICE guidelines on Sacral nerve stimulation for faecal incontinence. Tibial nerve stimulation Tibial nerve stimulation is a fairly new treatment for bowel incontinence. A fine needle is inserted into the tibial nerve just above the ankle and an electrode is placed on the foot. A mild electric current is passed through the needle to stimulate the tibial nerve. It’s not known exactly how this treatment works, but it’s thought to work in a similar way to sacral nerve stimulation. NICE concludes that the procedure appears to be safe, although there are still uncertainties about how well it works. Read the NICE guidelines on Treating faecal incontinence by stimulating the tibial nerve. Injectable bulking agents Bulking agents, such as collagen or


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the NICE guidelines on Treating faecal incontinence by stimulating the tibial nerve. Injectable bulking agents Bulking agents, such as collagen or silicone, can be injected into the muscles of the sphincter and rectum to strengthen them. The use of bulking agents in this way is a fairly new technique, so there’s little information about their long-term effectiveness and safety. You should discuss the possible advantages and disadvantages of this type of treatment in full with your treatment team before deciding whether to proceed. Read the NICE guidelines on Treating faecal incontinence with injectable bulking agents. Endoscopic heat therapy Endoscopic radiofrequency (heat) therapy is a fairly new treatment for bowel incontinence. Heat energy is applied to the sphincter muscles through a thin probe, to encourage scarring of the tissue. This helps tighten the muscles and helps to control bowel movements. The National Institute for Health and Care Excellence (NICE) recently produced


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This helps tighten the muscles and helps to control bowel movements. The National Institute for Health and Care Excellence (NICE) recently produced guidelines on this procedure. NICE concluded that the procedure appears to be safe, although there are still uncertainties about how well it works. As well as the uncertainties surrounding this procedure, it is also expensive. Therefore, it is usually only used on the NHS during clinical trials. Read the NICE guidelines on Treating faecal incontinence using endoscopic radiofrequency therapy. Artificial sphincter An artificial sphincter may be implanted if you have bowel incontinence caused by a problem with your sphincter muscles. This operation involves placing a circular cuff under the skin around the anus. The cuff is filled with fluid and sits tightly around the anus, keeping it closed. A tube is placed under the skin from the cuff to a control pump. In men, the pump is placed near the testicles, in women it’s placed near the vagina. A


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tube is placed under the skin from the cuff to a control pump. In men, the pump is placed near the testicles, in women it’s placed near the vagina. A special balloon is placed into the tummy, and this is connected to the control pump by tubing that runs under the skin. The pump is activated by pressing a button located under the skin. This drains the fluid from the cuff into the balloon, so your anus opens and you can pass stools. When you are finished, the fluid slowly refills the cuff and the anus closes. The use of an artificial sphincter is a relatively new procedure, so there isn’t much good-quality information about its long-term effectiveness and safety. Possible problems include infection, injury during surgery and the cuff becoming dislodged. In some cases, further surgery is required to correct problems. Read the NICE guidelines on Treating faecal incontinence with an artificial sphincter inserted through a cut in the abdomen. Colostomy A colostomy is usually only


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guidelines on Treating faecal incontinence with an artificial sphincter inserted through a cut in the abdomen. Colostomy A colostomy is usually only recommended if other surgical treatments are unsuccessful. A colostomy is a surgical procedure in which your colon (lower bowel) is cut and brought through the wall of your stomach to create an artificial opening. Your stools can then be collected in a bag, known as a colostomy bag, which is attached to the opening. 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 Urinary incontinence Constipation Colostomy Other health sites Education and Resources for Improving Childhood Continence (ERIC) NICE: Faecal


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inform Urinary incontinence Constipation Colostomy Other health sites Education and Resources for Improving Childhood Continence (ERIC) NICE: Faecal incontinence Age UK: incontinence 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/bowel-polyps/


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Brain stem death | 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 Brain stem death Brain stem death Brain stem death is when a person no longer has any brain stem function. When someone loses their brain stem function permanently, medical professionals will confirm they’re dead. The brain stem The brain stem is the lower part of the brain that’s connected to the spinal cord. It’s needed for the brain’s core functions, like consciousness, awareness, breathing and movement. Once the brain stem has stopped functioning, there’s no way of reversing it. The person will not be able to regain consciousness or recover. You might have heard the term ‘brain dead’. This refers to brain stem death. Ventilators In some circumstances, it’s possible to keep a person’s heart beating after brain stem death. This is done by keeping the


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stem death. Ventilators In some circumstances, it’s possible to keep a person’s heart beating after brain stem death. This is done by keeping the patient on a machine called a ventilator, which breathes for them. Even if someone is on a ventilator, there’s no way of reversing brain stem death. Their heart will eventually stop beating. How brain stem death occurs Brain death can occur when the blood and/or oxygen supply to the brain is stopped. This can be caused by: cardiac arrest – when the heart stops beating and the brain is starved of oxygen stroke –when the blood supply to the brain is blocked or interrupted a severe head injury a brain haemorrhage infections, like encephalitis or meningitis Diagnosing brain stem death There are a number of criteria for diagnosing brain stem death. A patient: must be unconscious and fail to respond to outside stimulation must only be able to breathe by using a ventilator must show no brain stem reflexes – these reflexes include coughing, gagging,


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outside stimulation must only be able to breathe by using a ventilator must show no brain stem reflexes – these reflexes include coughing, gagging, and pupils responding to light must show clear evidence that serious brain damage has occurred and can’t be reversed – this would usually be shown on a CT scan Ruling out other conditions Before testing for brain stem death, two senior doctors must carry out a series of checks. This process makes sure that the signs of brain stem death aren’t being caused by other factors, like: an overdose of drugs, poisons or other chemical agents an abnormally low body temperature (hypothermia) low levels of sugar or salts in the patient’s blood Once these factors have been ruled out, tests are carried out to confirm brain death. The diagnosis of brain death also has to be made by two senior doctors. The doctors will explain the tests to you. You will be kept informed about your loved one’s condition at all times. Testing for brain stem death The two


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doctors will explain the tests to you. You will be kept informed about your loved one’s condition at all times. Testing for brain stem death The two doctors will run a series of tests. They both have to agree on the results for a diagnosis of brain death to be confirmed. The tests are carried out twice to minimise any chance of error. The tests used to determine whether brain stem death has occurred are: shining a torch into both eyes to see if the patient reacts to the light stroking the cornea (the transparent outer layer of the eye) with a tissue or piece of cotton wool to see if the eye reacts applying pressure to the forehead to see if the patient moves in response inserting ice-cold water into each ear, which would usually cause a person’s eyes to move inserting a thin, plastic tube down the patient’s trachea (windpipe) to see if they gag or cough disconnecting the person from the ventilator for a short period of time to see if they make any attempt to breathe on their own Brain


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gag or cough disconnecting the person from the ventilator for a short period of time to see if they make any attempt to breathe on their own Brain death will only be diagnosed if a person does not respond to all of these tests. Occasionally, a person’s limbs or torso (the upper part of the body) may move after brain stem death has been diagnosed. These are spinal reflex movements generated by the spinal cord, and don’t involve the brain at all. They’ll not affect a diagnosis of brain stem death. Once brain stem death is diagnosed, even though the patient’s heart is still beating, they are legally dead. At this point the medical professionals will discuss next steps with a patient’s loved ones. This can include discussing potential organ donation, or other things that are important for end-of-life care for the patient. Organ and tissue donation After brain death has occurred, it may be possible for the person’s organs and tissue to be used for organ donation. This can often save or


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donation After brain death has occurred, it may be possible for the person’s organs and tissue to be used for organ donation. This can often save or improve the lives of others. Further information about organ and tissue donation 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 Coma Organ and tissue donation Other health sites Code of Practice for the diagnosis and confirmation of death: Academy of Medical Royal Colleges 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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NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats © 2025 NHS 24 – v1.1.1.17852


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


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Brain tumours: 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 Brain tumours: Children Brain tumours: Children Brain tumours are the most common tumours that develop in children. Children of any age may be affected. Boys are affected slightly more often 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, but there are many healthcare professionals and support organisations to help you through this difficult time. Understanding more about the cancer your child has, and the treatments that may be used, can often help parents to cope. Your child’s specialist will give you more


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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. Brain tumours A tumour in the brain can come from the brain itself (primary), or from another part of the body (secondary). This information is about primary brain tumours. Signs and symptoms Symptoms will depend on the size of the tumour, where it is and how it affects that part of the brain. Symptoms are caused by the pressure inside the head being higher than it should be. A growing tumour may push normal brain out of the way, or block the flow of fluid in the brain. Doctors call this raised intracranial pressure, and it can cause symptoms such as: headaches (often worse in the morning) vomiting (usually in the morning) or feeling sick fits (seizures) feeling very irritated or losing


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such as: headaches (often worse in the morning) vomiting (usually in the morning) or feeling sick fits (seizures) feeling very irritated or losing interest in day-to-day things eye problems, such as abnormal eye movements, blurring or double vision feeling very tired much more quickly than usual feeling extremely sleepy (drowsy) for no reason Brain tumours can also cause problems with balance and walking, weakness down one side of the body, or changes in behaviour. Some of these symptoms are common even without a brain tumour, and this can cause confusion in the early stages. The brain The brain is contained within the skull, which protects it. Between the brain and the skull, there are 3 layers of membrane called the meninges. These completely cover the brain and spinal cord and help to protect it. Between 2 of these layers is a space that contains a fluid called cerebrospinal fluid (CSF), which circulates around the brain and spinal cord. The main parts of the brain are: the


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space that contains a fluid called cerebrospinal fluid (CSF), which circulates around the brain and spinal cord. The main parts of the brain are: the cerebrum – this is at the top of the head and is the largest part of the brain; it’s made up of 2 halves (hemispheres), it controls thinking, learning, memory, problem-solving, emotions and touch, and it also helps us be aware of our body position the cerebellum – this is the back part of the brain, and it controls movement, balance and coordination the brain stem – this connects the brain to the spinal cord and is in the lower part of the brain just above the back of the neck; it controls breathing, body temperature, heart rate and blood pressure, eye movements and swallowing What happens when a brain tumour is suspected Knowing what a test involves can make things a bit easier. The specialist doctor and nurse will explain things but don’t be afraid to ask questions. Your doctor will want to hear about the problems your child has had


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doctor and nurse will explain things but don’t be afraid to ask questions. Your doctor will want to hear about the problems your child has had recently, and will examine him or her properly. This will include looking into the back of your child’s eyes with an ophthalmoscope to check for swelling, which can be a sign of raised pressure in the brain. They’ll usually check other things like balance, coordination, sensation and reflexes. CT or MRI scan Most children will have a CT or an MRI scan, which looks in detail at the inside of the brain. A CT scan uses X-rays. It’s quick and often is the best first-line investigation, but it does not give as detailed pictures as an MRI. It uses quite a lot of X-rays, and so it is important to make sure we do not use it on too many people if it can be avoided. An MRI scan uses no X-rays, and gives more detailed pictures, but takes much longer. Machines are noisy, and often children cannot lie still long enough to get proper images. It is sometimes


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detailed pictures, but takes much longer. Machines are noisy, and often children cannot lie still long enough to get proper images. It is sometimes necessary to have an anaesthetic for this scan. Ordinary X-rays are not usually helpful for brain tumours. Blood tests These are usually done to make sure it is safe to do an operation, and can also be used to help diagnose certain types of tumour. Biopsy It’s often necessary for doctors to remove a small part of the tumour (biopsy) to find out exactly what type of tumour it is. It means your child will need to go into hospital for an operation under general anaesthetic. The piece of tumour removed is then examined under a microscope by a specialist doctor called a pathologist. A biopsy isn’t always done; it is sometimes better to remove the whole tumour in one operation. In this case, it will be a few days before the exact type of tumour is known. Sometimes, it may be safer to do the operation in two stages. Part of the tumour might be


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be a few days before the exact type of tumour is known. Sometimes, it may be safer to do the operation in two stages. Part of the tumour might be removed in the first operation and the rest a few days later. Types of brain tumours There are different types of brain tumours and they are usually named after the type of cells they develop from. The main types are astrocytoma, ependymoma, and medulloblastoma, but there are many other, less common types. Brain tumours can be either benign (non-cancerous) or malignant (cancerous). Benign brain tumours These remain in the part of the brain that they started in and do not usually spread into other areas. Sometimes it may be difficult to remove a benign tumour, because of where it is and, in this situation, other treatments may be needed. The most common tumour of this type is a low-grade astrocytoma (also called low-grade glioma). Malignant primary brain tumours These are most likely to cause problems by causing pressure and damage to the


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(also called low-grade glioma). Malignant primary brain tumours These are most likely to cause problems by causing pressure and damage to the areas around them and possibly by spreading to the normal brain tissue close by. High-grade astrocytoma and ependymoma These tumours develop from the supporting cells of the brain known as glial cells, and are sometimes also called gliomas. Medulloblastomas These usually develop in the lower part of the brain, the cerebellum. They may spread to other parts of the brain or into the spinal cord, and treatment must include the whole of this. Treatment Because there are different types of brain tumours, treatment will not be the same for everyone. The doctors will look at the type of brain tumour, its size and where it is in the brain before deciding on the best treatment. These are the main treatments used to treat brain tumours. Your child may have one treatment or a combination of treatments. Surgery Usually, a neurosurgeon will operate to remove


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used to treat brain tumours. Your child may have one treatment or a combination of treatments. Surgery Usually, a neurosurgeon will operate to remove as much of the tumour as possible. Operations can be very long. It’s not uncommon for these to be more than 6 or 8 hours. Sometimes, the fluid in and around the brain does not flow freely, as a result of the tumour or brain swelling. In this case, it may be necessary to place a fine tube (shunt) to drain excess fluid from the brain and into the lining of the tummy area (abdomen). You cannot see the shunt outside the body. Another way of treating this is to create another drainage route for the fluid around the obstruction (called a ventriculostomy). After the operation, your child may spend some time in an intensive care ward or high dependency unit, so the nurses and doctors can keep a very close eye on them. Once a diagnosis is known, a plan to treat any tumour left behind can be made. For benign tumours, there may be no further


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a very close eye on them. Once a diagnosis is known, a plan to treat any tumour left behind can be made. For benign tumours, there may be no further treatment, but for some, radiotherapy or chemotherapy will be required. Radiotherapy Radiotherapy treats cancer by using high energy radiation beams. These are exactly the same as visible light, but instead of reflecting from the surface, the energy passes inside the body, where it causes damage to tumour cells. Radiotherapy is delivered extremely carefully, using machines linked to the MRI scans of your child’s brain. The process usually takes a few minutes each time, but often needs to continue for 5 or 6 weeks. Sometimes more specialised types of radiotherapy may be used. Your child’s oncologist will explain more about this. Chemotherapy Chemotherapy uses drugs to get rid of cancer cells. Chemotherapy is given into the veins, and sometimes as a liquid or tablets by mouth. Treatment is often quite prolonged, with periods of time in


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Chemotherapy is given into the veins, and sometimes as a liquid or tablets by mouth. Treatment is often quite prolonged, with periods of time in hospital and gaps when you will be able to return home. This part of the treatment is planned by an oncologist. The specialist doctor and nurse will explain your child’s treatment and answer your questions so that you understand what is involved. Other medicines your child may need to take Your child may need to take medicines for a while to reduce or control the symptoms of the brain tumour: Steroids These are medicines that reduce swelling and inflammation in the brain and can help with symptoms. Anticonvulsants These are medicines that help prevent fits, which can be a problem before or after operations on the brain. They may only be necessary for a short period, but sometimes are needed for longer. Side effects of treatment Your child’s doctor and specialist nurse will explain more about what to expect. Always let them know about any side


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Side effects of treatment Your child’s doctor and specialist nurse will explain more about what to expect. Always let them know about any side effects your child is having. Many side effects can be well controlled or made easier. Hair loss Both radiotherapy and chemotherapy can cause hair loss. Your child’s hair will usually grow back again after chemotherapy, although it may not after radiotherapy. Tiredness Tiredness is very common with both treatments and may continue for weeks after chemotherapy or radiotherapy finishes. Feeling sick Radiotherapy and chemotherapy may make your child feel sick. This can usually be controlled well with anti-sickness drugs, which the oncologist will prescribe for your child. Increased risk of an infection Chemotherapy can increase the risk of infection. It’s important to contact the oncologist or specialist nurse straight away if your child has a temperature, any signs of infection or suddenly feels unwell. Skin changes in the treated area if your


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nurse straight away if your child has a temperature, any signs of infection or suddenly feels unwell. Skin changes in the treated area if your child is having radiotherapy Radiotherapy can cause a mild form of sunburn. The skin may become red, flaky or sore if your child has fair skin and may become darker and flaky if your child has dark skin. You’ll be given advice on looking after the skin in the treated area. Clinical trials 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. It’s important to realise that a clinical trial is not an ‘experiment’, and your doctor will always offer you what is believed to be the best available treatment. Clinical trials are usually offered to explore ways of making new improvements to treatment, beyond what is already known. Specialist doctors carry out many trials for brain tumours. If appropriate, your child’s medical team will talk to you about


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what is already known. Specialist doctors carry out many trials for brain tumours. If appropriate, your child’s medical team will talk to you about taking part in a clinical trial, and will answer any questions you have. Written information is often 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 is right for your child. You can also join a trial, and then withdraw if you change your mind at a later date. Treatment guidelines Sometimes, clinical trials are not available for your child’s tumour. This may be because a recent trial has just finished, or because the tumour is very rare. In these cases, you can expect your doctors and nurses to offer treatment which is agreed to be the most appropriate, using guidelines which have been prepared by experts across the country. The Children’s Cancer and Leukaemia Group (CCLG) is an important organisation which helps to produce these guidelines.


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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 After treatment is over, your child will be seen regularly by specialists. This is to check their progress and how well they’re recovering from treatment. It is also to check that they don’t have any long-term problems from treatment. You can contact your child’s specialist doctor or nurse at any time if you have any worries about their health. Long-term side effects Sometimes treatments may cause possible long-term side effects that may develop later. Your child’s oncologist or specialist nurse will explain the possible risk of any long-term effects in your child’s situation. Children are monitored for any long-term problems following treatment so that they can be picked up and managed early on. 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


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up and managed early on. 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 of cancer. Further information and advice if your child has cancer Source: Children's Cancer and Leukemia 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


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feedback Add this page to Info For Me Other health sites Scottish Cancer Network: Patient information Search for cancer support services near you Enter a place or postcode NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats © 2025 NHS 24 – v1.1.1.17852


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


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https://www.nhsinform.scot/illnesses-and-conditions/cancer/cancer-types-in-adults/breast-cancer-female/


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Breast cancer (female) | 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 Breast cancer (female) Breast cancer (female) About breast cancer Symptoms of breast cancer Causes and risk factors of breast cancer Diagnosing breast cancer Treating breast cancer Living with breast cancer Preventing breast cancer About breast cancer Breast cancer is the most common type of cancer in the UK. Most women who get it (8 out of 10) are over 50, but younger women, and in rare cases, men can also get breast cancer. If it’s treated early enough, breast cancer can be prevented from spreading to other parts of the body. The breasts The breasts are made up of fat, connective tissue and thousands of tiny glands called lobules, which produce milk. When a woman has a baby, the milk is delivered to the nipple through tiny tubes called ducts,


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of tiny glands called lobules, which produce milk. When a woman has a baby, the milk is delivered to the nipple through tiny tubes called ducts, which allow her to breastfeed. The body is made up of billions of tiny cells, which usually grow and multiply in an orderly way. New cells are only produced when and where they’re needed. In cancer, this orderly process goes wrong and cells begin to grow and multiply uncontrollably. Read more about the causes of breast cancer Symptoms of breast cancer Breast cancer can have a number of symptoms, but the first noticeable symptom is usually a lump or area of thickened breast tissue. Most breast lumps aren’t cancerous, but it’s always best to have them checked by your doctor. You should also speak to your GP if you notice any of the following: a change in the size or shape of one or both breasts discharge from either of your nipples (which may be streaked with blood) a lump or swelling in either of your armpits dimpling on the skin of your


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discharge from either of your nipples (which may be streaked with blood) a lump or swelling in either of your armpits dimpling on the skin of your breasts a rash on or around your nipple a change in the appearance of your nipple, such as becoming sunken into your breast Breast pain alone isn’t a symptom of breast cancer. Learn more about the symptoms of breast cancer After examining your breasts, your GP may refer you to a specialist breast cancer clinic for further tests. This might include a mammography (breast screening) or a biopsy. Read more about breast screening and how breast cancer is diagnosed Types of breast cancer There are several different types of breast cancer, which can develop in different parts of the breast. Breast cancer is often divided into non-invasive and invasive types. Non-invasive breast cancer Non-invasive breast cancer is also known as cancer or carcinoma in situ. This cancer is found in the ducts of the breast and hasn’t developed the ability to spread


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cancer is also known as cancer or carcinoma in situ. This cancer is found in the ducts of the breast and hasn’t developed the ability to spread outside the breast. This form of cancer rarely shows as a lump in the breast that can be felt, and is usually found on a mammogram. The most common type of non-invasive cancer is ductal carcinoma in situ (DCIS). Invasive breast cancer Invasive cancer has the ability to spread outside the breast, although this doesn’t necessarily mean it has spread. The most common form of breast cancer is invasive ductal breast cancer, which develops in the cells that line the breast ducts. Invasive ductal breast cancer accounts for about 80% of all breast cancer cases and is sometimes called ‘no special type’. Other types of breast cancer Other less common types of breast cancer include invasive lobular breast cancer, which develops in the cells that line the milk-producing lobules, inflammatory breast cancer and Paget’s disease of the breast. It’s possible


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cancer, which develops in the cells that line the milk-producing lobules, inflammatory breast cancer and Paget’s disease of the breast. It’s possible for breast cancer to spread to other parts of the body, usually through the lymph nodes (small glands that filter bacteria from the body) or the bloodstream. If this happens, it’s known as ‘secondary’ or ‘metastatic’ breast cancer. Breast cancer screening There’s a good chance of recovery if breast cancer is detected in its early stages. For this reason, it’s vital that women check their breasts regularly for any changes and always get any changes examined by their GP. Mammographic screening (where X-ray images of the breast are taken) is the best available method of detecting an early breast lesion. However, you should be aware that a mammogram might fail to detect some breast cancers. It might also increase your chances of having extra tests and interventions, including surgery. Women with a higher-than-average risk of developing


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It might also increase your chances of having extra tests and interventions, including surgery. Women with a higher-than-average risk of developing breast cancer may be offered screening and genetic testing for the condition. As the risk of breast cancer increases with age, all women who are 50 to 70 years old are invited for breast cancer screening every 3 years. Women over 70 are also entitled to screening and can arrange an appointment through their GP or local screening unit. Read more about breast screening Treating breast cancer If cancer is detected at an early stage, it can be treated before it spreads to nearby parts of the body. Breast cancer is treated using a combination of surgery, chemotherapy and radiotherapy. Surgery is usually the first type of treatment you’ll have, followed by chemotherapy or radiotherapy or, in some cases, hormone or biological treatments. The type of surgery and the treatment you have afterwards will depend on the type of breast cancer you have.


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cases, hormone or biological treatments. The type of surgery and the treatment you have afterwards will depend on the type of breast cancer you have. Your doctor will discuss the best treatment plan with you. In a small proportion of women, breast cancer is discovered after it’s spread to other parts of the body (metastasis). Secondary cancer, also called advanced or metastatic cancer, isn’t curable, so the aim of treatment is to achieve remission (symptom relief). Read more about treating breast cancer Preventing breast cancer As the causes of breast cancer aren’t fully understood, it’s not possible to know if it can be prevented altogether. If you’re at increased risk of developing the condition, some treatments are available to reduce the risk. Studies have looked at the link between breast cancer and diet and, although there are no definite conclusions, there are benefits for women who maintain a healthy weight, exercise regularly and who have a low intake of saturated fat and


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definite conclusions, there are benefits for women who maintain a healthy weight, exercise regularly and who have a low intake of saturated fat and alcohol. It’s been suggested that regular exercise can reduce your risk of breast cancer by as much as a third. If you’ve been through the menopause, it’s particularly important that you’re not overweight or obese. This is because being overweight or obese causes more oestrogen to be produced, which can increase the risk of breast cancer. Read more about preventing breast cancer Living with breast cancer Being diagnosed with breast cancer can affect daily life in many ways, depending on what stage it’s at and what treatment you’re having. How women cope with their diagnosis and treatment varies from person to person. You can be reassured that there are several forms of support available, if you need it. For example: your family and friends can be a powerful support system you can communicate with other people in the same situation find out


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need it. For example: your family and friends can be a powerful support system you can communicate with other people in the same situation find out as much as possible about your condition don’t try to do too much or overexert yourself make time for yourself Read more about living with breast cancer Symptoms of breast cancer The first symptom of breast cancer most women notice is a lump or an area of thickened tissue in their breast. Most breast lumps (90%) aren’t cancerous, but it’s always best to have them checked by your doctor. You should speak to your GP if you notice any of the following: a lump or area of thickened tissue in either breast a change in the size or shape of one or both breasts discharge from either of your nipples (which may be streaked with blood) a lump or swelling in either of your armpits dimpling on the skin of your breasts a rash on or around your nipple a change in the appearance of your nipple, such as becoming sunken into your breast Breast pain alone


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of your breasts a rash on or around your nipple a change in the appearance of your nipple, such as becoming sunken into your breast Breast pain alone isn’t a symptom of breast cancer. Read further information: Breast Cancer Now: Signs and symptoms of breast cancer Cancer Research UK: Symptoms of breast cancer Macmillan Cancer Support: Signs and symptoms of breast cancer Breast awareness It’s important to be breast aware, so you can pick up any changes as soon as possible. Get to know what is normal for you. For instance, your breasts may look or feel different at different times of your life. This will make it much easier to spot potential problems. Read further information: Breast Cancer Now: Touch, Look, Check Breast Cancer Now: Signs and symptoms of breast cancer Causes and risk factors of breast cancer The causes of breast cancer aren’t fully understood, making it difficult to say why one woman may develop breast cancer and another may not. However, there are risk factors that are


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fully understood, making it difficult to say why one woman may develop breast cancer and another may not. However, there are risk factors that are known to affect your likelihood of developing breast cancer. Some of these you can’t do anything about, but there are some you can change. Age The risk of developing breast cancer increases with age. The condition is most common among women over 50 who have been through the menopause. About 8 out of 10 cases of breast cancer occur in women over 50. All women who are 50 to 70 years of age should be screened for breast cancer every 3 years as part of the NHS Breast Screening Programme. Women over the age of 70 are still eligible to be screened and can arrange this through their GP or local screening unit. Read more about breast screening Family history If you have close relatives who have had breast cancer or ovarian cancer, you may have a higher risk of developing breast cancer. However, because breast cancer is the most common cancer in


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breast cancer or ovarian cancer, you may have a higher risk of developing breast cancer. However, because breast cancer is the most common cancer in women, it’s possible for it to occur in more than one family member by chance. Most cases of breast cancer aren’t hereditary (they don’t run in families), but particular genes, known as BRCA1 and BRCA2, can increase your risk of developing both breast and ovarian cancer. It’s possible for these genes to be passed on from a parent to their child. A third gene (TP53) is also associated with an increased risk of breast cancer. If you have, for example, 2 or more close relatives from the same side of your family, such as your mother, sister or daughter, who have had breast cancer under the age of 50, you may be eligible for surveillance for breast cancer or for genetic screening to look for the genes that make developing breast cancer more likely. If you’re worried about your family history of breast cancer, discuss it with your GP. Read


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the genes that make developing breast cancer more likely. If you’re worried about your family history of breast cancer, discuss it with your GP. Read about predictive genetic tests for cancer risk genes Previous diagnosis of breast cancer If you’ve previously had breast cancer or early non-invasive cancer cell changes in breast ducts, you have a higher risk of developing it again, either in your other breast or in the same breast again. Previous benign breast lump A benign breast lump doesn’t mean you have breast cancer, but certain types of lump may slightly increase your risk of developing it. Certain benign changes in your breast tissue, such as atypical ductal hyperplasia (cells growing abnormally in ducts), or lobular carcinoma in situ (abnormal cells inside your breast lobes), can make getting breast cancer more likely. Breast density Your breasts are made up of thousands of tiny glands (lobules), which produce milk. This glandular tissue contains a higher concentration of


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density Your breasts are made up of thousands of tiny glands (lobules), which produce milk. This glandular tissue contains a higher concentration of breast cells than other breast tissue, making it denser. Women with dense breast tissue may have a higher risk of developing breast cancer because there are more cells that can become cancerous. Dense breast tissue can also make a breast scan (mammogram) difficult to read, because it makes any lumps or areas of abnormal tissue harder to spot. Younger women tend to have denser breasts. As you get older, the amount of glandular tissue in your breasts decreases and is replaced by fat, so your breasts become less dense. Exposure to oestrogen The female hormone, oestrogen, can sometimes stimulate breast cancer cells and cause them to grow. The ovaries, where your eggs are stored, begin to produce oestrogen when you start puberty, to regulate your periods. Your risk of developing breast cancer may rise slightly with the amount of oestrogen your


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oestrogen when you start puberty, to regulate your periods. Your risk of developing breast cancer may rise slightly with the amount of oestrogen your body is exposed to. For example, if you started your periods at a young age and experienced the menopause at a late age, you’ll have been exposed to oestrogen over a longer period of time. In the same way, not having children, or having children later in life, may slightly increase your risk of developing breast cancer because your exposure to oestrogen is uninterrupted by pregnancy. Being overweight or obese If you’ve experienced the menopause and are overweight or obese, you may be more at risk of developing breast cancer. This is thought to be linked to the amount of oestrogen in your body, because being overweight or obese after the menopause causes more oestrogen to be produced. Being tall If you’re taller than average, you’re more likely to develop breast cancer than someone who’s shorter than average. The reason for this isn’t


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tall If you’re taller than average, you’re more likely to develop breast cancer than someone who’s shorter than average. The reason for this isn’t fully understood, but it may be due to interactions between genes, nutrition and hormones. Alcohol Your risk of developing breast cancer can increase with the amount of alcohol you drink. Radiation Certain medical procedures that use radiation, like X-rays and computerised tomography (CT) scans, may slightly increase your risk of developing breast cancer. If you had radiotherapy to your chest area for Hodgkin lymphoma when you were a child, you should have already received a written invitation from the Department of Health for a consultation with a specialist to discuss your increased risk of developing breast cancer. Speak to your GP if you weren’t contacted, or if you didn’t attend a consultation. If you currently need radiotherapy for Hodgkin lymphoma, your specialist should discuss the risk of breast cancer before your treatment begins.


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If you currently need radiotherapy for Hodgkin lymphoma, your specialist should discuss the risk of breast cancer before your treatment begins. Hormone replacement therapy (HRT) Hormone replacement therapy (HRT) is associated with a slightly increased risk of developing breast cancer. Both combined HRT and oestrogen-only HRT can increase your risk of developing breast cancer, although the risk is slightly higher if you take combined HRT. Read further information: Breast Cancer Now: Breast cancer causes Macmillan Cancer Support: Risk factors for breast cancer Diagnosing breast cancer If you have suspected breast cancer, either because of your symptoms or because your mammogram has shown an abnormality, you’ll be referred to a specialist breast clinic for further tests. What to expect at the breast clinic The tests you’ll receive at the breast clinic depend on your current symptoms, your age, and the results of the initial examination you’ll have when you arrive. Many people don’t need


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clinic depend on your current symptoms, your age, and the results of the initial examination you’ll have when you arrive. Many people don’t need any further tests after the initial examination. Most of the time you can expect to spend up to 2 hours at the breast clinic. Mammogram and breast ultrasound If you have symptoms and have been referred by your GP, you’ll meet a specialist who’ll examine you to determine if you need further tests. If you’re under 40 years of age, the specialist may suggest you only have a breast ultrasound scan. This is because younger women have denser breasts, which means a mammogram isn’t as effective as an ultrasound for diagnosing breast disease. If you have a mammogram, it will produce an X-ray of your breasts. You may also need an ultrasound scan. Ultrasound uses high-frequency sound waves to produce an image of the inside of your breasts, showing any lumps or abnormalities. Your doctor may also suggest a breast ultrasound if they need to know whether a


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of the inside of your breasts, showing any lumps or abnormalities. Your doctor may also suggest a breast ultrasound if they need to know whether a lump in your breast is solid or contains liquid. Read more about breast screening Biopsy A biopsy is where a sample of tissue cells is taken from your breast and tested to see if it’s cancerous. You may also need a scan and a needle test on lymph nodes in your armpit (axilla) to see whether these are also affected. Biopsies can be taken in different ways, and the type you have will depend on what your doctor knows about your condition. Different methods of carrying out a biopsy are discussed below. Needle aspiration may be used to test a sample of your breast cells for cancer or to drain a benign cyst (a small fluid-filled lump). Your doctor will use a small needle to extract a sample of cells, without removing any tissue. Needle biopsy is the most common type of biopsy. A sample of tissue is taken from a lump in your breast using a large


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without removing any tissue. Needle biopsy is the most common type of biopsy. A sample of tissue is taken from a lump in your breast using a large needle. You’ll have a local anaesthetic, which means you’ll be awake during the procedure, but your breast will be numb. Your doctor may suggest that you have a guided needle biopsy (usually guided by ultrasound or X-ray, but sometimes MRI is used) to obtain a more precise and reliable diagnosis of cancer and to distinguish it from any non-invasive change, particularly ductal carcinoma in situ (DCIS). Vacuum-assisted biopsy, also known as a mammotome biopsy, is another type of biopsy. During the procedure, a needle is attached to a gentle suction tube, which helps to obtain the sample and clear any bleeding from the area. Read further information: Breast Cancer Now: What happens at a breast clinic appointment? Breast Cancer Now: Your pathology results Macmillan Cancer Support: Breast cancer Further tests for breast cancer If a diagnosis of


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appointment? Breast Cancer Now: Your pathology results Macmillan Cancer Support: Breast cancer Further tests for breast cancer If a diagnosis of breast cancer is confirmed, more tests will be needed to determine the stage and grade of the cancer, and to work out the best method of treatment. If your cancer was detected through the NHS Breast Screening Programme, you’ll have further tests in the screening centre before being referred for treatment. Scans and X-rays Computerised tomography (CT) scans, or chest X-ray and liver ultrasound scans, may be needed to check whether the cancer has spread to your lungs or liver. An MRI scan of the breast may be needed to clarify or to assess the extent of the condition within the breast. If your doctor thinks that the cancer could have spread to your bones, you may need a bone scan. Before having a bone scan, a substance containing a small amount of radiation, known as an isotope, will be injected into a vein in your arm. This will be absorbed


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a bone scan, a substance containing a small amount of radiation, known as an isotope, will be injected into a vein in your arm. This will be absorbed into your bone if it’s been affected by cancer. The affected areas of bone will show up as highlighted areas on the bone scan, which is carried out using a special camera. Tests to determine specific types of treatment You’ll also need tests that show whether the cancer will respond to specific types of treatment. The results of these tests can give your doctors a more complete picture of the type of cancer you have and how best to treat it. The types of test you could be offered are discussed below. In some cases, breast cancer cells can be stimulated to grow by hormones that occur naturally in your body, such as oestrogen and progesterone. If this is the case, the cancer may be treated by stopping the effects of the hormones, or by lowering the level of these hormones in your body. This is known as ‘hormone therapy’. During a hormone


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stopping the effects of the hormones, or by lowering the level of these hormones in your body. This is known as ‘hormone therapy’. During a hormone receptor test, a sample of cancer cells will be taken from your breast and tested to see if they respond to either oestrogen or progesterone. If the hormone is able to attach to the cancer cells (using a hormone receptor), they’re known as ‘hormone receptor positive’. While hormones can encourage the growth of some types of breast cancer, other types are stimulated by a protein called human epidermal growth factor receptor 2 (HER2). These types of cancer can be diagnosed using a HER2 test, and treated with medication to block the effects of HER2. This is known as ‘biological’ or ‘targeted’ therapy. Stage and grade of breast cancer Stage of breast cancer When your breast cancer is diagnosed, the doctors will give it a stage. The stage describes the size of the cancer and how far it has spread. Ductal carcinoma in situ (DCIS) is sometimes


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the doctors will give it a stage. The stage describes the size of the cancer and how far it has spread. Ductal carcinoma in situ (DCIS) is sometimes described as stage 0. Other stages of breast cancer describe invasive breast cancer: stage 1 – the tumour measures less than 2cm, the lymph nodes in the armpit aren’t affected, and there are no signs that the cancer has spread elsewhere in the body stage 2 – the tumour measures 2 to 5cm or the lymph nodes in the armpit are affected, or both, and there are no signs that the cancer has spread elsewhere in the body stage 3 – the tumour measures 2 to 5cm and may be attached to structures in the breast, such as skin or surrounding tissues, the lymph nodes in the armpit are affected but there are no signs that the cancer has spread elsewhere in the body stage 4 – the tumour is of any size and the cancer has spread to other parts of the body (metastasis) This is a simplified guide. Each stage is divided into further categories: A, B and C. If


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cancer has spread to other parts of the body (metastasis) This is a simplified guide. Each stage is divided into further categories: A, B and C. If you’re not sure what stage you have, ask your doctor. TNM staging system The TNM staging system may also be used to describe breast cancer, as it can provide accurate information about the diagnosis. 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. Grade of breast cancer The grade describes the appearance of the cancer cells. low grade (G1) – the cells, although abnormal, appear to be growing slowly medium grade (G2) – the cells look more abnormal than low-grade cells high grade (G3) – the cells look even more abnormal and are more likely to grow quickly Read further information: Cancer Research UK: TNM staging for breast cancer Cancer Research UK: Stages and grades of breast cancer Treating breast cancer


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further information: Cancer Research UK: TNM staging for breast cancer Cancer Research UK: Stages and grades of breast cancer Treating breast cancer Surgery is usually the first type of treatment for breast cancer. The type of surgery you undergo will depend on the type of breast cancer you have. Surgery is usually followed by chemotherapy or radiotherapy or, in some cases, hormone or biological treatments. Again, the treatment you’ll have will depend on your type of breast cancer. Your doctor will discuss the most suitable treatment plan with you. Chemotherapy or hormone therapy will sometimes be the first treatment. Secondary breast cancer Most breast cancers are discovered in the condition’s early stages. However, a small proportion of women discover that they have breast cancer after it’s spread to other parts of the body (known as metastasis). If this is the case, the type of treatment you have may be different. Secondary cancer, also called ‘advanced’ or ‘metastatic’ cancer,


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metastasis). If this is the case, the type of treatment you have may be different. Secondary cancer, also called ‘advanced’ or ‘metastatic’ cancer, isn’t curable and treatment aims to achieve remission (where the cancer shrinks or disappears, and you feel normal and able to enjoy life to the full). Read further information about secondary breast cancer Surgery There are 2 main types of breast cancer surgery. They are: surgery to remove the cancerous lump (tumour), known as breast-conserving surgery surgery to remove the whole breast, which is called a mastectomy In many cases, a mastectomy can be followed by reconstructive surgery to try to recreate a bulge to replace the breast that was removed. Studies have shown that breast-conserving surgery followed by radiotherapy is as successful as total mastectomy at treating early-stage breast cancer. Breast-conserving surgery Breast-conserving surgery ranges from a lumpectomy or wide local excision, where just the tumour and a little


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cancer. Breast-conserving surgery Breast-conserving surgery ranges from a lumpectomy or wide local excision, where just the tumour and a little surrounding breast tissue is removed, to a partial mastectomy or quadrantectomy, where up to a quarter of the breast is removed. If you have breast-conserving surgery, the amount of breast tissue you have removed will depend on the: type of cancer you have size of the tumour and where it is in your breast amount of surrounding tissue that needs to be removed size of your breasts Your surgeon will always remove an area of healthy breast tissue around the cancer, which will be tested for traces of cancer. If there’s no cancer present in the healthy tissue, there’s less chance that the cancer will reoccur. If cancer cells are found in the surrounding tissue, more tissue may need to be removed from your breast. After having breast-conserving surgery, you will usually be offered radiotherapy to destroy any remaining cancer cells. Mastectomy A


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your breast. After having breast-conserving surgery, you will usually be offered radiotherapy to destroy any remaining cancer cells. Mastectomy A mastectomy is the removal of all the breast tissue, including the nipple. If there are no obvious signs that the cancer has spread to your lymph nodes, you may have a mastectomy, where your breast is removed, along with a sentinel lymph node biopsy. If the cancer has spread to your lymph nodes, you will probably need more extensive removal (clearance) of lymph nodes from the axilla (under your arm). Reconstruction Breast reconstruction is surgery to make a new breast shape that looks as much as possible like your other breast. Reconstruction can be carried out at the same time as a mastectomy (immediate reconstruction), or it can be carried out later (delayed reconstruction). It can be done either by inserting a breast implant or by using tissue from another part of your body to create a new breast. Read further information about breast


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either by inserting a breast implant or by using tissue from another part of your body to create a new breast. Read further information about breast reconstruction Lymph node surgery To find out if the cancer has spread, a procedure called a sentinel lymph node biopsy may be carried out. The sentinel lymph nodes are the first lymph nodes that the cancer cells reach if they spread. They’re part of the lymph nodes under the arm (axillary lymph nodes). The position of the sentinel lymph nodes varies, so they’re identified using a combination of a radioisotope and a blue dye. The sentinel lymph nodes are examined in the laboratory to see if there are any cancer cells present. This provides a good indicator of whether the cancer has spread. If there are cancer cells in the sentinel nodes, you may need further surgery to remove more lymph nodes from under the arm. Radiotherapy Radiotherapy uses controlled doses of radiation to kill cancer cells. It’s usually given after surgery and


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nodes from under the arm. Radiotherapy Radiotherapy uses controlled doses of radiation to kill cancer cells. It’s usually given after surgery and chemotherapy to kill any remaining cancer cells. If you need radiotherapy, your treatment will begin about a month after your surgery or chemotherapy, to give your body a chance to recover. You’ll probably have radiotherapy sessions 3 to 5 days a week, for 3 to 6 weeks. Each session will only last a few minutes. The type of radiotherapy you have will depend on your cancer and surgery type. Some women may not need to have radiotherapy at all. The types available are: breast radiotherapy – after breast-conserving surgery, radiation is applied to the whole of the remaining breast tissue chest wall radiotherapy – after a mastectomy, radiotherapy is applied to the chest wall breast boost – some women may be offered a boost of high-dose radiotherapy in the area where the cancer was removed; however, the boost may affect the appearance of the


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women may be offered a boost of high-dose radiotherapy in the area where the cancer was removed; however, the boost may affect the appearance of the breast, particularly if you have large breasts, and can sometimes have other side effects, including hardening of the breast tissue (fibrosis) radiotherapy to the lymph nodes – where radiotherapy is aimed at the armpit (axilla) and the surrounding area to kill any cancer that may be present in the lymph nodes The side effects of radiotherapy include: irritation and darkening of the skin on your breast, which may lead to sore, red, weepy skin fatigue (extreme tiredness) lymphoedema (excess fluid build-up in your arm caused by blockage of the lymph nodes under your arm) Read further information about radiotherapy for breast cancer Chemotherapy Chemotherapy involves using anti-cancer (cytotoxic) medication to kill the cancer cells. It’s usually used after surgery to destroy any cancer cells that haven’t been removed. This is called adjuvant


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medication to kill the cancer cells. It’s usually used after surgery to destroy any cancer cells that haven’t been removed. This is called adjuvant chemotherapy. In some cases, you may have chemotherapy before surgery, which is often used to shrink a large tumour. This is called neo-adjuvant chemotherapy. Several different medications are used for chemotherapy and three are often given at once. The choice of medication and the combination will depend on the type of breast cancer you have and how much it’s spread. Chemotherapy is usually given as an outpatient treatment, which means you won’t have to stay in hospital overnight. The medications are usually given through a drip straight into the blood through a vein. In some cases, you may be given tablets that you can take at home. You may have chemotherapy sessions once every 2 to 3 weeks, over a period of 4 to 8 months, to give your body a rest in between treatments. The main side effects of chemotherapy are caused by their influence


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over a period of 4 to 8 months, to give your body a rest in between treatments. The main side effects of chemotherapy are caused by their influence on normal, healthy cells, such as immune cells. Side effects include: infections loss of appetite nausea and vomiting tiredness hair loss sore mouth Many side effects can be prevented or controlled with medicines that your doctor can prescribe. Chemotherapy medication can also stop the production of oestrogen in your body, which is known to encourage the growth of some breast cancers. If you haven’t experienced the menopause, your periods may stop while you’re undergoing chemotherapy treatment. After you’ve finished the course of chemotherapy, your ovaries should start producing oestrogen again. However, this doesn’t always happen and you may enter an early menopause. This is more likely in women over 40 years old, because they’re closer to menopausal age. Your doctor will discuss with you the impact that any treatment will have on your


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women over 40 years old, because they’re closer to menopausal age. Your doctor will discuss with you the impact that any treatment will have on your fertility. Chemotherapy for secondary breast cancer If your breast cancer has spread beyond the breast and lymph nodes to other parts of your body, chemotherapy won’t cure the cancer, but it may shrink the tumour, relieve your symptoms and help lengthen your life. Read further information about chemotherapy for breast cancer Hormone treatment Some breast cancers are stimulated to grow by the hormones oestrogen or progesterone, which are found naturally in your body. These types of cancer are known as hormone-receptor-positive cancers. Hormone therapy works by lowering the levels of hormones in your body or by stopping their effects. The type of hormone therapy you’ll have will depend on the stage and grade of your cancer, which hormone it’s sensitive to, your age, whether you’ve experienced the menopause and what other type of treatment


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stage and grade of your cancer, which hormone it’s sensitive to, your age, whether you’ve experienced the menopause and what other type of treatment you’re having. You’ll probably have hormone therapy after surgery and chemotherapy, but it’s sometimes given before surgery to shrink a tumour, making it easier to remove. Hormone therapy may be used as the only treatment for breast cancer if your general health prevents you from having surgery, chemotherapy or radiotherapy. In most cases, you’ll need to take hormone therapy for up to five years after having surgery. If your breast cancer isn’t sensitive to hormones, hormone therapy will have no effect. Tamoxifen Tamoxifen stops oestrogen from binding to oestrogen-receptor-positive cancer cells. It’s taken every day as a tablet or liquid. It can cause several side effects, including: tiredness changes to your periods nausea and vomiting hot flushes aching joints headaches weight gain Aromatase inhibitors If you’ve experienced the


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tiredness changes to your periods nausea and vomiting hot flushes aching joints headaches weight gain Aromatase inhibitors If you’ve experienced the menopause, you may be offered an aromatase inhibitor. This type of medication works by blocking aromatase, a substance that helps produce oestrogen in the body after the menopause. Before the menopause, oestrogen is made by the ovaries. Three aromatase inhibitors may be offered. These are anastrozole, exemestane and letrozole. These are taken as a tablet once a day. Side effects include: hot flushes and sweats lack of interest in sex (loss of libido) nausea and vomiting tiredness aching joints and bone pain headaches skin rashes Ovarian ablation or suppression In women who haven’t experienced the menopause, oestrogen is produced by the ovaries. Ovarian ablation or suppression stops the ovaries working and producing oestrogen. Ablation can be carried out using surgery or radiotherapy. It stops the ovaries working permanently and means


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working and producing oestrogen. Ablation can be carried out using surgery or radiotherapy. It stops the ovaries working permanently and means you’ll experience the menopause early. Ovarian suppression involves using a medication called goserelin, which is a luteinising hormone-releasing hormone agonist (LHRHa). Your periods will stop while you’re taking it, although they should start again once your treatment is complete. If you’re approaching the menopause (around the age of 50), your periods may not start again after you stop taking goserelin. Goserelin is taken as an injection once a month and can cause menopausal side effects, including: hot flushes and sweats mood swings trouble sleeping Read further information about hormone therapy Biological therapy (targeted therapy) Some breast cancers are stimulated to grow by a protein called human epidermal growth factor receptor 2 (HER2). These cancers are called HER2-positive. Biological therapy works by stopping the effects of HER2


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human epidermal growth factor receptor 2 (HER2). These cancers are called HER2-positive. Biological therapy works by stopping the effects of HER2 and by helping your immune system to fight off cancer cells. If you have high levels of the HER2 protein and are able to have biological therapy, you’ll probably be prescribed a medicine called trastuzumab. Trastuzumab, also known by the brand name Herceptin, is usually used after chemotherapy. Trastuzumab Trastuzumab is a type of biological therapy known as a monoclonal antibody. Antibodies occur naturally in your body and are made by your immune system to destroy harmful cells, such as viruses and bacteria. The trastuzumab antibody targets and destroys cancer cells that are HER2-positive. Trastuzumab is usually given intravenously, through a drip. It’s also sometimes available as an injection under the skin (a subcutaneous injection). You will have the treatment in hospital. Each treatment session takes up to one hour and the number of


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under the skin (a subcutaneous injection). You will have the treatment in hospital. Each treatment session takes up to one hour and the number of sessions you need will depend on whether you have early or more advanced breast cancer. On average, you’ll need a session once every three weeks for early breast cancer, and weekly sessions if your cancer is more advanced. Trastuzumab can cause side effects, including heart problems. This means that it’s not suitable if you have a heart problem, such as angina, uncontrolled high blood pressure (hypertension) or heart valve disease. If you need to take trastuzumab, you’ll have regular tests on your heart to make sure it’s not causing any problems. Other side effects of trastuzumab may include: an initial allergic reaction to the medication, which can cause nausea, wheezing, chills and fever diarrhoea tiredness aches and pains Clinical trials A great deal of progress has been made in breast cancer treatment, and more women now live longer and


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tiredness aches and pains Clinical trials A great deal of progress has been made in breast cancer treatment, and more women now live longer and have fewer side effects from treatment. These advances were discovered in clinical trials, where new treatments and treatment combinations are compared with standard ones. All cancer trials in the UK are carefully overseen to ensure they’re worthwhile and safely conducted. In fact, participants in clinical trials can do better overall than those in routine care. If you’re asked to take part in a trial, you’ll be given an information sheet and, if you want to take part, you’ll be asked to sign a consent form. You can refuse or withdraw from a clinical trial without it affecting your care. Read further information: Breast Cancer Now: Clinical trials Against Breast Cancer: Our research Psychological help Dealing with cancer can be a huge challenge, for both patients and their families. It can cause emotional and practical difficulties. Many women


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help Dealing with cancer can be a huge challenge, for both patients and their families. It can cause emotional and practical difficulties. Many women have to cope with the removal of part or all of a breast, which can be very upsetting. It often helps to talk about your feelings or other difficulties with a trained counsellor or therapist. You can ask for this kind of help at any stage of your illness. There are various ways to find help and support. Your hospital doctor, specialist nurse or GP can refer you to a counsellor. If you’re feeling depressed, talk to your GP. A course of antidepressant drugs may help, or your GP can arrange for you to see a counsellor or psychotherapist. It can help to talk to someone who’s been through the same thing as you. Many organisations have helplines and online forums. They can also put you in touch with other people who’ve had cancer treatment. Read further information: Breast Cancer Now: Support for you Macmillan Cancer Support: Online community


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other people who’ve had cancer treatment. Read further information: Breast Cancer Now: Support for you Macmillan Cancer Support: Online community Complementary therapies Complementary therapies are holistic therapies that can promote physical and emotional wellbeing. They’re given alongside conventional treatments and include relaxation techniques, massage, aromatherapy and acupuncture. Complementary therapy can help some women cope with diagnosis and treatment, and provide a break from the treatment plan. Your hospital or breast unit may be able to provide access to complementary therapies or suggest where you can get them. It’s important to speak to your breast cancer specialist nurse about any complementary therapy you wish to use, to make sure it doesn’t interfere with your conventional treatment. Read further information about complementary therapies Living with breast cancer Recovery Most women with breast cancer have an operation as part of their treatment. Getting back to


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therapies Living with breast cancer Recovery Most women with breast cancer have an operation as part of their treatment. Getting back to normal after surgery can take some time. It’s important to take things slowly and give yourself time to recover. During this time, avoid lifting things – for example, children or heavy shopping bags – and avoid heavy housework. You may also be advised not to drive. Some other treatments, particularly radiotherapy and chemotherapy, can make you very tired. You may need to take a break from some of your normal activities for a while. Don’t be afraid to ask for practical help from family and friends. Follow-up After your treatment has finished, you’ll be invited for regular check-ups, usually every 3 months for the first year. If you’ve had early breast cancer, your healthcare team will agree a care plan with you after your treatment has finished. This plan contains the details of your follow-up. You will receive a copy of the plan, which will also be


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with you after your treatment has finished. This plan contains the details of your follow-up. You will receive a copy of the plan, which will also be sent to your GP. During the check-up, your doctor will examine you and may carry out blood tests or X-rays to see how your cancer is responding to treatment. You should also be offered a mammogram every year for the first 5 years after your treatment. Long-term complications Although it’s rare, your treatment for breast cancer may cause new problems, such as: pain and stiffness in your arms and shoulders may occur after surgery, and the skin in these areas may be tight lymphoedema (a build-up of excess lymph fluid which causes swelling) – this may occur if surgery or radiotherapy damages the lymphatic drainage system in the armpit Talk to your healthcare team if you experience these or any other long-term effects of treatment. Read further information: Breast Cancer Now: Life after treatment Breast Cancer Now: Lymphoedema Cancer Research


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long-term effects of treatment. Read further information: Breast Cancer Now: Life after treatment Breast Cancer Now: Lymphoedema Cancer Research UK: Follow up after breast cancer treatment Your body and breasts after treatment Dealing with changes to your body A diagnosis of breast cancer may change how you think about your body. All women react differently to the bodily changes that happen as a result of breast cancer treatment. Some women react positively, but others find it more difficult to cope. It’s important to give yourself time to come to terms with any changes to your body. Read further information: Breast Cancer Now: Coping with breast cancer emotionally healthtalk: Body image and breast cancer Macmillan Cancer Support: Changes to your appearance and body image Early menopause Although most cases of breast cancer occur in women over 50 who have experienced the menopause, some younger women have to cope with early menopause brought on by cancer treatment. Symptoms can


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women over 50 who have experienced the menopause, some younger women have to cope with early menopause brought on by cancer treatment. Symptoms can include hot flushes, vaginal dryness and loss of sexual desire. Talk to your healthcare team about any symptoms you have and they’ll be able to help. Read further information: Breast Cancer Now: Fertility and breast cancer treatment Cancer Research UK: Breast cancer and menopausal symptoms Macmillan: Menopausal symptoms and cancer treatment Prosthesis A breast prosthesis is an artificial breast, which can be worn inside your bra to replace the breast that’s been removed. Soon after a mastectomy, you’ll be given a lightweight foam breast to wear until the area affected by surgery or radiotherapy has healed. After it’s healed, you’ll be offered a silicone prosthesis. Prostheses come in many different shapes and sizes, and you should be able to find one that suits you. Read further information: Breast Cancer Now: Your body after breast cancer


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shapes and sizes, and you should be able to find one that suits you. Read further information: Breast Cancer Now: Your body after breast cancer treatment Cancer Research UK: False breast shape (prosthesis) after breast cancer surgery Reconstruction If you didn’t have immediate breast reconstruction (carried out at the time of a mastectomy), you can have reconstruction later. This is called a delayed reconstruction. There are 2 main methods of breast reconstruction – reconstruction using your own tissue and reconstruction using an implant. The type that’s most suitable for you will depend on many factors, including the treatment you’ve had, any ongoing treatment and the size of your breasts. Talk to your healthcare team about which reconstruction is suitable for you. Read further information about breast reconstruction Relationships with friends and family It’s not always easy to talk about cancer, either for you or your family and friends. You may sense that some people feel awkward


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friends and family It’s not always easy to talk about cancer, either for you or your family and friends. You may sense that some people feel awkward around you or avoid you. Being open about how you feel and what your family and friends can do to help may put them at ease. However, don’t be afraid to tell them that you need some time to yourself, if that’s what you need. Read further information: Breast Cancer Now: Telling family and friends about your breast cancer Macmillan Cancer Support: Talking about your cancer Healthtalk: How breast cancer affects families Your sex life Breast cancer and its treatment can affect your sex life. It’s common for women to lose interest in sex after breast cancer treatment. Your treatment may leave you feeling very tired. You may feel shocked, confused or depressed about being diagnosed with cancer. You may be upset by the changes to your body or grieve the loss of your breasts or, in some cases, your fertility. It’s understandable that you may not


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may be upset by the changes to your body or grieve the loss of your breasts or, in some cases, your fertility. It’s understandable that you may not feel like having sex while coping with all this. Try to share your feelings with your partner. If you have problems with sex that aren’t getting better with time, you may want to speak to a counsellor or sex therapist. Read further information: Breast Cancer Now: Sex and breast cancer treatment Cancer Research UK: Life after breast cancer surgery Macmillan Cancer Support: Sex and side effects of cancer treatment Money and financial support If you have to reduce or stop work because of your cancer, you may find it difficult to cope financially. If you have cancer or you’re caring for someone with cancer, you may be entitled to financial support, for example: if you have a job but can’t work because of your illness, you’re entitled to Statutory Sick Pay from your employer if you don’t have a job and can’t work because of your illness, you


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because of your illness, you’re entitled to Statutory Sick Pay from your employer if you don’t have a job and can’t work because of your illness, you may be entitled to Employment and Support Allowance if you’re caring for someone with cancer, you may be entitled to Carer’s Allowance you may be eligible for other benefits if you have children living at home, or if you have a low household income Find out what help is available to you as soon as possible. The social worker at your hospital will be able to give you the information you need. Talk to other people Your GP or nurse may be able to answer any questions you have about your cancer or treatment. You may find it helpful to talk to a trained counsellor or psychologist, or to someone at a specialist helpline. Your GP surgery will have information on these. Some people find it helpful to talk to other people who have breast cancer, either at a local support group or in an internet chatroom. Read further information: Breast Cancer


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to talk to other people who have breast cancer, either at a local support group or in an internet chatroom. Read further information: Breast Cancer Now: Support for you Macmillan Cancer Support: Online community Preventing breast cancer As the causes of breast cancer aren’t fully understood, it’s not known if it can be prevented altogether. Some treatments are available to reduce the risk in women who have a higher risk of developing the condition than the general population. Diet and lifestyle Regular exercise and a healthy, balanced diet are recommended for all women because they can help prevent many conditions, including heart disease, diabetes and many forms of cancer. Regular exercise can reduce your risk of developing breast cancer. If you have been through the menopause, it’s particularly important that you’re not overweight or obese. This is because these conditions cause more oestrogen to be produced, which can increase the risk of breast cancer. Breastfeeding Studies have


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obese. This is because these conditions cause more oestrogen to be produced, which can increase the risk of breast cancer. Breastfeeding Studies have shown that women who breastfeed are statistically less likely to develop breast cancer than those who don’t. The reasons aren’t fully understood, but it could be because women don’t ovulate as regularly while they’re breastfeeding and oestrogen levels remain stable. Treatments to reduce your risk If you have an increased risk of developing breast cancer, treatment is available to reduce your risk. Your level of risk is determined by factors such as your age, your family’s medical history and the results of genetic tests. You will usually be referred to a specialist genetics service if it’s thought you have an increased risk of breast cancer. Healthcare professionals working at these services should discuss treatment options with you. The 2 main treatments are surgery to remove the breasts (mastectomy) or medication. Mastectomy A


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services should discuss treatment options with you. The 2 main treatments are surgery to remove the breasts (mastectomy) or medication. Mastectomy A mastectomy is surgery to remove the breasts. It can be used to treat breast cancer and reduce the chances of developing the condition in the small number of women from high-risk families. By removing as much breast tissue as possible, a mastectomy can reduce your risk of breast cancer by up to 90%. However, like all operations, there’s a risk of complications, and having your breasts removed can have a significant effect on your body image and sexual relationships. If you want to, you can usually choose to have breast reconstruction either during the mastectomy operation, or at a later date. During breast reconstruction surgery, your original breast shape is recreated using either breast implants or tissue from elsewhere in your body. An alternative is to use breast prostheses. These are artificial breasts that can be worn inside your


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implants or tissue from elsewhere in your body. An alternative is to use breast prostheses. These are artificial breasts that can be worn inside your bra. Read more about your body and your breasts after treatment Medication In 2013, the National Institute for Health and Care Excellence (NICE) announced that 2 medications, called tamoxifen and raloxifene, would be available on the NHS for women who have an increased risk of developing breast cancer. Either tamoxifen or raloxifene can be used in women who’ve been through the menopause, but only tamoxifen should be used in women who haven’t. These medications may not be suitable if in the past you’ve had blood clots or womb cancer, or if you have an increased risk of developing these problems in the future. Women who’ve already had a mastectomy to remove both breasts won’t be offered these medications, because their risk of developing breast cancer is very small. A course of treatment with tamoxifen or raloxifene will usually involve


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medications, because their risk of developing breast cancer is very small. A course of treatment with tamoxifen or raloxifene will usually involve taking a tablet every day for 5 years. Raloxifene can cause side effects including flu-like symptoms, hot flushes and leg cramps. Side effects of tamoxifen can include hot flushes and sweats, changes to your periods, and nausea and vomiting. Your chances of giving birth to a child with birth defects increase while you’re taking tamoxifen, so you’ll be advised to stop taking it at least 2 months before trying for a baby. The medication can also increase your risk of blood clots, so you should stop taking it 6 weeks before having any planned surgery. Tamoxifen and raloxifene aren’t currently licensed for the purpose of reducing the risk of breast cancer in women with an increased risk of developing the condition. However, they can still be used if you understand the benefits and risks, and your doctor believes the treatment will be helpful.


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the condition. However, they can still be used if you understand the benefits and risks, and your doctor believes the treatment will be helpful. Read further information: Breast Cancer Now: Breast cancer causes Cancer Research UK: Diet and cancer Source: NHS 24 - Opens in new browser window Last updated: 07 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 Breast cancer (male) Other health sites Breast Cancer Now Cancer Research UK: Breast cancer Macmillan Cancer Support: Breast 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


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Bronchiectasis | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotland’s Service Directory 0 Home Illnesses and conditions Lungs and airways Bronchiectasis Bronchiectasis Bronchiectasis is a long-term condition where the airways of the lungs become abnormally widened. It leads to a build-up of mucus (phlegm) that can increase risk of infection. It can affect anyone at any age, but symptoms don’t usually develop until middle age. Symptoms of bronchiectasis The most common symptoms of bronchiectasis include: a persistent cough that usually brings up mucus recurrent chest infections fatigue Symptoms can vary from person to person. They tend to get worse if you have an infection in your lungs. When to get medical advice Phone 111 if: You have bronchiectasis and either: a bluish tinge to the skin and lips confusion a high temperature of 38°C (100.4F) or above rapid breathing (more than 25 breaths a minute)


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either: a bluish tinge to the skin and lips confusion a high temperature of 38°C (100.4F) or above rapid breathing (more than 25 breaths a minute) severe chest pain that makes it too painful to cough and clear your lungs Speak to your GP practice if: you’ve had a cough for more than 3 weeks Diagnosing bronchiectasis Your GP may: ask you about your symptoms ask whether you smoke listen to your lungs with a stethoscope (the lungs of people with bronchiectasis often make a distinctive crackling noise) send you for an X-ray to rule out other conditions If your GP thinks you may have a lung infection, they may take a sample of mucus so it can be checked for bacteria. Referral to a specialist If your GP thinks you may have bronchiectasis, they’ll refer you to a specialist in treating lung conditions for further tests such as: a CT scan – to see if your airways have widened or to see any signs of chronic infection blood tests – to check how well your immune system is working mucus (sputum)


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if your airways have widened or to see any signs of chronic infection blood tests – to check how well your immune system is working mucus (sputum) test – to check for bacteria or fungi throat swab – to look for viruses genetic screening test – where a sample of blood or saliva is checked for the faulty gene that causes cystic fibrosis lung function test – to measure how hard and how quickly you can blow out air from your lungs to check how well they’re working bronchoscopy – a flexible tube with a camera to look into your lungs to look for anything abnormal and to take samples from the airways if a chronic infection is suspected Treatment for bronchiectasis The damage caused to the lungs by bronchiectasis is permanent. But treatment can help your symptoms and stop the damage getting worse. The main treatments include: exercises and special devices to help you clear mucus out of your lungs medication to help improve airflow within the lungs antibiotics to treat any lung infections You


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devices to help you clear mucus out of your lungs medication to help improve airflow within the lungs antibiotics to treat any lung infections You should: stop smoking (if you smoke) have the flu vaccine every year make sure you have had the pneumococcal vaccine to protect against pneumonia make sure you have had the coronavirus (COVID-19) vaccine exercise regularly keep yourself well hydrated aim for a healthy weight Surgery for bronchiectasis is only in rare cases. It’s only used if other treatments haven’t worked, the damage to the lung is localised to one lobe, and you’re otherwise healthy. Exercises There are a range of exercises which can help to remove mucus from your lungs. These are known as airway clearance techniques. They can often help coughing and breathlessness. You can be referred to a physiotherapist who can teach you these techniques. Active cycle of breathing techniques (ACBT) Active cycle of breathing techniques (ACBT) involves you repeating a cycle made up of


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these techniques. Active cycle of breathing techniques (ACBT) Active cycle of breathing techniques (ACBT) involves you repeating a cycle made up of different steps. For example, a period of normal breathing, followed by deep breaths to loosen the mucus and force it up. Then you cough the mucus out. The cycle is then repeated for 20 to 30 minutes. Do not attempt ACBT if you haven’t first been taught the steps by a physiotherapist. Doing it incorrectly could damage your lungs. If you’re otherwise healthy, you’ll probably only need to do ACBT once or twice a day. If you develop a lung infection, you may need to do it more. Postural drainage Changing your position can also make it easier to remove mucus from your lungs. This is known as postural drainage. The steps are usually done with the help of a physiotherapist or carer. Devices There are also handheld devices that can help to remove mucus from your lungs. Generally, they use a combination of vibrations and air pressure to make it


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are also handheld devices that can help to remove mucus from your lungs. Generally, they use a combination of vibrations and air pressure to make it easier to cough out any mucus. Examples of these devices include the Flutter, the RC cornet, the Acapella and the Aerobika. These devices aren’t always available on the NHS. You may have to pay for one yourself. Medication In some cases, medications to make breathing or clearing your lungs easier may be prescribed. Bronchodilators If you have very severe symptoms, you may be prescribed bronchodilator medications. Bronchodilators are medications you breathe in. They help make breathing easier by relaxing the muscles in the lungs. Examples of this type of medication include: beta-2 agonist such as salbutamol, terbutaline, formoterol or salmeterol antimuscarinics such as tiotropium, glycopyrronium or aclidinium Antibiotics If your symptoms are getting worse because of infection, you’ll need to be treated with antibiotics. If you’re well


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or aclidinium Antibiotics If your symptoms are getting worse because of infection, you’ll need to be treated with antibiotics. If you’re well enough to be treated at home, you’ll probably be prescribed 2 to 3 antibiotic tablets a day for 14 days. It’s important to finish the course even if you feel better. Recovering fully from a bronchiectasis exacerbation can take months. If your symptoms are more severe, you may need to go to hospital for antibiotic injections. If you have 3 or more infections in a year, or your symptoms during infection are very severe, you may be given antibiotics on a long-term basis. Nebulised medications Occasionally, medication breathed in through a device called a nebuliser may be recommended. This makes it easier to clear your lungs. Nebulisers have: a face mask or mouthpiece a chamber to change medication into a fine mist a compressor to pump the medication into your lungs Different medications can be given using a nebuliser. For example, salt water


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into a fine mist a compressor to pump the medication into your lungs Different medications can be given using a nebuliser. For example, salt water solutions, which should only be used if prescribed by your healthcare professional. These medications help to reduce the thickness of your mucus so it’s easier to cough out. The medications used with a nebuliser can be provided on prescription. But the nebuliser device itself isn’t always available on the NHS. You may have to pay for a device, but only if it is advised for use by your healthcare professional. What causes bronchiectasis? The cause of bronchiectasis is not fully understood. Widened airways and increased risk of infection can be linked to: previous infections, such as pneumonia or whooping cough problems with the immune system (the body’s defence against infection) having long-term lung conditions (COPD) allergic bronchopulmonary aspergillosis (ABPA) – if you breathe in spores from a fungi that you’re allergic to In most cases


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lung conditions (COPD) allergic bronchopulmonary aspergillosis (ABPA) – if you breathe in spores from a fungi that you’re allergic to In most cases of bronchiectasis, no clear cause can be found. This is known as idiopathic bronchiectasis. Source: Scottish Government - Opens in new browser window Last updated: 27 August 2024 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Don’t include personal information e.g. name, location or any personal health conditions. Email Address e.g. you@example.com Message Maximum of 500 characters Send feedback Add this page to Info For Me Also on NHS inform Quit Your Way Scotland Shortness of breath Other health sites National Congenital Anomaly and Rare Disease Registration Service: Patient leaflet 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


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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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Bulimia nervosa | 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 Eating Disorders Bulimia nervosa Bulimia nervosa Bulimia nervosa (BSL) | Bulimia nervosa (audio) | Bulimia nervosa is a serious eating disorder and mental health condition. People with bulimia can find themselves trapped in a cycle of eating a large amount of food (also called bingeing). They then use methods like vomiting, over exercising or using laxatives to get rid of the food. Symptoms of bulimia nervosa There are some common symptoms of bulimia nervosa. You may experience some or all of these. This includes: bingeing – eating an unusually large amount of food in a short time, this could be as much as or more than what a person might eat in a day purging – trying to reduce the effect of bingeing by attempting to get food out of your body fasting – trying to restrict


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a person might eat in a day purging – trying to reduce the effect of bingeing by attempting to get food out of your body fasting – trying to restrict food intake focus on food – thinking about food all the time, being secretive about food intake or hoarding food organising your life around a shopping, eating and purging cycle having a fear of eating in front of others focusing on your body shape and weight focusing on exercising to burn calories beyond a healthy level wearing baggy clothes to hide your body withdrawing from friends and family difficulty sleeping or sleeping more than usual feeling irritable, low mood or anxiety feeling guilt, shame or despair always checking the ingredients or nutritional labels of food difficulty concentrating For some people bingeing and purging might be a way of trying to cope with overwhelming feelings. Speak to your GP practice and ask for an urgent appointment if: You think you have an eating disorder like bulimia nervosa or are experiencing


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Speak to your GP practice and ask for an urgent appointment if: You think you have an eating disorder like bulimia nervosa or are experiencing symptoms like: collapsing or fainting dizziness significant tiredness or fatigue weakness dehydration muscle spasms pins and needles irregular heartbeat (arrhythmia) chest pains high levels of distress like feeling really upset, agitated and uncomfortable Diagnosing bulimia nervosa When making a diagnosis, your GP will probably ask questions about your eating habits. They could ask: how you feel about your body shape or weight if you make yourself sick after eating if you use other methods of purging or use laxatives if you binge-eat It’s important to answer these questions honestly. Your GP isn’t trying to judge you or catch you out. They just need to accurately assess your symptoms. Your GP may also check your weight and other physical measurements. If this feels frightening, you can request that you are not told your weight BEAT have more


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also check your weight and other physical measurements. If this feels frightening, you can request that you are not told your weight BEAT have more information on planning an appointment, how to talk to your GP and what will happen at an appointment. If you feel like it would help you, you can take a friend or family member to your appointment. It can be difficult to know what the right questions to ask at an appointment are, it’s ok to ask has some ideas that may be helpful. Blood tests and other tests Your GP might check your pulse and blood pressure. Sometimes an electrocardiogram (ECG) may be needed to check how well your heart is working. Your GP may do blood tests to check the level of: fluids in your body chemicals or minerals, like potassium, in your blood Blood tests look for the complications of bulimia nervosa. Even if they come back as ‘normal’, your GP may still refer you to an eating disorder specialist if you’re experiencing bulimia nervosa symptoms. They may also


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come back as ‘normal’, your GP may still refer you to an eating disorder specialist if you’re experiencing bulimia nervosa symptoms. They may also suggest you make a dental appointment as frequent vomiting can harm your dental health. Treatment for bulimia nervosa Before your treatment begins, it’s likely you’ll have an overall assessment of your health. Your GP or another healthcare professional will do this. The assessment will help your healthcare professional plan for your treatment and care. They may assess: your overall health and any medical needs your social situation, like how much support you have from family and friends your mental wellbeing or other mental health concerns any other risks that might affect you whether there are any physical health risks that need urgent treatment Guided self-help For many people, guided self-help, based on a cognitive behavioural approach, can be an effective treatment for bulimia nervosa. Guided self-help is where you work through


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self-help, based on a cognitive behavioural approach, can be an effective treatment for bulimia nervosa. Guided self-help is where you work through information and activities on your own. You’ll have regular support sessions. Activities can include things like worksheets and writing about difficult thoughts and feelings. Eating disorder service Your GP may refer you for treatment to an eating disorder service. An eating disorder service will usually offer a structured programme of treatment which may include physical monitoring, dietetic advice and psychological treatment. Freed has more information about seeking help for an eating disorder. Psychological treatment for adults Cognitive behavioural therapy The main type of psychological treatment for bulimia nervosa is cognitive behavioural therapy (CBT). CBT starts with the idea that thoughts, feelings, and behaviour are linked and affect one another. CBT aims to improve your eating behaviours. It tries to help you see how the ways


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feelings, and behaviour are linked and affect one another. CBT aims to improve your eating behaviours. It tries to help you see how the ways you think, affect how you feel, and what you do. Interpersonal psychotherapy One alternative to CBT is interpersonal psychotherapy (IPT). IPT explores the way your relationships with people close to you impact the way you feel and how to improve these relationships. Other psychological therapies include: integrative cognitive affective therapy schema therapy The psychological therapies matrix for Bulimia Nervosa explains what therapies are most likely to help you based on your needs and the current evidence. Learn more about talking therapies Psychological treatments for children and young people Family Based Treatment (FBT) involves the whole family in solving their child or young person’s eating disorder. During FBT parents and carers are an essential part of the solution and members of the treatment team. CBT may also be used. It can be


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disorder. During FBT parents and carers are an essential part of the solution and members of the treatment team. CBT may also be used. It can be tailored for young people experiencing bulimia nervosa. If these treatments are not suitable then psychodynamic psychotherapy might be offered. This helps you understand how your current feelings and behaviour are shaped by your past experiences. Medication Antidepressants like selective serotonin reuptake inhibitors (SSRIs) may be used to treat bulimia. They can reduce the urges to binge and purge and improve how you feel. The medication will usually take several weeks before it starts to work. You’ll usually start on a low dose. The dose will gradually increase as your body adjusts to the medicine. Very few types of medication are recommended for children and young people below the age of 16. Relapse Recovery from bulimia nervosa can take a long time but treatments are effective for many people. Symptoms may return after treatment. This is


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Relapse Recovery from bulimia nervosa can take a long time but treatments are effective for many people. Symptoms may return after treatment. This is often called a relapse, and is more likely during times of stress. If relapse happens, the approach to getting treatment is the same. The first step is to go to your GP. Using the strategies you found useful before are likely to be helpful. Complications of bulimia nervosa There are physical complications associated with bulimia nervosa. These can include: dental problems – regular vomiting can cause your stomach acid to damage the enamel on your teeth, which can lead to tooth decay repeated vomiting can cause bad breath and a sore throat your skin and hair can become dry and your fingernails can become brittle due to a lack of nutrients your saliva glands can become swollen from frequent vomiting, which makes your face appear rounder than before frequent use of laxatives can damage your bowel muscles, causing permanent constipation


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vomiting, which makes your face appear rounder than before frequent use of laxatives can damage your bowel muscles, causing permanent constipation (finding it difficult to poo) an increased risk of heart problems Frequent vomiting or laxative use can cause: tiredness weakness abnormal heart rhythms kidney damage convulsions (fits) muscle spasms Some of these symptoms are cause by an imbalance in your electrolytes, in particular, low potassium levels. If you have periods, bulimia nervosa can cause them to become unpredictable, or stop altogether. This does not mean bulimia nervosa makes you infertile. While it may be harder to get pregnant while living with bulimia nervosa, you should continue to use birth control if you aren’t planning a pregnancy. If you have diabetes, you’ll need regular health checks to help avoid problems with your eyes or other serious complications. This is particularly important if you have type 1 diabetes. It’s common for people with bulimia nervosa to


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your eyes or other serious complications. This is particularly important if you have type 1 diabetes. It’s common for people with bulimia nervosa to experience other mental health problems like depression. Getting help for bulimia nervosa People with bulimia nervosa can be anxious about seeking treatment but its important to get help as soon as possible. Helping yourself If you have eating problems or think you may have bulimia nervosa, it’s important to seek help as soon as possible. You could start by: talking to someone you trust, like a friend, member of your family or teacher going to see your GP – you may find it helpful to bring someone with you for support Beat has more information about how to prepare for speaking to your GP and what to expect during your appointment. Helping someone else If someone close to you is showing signs of bulimia nervosa, you can offer help and support. You could try talking to them about how they feel, and encourage them to think about getting


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of bulimia nervosa, you can offer help and support. You could try talking to them about how they feel, and encourage them to think about getting help. Try not to put pressure on them or be critical of them, as this could make things worse. You could also offer to help by going with the person to see their GP. You could speak to your own GP or a healthcare professional if you’d like some advice on how to help someone. You could also get help from an online or in person support group for people who have loved ones with eating disorders. Your GP or healthcare professional can help you find services suitable for you. If you’re at school your pastoral care team might also be able to help. Read more about how to support someone with an eating disorder Further support Find information and services that can offer advice and support about eating disorders Source: Scottish Government - Opens in new browser window Last updated: 29 April 2025 How can we improve this page? Help us improve NHS


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disorders Source: Scottish Government - Opens in new browser window Last updated: 29 April 2025 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Don’t include personal information e.g. name, location or any personal health conditions. Email Address e.g. you@example.com Message Maximum of 500 characters Send feedback Other languages and formats Bulimia nervosa (BSL) | Bulimia nervosa (audio) | Bulimia nervosa (BSL) | Bulimia nervosa (audio) | Add this page to Info For Me Also on NHS inform Eating disorders Avoidant restrictive food intake disorder (ARFID) Anorexia nervosa Binge eating disorder (BED) Eating disorder resources How to support someone with an eating disorder Self-esteem self-help guide Other health sites Beat Eating Disorders Cared Scotland FEAST Freed For All Peace Pathway Royal College of Psychiatrists: anorexia and bulimia SupportED Scotland NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback


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Royal College of Psychiatrists: anorexia and bulimia SupportED 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/illnesses-and-conditions/muscle-bone-and-joints/leg-and-foot-problems-and-conditions/bunion-hallux-valgus/


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


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Carcinoid syndrome and carcinoid tumours | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotland’s Service Directory 0 Home Illnesses and conditions Cancer Cancer types in adults Carcinoid syndrome and carcinoid tumours Carcinoid syndrome and carcinoid tumours A carcinoid tumour is a rare cancer of the neuroendocrine system – the body system that produces hormones. The tumour usually grows in the bowels or appendix, but it can also be found in the stomach, pancreas, lung, breast, kidney, ovaries or testicles. It tends to grow very slowly. Carcinoid syndrome is the collection of symptoms some people get when a carcinoid tumour – usually one that has spread to the liver – releases hormones such as serotonin into the bloodstream. Signs and symptoms In the early stages of having a carcinoid tumour, you may not have any symptoms. You may also not have symptoms if the tumour is just in your digestive system, as


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stages of having a carcinoid tumour, you may not have any symptoms. You may also not have symptoms if the tumour is just in your digestive system, as any hormones it produces will be broken down by your liver. If symptoms do develop, they tend to be fairly general and can be easily mistaken for signs of other illnesses. Symptoms may result from both the tumour itself and from any hormones it releases into the bloodstream. Symptoms caused by the tumour Symptoms will depend on where in the body the tumour develops: a bowel carcinoid tumour may cause tummy pain, a blocked bowel (diarrhoea, constipation, feeling or being sick) and bleeding from the bottom (rectal bleeding) a lung carcinoid tumour may cause a cough, which may make you cough up blood, and cause wheezing, breathlessness, chest pain and tiredness a stomach carcinoid tumour may cause pain, weight loss, tiredness and weakness Some tumours may not cause any symptoms and are discovered by chance. For example, an appendix


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may cause pain, weight loss, tiredness and weakness Some tumours may not cause any symptoms and are discovered by chance. For example, an appendix carcinoid tumour may only be found when the appendix is being removed for another reason. Symptoms caused by the hormones (carcinoid syndrome) Typical symptoms of carcinoid syndrome include: diarrhoea, tummy pain and loss of appetite flushing of the skin, particularly the face fast heart rate breathlessness and wheezing These symptoms may come on unexpectedly, as the hormones can be produced by the tumour at any time. Some people may also develop carcinoid heart disease, where the heart valves thicken and stop working properly. There is also a risk of developing a rare but serious reaction called a carcinoid crisis, which involves severe flushing, breathlessness and a drop in blood pressure. What causes carcinoid tumours? It’s not known exactly why carcinoid tumours develop, but it’s thought that most occur by chance. Your chances of


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What causes carcinoid tumours? It’s not known exactly why carcinoid tumours develop, but it’s thought that most occur by chance. Your chances of developing a carcinoid tumour may be increased if you have: a rare family syndrome called multiple endocrine neoplasia type 1 (MEN1) parents or siblings with a carcinoid tumour parents with squamous cell skin cancer, non-Hodgkin’s lymphoma, or cancer of the brain, breast, liver, womb, bladder or kidney conditions called neurofibromatosis or tuberous sclerosis Diagnosing carcinoid tumours A carcinoid tumour may be found incidentally – for example, as a surgeon is removing an appendix. In this case, the tumour will often be caught early and removed along with the appendix, causing no further problems. Otherwise, people usually speak to their GP after they have developed symptoms. A carcinoid tumour may be diagnosed after carrying out a series of scans and tests, which may include measuring the amount of serotonin in your urine and having an


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may be diagnosed after carrying out a series of scans and tests, which may include measuring the amount of serotonin in your urine and having an endoscopy. Treating carcinoid tumours and carcinoid syndrome If the tumour is caught early, it may be possible to completely remove it and cure the cancer altogether. Otherwise, surgeons will remove as much of the tumour as possible (debulking). If the tumour cannot be removed, but it’s not growing or causing symptoms, you may not need treatment straight away – it might just be carefully monitored. If it’s causing symptoms, you may be offered one of the following treatments: injections of medicines called somatostatin analogues, such as octreotide and lanreotide, which can slow down the growth of the tumour radiotherapy to kill some of the cancer cells a procedure to block the blood supply to the tumour (for tumours in the liver), known as hepatic artery embolisation a procedure that uses a heated probe to kill cancer cells (for tumours in


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the tumour (for tumours in the liver), known as hepatic artery embolisation a procedure that uses a heated probe to kill cancer cells (for tumours in the liver), called radiofrequency ablation chemotherapy to shrink the tumour and control your symptoms Symptoms of carcinoid syndrome can be treated with injections of octreotide and lanreotide. You may also be given medication to widen your airways (to relieve wheezing and breathlessness) and anti-diarrhoea medication. What can I do to help myself? There are things you can do yourself to manage some of the symptoms of carcinoid syndrome. Generally, you should avoid triggers of flushing, such as: alcohol large meals spicy foods foods containing the substance tyramine, such as aged cheese and salted or pickled meats stress Some medications, such as selective serotonin reuptake inhibitor (SSRI) antidepressants, may make symptoms worse by further increasing your levels of serotonin – but never stop taking medication without seeking medical


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antidepressants, may make symptoms worse by further increasing your levels of serotonin – but never stop taking medication without seeking medical advice. If you have diarrhoea, it’s important to keep drinking little and often to avoid dehydration. Outlook If the whole tumour can be removed, this may cure the cancer and symptoms altogether. But even if surgeons cannot remove the entire tumour, it usually grows slowly and can be controlled with medication. Overall, people with carcinoid tumours have a good life expectancy compared to many other cancers. Many people remain relatively well and lead active lives, with only occasional symptoms. But as the tumour grows or spreads, it will produce more and more hormones, and it may eventually be difficult to completely control symptoms with medication. You may need further surgery or other treatments. Unfortunately, life expectancy is not as good for cancer that has spread to other parts of your body, because it won’t usually be possible to


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Unfortunately, life expectancy is not as good for cancer that has spread to other parts of your body, because it won’t usually be possible to remove all of it. However, treatment can still control your symptoms and slow down the spread of cancer. Information about you If you have carcinoid syndrome, your clinical team will pass information about you on to the National Congenital Anomaly and Rare Diseases Registration Service (NCARDRS). This helps scientists look for better ways to prevent and treat this condition. You can opt out of the register at any time. Find out more about the register Source: NHS 24 - Opens in new browser window Last updated: 14 October 2024 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Don’t include personal information e.g. name, location or any personal health conditions. Email Address e.g. you@example.com Message Maximum of 500 characters Send feedback Add this page to Info For Me Also on NHS inform


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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 Neuroendocrine tumours Other health sites Cancer Research UK: Carcinoid syndrome Cancer Research UK: Neuroendocrine tumours 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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Catarrh | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotland’s Service Directory 0 Home Illnesses and conditions Lungs and airways Catarrh Catarrh Catarrh is a build-up of mucus (phlegm) in your airways. It usually affects the back of the nose, the throat or the sinuses. It’s often temporary, but some people experience it for months or years. This is known as chronic catarrh. Catarrh is not harmful and there are treatments available. Symptoms of catarrh Catarrh can lead to a: constant need to clear your throat feeling that your throat is blocked blocked or stuffy nose that you can’t clear runny nose feeling of mucus running down the back of your throat persistent cough headache facial pain reduced sense of smell and taste crackling sensation in your ear and some temporary hearing loss These problems can be frustrating to live with. They may affect your sleep, making you feel tired. When to get medical


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some temporary hearing loss These problems can be frustrating to live with. They may affect your sleep, making you feel tired. When to get medical advice Speak to your GP practice if: your catarrh is affecting your daily life you have symptoms of catarrh for more than a few weeks Diagnosing catarrh Your GP may check if there’s a condition causing it like nasal polyps or allergies. You may be referred to a specialist for tests. Treatment for catarrh Catarrh will often pass in a few days or weeks. Treatment from your pharmacist You can ask a pharmacist for: advice about catarrh over-the-counter medications such as decongestants, antihistamines or steroid nasal sprays Find your nearest pharmacy Things you can do to help your symptoms Do stay well hydrated use a saline nasal rinse several times a day – these can be bought from a pharmacy or made at home with half a teaspoon of salt in a pint of boiled water that’s been left to cool avoid things that trigger your symptoms, such as


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or made at home with half a teaspoon of salt in a pint of boiled water that’s been left to cool avoid things that trigger your symptoms, such as allergens or smoky places avoid warm, dry atmospheres, such as places with air conditioning and car heating systems – placing plants or bowls of water in a room may help to keep the air humid What causes catarrh? Catarrh is usually caused by the immune system reacting to an infection or irritation. This causes the lining of your nose and throat to become swollen and produce mucus. This can be triggered by: a cold or other infections hay fever or other types of allergic rhinitis non-allergic rhinitis nasal polyps Treating the underlying condition, if you have one, may help your catarrh. It’s unclear what causes chronic catarrh, but it’s often the result of an allergy or infection. It may be linked to an: abnormality in the way mucus travels within the nose increased sensitivity to mucus in the back of the nose and throat Source: Scottish


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linked to an: abnormality in the way mucus travels within the nose increased sensitivity to mucus in the back of the nose and throat Source: Scottish Government - Opens in new browser window Last updated: 27 August 2024 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Don’t include personal information e.g. name, location or any personal health conditions. Email Address e.g. you@example.com Message Maximum of 500 characters Send feedback Add this page to Info For Me Also on NHS inform Allergic rhinitis Common cold Decongestants Other health sites ENT UK: Catarrh Allergy 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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Cerebral palsy | 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 Cerebral palsy Cerebral palsy Cerebral palsy is a condition caused by either damage to the brain, or abnormal development of the brain. This damage normally occurs before birth or during a child’s early development. Cerebral palsy is not normally progressive in nature. Cerebral palsy usually causes abnormal muscle tone and movement. The main types of abnormal muscle tone are: Spastic cerebral palsy This is the most common type of abnormal muscle tone. Someone with spastic cerebral palsy is likely to experience a tightening of the muscles throughout the body. This tightening can be persistent or intermittent. The amount of stiffness experienced will vary from person to person. Dyskinetic cerebral palsy Individuals with this type of muscle tone may have


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The amount of stiffness experienced will vary from person to person. Dyskinetic cerebral palsy Individuals with this type of muscle tone may have dystonia or more rarely athetosis. This describes a type of abnormal muscle control where the muscles can shift from tight to floppy without warning, resulting in involuntary movements. Ataxic cerebral palsy This is the least common type of cerebral palsy. It can be identified by shaky movement and poor balance. Someone with ataxic cerebral palsy may struggle with fine motor movements and coordination, like writing or using cutlery. They may have a tremor that increases with activity, and struggle with balance. This can make standing or sitting in an upright position difficult. Mixed cerebral palsy Someone with mixed cerebral palsy may have signs of more than one type of abnormal muscle tone at the same time. Symptoms of cerebral palsy The symptoms of cerebral palsy can vary from person to person and are dependent on the type of brain injury


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the same time. Symptoms of cerebral palsy The symptoms of cerebral palsy can vary from person to person and are dependent on the type of brain injury or abnormality. Someone with cerebral palsy may: struggle with movement and balance, and may be unable to walk struggle to speak, and possibly need to use electronic aids have difficulties with eating, drinking and swallowing have problems with their vision experience pain symptoms experience fatigue (tiredness) have problems with their sleep have epilepsy have a learning disability display behavioural problems have bladder control problems have problems with their digestive system (constipation) struggle to control their saliva struggle to process information from their senses A person with cerebral palsy may have secondary symptoms. These are caused by the impact of the condition on their body, rather than directly by cerebral palsy. These can include: tightness in joints and muscles dislocations a change in their physical abilities


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body, rather than directly by cerebral palsy. These can include: tightness in joints and muscles dislocations a change in their physical abilities changes in the amount of pain they experience increased fatigue Causes of cerebral palsy Cerebral palsy is caused by damage to the brain during pregnancy, birth or early development. There are some things that can increase the risk of a child developing cerebral palsy. These include: premature birth (being born early) neonatal encephalopathy (caused by lack of oxygen to the brain in pregnancy or around the time of birth) stroke or bleeding in the baby’s brain during pregnancy or after birth infection during pregnancy or after birth meningitis head injuries It’s not always possible to tell why a child has developed cerebral palsy. A child can develop cerebral palsy despite their parents having done everything right during pregnancy and childbirth. The parents of a child with cerebral palsy are not to blame. Diagnosing cerebral palsy There


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done everything right during pregnancy and childbirth. The parents of a child with cerebral palsy are not to blame. Diagnosing cerebral palsy There isn’t one single test that can diagnose cerebral palsy. Your medical professional will need to see how your child develops over time to make a diagnosis. They may also use tests such as brain scans to confirm the diagnosis. Coping with waiting for a diagnosis Waiting for a diagnosis can be very stressful for parents. It’s natural to feel anxious when your child is unwell. NHS inform has advice on dealing with anxiety and stress, and information on where to go to find support for your mental wellbeing. Read more about mental wellbeing services Most children are diagnosed by two years old. Some children are diagnosed earlier if they’ve spent time in medical settings, for example children who were born premature. To diagnose cerebral palsy, your medical professional will examine your child’s medical history, and how well they can move,


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who were born premature. To diagnose cerebral palsy, your medical professional will examine your child’s medical history, and how well they can move, balance, and react. They may also use scans like an MRI to see if there’s any sign of damage or abnormal development of the brain. Living with cerebral palsy While cerebral palsy is a non-progressive condition (it doesn’t normally get worse over time), it may not stay the same throughout life. Symptoms can change with age, even in adulthood. Contact your GP if: you or your child is experiencing a change in condition you or your child’s symptoms are getting worse Cerebral palsy doesn’t normally shorten life expectancy. People with cerebral palsy often go on to live long, rich and rewarding lives. There are resources and treatments available to help both children and adults with cerebral palsy. Everyone with cerebral palsy will have individual needs and these needs may change over time. Your healthcare professional will help you find


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palsy. Everyone with cerebral palsy will have individual needs and these needs may change over time. Your healthcare professional will help you find treatments and resources that work for you or your child. Physiotherapy Targeted physiotherapy can help you or your child improve and maintain posture, coordination, strength and balance. Physiotherapists may recommend specialist mobility equipment and advise about the use of orthotic splints. Occupational therapy Occupational therapists help people who struggle to complete everyday tasks find new ways of completing them. They can show you or your child how to break down activities into smaller movements, helping build confidence. Occupational therapists also have good knowledge of the medical aids and technologies available to help you or your child. Speech and language therapy If you or your child is struggling to talk, a speech and language therapist can help. They have a range of techniques that can help people improve at talking,


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your child is struggling to talk, a speech and language therapist can help. They have a range of techniques that can help people improve at talking, like helping you or your child learn to shape a sound. Some speech therapists will recommend the use of specialist communication aids. If you or your child is having issues with swallowing, a speech and language therapist can also help by performing an assessment and making recommendations. Orthotics An orthotic device is a piece of equipment that supports a part of the body. This can help improve you or your child’s ability to move and be active. Orthotics can help with a wide range of the physical problems that can be caused by cerebral palsy. Some will only be used for a short period of time, while others may be used throughout you or your child’s entire life. The need for them can also change with time. An orthotist will examine you or your child’s ability to move and make recommendations according to you or your child’s personal


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change with time. An orthotist will examine you or your child’s ability to move and make recommendations according to you or your child’s personal needs. Mental health support for those with cerebral palsy If you have cerebral palsy and need support with your mental health, there are services available through the NHS. Read more about mental health Mental wellbeing support for the parents of children with cerebral palsy Finding out that your child has cerebral palsy can be very overwhelming for parents. You may feel anxious about the future and isolated from other parents. There are resources available from NHS inform that can help you cope with the emotions you’re feeling. If you’re feeling isolated, an online support group might help you feel less alone. Read more about mental wellbeing services Find out more about online support groups for parents of children with cerebral palsy Medication Although medication cannot cure cerebral palsy, some types may help ease some of the


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groups for parents of children with cerebral palsy Medication Although medication cannot cure cerebral palsy, some types may help ease some of the symptoms, like muscle relaxants for those with spastic or dystonic cerebral palsy. Speak to your healthcare provider for further information about medication. Surgery Surgery may be recommended to help with certain symptoms of cerebral palsy. For example, surgery on muscles, bones and nerves can help mobility. Speak to your healthcare provider for further information on surgical options. Read more about support for adults and children living with cerebral palsy Last updated: 12 August 2024 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Don’t include personal information e.g. name, location or any personal health conditions. Email Address e.g. you@example.com Message Maximum of 500 characters Send feedback Add this page to Info For Me Other health sites Cerebral Palsy Scotland NHS inform


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you@example.com Message Maximum of 500 characters Send feedback Add this page to Info For Me Other health sites Cerebral Palsy 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/illnesses-and-conditions/muscle-bone-and-joints/neck-and-back-problems-and-conditions/cervical-spondylosis/


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Cervical spondylosis | 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 Neck and back problems and conditions Cervical spondylosis Cervical spondylosis This information may be useful for those who have been diagnosed with cervical spondylosis. People who are experiencing new or ongoing symptoms should visit their healthcare professional for assessment, diagnosis or treatment. Read more about managing a neck problem What is cervical spondylosis? Cervical spondylosis is the medical term for neck pain caused by age-related changes to bones and tissues. Apart from age, there are several other risk factors that may increase the likelihood of developing cervical spondylosis. These include: lack of exercise or movement sitting in a sedentary position for long periods obesity previous neck injuries or surgery severe arthritis Symptoms


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lack of exercise or movement sitting in a sedentary position for long periods obesity previous neck injuries or surgery severe arthritis Symptoms of cervical spondylosis Many people experience no noticeable symptoms. It’s common to experience some or all of these symptoms including: neck pain stiffness headaches which usually start at the back of the head, just above the neck, and travel over the top to the forehead. Pain usually comes and goes, with flare-ups followed by symptom-free periods. Rarely, it can irritate a nerve in the neck, which can cause symptoms such as pain and or altered sensation in your arm for example pins and needles or numbness. If any of these occur, it’s a good idea to talk to a health care professional. Diagnosing cervical spondylosis In order for cervical spondylosis to be diagnosed you will need an assessment from a healthcare professional. They’ll initially ask you questions about your neck issue and then carry out a physical examination. This may include


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from a healthcare professional. They’ll initially ask you questions about your neck 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. Treatment of cervical spondylosis Cervical spondylosis is a long term condition, and symptoms are often variable from day to day. Many patients have found that managing their symptoms can help improve their quality of life. There are some things you can do to help manage this condition yourself. Read more about exercises for cervical spondylosis Work Cervical spondylosis 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


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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. You should see the biggest change in your symptoms within the first couple of weeks. Most problems should have improved within 6 weeks. If your neck pain hasn’t improved within 6 weeks of following this advice, or if your symptoms get worse at any time, it’s a good idea to talk to a healthcare professional about your symptoms. Read about how to access MSK services 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: 06 February 2025 How can we improve this page? Help us


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Source: NHS 24 MSK Clinical Advisory Group - 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 Exercises for cervical spondylosis How to access MSK services Mental wellbeing Other health sites Pain Association 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/illnesses-and-conditions/muscle-bone-and-joints/chest-and-rib-problems-and-conditions/chest-and-rib-injury/


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Chest infection | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotland’s Service Directory 0 Home Illnesses and conditions Infections and poisoning Chest infection Chest infection Chest infections are common, especially after a cold or flu during autumn and winter. Although most are mild and get better on their own, some can be serious or even life-threatening. Signs and symptoms of a chest infection The main symptoms of a chest infection can include: a persistent cough coughing up yellow or green phlegm (thick mucus), or coughing up blood breathlessness or rapid and shallow breathing wheezing a high temperature (fever) a rapid heartbeat chest pain or tightness feeling confused and disorientated You may also experience more general symptoms of an infection, such as a headache, fatigue, sweating, loss of appetite, or joint and muscle pain. When to get medical advice Phone 999 or go to A&E if: you have


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such as a headache, fatigue, sweating, loss of appetite, or joint and muscle pain. When to get medical advice Phone 999 or go to A&E if: you have severe difficulty breathing – for example, you struggle to speak without pausing, gasping or choking you have severe chest pain in the middle of your chest that isn’t going away – it may feel like pressure, tightness or squeezing you have pain that spreads to your arms, back, neck and jaw you feel more drowsy than usual or find it more difficult to wake up your lips or skin are turning very pale, blue or grey – on brown or black skin this is easier to see on the palms of your hands Contact your GP urgently if you: are more short of breath than usual have pain when breathing in or coughing are feeling confused, dizzy, or lightheaded feel sick or are being sick – for example, you can’t keep food or fluids down are coughing up blood (haemoptysis) have heart palpitations – this may feel like your heart is racing, going too slowly or skipping a


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or fluids down are coughing up blood (haemoptysis) have heart palpitations – this may feel like your heart is racing, going too slowly or skipping a beat or like a fluttering feeling in are peeing less than usual – this can be a sign of dehydration have a very high or low temperature – for example, you feel either hot or cold to touch or you’re shivering If your GP is closed, phone 111. Speak to your GP practice if: you have breathlessness which is not improving you have had a cough for more than 3 weeks you have a fever your symptoms are not improving or they are affecting your daily life Your GP should be able to diagnose you based on your symptoms and by listening to your chest using a stethoscope (a medical instrument used to listen to the heart and lungs). In some cases, further tests – such as a chest X-ray, breathing tests and testing phlegm or blood samples – may be needed. What causes chest infections? A chest infection is an infection of the lungs or airways. The main types


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phlegm or blood samples – may be needed. What causes chest infections? A chest infection is an infection of the lungs or airways. The main types of chest infection are bronchitis and pneumonia. Most bronchitis cases are caused by viruses, whereas most pneumonia cases are due to bacteria. These infections are usually spread when an infected person coughs or sneezes. This launches tiny droplets of fluid containing the virus or bacteria into the air, where they can be breathed in by others. The infections can also be spread to others if you cough or sneeze onto your hand, an object or a surface, and someone else shakes your hand or touches those surfaces before touching their mouth or nose. Certain groups of people have a higher risk of developing serious chest infections, such as: babies and very young children children with developmental problems people who are very overweight elderly people pregnant women people who smoke people with long-term health conditions, such as asthma, heart


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problems people who are very overweight elderly people pregnant women people who smoke people with long-term health conditions, such as asthma, heart disease, diabetes, kidney disease, cystic fibrosis or chronic obstructive pulmonary disease (COPD) people with a weakened immune system – this could be due to a recent illness, a transplant, high-dose steroids, chemotherapy or a health condition, such as an undiagnosed HIV infection Read more about the causes of bronchitis and the causes of pneumonia Caring for your symptoms at home Many chest infections aren’t serious and get better within a few days or weeks. You won’t usually need to see your GP, unless your symptoms suggest you have a more serious infection. While you recover at home, there are things you can do to improve your symptoms. Do get plenty of restdrink lots of fluid to prevent dehydration and to loosen the mucus in your lungs, making it easier to cough uptreat headaches, fever and aches and pains with pain relief such as


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dehydration and to loosen the mucus in your lungs, making it easier to cough uptreat headaches, fever and aches and pains with pain relief such as paracetamol or ibuprofendrink a warm drink of honey and lemon to relieve a sore throat caused by persistent coughingraise your head up with extra pillows while you’re sleeping to make breathing easierstop smoking if you smoke Avoid cough medicines, as there’s little evidence they work. Coughing actually helps you clear the infection more quickly by getting rid of the phlegm from your lungs. Antibiotics aren’t recommended for many chest infections, because they only work if the infection is caused by bacteria, rather than a virus. Your GP will usually only prescribe antibiotics if they think you have pneumonia, or you’re at risk of complications such as fluid building up around the lungs (pleurisy). If there’s a flu outbreak in your local area and you’re at risk of serious infection, your GP may also prescribe antiviral medication. Read more


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If there’s a flu outbreak in your local area and you’re at risk of serious infection, your GP may also prescribe antiviral medication. Read more about treating bronchitis and treating pneumonia Preventing chest infections There are measures you can take to help reduce your risk of developing chest infections and stop them spreading to others. Stop smoking If you smoke, one of the best things you can do to prevent a chest infection is to stop. Smoking damages your lungs and weakens your defences against infection. Read more information and advice about stopping smoking Good hygiene Although chest infections generally aren’t as contagious as other common infections, like flu, you can pass them on to others through coughing and sneezing. Therefore, it’s important to cover your mouth when you cough or sneeze, and to wash your hands regularly. Put tissues in the bin immediately. Alcohol and diet Excessive and prolonged alcohol misuse can weaken your lungs’ natural defences against


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Put tissues in the bin immediately. Alcohol and diet Excessive and prolonged alcohol misuse can weaken your lungs’ natural defences against infections and make you more vulnerable to chest infections. To keep your risk of alcohol-related harm low, the NHS recommends: not regularly drinking more than 14 units of alcohol a week if you drink as much as 14 units a week, it’s best to spread this evenly over 3 or more days if you’re trying to reduce the amount of alcohol you drink, it’s a good idea to have several alcohol-free days each week Regular or frequent drinking means drinking alcohol most weeks. The risk to your health is increased by drinking any amount of alcohol on a regular basis. Eating a healthy, balanced diet can help strengthen the immune system, making you less vulnerable to developing chest infections. Read more about healthy eating and tips on cutting down on alcohol Vaccinations If you’re at an increased risk of chest infections, your GP may recommend being vaccinated


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eating and tips on cutting down on alcohol Vaccinations If you’re at an increased risk of chest infections, your GP may recommend being vaccinated against flu and pneumococcal infections (a bacterium that can cause pneumonia). These vaccinations should help to reduce your chances of getting chest infections in the future. Flu and pneumococcal vaccinations are usually recommended for: babies and young children pregnant women (flu jab only) people aged 65 and over people with long-term health conditions or weakened immune systems Source: NHS 24 - Opens in new browser window Last updated: 18 February 2025 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Don’t include personal information e.g. name, location or any personal health conditions. Email Address e.g. you@example.com Message Maximum of 500 characters Send feedback Add this page to Info For Me Also on NHS inform Chronic obstructive pulmonary disease NHS inform About NHS inform


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of 500 characters Send feedback Add this page to Info For Me Also on NHS inform Chronic obstructive pulmonary 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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Chilblains | 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 Chilblains Chilblains Chilblains are small, itchy swellings on the skin that can appear after you’ve been in the cold. Chilblains can be uncomfortable, but they usually get better on their own within a few weeks. Symptoms of chilblains Chilblains can turn the skin red and may cause a burning or stinging sensation.Source: https://dermnetnz.org/ In severe cases, chilblains can cause the skin to blister.Source: https://dermnetnz.org/ Chilblains most often affect the body’s extremities, such as the toes, fingers, heels, ears and nose. They usually develop several hours after being in the cold. Symptoms of chilblains include: a burning or itching feeling in the affected areas, which can get worse if you go into a warm room swelling the affected skin turning red or dark blue


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burning or itching feeling in the affected areas, which can get worse if you go into a warm room swelling the affected skin turning red or dark blue in severe cases, the surface of the skin breaks, and sores or blisters develop Do not scratch your skin if you have chilblains. It can break easily and become infected. When to get medical advice You do not usually need to see a GP, as chilblains normally get better on their own within a few weeks. Speak to your GP practice if: you have chilblains and your skin has not got any better after 2 to 3 weeks there is pus coming out of your skin your temperature is very high or you feel hot or shivery you keep getting chilblains your chilblains are severe you have diabetes and have chilblains – foot problems can be more serious if you have diabetes Treatment for chilblains Chilblains often get better on their own without treatment. Things you can do to help your symptoms A soothing lotion, such as calamine or witch hazel, can help relieve


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better on their own without treatment. Things you can do to help your symptoms A soothing lotion, such as calamine or witch hazel, can help relieve itching. A pharmacist can give you advice about the right product for you. Find your nearest pharmacy Treatment from your doctor If your chilblains are severe and keep returning, your GP may prescribe a medication called nifedipine. You take nifedipine as a daily tablet or capsule. It works by relaxing the blood vessels, improving your circulation. Nifedipine can help existing chilblains heal, or can be taken to stop them developing. What causes chilblains? Chilblains are caused by an abnormal reaction to the cold. They’re common in the UK because the weather is damp and cold in the winter. Some people develop chilblains that last for several months every winter. When the skin is cold, blood vessels near its surface get narrower. If the skin is then exposed to heat, the blood vessels become wider. If this happens too quickly, blood vessels


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near its surface get narrower. If the skin is then exposed to heat, the blood vessels become wider. If this happens too quickly, blood vessels near the surface of the skin can’t always handle the increased blood flow. Blood can leak into the surrounding tissue, which may cause the swelling and itchiness of chilblains. Who’s more at risk of chilblains? Some people are more at risk of chilblains than others. This includes people with: poor circulation a family history of chilblains regular exposure to cold, damp or draughty conditions a poor diet or low body weight lupus – a long-term condition that causes swelling in the body’s tissues Raynaud’s phenomenon – a common condition that affects the blood supply to certain parts of the body, usually the fingers and toes People who smoke are more at risk of chilblains as nicotine constricts blood vessels. Chilblains can also occur on areas of the feet exposed to pressure. For example, a bunion or a toe that’s squeezed by tight shoes. How to


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vessels. Chilblains can also occur on areas of the feet exposed to pressure. For example, a bunion or a toe that’s squeezed by tight shoes. How to prevent chilblains If you’re more at risk of chilblains, you help prevent them by: staying out of the cold where possible looking after your feet improving your circulation If your skin gets cold, you should warm it up gradually. Heating the skin too quickly – for example, by placing your feet in hot water or near a heater – is one of the main causes of chilblains. Do stop smoking – nicotine causes the blood vessels to constrict, which can make chilblains worse keep active – this helps improve your circulation wear warm clothes and insulate your hands, feet and legs – wearing long johns, long boots, tights, leg warmers or long socks will help wear a clean pair of socks if you get cold feet in bed avoid tight shoes and boots – these can restrict the circulation to your toes and feet moisturise your feet regularly – this stops them drying out


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avoid tight shoes and boots – these can restrict the circulation to your toes and feet moisturise your feet regularly – this stops them drying out and the skin cracking eat at least 1 hot meal during the day – this’ll help warm your whole body, particularly in cold weather warm your shoes on the radiator before you put them on – make sure damp shoes are dry before you wear them; if your feet are already cold, make sure your shoes aren’t too hot to avoid causing chilblains warm your hands before going outdoors – soak them in warm water for several minutes and dry thoroughly, and wear cotton-lined waterproof gloves if necessary; if your hands are already cold, make sure not to warm them up too quickly to avoid causing chilblains keep your house well heated – try to keep at least 1 room in the house warm and avoid draughts if you’re diabetic, regularly check your feet (or ask someone else to do this) – people with diabetes may not be able to feel their feet and could have infected


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regularly check your feet (or ask someone else to do this) – people with diabetes may not be able to feel their feet and could have infected chilblains without realising it Complications of chilblains If you have severe or recurring chilblains, there’s a small risk of complications such as: infection from blistered or scratched skin ulcers forming on the skin permanent discolouration of the skin scarring of the skin Avoiding complications of chilblains It’s often possible to avoid complications of chilblains. Don’t do not scratch or rub the affected areas of skin do not directly overheat the chilblains (by using hot water, for example) You can reduce your risk of infection by: cleaning any breaks in your skin with antiseptic covering the area with an antiseptic dressing changing the dressing every other day until your skin heals If the skin does become infected, you may be prescribed antibiotics. Source: NHS 24 - Opens in new browser window Last updated: 17 January 2025 How can we


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skin does become infected, you may be prescribed antibiotics. 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 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/kidneys-bladder-and-prostate/chronic-kidney-disease/


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Chronic kidney 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 Kidneys, bladder and prostate Chronic kidney disease Chronic kidney disease About chronic kidney disease Symptoms of chronic kidney disease Causes of chronic kidney disease Diagnosis of chronic kidney disease Treating chronic kidney disease Preventing chronic kidney disease Living with chronic kidney disease About chronic kidney disease Chronic kidney disease (CKD) is a long-term condition where the kidneys do not work effectively. CKD does not usually cause symptoms until it reaches an advanced stage. It’s usually detected at earlier stages by blood and urine tests. Symptoms of advanced kidney disease The main symptoms of advanced kidney disease include: tiredness swollen ankles, feet or hands (due to water retention) shortness of breath nausea blood in the urine Read more


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kidney disease include: tiredness swollen ankles, feet or hands (due to water retention) shortness of breath nausea blood in the urine Read more about the symptoms of chronic kidney disease Diagnosing chronic kidney disease Chronic kidney disease is most frequently diagnosed through blood and urine tests. If you’re at a high risk of developing CKD, you may be screened annually. Screening may be recommended if you have: high blood pressure (hypertension) diabetes a family history of CKD Read more about diagnosing chronic kidney disease Why does it happen? The kidneys are 2 bean-shaped organs, the size of your fist. They’re located on either side of the body, just beneath the ribcage. The main role of the kidneys is to filter waste products from the blood before converting them into urine. The kidneys also: help maintain blood pressure maintain the correct levels of chemicals in your body which, in turn, will help heart and muscles function properly produce the active form of vitamin D


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the correct levels of chemicals in your body which, in turn, will help heart and muscles function properly produce the active form of vitamin D that keeps bones healthy produce a substance called erythropoietin, which stimulates production of red blood cells Chronic kidney disease is the reduced ability of the kidney to carry out these functions in the long-term. This is most often caused by damage to the kidneys from other conditions, most commonly diabetes and high blood pressure. Read more about the causes of chronic kidney disease Who is affected? CKD is common and mainly associated with ageing. The older you get, the more likely you are to have some degree of kidney disease. It’s estimated that about 1 in 5 men and 1 in 4 women between the ages of 65 and 74 has some degree of CKD. CKD is more common in people of south Asian origin (those from India, Bangladesh, Sri Lanka and Pakistan) and black people than the general population. The reasons for this include higher rates of


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(those from India, Bangladesh, Sri Lanka and Pakistan) and black people than the general population. The reasons for this include higher rates of diabetes in south Asian people and higher rates of high blood pressure in African or Caribbean people. Treating chronic kidney disease There is no cure for chronic kidney disease, although treatment can slow or halt the progression of the disease and can prevent other serious conditions developing. People with CKD are known to have an increased risk of a heart attack because of changes that occur to the circulation. In a minority of people, CKD may cause kidney failure, also known as established renal failure (ERF) or end-stage kidney disease. In this situation, the usual functions of the kidney stop working. To survive, people with ERF may need to have artificial kidney treatment, called dialysis, or a kidney transplant. Read more about treating chronic kidney disease Living kidney donation A kidney transplant from a living donor can be


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or a kidney transplant. Read more about treating chronic kidney disease Living kidney donation A kidney transplant from a living donor can be planned to avoid or reduce the time someone is on dialysis. This can offer a better long term outcome for the person receiving the organ. There are 2 types of living kidney donation: directed donation – a person can donate a kidney to someone they know, like a family member or a friend altruistic kidney donation – a person can donate a kidney anonymously to someone they do not know Further information about living donation. Living with chronic kidney disease Being diagnosed with chronic kidney disease can be worrying, but support and advice are available to help you cope. Read more about living with chronic kidney disease Preventing chronic kidney disease The main way to reduce the chances of CKD developing is to ensure any existing conditions, such as diabetes and high blood pressure, are carefully managed. Some lifestyle changes can also


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CKD developing is to ensure any existing conditions, such as diabetes and high blood pressure, are carefully managed. Some lifestyle changes can also reduce the risk of CKD developing, these include: having a healthy diet avoiding drinking excessive amounts of alcohol exercising regularly avoiding medicines that can damage the kidney Read more about preventing chronic kidney disease Symptoms of chronic kidney disease Most people with CKD have no symptoms because the body can tolerate even a large reduction in kidney function. In other words, we are born with a lot more kidney function than is necessary for survival. Kidney function is often sufficient if only 1 kidney is working. That is why people can give a kidney to someone needing a kidney transplant. A change in kidney function is usually discovered through a routine blood or urine test. If you are diagnosed with kidney disease, your kidney function will be monitored with regular blood and urine tests, and treatment aims to keep


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test. If you are diagnosed with kidney disease, your kidney function will be monitored with regular blood and urine tests, and treatment aims to keep any symptoms to a minimum. If the kidneys continue to lose function and there is progression towards kidney failure (established renal failure or ERF), this will usually be tracked by blood tests and monitoring. If kidney failure does occur, the symptoms may include: weight loss and poor appetite swollen ankles, feet or hands (due to water retention) shortness of breath blood or protein in your urine (protein in your urine is not something you will notice as it can only be detected during a urine test) an increased need to urinate, particularly at night insomnia itchy skin muscle cramps high blood pressure (hypertension) nausea erectile dysfunction in men (an inability to get or maintain an erection) These are general symptoms and can be caused by many less serious conditions. Many of the symptoms above can be avoided if treatment begins


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erection) These are general symptoms and can be caused by many less serious conditions. Many of the symptoms above can be avoided if treatment begins at an early stage, before any symptoms appear. If you are worried by any of these symptoms, arrange to see your GP. Causes of chronic kidney disease Kidney disease is most often caused by other conditions that put a strain on the kidneys. High blood pressure (hypertension) and diabetes are the most common causes of kidney disease. High blood pressure Blood pressure is a measure of the pressure your heart generates in your arteries with each pulse. Too much pressure can damage your body’s organs, leading to heart disease, stroke and worsening of kidney function. The cause of around 90% of cases of high blood pressure is unknown. There appears to be a link between the condition and a person’s general health, diet, and lifestyle. Known risk factors for high blood pressure include: age (the risk of developing high blood pressure increases as


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general health, diet, and lifestyle. Known risk factors for high blood pressure include: age (the risk of developing high blood pressure increases as you get older) family history of high blood pressure (the condition seems to run in families) being of African-Caribbean or south Asian origin obesity lack of exercise smoking excessive alcohol consumption high amount of salt in your diet high-fat diet stress Hypertension causes damage by putting strain on the small blood vessels in the kidneys. This prevents the filtering process from working properly. Diabetes Diabetes is a condition in which the body produces no – or too little – insulin (type 1 diabetes) or has become unable to make effective use of insulin (type 2 diabetes). Insulin is needed to regulate levels of glucose (sugar) in your blood, preventing the levels going too high after a meal and too low between meals. If diabetes is poorly controlled, too much glucose can build up in your blood. The glucose can damage the tiny


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a meal and too low between meals. If diabetes is poorly controlled, too much glucose can build up in your blood. The glucose can damage the tiny filters in the kidneys, which affects the ability of your kidneys to filter out waste products and fluids. It is estimated that 20% to 40% of people with type 1 diabetes will develop kidney disease before they reach 50 years of age. Around 30% of people with type 2 diabetes also show signs of developing kidney damage. The first sign of diabetic kidney disease is the appearance of low levels of protein in the urine. Therefore, your GP will ask for an annual urine test so any kidney disease can be detected as early as possible. All people with diabetes should have a kidney check every year. Early detection of kidney dysfunction in diabetes is important because it identifies people at risk or complications, such as eye problems and impotence. Other causes There are many other conditions that less commonly cause CKD, including: glomerulonephritis


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such as eye problems and impotence. Other causes There are many other conditions that less commonly cause CKD, including: glomerulonephritis (inflammation of the kidney) pyelonephritis (infection in the kidney) polycystic kidney disease (an inherited condition where both kidneys are larger than normal due to the gradual growth of masses of cysts) failure of normal kidney development in an unborn baby while developing in the womb systemic lupus erythematosus (a condition of the immune system where the body attacks the kidney as if it were foreign tissue) long-term, regular use of medicines, such as lithium and non-steroidal anti-inflammatory drugs (NSAIDs), including aspirin and ibuprofen blockages, for example due to kidney stones or prostate disease Diagnosis of chronic kidney disease Chronic kidney disease (CKD) is most frequently diagnosed through blood and urine tests. Screening If you are in a high-risk group for developing CKD, it is important to be regularly screened for the


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through blood and urine tests. Screening If you are in a high-risk group for developing CKD, it is important to be regularly screened for the condition. People who are not in a high-risk group are not normally screened for CKD. Annual screening is recommended for the following groups: people with high blood pressure (hypertension) people with diabetes people with acute kidney injury caused by medications such as lithium or NSAIDs such as ibuprofen, kidney stones or an enlarged prostate people with cardiovascular disease (conditions that affect the heart, arteries and veins, such as coronary heart disease or heart failure) people with a family history of stage 5 CKD (see below for more information about staging) or an inherited kidney disease people with diseases that affect several parts of the body and may affect the kidneys, such as systemic lupus erythematosus people with blood in the urine (haematuria) or protein in the urine (proteinuria) where there is no known cause Your GP can


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lupus erythematosus people with blood in the urine (haematuria) or protein in the urine (proteinuria) where there is no known cause Your GP can advise you about whether or not you should be screened for CKD. Most often, the diagnosis of kidney disease is made because a routine blood or urine test indicates the kidneys may not be functioning normally. If this happens, the test is usually repeated to confirm the diagnosis. Glomerular filtration rate (GFR) An effective way of assessing how well your kidneys are working is to calculate your glomerular filtration rate (GFR). GFR is a measurement of how many millilitres (ml) of waste fluid your kidneys can filter from the blood in a minute (measured in ml/min). A healthy pair of kidneys should be able to filter more than 90ml/min. It is difficult to measure the GFR directly, so it is estimated using a formula. The result is called the estimated GFR or eGFR. Calculating your eGFR involves taking a blood sample and measuring the levels of a


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using a formula. The result is called the estimated GFR or eGFR. Calculating your eGFR involves taking a blood sample and measuring the levels of a waste product called creatinine and taking into account your age, gender and ethnic group. The result is similar to the percentage of normal kidney function. For example, an eGFR of 50ml/min equates to 50% kidney function. The following tests are used to detect proteinuria (protein in the urine) urine tests – used to see whether there is blood or protein in your urine albumin and creatinine testing – this is another urine test which compares the amounts of albumin (a protein) and creatinine in your urine, and the ratio of the 2 (the albumin:creatinine ratio or ACR) can be used with eGFR to give doctors a more accurate idea of how the kidneys are functioning Staging A 6-stage system, based on eGFR levels, is used to describe the progression of CKD. The higher the stage, the more severe the CKD. Stage 1 (sometimes called G1): the eGFR is


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on eGFR levels, is used to describe the progression of CKD. The higher the stage, the more severe the CKD. Stage 1 (sometimes called G1): the eGFR is normal (above 90 or more), but other testing shows evidence of kidney damage. Stage 2 (G2): the eGFR has decreased slightly (60 to 89), but is still considered to be in the normal range for a young adult. If you have stage 1 or 2 CKD, it is recommended you have annual eGFR tests so the progression of the condition can be carefully monitored. Stage 3 is divided into 2: stage 3a (G3a) and 3b (G3b). In stage 3a, the eGFR has decreased mildly (45 to 59) and this is termed a mild to moderate decrease in kidney function and should be checked annually. In stage 3b (G3b) it has decreased moderately (30 to 44) and is termed a moderate to severe reduction in kidney function and should be checked every 6 months. Stage 4 (G4): the eGFR has reduced severely (15 to 29). By this time, it is possible you will be experiencing symptoms of CKD. Further


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6 months. Stage 4 (G4): the eGFR has reduced severely (15 to 29). By this time, it is possible you will be experiencing symptoms of CKD. Further testing should be carried out every 6 months. Stage 5 (G5): the kidneys have lost almost all of their function (an eGFR of below 15), which is known as established renal failure. Further testing should be carried out every 3 months. However, over time, GFR can fluctuate, so one abnormal test result does not automatically mean you have CKD. A diagnosis of CKD is usually only confirmed if repeated eGFR tests show your eGFR is consistently lower than normal over 3 months. Other tests Other tests are also used to assess the levels of damage to your kidneys: kidney scans, such as an ultrasound scan, a magnetic resonance imaging (MRI) scan or a computerised tomography (CT) scan, are used to find out whether there are any unusual blockages in your urine flow – in cases of advanced kidney disease, the kidneys are shrunken and have an uneven shape


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whether there are any unusual blockages in your urine flow – in cases of advanced kidney disease, the kidneys are shrunken and have an uneven shape kidney biopsy – a small sample of kidney tissue is taken so that the cells can be examined under a microscope for damage Treating chronic kidney disease Lifestyle changes The following lifestyle changes are known to help reduce your blood pressure and help control CKD: stopping smoking eating a healthy, low-fat, balanced diet restricting your salt intake to less than 6g (0.2oz) a day not using over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, except when advised to by a medical professional moderating your alcohol intake so it is within recommended limits losing weight if you are overweight or obese doing regular exercise for at least 30 minutes a day, 5 times a week Read more about preventing high blood pressure through lifestyle changes. Medications for high blood pressure One of the main ways to reduce


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a week Read more about preventing high blood pressure through lifestyle changes. Medications for high blood pressure One of the main ways to reduce the progression of kidney damage is to manage high blood pressure. Good control of blood pressure is vital to protect the kidneys. People with CKD should aim to get their blood pressure down to below 140/90mmHg but if you also have diabetes you should aim to get it down to below 130/80mmHg. There are many types of blood pressure drugs. Medicines called angiotensin converting enzyme (ACE) inhibitors are used to control high blood pressure in people with CKD. As well as reducing blood pressure around the body and reducing the strain on blood vessels, ACE inhibitors give additional protection to the kidney. ACE inhibitors include: ramipril enalapril lisinopril perindopril Side effects of ACE inhibitors include: a persistent, dry cough dizziness tiredness or weakness headaches Most of these side effects should pass within a few days, although


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include: a persistent, dry cough dizziness tiredness or weakness headaches Most of these side effects should pass within a few days, although some people continue to have a dry cough. If the side effects of ACE inhibitors are particularly troublesome, you can be given an alternative medication called an angiotensin-II receptor blocker (ARB). This group of medicines includes: candesartan eprosartan irbesartan azilsartan olmesartan temisartan valsartan losartan The side effects of ARBs are uncommon, but can include dizziness. Both ACE inhibitors and ARBs can cause a reduction in kidney function in some people and increased levels of potassium in the blood, so blood tests will need to be performed after you start treatment and whenever the dose changes. If you are on an ACE inhibitor or ARB and you develop a fever/infection or need medicines for other conditions, it’s important to ask your doctor if the ACE inhibitor or ARB needs to be temporarily stopped. Medication to reduce


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medicines for other conditions, it’s important to ask your doctor if the ACE inhibitor or ARB needs to be temporarily stopped. Medication to reduce cholesterol Studies have shown that people with CKD have a higher risk of cardiovascular disease, including heart attacks and strokes. This is because some of the risk factors for CKD are the same as those for heart attacks and strokes, including high blood pressure and high levels of cholesterol in the blood (atherosclerosis). Statins are a type of medication used to lower cholesterol levels. Cholesterol causes narrowing of the arteries that can lead to a blockage of the blood supply to the heart (causing a heart attack) or the brain (causing a stroke). Statins work by blocking the effects of an enzyme in your liver (called HMG-CoA reductase), which is used to make cholesterol. Statins sometimes have mild side effects, including: constipation diarrhoea headaches abdominal pain Occasionally, statins can cause muscle pain, weakness and


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have mild side effects, including: constipation diarrhoea headaches abdominal pain Occasionally, statins can cause muscle pain, weakness and tenderness. If you experience any of these symptoms, contact your GP. You may need to have a blood test or change your treatment. If you have kidney disease, you may be asked to reduce your daily fluid and salt intake. You may develop a build-up of fluid as your kidneys will not be able to get rid of fluid as well as they did before. If you are asked to reduce the amount of fluid you drink, you must also take into account fluid in foods, such as soup and yoghurt. Your GP or dietitian can advise you about this. The excess fluid that occurs as a result of kidney disease often builds up in your ankles or around your lungs. You may also be given diuretics (water tablets), such as furosemide, which will help get rid of the excess fluid from your body. If you do not have any fluid retention and you have not been told to reduce your fluid intake, there


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help get rid of the excess fluid from your body. If you do not have any fluid retention and you have not been told to reduce your fluid intake, there is no need to do so. In fact, it could be harmful in some circumstances. Anaemia Many people with stage three, four and five CKD develop anaemia. Anaemia is a condition in which you do not have enough red blood cells. Symptoms of anaemia include: tiredness lethargy shortness of breath (dyspnoea) palpitations (awareness of heartbeat) Anaemia can occur because of many other conditions and your doctor will investigate to rule out other possible causes. Most people with kidney disease will be given iron supplements because iron is needed for the production of red blood cells. To boost iron levels, iron may be given as tablets, such as daily ferrous sulphate tablets, or as occasional intravenous infusions. If this is not enough to treat anaemia, you may be started on injections of erythropoietin, a hormone which helps your body produce more


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infusions. If this is not enough to treat anaemia, you may be started on injections of erythropoietin, a hormone which helps your body produce more red blood cells. These injections are often administered into a vein (intravenously) or under the skin (subcutaneously). Examples of these injections include epoetin alfa, beta and zeta, darbepoetin and methoxy polyethylene glycol-epoetin beta. Correction of phosphate balance If you have stage 4 or 5 kidney disease, you can get a build-up of phosphate in your body because your kidneys cannot get rid of it. Phosphate is a mineral that, with calcium, makes up most of your bones. Phosphate is obtained through diet, mainly dairy foods. The kidneys usually filter out excess phosphate. If phosphate levels rise too much, it can upset the normal calcium balance of the body. This can lead to thinning of the bones and furring of the arteries. You may be asked to limit the amount of phosphate in your diet. Foods high in phosphate include red meat,


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of the bones and furring of the arteries. You may be asked to limit the amount of phosphate in your diet. Foods high in phosphate include red meat, dairy produce, eggs and fish. Your GP or dietitian should be able to advise you about how much phosphate you can eat. However, there is no advantage in reducing your intake of these foods unless you have a raised phosphate level. Always ask a healthcare professional before changing your diet. If reducing the amount of phosphate in your diet does not lower your phosphate level enough, you may be given medicines called phosphate binders. These medicines bind to the phosphate in the food inside your stomach and stop it from being absorbed into your body. To work properly, phosphate binders must be taken just before meals. The most commonly used phosphate binder is calcium carbonate, but there are also alternatives that may be more suitable for you. The side effects of phosphate binders are uncommon but include: nausea stomach ache


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there are also alternatives that may be more suitable for you. The side effects of phosphate binders are uncommon but include: nausea stomach ache constipation diarrhoea flatulence (wind) skin rash itchy skin Vitamin D supplements People with kidney disease can have low levels of vitamin D, necessary for healthy bones. This is because the kidneys need to activate the vitamin D from food and the sun before it can be used by the body. Treatment for kidney failure – transplant or dialysis Many people with kidney failure can continue with treatment using medicines and will have good-functioning kidneys for the rest of their lives. In a few people, kidney disease will progress to the stage where the kidneys stop working and it becomes life threatening. This is called kidney failure or established renal failure (ERF). This rarely happens suddenly, and there will be time to plan the next stage of your condition. The decision whether to have dialysis, a kidney transplant or supportive


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suddenly, and there will be time to plan the next stage of your condition. The decision whether to have dialysis, a kidney transplant or supportive treatment should be discussed with your healthcare team. Read more about dialysis and kidney transplants. Supportive treatment If you decide not to have dialysis or a transplant for kidney failure, or they are not suitable for you, you will be offered supportive treatment. This is also called palliative care. The aim is to treat and control the symptoms of kidney failure without using dialysis or transplantation. Supportive treatment includes medical, psychological and practical care for both the person with kidney failure and their family, including discussion about how you feel and planning for the end of life. Many people choose supportive treatment because they: are unlikely to benefit or have quality of life with treatment do not want to go through the inconvenience of treatment with dialysis are advised against dialysis because they


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have quality of life with treatment do not want to go through the inconvenience of treatment with dialysis are advised against dialysis because they have other serious illnesses that will shorten their life, and the negative aspects of treatment outweigh any likely benefits have been on dialysis but have decided to stop this treatment are being treated with dialysis, but have another serious physical illness, especially severe heart disease or stroke, that will shorten their life If you choose to have supportive treatment, your kidney unit will still look after you. Doctors and nurses will make sure you receive: medicines to protect your remaining kidney function for as long as possible medicines to treat other symptoms of kidney failure, such as feeling out of breath, anaemia, loss of appetite or itchy skin help to plan your home and money affairs bereavement support for your family after your death Read more information: Kidney Research UK: Information on choosing not to start


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money affairs bereavement support for your family after your death Read more information: Kidney Research UK: Information on choosing not to start dialysis Bereavement support from CRUSE What is good kidney disease care? Kidney disease services should: identify people at risk of kidney disease, especially people with high blood pressure or diabetes, and treat them as early as possible to maintain their kidney function give people access to investigative treatment and follow them up to reduce the risk of the disease getting worse give people good-quality information about managing their condition provide information about the development of the disease and treatment options provide access to a specialist renal (kidney) team give people access to transplant or dialysis services if required provide supportive care Your treatment for kidney disease will need to be reviewed regularly. It may be helpful for you to make a care plan because this can help you manage your day-to-day health.


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disease will need to be reviewed regularly. It may be helpful for you to make a care plan because this can help you manage your day-to-day health. Your kidney disease specialist nurse may be able to help with this. Preventing chronic kidney disease In most cases, chronic kidney disease (CKD) cannot be completely prevented, although you can take steps to reduce the chances of the condition developing. Managing your condition If you have a chronic (long-term) condition, such as diabetes, that could potentially cause chronic kidney disease, it is important it is carefully managed. Follow the advice of your GP and keep all appointments relating to your condition. People with diabetes are advised to have their kidney function tested every year. Read more about Type 1 diabetes and Type 2 diabetes Smoking Smoking increases your risk of cardiovascular disease, including heart attacks or strokes, and it can increase the likelihood that any existing kidney problems will get worse. If you stop


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disease, including heart attacks or strokes, and it can increase the likelihood that any existing kidney problems will get worse. If you stop smoking, you will improve your general health and reduce your risk of developing other serious conditions, such as lung cancer and heart disease. The NHS smoking helpline can offer you advice and encouragement to help you quit smoking. Phone Quit Your Way Scotland on 0800 84 84 84. Read more about stopping smoking Diet A healthy diet is important for preventing chronic kidney disease. It will lower the amount of cholesterol in your blood and keep your blood pressure at a healthy level. Eat a balanced diet that includes plenty of fresh fruit and vegetables (5 a day) and whole grains. Limit the amount of salt in your diet to no more than 6g (0.2oz) a day. Too much salt will increase your blood pressure. One teaspoonful of salt is equal to about 6g. Avoid eating foods high in saturated fat because this will increase your cholesterol level. Foods


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One teaspoonful of salt is equal to about 6g. Avoid eating foods high in saturated fat because this will increase your cholesterol level. Foods high in saturated fat include: meat pies sausages and fatty cuts of meat butter ghee (a type of butter often used in Indian cooking) lard cream hard cheese cakes and biscuits foods that contain coconut oil or palm oil Eating some foods that are high in unsaturated fat can help decrease your cholesterol level. Foods high in unsaturated fat include: oily fish avocados nuts and seeds sunflower oil rapeseed oil olive oil Read more about healthy food and diet Alcohol Drinking excessive amounts of alcohol will cause your blood pressure to rise, as well as raising cholesterol levels in your blood. Therefore, sticking to the recommended alcohol consumption limits is the best way to reduce your risk of developing high blood pressure (hypertension) and CKD. Exercise Regular exercise should help lower your blood pressure and reduce your risk of


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of developing high blood pressure (hypertension) and CKD. Exercise Regular exercise should help lower your blood pressure and reduce your risk of developing CKD. At least 150 minutes (2 hours and 30 minutes) of moderate-intensity aerobic activity (such as cycling or fast walking) every week, is recommended. Read more about health and fitness Painkillers Kidney disease can be caused by the improper use (such as taking too many) of non-steroidal anti-inflammatories (NSAIDs), such as aspirin and ibuprofen. If you need to take painkillers, make sure you follow the instructions. This can help to avoid kidney damage. Living with chronic kidney disease Relationships and support Coming to terms with a condition such as kidney disease can put a strain on you, your family and your friends. It can be difficult to talk to people about your condition, even if they are close to you. Learning about kidney disease often helps because you and your family will understand more about what to expect and


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even if they are close to you. Learning about kidney disease often helps because you and your family will understand more about what to expect and feel more in control of the illness, instead of feeling that your lives are now dominated by kidney disease and its treatment. Be open about how you feel, and let your family and friends know what they can do to help. However, do not feel shy about telling them that you need some time to yourself, if that is what you need. Get support Your GP or nurse can reassure you if you have questions about your kidney disease, or you may find it helpful to talk to a trained counsellor, psychologist or specialist telephone helpline operator. Your GP practice will have information on these. Some people find it helpful to talk to other people with kidney disease at a local support group or online. Money and finances If you have to stop work or work part time because of your kidney disease, you may find it hard to cope financially. You may be entitled to


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finances If you have to stop work or work part time because of your kidney disease, you may find it hard to cope financially. You may be entitled to one or more of the following types of financial support: if you have a job but cannot work because of your illness, you are entitled to Statutory Sick Pay from your employer if you do not have a job and cannot work because of your illness, you may be entitled to Employment and Support Allowance if you are aged 64 or under and need help with personal care or have walking difficulties, you may be eligible for Disability Living Allowance if you are aged 65 or over, you may be able to get Attendance Allowance if you are caring for someone with kidney disease, you may be entitled to Carer’s Allowance you may be eligible for other benefits if you have children living at home or if you have a low household income Sex and pregnancy The symptoms of kidney disease and the stress it causes in your life can affect your sexual relationships. Some


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household income Sex and pregnancy The symptoms of kidney disease and the stress it causes in your life can affect your sexual relationships. Some couples become closer after a diagnosis of kidney disease, while others find that their loved ones are affected by worries about how they will cope with the effects of the illness. Both men and women may experience issues about body image and self-esteem, and this can affect the relationship. Try to share your feelings with your partner. If you have problems with sex that do not get better with time, speak to a counsellor or sex therapist. People on dialysis often experience specific sexual difficulties. Loss of sex drive in both men and women and impotence in men are commonly reported problems. Treatment is available, but it may take some time and requires commitment from both partners. The first step is to discuss it with your healthcare team. Pregnancy Both men and women with early stage kidney disease will find their fertility is


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The first step is to discuss it with your healthcare team. Pregnancy Both men and women with early stage kidney disease will find their fertility is unaffected. This means it is important to use contraception unless you want to have a baby. Later stage kidney disease may affect women’s periods, which can make pregnancy more difficult. For men, later stage kidney disease can cause a reduction in sperm count. However, having kidney disease does not mean you will not get pregnant or be able to father a child, so both men and women need to use an effective method of contraception unless they want to have a baby. Women who want to have a baby should talk to their renal specialist or an obstetrician with an interest in kidney disease. Depending on the stage of kidney disease, there can be risks to both the mother and the baby. It is important to minimise any risk with a planned pregnancy. Your healthcare team can advise you about this. Holidays and insurance If you have mild kidney disease


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to minimise any risk with a planned pregnancy. Your healthcare team can advise you about this. Holidays and insurance If you have mild kidney disease or you’ve had a transplant, going on holiday shouldn’t pose additional health problems, whether you’re staying in the UK or going abroad. If you’re on dialysis, you can still enjoy holidays provided you book your treatment before you go away. If you’re on dialysis and want to travel, discuss your plans with your renal unit as early as you can. It can sometimes be more difficult to arrange dialysis in the UK than it is abroad. The NHS will look after you if you get ill while on holiday in the UK. If you’re in Europe, the European Health Insurance Card (EHIC) entitles you to free or reduced-cost hospital treatment. It’s a good idea to take out holiday health insurance in addition to carrying the EHIC. Anyone with kidney disease should declare it as a pre-existing medical condition on standard insurance application forms. It may exclude you


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EHIC. Anyone with kidney disease should declare it as a pre-existing medical condition on standard insurance application forms. It may exclude you from some policies. Using over-the-counter medicines Some remedies are potentially harmful for people with kidney disease. Make sure you check with your doctor before taking a new over the counter medicine. You’re at higher risk of being harmed by certain over the counter remedies if: you have advanced kidney disease (stage 4 or 5, or a kidney function below 30% of normal) you have mild-to-moderate kidney disease (stage 3 with a kidney function between 30 and 60% of normal) and are elderly with another serious illness, such as coronary heart disease What’s safe and what’s not Summarised below is a list of which over the counter remedies are safe for people with kidney disease to use and which should be avoided. This is just a guide. For more detailed information, consult your pharmacist, renal specialist or GP. Headaches Paracetamol is safe


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be avoided. This is just a guide. For more detailed information, consult your pharmacist, renal specialist or GP. Headaches Paracetamol is safe and the best choice of painkiller to treat a headache, but avoid soluble products as they are high in sodium. If your kidney function is less than about 50%, avoid painkillers containing aspirin, ibuprofen or similar drugs such as diclofenac. These products can deteriorate the function of damaged kidneys. Low-dose aspirin of 75mg to 150mg a day can be used if it’s prescribed for the prevention of vascular disease. You should also avoid ibuprofen if you’re taking anti-rejection treatment following a kidney transplant. Coughs and colds Many of the products available for coughs and colds contain a mixture of ingredients, so check the packaging carefully. Some products contain paracetamol, which is safe, but others contain high doses of aspirin, which it’s best to avoid. Many cold remedies also contain decongestants, which you should avoid if you


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but others contain high doses of aspirin, which it’s best to avoid. Many cold remedies also contain decongestants, which you should avoid if you have high blood pressure. The best way to clear congestion is by steam inhalation with menthol or eucalyptus. For coughs, try a simple linctus or glycerine honey and lemon to soothe your throat. Muscle and joint pains If you have muscle or joint pain, it’s ideal to use topical preparations (applied to the skin), which are rubbed on to the painful area. Avoid tablets containing ibuprofen or similar drugs such as diclofenac if your kidney function is below 50%. Ibuprofen gel or spray is safer than ibuprofen tablets, but it isn’t completely risk-free as a small amount of the drug penetrates the skin into the bloodstream. Kidney failure About 1% of people with stage three CKD develop kidney failure, also called established renal failure (ERF). Kidney failure has a major impact on your life and the lives of those close to you. People diagnosed


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also called established renal failure (ERF). Kidney failure has a major impact on your life and the lives of those close to you. People diagnosed with kidney failure usually go through shock, grief and denial before they accept their condition. Choices if you have established renal failure If you have established renal failure (ERF), you will need to decide whether to have treatment with dialysis or a kidney transplant. You may decide to have neither treatment and to have supportive care. These choices should be made with your healthcare team. For people who want active treatment for their ERF, a transplant would be the best option. However, a transplant is only suitable for about half of all people with ERF. This is because they may have had recent cancer or are not physically fit. Many people who have slowly progressive kidney failure and other serious health problems, and who are usually older, may choose to avoid dialysis. Supportive care can still allow you to live for some time


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and other serious health problems, and who are usually older, may choose to avoid dialysis. Supportive care can still allow you to live for some time with a good quality of life. Transplant A kidney transplant, when suitable, is the best treatment for ERF. The transplanted kidney can be obtained from a deceased or living donor and survival rates are now extremely good. About 90% of transplants still function after five years and many transplants work usefully after 20 years. The main reason people have to wait for a transplant is the shortage of available donors. Over a third of kidney transplants are now from live donors. A live donor kidney can be transplanted before the need for dialysis, rather than after a period of time on dialysis. One major risk after transplantation is rejection, where the immune system attacks the donated kidney because it mistakes it for a foreign object. This is prevented with the use of strong drugs to suppress the immune system. These drugs need to be


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because it mistakes it for a foreign object. This is prevented with the use of strong drugs to suppress the immune system. These drugs need to be taken meticulously. They are usually well tolerated but may have side effects, including an increased susceptibility to infections and some forms of cancer. For this reason, transplant patients are given regular reviews in a specialist transplant clinic. Dialysis Dialysis can take place at home or in hospital. It involves filtering the blood of waste products and excess water. It is not as efficient as a human kidney, so people with kidney failure usually need to restrict their intake of fluid and certain foods. They also require additional medicines such as iron supplements, phosphate binders and antihypertensive medicine (to reduce blood pressure). There are 2 types of dialysis: peritoneal dialysis and haemodialysis. Peritoneal dialysis The abdomen (tummy) has a lining called the peritoneal membrane, which can be used as a filter to remove


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and haemodialysis. Peritoneal dialysis The abdomen (tummy) has a lining called the peritoneal membrane, which can be used as a filter to remove excess waste and water. If you have opted for peritoneal dialysis, a tube (catheter) will be inserted into your abdomen during an operation. This will allow you to drain dialysis fluid in and out of your tummy yourself. You will not need to go into hospital to be treated, but you will have to spend an hour or two each day draining the fluid. The treatment involves either four exchanges spaced out during the day, each taking half an hour, or attaching yourself to a machine overnight that pumps the fluid in and out for you. Haemodialysis Haemodialysis removes waste products and excess fluid that build up in the body when the kidneys stop working. Blood is taken from the body to be cleaned in a filter known as a dialyser. It is effectively an artificial kidney. The whole process takes about four hours and usually has to be repeated three times a


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known as a dialyser. It is effectively an artificial kidney. The whole process takes about four hours and usually has to be repeated three times a week. Most people go into hospital to have haemodialysis. However, some people choose to have the treatment in their own home. Home haemodialysis will give you more flexibility, but comes with greater responsibility. You’ll need to have the space in your home for a dedicated machine and, in most cases, a lot of support from a close family member or friend. Some people choose to have their dialysis at night while they are asleep. Most people who choose home haemodialysis have it every day, so their fluid intake is not as restricted. Quality vascular access During haemodialysis, it is important that large volumes of blood are passed through the machine. This requires special measures to get into large enough blood vessels. For this reason, haemodialysis patients need a minor operation to join one of the deep arteries to a superficial vein


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large enough blood vessels. For this reason, haemodialysis patients need a minor operation to join one of the deep arteries to a superficial vein (called a fistula). This is carried out in day surgery and should be done at least 6 weeks before dialysis is required because it needs time to mature before it can be used. Occasionally, there will be insufficient time for a fistula to be created before dialysis is required. In this case, a temporary solution is found, usually involving the use of an indwelling plastic dialysis catheter. A catheter is a surgical tube inserted into the body to allow for the transfer of fluid. All the issues will be discussed in detail with you by the dialysis team before any decisions are made. Source: NHS 24 - Opens in new browser window Last updated: 26 March 2025 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Don’t include personal information e.g. name, location or any personal health conditions. Email


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NHS inform Thank You Your feedback has been received Don’t include personal information e.g. name, location or any personal health conditions. Email Address e.g. you@example.com Message Maximum of 500 characters Send feedback Add this page to Info For Me Also on NHS inform Dialysis Other health sites Lab Tests Online: GFR test National Kidney Federation Kidney Care UK Kidney Research UK UK Kidney Association PKD charity 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/chronic-lymphocytic-leukaemia/


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https://www.nhsinform.scot/illnesses-and-conditions/cancer/cancer-types-in-adults/chronic-myeloid-leukaemia/


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Chronic myeloid leukaemia | 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 Chronic myeloid leukaemia Chronic myeloid leukaemia About chronic myeloid leukaemia Symptoms of chronic myeloid leukaemia Causes of chronic myeloid leukaemia Diagnosing chronic myeloid leukaemia Treating chronic myeloid leukaemia Complications of chronic myeloid leukaemia About chronic myeloid leukaemia Leukaemia is cancer of the white blood cells. Chronic leukaemia means the condition progresses slowly over many years. Chronic leukaemia is classified according to the type of white blood cells that are affected by cancer. There are 2 main types: lymphocytes – mostly used to fight viral infections myeloid cells – which perform a number of different functions, such as fighting bacterial infections, defending the body against parasites and


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myeloid cells – which perform a number of different functions, such as fighting bacterial infections, defending the body against parasites and preventing the spread of tissue damage These pages focus on chronic myeloid leukaemia, which is a cancer of the myeloid cells. The following other types of leukaemia are covered elsewhere: chronic lymphocytic leukaemia acute myeloid leukaemia acute lymphoblastic leukaemia What happens in chronic leukaemia Your bone marrow produces stem cells. These are unique cells because they have the ability to develop into three important types of blood cell: red blood cells – which carry oxygen around the body white blood cells – which help fight infection platelets – which help stop bleeding In leukaemia, a genetic mutation in the stem cells causes a huge over-production of white blood cells and a corresponding drop in red blood cells and platelets. It’s this lack of red blood cells which causes symptoms of anaemia, such as tiredness, and the lack of


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drop in red blood cells and platelets. It’s this lack of red blood cells which causes symptoms of anaemia, such as tiredness, and the lack of platelets that increases the risk of excessive bleeding. Warning signs of chronic myeloid leukaemia In its early stages, chronic myeloid leukaemia usually causes no noticeable symptoms. As the condition develops, symptoms include: tiredness weight loss night sweats a feeling of bloating bruising bone pain Read more about the symptoms of chronic myeloid leukaemia How common is chronic myeloid leukaemia? Chronic myeloid leukaemia is quite a rare type of cancer. Chronic myeloid leukaemia can affect people of any age, but it is more common in people aged 40 to 60. There is no evidence that it runs in families. Symptoms of chronic myeloid leukaemia In its early stages, chronic myeloid leukaemia usually causes no noticeable symptoms and it is often diagnosed during tests for a different condition. When symptoms do develop, they are similar to those of


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no noticeable symptoms and it is often diagnosed during tests for a different condition. When symptoms do develop, they are similar to those of many other illnesses and can include: tiredness frequent infections unexplained weight loss a feeling of bloating less commonly, swollen lymph nodes – glands found in the neck and under your arms, which are usually painless Chronic myeloid leukaemia can also cause swelling in your spleen (an organ that helps to filter impurities from your blood). This can cause a lump to appear on the left side of your abdomen, which may be painful when touched. A swollen spleen can also put pressure on your stomach, causing a lack of appetite and indigestion. The symptoms of chronic myeloid leukaemia in its advanced stage will be much more noticeable and troublesome. They include: severe fatigue bone pain night sweats fever easily bruised skin Causes of chronic myeloid leukaemia Chronic myeloid leukaemia is caused by a DNA mutation in the stem cells which


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sweats fever easily bruised skin Causes of chronic myeloid leukaemia Chronic myeloid leukaemia is caused by a DNA mutation in the stem cells which produce white blood cells. The change in the DNA causes the stem cells to produce more white blood cells than are needed. They are also released from the bone marrow before they are mature and able to fight infection like healthy ‘adult’ white blood cells. As the number of immature cells increases, the number of healthy red blood cells and platelets fall, and it’s this fall which causes many of the symptoms of chronic leukaemia. Philadelphia chromosome Although the cause of chronic myeloid leukaemia is genetic, it is not inherited as it is an acquired genetic abnormality. Most people with the condition have an abnormal chromosome, where a section of DNA from one chromosome has been swapped with a section from another. This is called the Philadelphia chromosome and it makes the cell produce a protein that encourages the leukaemic cells to


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a section from another. This is called the Philadelphia chromosome and it makes the cell produce a protein that encourages the leukaemic cells to resist normal cell death and grow and multiply far more quickly than usual. Possible triggers for chronic leukaemia What triggers the development of chronic leukaemia and causes the initial mutation in stem cells is unknown. The one proven risk factor is exposure to radiation. However, radiation is only a significant risk if the levels are extremely high, such as those recorded after an atomic bomb explodes, or those released after a nuclear reactor accident, such as the one at Chernobyl. Benzene There is limited evidence that prolonged exposure to the chemical benzene leads to an increased risk of chronic myeloid leukaemia. Benzene is found in petrol and is also used in the rubber industry, but in the UK there are strict controls to protect people from prolonged exposure. Benzene is also found in cigarettes. However, it is thought that


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but in the UK there are strict controls to protect people from prolonged exposure. Benzene is also found in cigarettes. However, it is thought that smoking is more of a risk factor in acute leukaemia than it is in chronic leukaemia. Occupational risks A number of occupations have been linked to an increased risk of chronic leukaemia, possibly due to exposure to certain substances such as pesticides or chemicals. These occupations include: all types of agricultural workers people who are involved with rubber or plastic manufacture tailors and dressmakers cleaners builder’s labourer Other risk factors There is some evidence to show an increased risk of chronic leukaemia in people who: are obese have a weakened immune system – due to HIV or AIDS or taking immunosuppressants after an organ transplant have inflammatory bowel disease – such as ulcerative colitis or Crohn’s disease Diagnosing chronic myeloid leukaemia Chronic myeloid leukaemia is often first detected when a routine blood


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as ulcerative colitis or Crohn’s disease Diagnosing chronic myeloid leukaemia Chronic myeloid leukaemia is often first detected when a routine blood test is carried out to diagnose another, unrelated, condition. A blood test that reveals abnormally high levels of white blood cells could be a sign of chronic leukaemia. If you have a blood test with abnormal results, you will be referred to a haematologist (a specialist in treating blood conditions) for further testing. Bone marrow biopsy To confirm a diagnosis of chronic leukaemia, the haematologist will take a small sample of your bone marrow to examine under a microscope. This procedure is known as a bone marrow biopsy. A bone marrow biopsy is usually carried out under a local anaesthetic. The haematologist will numb an area of skin at the back of your hip bone, before using a needle to remove the bone marrow sample. You may experience some pain once the anaesthetic wears off and some bruising and discomfort for a few days


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needle to remove the bone marrow sample. You may experience some pain once the anaesthetic wears off and some bruising and discomfort for a few days afterwards. The procedure takes around 15 minutes to complete and you should not have to stay in hospital overnight. The bone marrow sample will be checked to see if there are cancerous cells. If there are, the biopsy will also be able to help determine which type of chronic leukaemia is present. Further tests There are a number of additional tests that can be used to help reveal more information about the progress and extent of the leukaemia. These can also provide an insight into how the leukaemia should be treated. Cytogenetic testing Cytogenetic testing involves identifying the genetic make-up of the cancerous cells. There are a number of specific genetic variations that can occur during leukaemia and knowing what these variations are can have an important impact on treatment. For example, 90% of people with chronic myeloid leukaemia


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leukaemia and knowing what these variations are can have an important impact on treatment. For example, 90% of people with chronic myeloid leukaemia have the Philadelphia chromosome. People who have this chromosome are known to respond well to a medicine called imatinib. Polymerase chain reaction (PCR) A polymerase chain reaction (PCR) test can be done on a blood sample. This is an important test to diagnose and monitor the response to treatment. The blood test is repeated every 3 months for at least 2 years after starting treatment, then less often once remission is achieved. Imaging tests In some cases, the hospital may want to perform some imaging tests to help rule out other conditions or confirm a diagnosis. This may be either: an X-ray – usually to examine your chest an ultrasound scan – usually to examine your spleen and liver Treating chronic myeloid leukaemia Imatinib tablets are usually given as soon as you have been diagnosed with chronic myeloid leukaemia, to slow its


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Treating chronic myeloid leukaemia Imatinib tablets are usually given as soon as you have been diagnosed with chronic myeloid leukaemia, to slow its progression. These tablets are taken every day for life, and most patients do really well on them. The aim of treatment is to achieve the following: by 3 months, correct the blood count by 12 months, clear the bone marrow of cells containing the Philadelphia chromosome by 18 months, get to a stage where the leukaemia can only be detected by a very sensitive molecular test (molecular remission) Chemotherapy is usually offered if the cancer reaches an advanced stage. Treating early-stage chronic myeloid leukaemia Imatinib A medicine called imatinib is the main treatment recommended for chronic myeloid leukaemia. It is usually given as soon as a diagnosis is made because the medicine is designed to slow the progression of the cancer and to prevent the condition reaching the accelerated or advanced phase. Imatinib is a type of tyrosine kinase


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to slow the progression of the cancer and to prevent the condition reaching the accelerated or advanced phase. Imatinib is a type of tyrosine kinase inhibitor. This means it blocks a protein called tyrosine kinase (tyrosine kinase helps to stimulate the growth of cancer cells). This reduces the production of abnormal white blood cells. Imatinib is taken as a tablet. The side effects of imatinib are usually mild and should improve with time. They include: nausea vomiting swelling in the face and lower legs muscle cramps rash diarrhoea Nilotinib It is estimated that 10 to 40% of people who take imatinib become resistant to its effects, so an alternative treatment is required. The National Institute for Health and Care Excellence (NICE) has recommended nilotinib for the treatment of chronic myeloid leukaemia that is resistant or intolerant to imatinib. In some cases, nilotinib is recommended as the first treatment. Nilotinib works in a similar way to imatinib in that it blocks the


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to imatinib. In some cases, nilotinib is recommended as the first treatment. Nilotinib works in a similar way to imatinib in that it blocks the effects of proteins that help stimulate the growth of cancer cells. Side effects of nilotinib can include: vomiting abdominal pain bone and joint pain dry skin loss of appetite hair loss insomnia night sweats dizziness tingling or numbness If the side effects become particularly troublesome, temporarily stopping the treatment usually helps to bring them under control. Treatment can then be resumed, possibly using a lower dose of medication. Read about the complications of chronic myeloid leukaemia for more information and advice about being vulnerable to infection and bleeding. Treating advanced chronic myeloid leukaemia Chemotherapy Once chronic myeloid leukaemia has progressed to a more advanced stage, chemotherapy is the next treatment. Chemotherapy tablets are usually used first because they have fewer and milder side effects than


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advanced stage, chemotherapy is the next treatment. Chemotherapy tablets are usually used first because they have fewer and milder side effects than chemotherapy injections. Side effects include: tiredness skin rash increased vulnerability to infection Chemotherapy can weaken your immune system, which helps protect you against infection. This is known as being immunocompromised. Read chronic leukaemia complications for more information about this. If your symptoms persist or get worse, chemotherapy injections (intravenous chemotherapy) will need to be used. Intravenous chemotherapy causes more side effects than chemotherapy tablets and they tend to be more severe. Side effects include: nausea vomiting tiredness hair loss infertility These side effects should resolve after your treatment has finished, although there is a risk that infertility could be permanent. Bone marrow and stem cell transplants A bone marrow transplant can offer a cure for chronic leukaemia, although it is only


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could be permanent. Bone marrow and stem cell transplants A bone marrow transplant can offer a cure for chronic leukaemia, although it is only suitable and necessary for some patients. Before transplantation can take place, the person receiving the transplant has to have aggressive, high-dose chemotherapy and radiotherapy to destroy any cancerous cells in their body. This can put enormous strain on the body and can cause significant side effects and potential complications. Transplantations have better outcomes if the donor has the same tissue type as the person who is receiving the donation. The best candidate to provide a donation is usually a brother or sister with the same tissue type. Due to these issues, transplantations are usually only successful when they are carried out in children and young people, or older people in good health, and there is a suitable brother or sister who can provide a donation. In most cases of chronic leukaemia, the potential risks of transplantation


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and there is a suitable brother or sister who can provide a donation. In most cases of chronic leukaemia, the potential risks of transplantation far outweigh any benefit. However, your specific circumstances may mean that the benefits of treatment outweigh the risks. Read more about bone marrow transplants Complications of chronic myeloid leukaemia Being immunocompromised (having a weakened immune system) is a possible complication for some patients with chronic leukaemia. There are 2 reasons for this: the lack of healthy white blood cells means your immune system is less able to fight infection many of the medicines used to treat chronic leukaemia can weaken the immune system This means you are more vulnerable to developing an infection, and that any infection you have has an increased potential to cause serious complications. You may be advised to take regular doses of antibiotics to prevent infections from occurring. You should immediately report any possible symptoms of an


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may be advised to take regular doses of antibiotics to prevent infections from occurring. You should immediately report any possible symptoms of an infection to your GP or care team because prompt treatment may be required to prevent serious complications. Symptoms of infection include: high temperature (fever) of 38C (101.4F) or above headache aching muscles diarrhoea tiredness Avoid contact with anyone who is known to have an infection, even if it is a type of infection that you were previously immune to, such as chickenpox or measles. This is because your previous immunity to these conditions will probably be suppressed (lowered). While it is important to go outside on a regular basis, both for exercise and for your psychological wellbeing, avoid visiting crowded places and using public transport during rush hour. Also ensure that all of your vaccinations are up-to-date. Your GP or care team will be able to advise you about this. You will be unable to have any vaccine that contains


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of your vaccinations are up-to-date. Your GP or care team will be able to advise you about this. You will be unable to have any vaccine that contains activated particles of viruses or bacteria, such as: the mumps, measles and rubella (MMR) vaccine the polio vaccine the oral typhoid vaccine the BCG vaccine (used to vaccinate against tuberculosis) the yellow fever vaccine Psychological effects of chronic leukaemia Receiving a diagnosis of chronic leukaemia can be very distressing, particularly if it is unlikely that your condition can be cured. At first, the news may be difficult to take in. The situation can be made worse if you are confronted with the knowledge that even though your leukaemia may not currently be causing any symptoms, it could be a serious problem in later life. Having to wait many years to see how the leukaemia develops can be immensely stressful and can trigger feelings of stress, anxiety and depression. If you have been diagnosed with leukaemia, talking to a


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can be immensely stressful and can trigger feelings of stress, anxiety and depression. If you have been diagnosed with leukaemia, talking to a counsellor or psychiatrist (a doctor who specialises in treating mental health conditions) may help you to combat feelings of depression and anxiety. Antidepressants or medicines that help to reduce feelings of anxiety may also help you cope better with the condition. You may find it useful to talk to other people who are living with leukaemia. Your GP or multidisciplinary team may be able to provide you with details of local support groups. Another excellent resource is Macmillan Cancer Support. Their helpline number is 0808 808 00 00 and is open Monday to Friday, 8am to 8pm. Further information You can read more information from Cancer Research UK about chronic myeloid leukaemia. Source: NHS 24 - Opens in new browser window Last updated: 14 October 2024 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been


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- Opens in new browser window Last updated: 14 October 2024 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Don’t include personal information e.g. name, location or any personal health conditions. Email Address e.g. you@example.com Message Maximum of 500 characters Send feedback Add this page to Info For Me Also on NHS inform Chronic lymphocytic leukaemia Acute myeloid leukaemia Other health sites Blood cancer UK: Chronic myeloid leukaemia Cancer Research UK: Chronic myeloid leukaemia Macmillan Cancer Support: Chronic myeloid leukaemia 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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Chronic pain | 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 Chronic pain Chronic painChronic or persistent pain is pain that lasts longer than 12 weeks, or beyond the natural healing time What is chronic pain? Read about chronic pain symptoms and causes Living with chronic pain Read about pain management strategies to live better with chronic pain Coping with a flare up of chronic pain Find out how to cope with a flare up of chronic pain Fibromyalgia Read about fibromyalgia symptoms, causes and treatment. 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/cirrhosis/


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Cirrhosis | 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 Cirrhosis Cirrhosis About cirrhosis Symptoms of cirrhosis Causes of cirrhosis Diagnosing cirrhosis Treating cirrhosis Preventing cirrhosis About cirrhosis Cirrhosis is scarring of the liver caused by continuous, long-term liver damage. Scar tissue replaces healthy tissue in the liver and prevents the liver from working properly. The damage caused by cirrhosis can’t be reversed and can eventually become so extensive that your liver stops functioning. This is called liver failure. Cirrhosis can be fatal if the liver fails. However, it usually takes years for the condition to reach this stage and treatment can help slow its progression. Each year in the UK, around 4,000 people die from cirrhosis and 700 people with the condition need a liver transplant


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can help slow its progression. Each year in the UK, around 4,000 people die from cirrhosis and 700 people with the condition need a liver transplant to survive. Signs and symptoms There are usually few symptoms in the early stages of cirrhosis. However, as your liver loses its ability to function properly, you’re likely to experience a loss of appetite, nausea and itchy skin. In the later stages, symptoms can include jaundice, vomiting blood, dark, tarry-looking stools, and a build-up of fluid in the legs (oedema) and abdomen (ascites). Read more about the symptoms of cirrhosis. When to see your GP As cirrhosis doesn’t have many obvious symptoms during the early stages, it’s often picked up during tests for an unrelated illness. See your GP if you have any of the following symptoms: fever and shivering shortness of breath vomiting blood very dark or black, tarry stools (faeces) periods of confusion or drowsiness Read more about diagnosing cirrhosis. What causes cirrhosis? In the UK,


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very dark or black, tarry stools (faeces) periods of confusion or drowsiness Read more about diagnosing cirrhosis. What causes cirrhosis? In the UK, the most common causes of cirrhosis are: drinking too much alcohol (alcohol misuse) over many years being infected with the hepatitis C virus for a long time a condition called non-alcoholic steatohepatitis (NASH) that causes excess fat to build up in the liver NASH is on the rise in the UK, due to increasing levels of obesity and reduced physical activity. It’s likely that it will overtake alcohol and hepatitis C as the most common cause of cirrhosis. Less common causes of cirrhosis include hepatitis B infection and inherited liver diseases, such as haemochromatosis. Read more about the causes of cirrhosis. Treating cirrhosis There’s currently no cure for cirrhosis. However, it’s possible to manage the symptoms and any complications, and slow its progression. Treating underlying conditions that may be the cause, such as using anti-viral


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manage the symptoms and any complications, and slow its progression. Treating underlying conditions that may be the cause, such as using anti-viral medication to treat a hepatitis C infection, can also stop cirrhosis getting worse. You may be advised to cut down or stop drinking alcohol, or to lose weight if you’re overweight. A wide range of alcohol support services are available. In its more advanced stages, the scarring caused by cirrhosis can make your liver stop functioning. In this case, a liver transplant is the only treatment option. Read more about treating cirrhosis. Preventing cirrhosis Not exceeding the recommended limits for alcohol consumption is the best way of preventing alcohol-related cirrhosis. Hepatitis B and C are infections you can get by having unprotected sex or sharing needles to inject drugs. Using a condom during sex and not injecting drugs will reduce your risk of developing hepatitis B and C. A vaccine for hepatitis B is available, but there’s currently no


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sex and not injecting drugs will reduce your risk of developing hepatitis B and C. A vaccine for hepatitis B is available, but there’s currently no vaccine for hepatitis C. Read more about preventing cirrhosis. Symptoms of cirrhosis There are usually few symptoms during the early stages of cirrhosis. Noticeable problems tend to develop as the liver becomes more damaged. In early stage cirrhosis, the liver is able to function properly despite being damaged. As the condition progresses, symptoms tend to develop when functions of the liver are affected. Symptoms of cirrhosis can include: tiredness and weakness loss of appetite weight loss and muscle wasting feeling sick (nausea) and vomiting tenderness or pain around the liver area tiny red lines (blood capillaries) on the skin above waist level very itchy skin yellowing of the skin and the whites of the eyes (jaundice) a tendency to bleed and bruise more easily, such as frequent nosebleeds or bleeding gums hair loss fever and shivering


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whites of the eyes (jaundice) a tendency to bleed and bruise more easily, such as frequent nosebleeds or bleeding gums hair loss fever and shivering attacks swelling in the legs, ankles and feet due to a build-up of fluid (oedema) swelling in your abdomen (tummy), due to a build-up of fluid known as ascites (severe cases can make you look heavily pregnant) You may also notice changes in your personality, problems sleeping (insomnia), memory loss, confusion and difficulty concentrating. This is known as encephalopathy and occurs when toxins affect your brain because your liver is unable to remove them from your body. Late-stage symptoms In the later stages of cirrhosis, you may vomit blood or have tarry, black stools. This is because blood can’t flow through the liver properly, which causes an increase in blood pressure in the vein that carries blood from the gut to the liver (portal vein). The increase in blood pressure forces blood through smaller, fragile vessels that line your


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carries blood from the gut to the liver (portal vein). The increase in blood pressure forces blood through smaller, fragile vessels that line your stomach and gullet (varices). These can burst under high blood pressure, leading to internal bleeding, which is visible in vomit and/or stools. Over time, the toxins that would normally be removed from the body by a healthy liver can cause multiple organ failure, followed by death. When to seek medical help You should see your GP if you have persistent signs and symptoms of cirrhosis. Seek immediate medical help if you develop the following symptoms, particularly if you’ve been previously diagnosed with cirrhosis: fever and shivering attacks shortness of breath vomiting blood very dark or black tarry stools periods of mental confusion or drowsiness Causes of cirrhosis There are many different causes of cirrhosis. In the UK, the most common causes are drinking excessive amounts of alcohol and long-term hepatitis C infections. In some cases,


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causes of cirrhosis. In the UK, the most common causes are drinking excessive amounts of alcohol and long-term hepatitis C infections. In some cases, no specific cause is identified. Alcohol consumption The liver breaks down toxins (poisons), such as alcohol, but too much alcohol can scar and damage the liver’s cells. Men and women who drink more than 14 units of alcohol a week are considered to be drinking too much. If you’re a heavy drinker, your chances of developing cirrhosis are increased. However, it’s important to realise that cirrhosis of the liver isn’t just a condition that affects people dependent on alcohol. If you’re a heavy social drinker, you can also develop cirrhosis. Alcohol-related cirrhosis usually develops after 10 or more years of heavy drinking. For unknown reasons, some people are more susceptible to liver cell damage than others. Women who drink heavily are more susceptible to liver damage than men, partly because of their different body size and build. Stages


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than others. Women who drink heavily are more susceptible to liver damage than men, partly because of their different body size and build. Stages of alcoholic liver damage People who drink excessively and continue to drink heavily develop cirrhosis in 3 separate stages. The first stage of alcohol-related liver disease is known as ‘fatty liver’, which almost all excessive drinkers develop. It’s a side effect of the liver breaking alcohol down and disappears when you drink less. The second stage of alcohol-related liver disease is alcoholic hepatitis. Around 20% to 30% of people who continue to drink heavily develop alcoholic hepatitis. During this stage, the liver becomes inflamed. If alcoholic hepatitis deteriorates into its most extreme form (liver failure) it can lead to death. About 10% of heavy drinkers develop cirrhosis, which is the third stage of alcohol-related liver disease. This risk of developing cirrhosis, along with the risk of alcoholic hepatitis, is one of the main


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the third stage of alcohol-related liver disease. This risk of developing cirrhosis, along with the risk of alcoholic hepatitis, is one of the main reasons the government recommends that men and women should not regularly drink more than 14 units a week. If you do drink as much as 14 units a week, it is advised that you spread your drinking over 3 or more days. A unit of alcohol is roughly equivalent to half a pint of normal-strength lager or a single measure (25ml) of spirits. A small glass of wine (125ml) is about 1.5 units. Read more about alcohol units. Your GP can give you help and advice if you’re finding it difficult to cut down the amount you drink. Hepatitis Hepatitis is inflammation of the liver. Left untreated, it can damage the liver over many years, eventually resulting in cirrhosis. In the UK, hepatitis C is the most common form of hepatitis. The hepatitis C virus is usually transmitted through blood-to-blood contact, most commonly by sharing needles used to inject


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form of hepatitis. The hepatitis C virus is usually transmitted through blood-to-blood contact, most commonly by sharing needles used to inject drugs. Two other types of hepatitis infection, hepatitis B and D, can also cause cirrhosis. Non-alcoholic steatohepatitis Non-alcoholic steatohepatitis (NASH) is a severe liver condition that can lead to cirrhosis. As with alcohol-related liver disease, the early stage of NASH is the build-up of excess fat in the liver. This fat is associated with inflammation and scarring, which could lead to cirrhosis. NASH can develop in people who are obese, have diabetes, have high levels of fat in the blood (high cholesterol) and high blood pressure. Most people with NASH feel well and aren’t aware they have a problem until cirrhosis occurs and liver function is affected. NASH is on the rise in the UK due to increasing levels of obesity and reduced physical activity. It’s likely that it will overtake alcohol and hepatitis C as the most common cause of


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to increasing levels of obesity and reduced physical activity. It’s likely that it will overtake alcohol and hepatitis C as the most common cause of cirrhosis. Other causes There are a number of other conditions that can prevent the liver functioning healthily and can lead to cirrhosis. These include: autoimmune liver disease – the immune system usually makes antibodies to attack bacteria and viruses; however, if you have an autoimmune disease, such as autoimmune hepatitis, primary biliary cirrhosis or primary sclerosing cholangitis (PSC), your immune system will make antibodies that attack healthy organs some rare, genetic conditions – such as haemochromatosis (a build-up of iron in the liver and other parts of the body) and Wilson’s disease (a build-up of copper in the liver and other parts of the body) any condition that causes the bile ducts to become blocked – such as cancer of the bile ducts or pancreatic cancer Budd-Chiari syndrome – caused by blood clots blocking the veins


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bile ducts to become blocked – such as cancer of the bile ducts or pancreatic cancer Budd-Chiari syndrome – caused by blood clots blocking the veins that carry blood from the liver Less commonly, the use of certain medications, such as amiodarone and methotrexate, can also cause cirrhosis. Diagnosing cirrhosis If your GP suspects cirrhosis, they’ll check your medical history and carry out a physical examination to look for signs of chronic liver disease. If your GP suspects your liver is damaged, you’ll be referred for tests to confirm the diagnosis. Tests You may have a number of different tests. Blood tests Blood tests can measure your liver function and the amount of liver damage. A blood test may be used to measure the levels of the liver enzymes alanine transaminase (ALT) and aspartate transferase (AST) in your blood, as these will be raised if you have inflammation of the liver (hepatitis). Scans An ultrasound scan, transient elastography scan, computerised tomography (CT) scan


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be raised if you have inflammation of the liver (hepatitis). Scans An ultrasound scan, transient elastography scan, computerised tomography (CT) scan or a magnetic resonance imaging (MRI) scan may be carried out on your liver. A transient elastography scan is similar to an ultrasound scan carried out during pregnancy (it’s sometimes known as a Fibroscan). These scans can produce detailed images of your liver or check liver stiffness to identify any scarring. The Lab Tests Online UK website has more information about ALT and AST measurements. Liver biopsy A liver biopsy is where a fine needle is inserted into your body (usually between your ribs) to remove a small sample of liver cells. The sample is sent to a laboratory so it can be examined under a microscope. The biopsy is usually carried out under local anaesthetic, as a day case or with an overnight stay in hospital. The outcome of the biopsy will confirm a diagnosis of cirrhosis and may provide more information about the cause.


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with an overnight stay in hospital. The outcome of the biopsy will confirm a diagnosis of cirrhosis and may provide more information about the cause. However, transient elastography is increasingly being used as an alternative to a biopsy in the diagnosis of cirrhosis. Endoscopy An endoscopy is where an endoscope (a thin, long, flexible tube with a light and video camera at the end) is passed down your throat and into your stomach. Images of your oesophagus (tube from your throat to your stomach) and stomach are transmitted to an external screen where any varices (swollen vessels), which are a sign of cirrhosis, can be seen. Grading There are several different grading systems for cirrhosis according to how serious it is. One system is the Child-Pugh score which, based on your examination and laboratory tests, grades cirrhosis from A (relatively mild) to C (severe). An alternative system called model of end-stage liver disease (MELD) uses the results of a blood test to help identify


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mild) to C (severe). An alternative system called model of end-stage liver disease (MELD) uses the results of a blood test to help identify people who need an urgent liver transplant. Treating cirrhosis Cirrhosis can’t be cured, so treatment aims to manage the symptoms and any complications and stop the condition getting worse. It’s usually not possible to reverse liver damage that’s already occurred, although recent research suggests this may eventually be possible in cases where the underlying cause of the liver damage can be successfully treated. Treatment is likely to take place at a hospital with a specialist hepatology unit, which treats disorders of the liver, gall bladder and biliary ducts. Stopping cirrhosis getting worse Taking medication to treat the underlying cause of the liver damage and making healthy lifestyle changes can help stop cirrhosis getting worse and reduce your risk of developing further health problems. Medication The medication you need will depend on the


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help stop cirrhosis getting worse and reduce your risk of developing further health problems. Medication The medication you need will depend on the specific cause of the damage to your liver. For example, if you have viral hepatitis you may be prescribed anti-viral medications. If you have autoimmune hepatitis you may be given steroid medication (corticosteroids) or medication to suppress your immune system (immunosuppressants). Lifestyle changes There are a number of things you can do to help yourself stay healthy and reduce your chances of developing further problems if you have cirrhosis, including: completely avoid alcohol, regardless of the cause of your cirrhosis, as alcohol consumption increases the rate at which the condition progresses lose weight if you’re overweight or obese regular exercise to reduce muscle wasting practise good hygiene to reduce your chances of developing infections speak to your GP about vaccinations you may need, such as the annual flu vaccine or travel


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hygiene to reduce your chances of developing infections speak to your GP about vaccinations you may need, such as the annual flu vaccine or travel vaccines speak to your GP or pharmacist if you’re taking over-the-counter or prescription medications, as cirrhosis can affect the way your body processes some medicines Malnutrition is common in people with cirrhosis, so it’s important to ensure you have a balanced diet to help you get all the nutrients you need. Avoiding salty foods and not adding salt to foods you eat can help reduce your risk of developing swelling in your legs, feet and abdomen (tummy) caused by a build up of fluid. See tips for a lower salt diet for more information. The damage to your liver can also mean it’s unable to store glycogen, a carbohydrate that provides short-term energy. When this happens, the body uses its own muscle tissue to provide energy between meals, which leads to muscle wasting and weakness. Therefore, you may need extra calories and protein in


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own muscle tissue to provide energy between meals, which leads to muscle wasting and weakness. Therefore, you may need extra calories and protein in your diet. Healthy snacking between meals can top up your calories and protein. It may also be helpful to eat 3 or 4 small meals a day, rather than 1 or 2 large meals. Easing symptoms A number of treatments can ease the symptoms of cirrhosis, including: a low-sodium (salt) diet or tablets called diuretics to reduce the amount of fluid in your body tablets to reduce high blood pressure in your portal vein (the main vein that transports blood from the gut to the liver) and prevent or treat any infection creams to reduce itching Managing complications of advanced cirrhosis In cases of advanced cirrhosis, complications caused by the condition may need treatment. Swollen varices If you vomit blood or pass blood in your stools, you probably have swollen veins in your oesophagus (the long tube that carries food from the throat to the stomach).


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or pass blood in your stools, you probably have swollen veins in your oesophagus (the long tube that carries food from the throat to the stomach). These are known as oesophageal varices. In these cases, urgent medical attention is required. This means seeing your GP or going to the accident and emergency (A&E) department of your nearest hospital immediately. Certain procedures can help stop the bleeding and reduce the risk of it happening again, such as: banding – an endoscopy is carried out (a thin, flexible tube is passed down your throat) and a small band is placed around the base of the varices to help control the bleeding injection glue therapy – following an endoscopy, a type of medical ‘super glue’ is injected into the varices to make the blood clot, which helps to stop the bleeding a Sengstaken tube with a balloon on the end – a special tube is passed down your throat into your stomach and the balloon is inflated; this puts pressure on the varices and helps stop the bleeding


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special tube is passed down your throat into your stomach and the balloon is inflated; this puts pressure on the varices and helps stop the bleeding and you’ll be heavily sedated during the procedure a transjugular intrahepatic portosystemic stent shunt (TIPSS) – a metal tube called a stent is passed across your liver to join 2 large veins (the portal vein and hepatic vein); this creates a new route for your blood to flow through, therefore relieving the pressure that causes the varices You may also be given a type of medication called a beta-blocker, such as propanolol, to reduce the risk of bleeding or reduce the severity of any bleed that does occur. Fluid in the tummy and legs Ascites (a build-up of fluid around your stomach area) and peripheral oedema (fluid around your legs and ankles) are common complications of advanced cirrhosis. They’ll need to be addressed as soon as possible. You may have 20 to 30 litres of free water in your stomach area (abdomen), which can make it


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They’ll need to be addressed as soon as possible. You may have 20 to 30 litres of free water in your stomach area (abdomen), which can make it difficult for you to eat and breathe properly. The main treatments for ascites and oedema are restricting sodium (salt) in your diet and taking diuretic tablets, such as spironolactone or furosemide. If the fluid around your stomach becomes infected, you may need to be treated with antibiotics. Alternatively, antibiotics may be used on a regular basis to prevent infection in people at high risk. In severe cases of ascites, tubes may be used to drain the fluid from your abdomen. This will usually be repeated every few weeks. Encephalopathy People with cirrhosis can sometimes develop problems with their brain function (encephalopathy). This occurs because the liver isn’t clearing toxins properly. The main treatment for encephalopathy is lactulose syrup. This acts as a laxative (it helps clear the bowels) and helps the body remove the toxins that


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main treatment for encephalopathy is lactulose syrup. This acts as a laxative (it helps clear the bowels) and helps the body remove the toxins that build up in the body when the liver is failing. In some cases, other laxatives or an enema may be used. Bleeding Cirrhosis can affect the liver’s ability to make the blood clot (thicken), leaving you at risk of severe bleeding if you cut yourself. Vitamin K and a blood product called plasma can be given in emergencies to treat episodes of bleeding. You’ll need to apply pressure to any cuts that bleed. Therefore, you should seek specialist advice before having medical procedures, including any dental work. Liver transplant Your liver may stop functioning if it’s severely damaged by scarring. In this situation, a liver transplant is the only option. This is a major procedure that involves removing your diseased liver and replacing it with a healthy donor liver. However, you’ll probably have to wait a long time for a liver transplant because


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your diseased liver and replacing it with a healthy donor liver. However, you’ll probably have to wait a long time for a liver transplant because there are more people waiting for a transplant than there are donors. The NHSBT Organ Donation website has more information about transplants and joining the Organ Donor Register. Preventing cirrhosis You can reduce your chances of developing cirrhosis by limiting your alcohol consumption and protecting yourself from a hepatitis infection. Limiting your alcohol consumption Heavy alcohol consumption is one of the most common causes of cirrhosis of the liver. One of the best ways to avoid this is to keep within recommended limits. men and women are advised not to regularly drink more than 14 units a week spread your drinking over 3 days or more if you drink as much as 14 units a week If you have cirrhosis, you should stop drinking alcohol immediately because it speeds up the rate at which the condition progresses, regardless of the cause. Read


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you should stop drinking alcohol immediately because it speeds up the rate at which the condition progresses, regardless of the cause. Read more about alcohol misuse. Protect yourself from hepatitis Cirrhosis can be caused by infectious conditions, such as hepatitis B and C. Hepatitis B and C can be caught through having unprotected sex or by sharing needles to inject drugs. Using a condom when having sex will help you avoid the risk of getting hepatitis, as will avoiding injecting drugs. Anyone who’s at risk of getting hepatitis B, such as police officers and social care workers, can be protected by being vaccinated against the condition. However, there’s currently no vaccine for hepatitis C. People born in areas of the world where hepatitis B and C are widespread, such as parts of South Asia and Africa, need to be screened for hepatitis, as early treatment can help prevent the onset of cirrhosis. Source: NHS 24 - Opens in new browser window Last updated: 29 May 2023 How can we


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as early treatment can help prevent the onset of cirrhosis. 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 Other health sites Lab Tests Online UK: bilirubin Adfam: support for families British Liver Trust British Liver Trust: hepatitis C PBC Foundation: primary biliary cholangitis Hepatitis C Trust 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/chest-and-rib-problems-and-conditions/clavicle-collar-bone-fracture/


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Clostridium difficile | 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 Clostridium difficile Clostridium difficile Clostridium difficile, also known as C. difficile or C. diff, is a bacterium that can infect the bowel and cause diarrhoea. The infection most commonly affects people who have recently been treated with antibiotics, but can spread easily to others. C. difficile infections are unpleasant and can sometimes cause serious bowel problems, but they can usually be treated with another course of antibiotics. Symptoms of a C. difficile infection Symptoms of a C. difficile infection usually develop when you’re taking antibiotics, or when you’ve finished taking them within the last few weeks. The most common symptoms are: watery diarrhoea, which can be bloody painful tummy cramps feeling sick signs of dehydration, such as


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last few weeks. The most common symptoms are: watery diarrhoea, which can be bloody painful tummy cramps feeling sick signs of dehydration, such as a dry mouth, headaches and peeing less often than normal a high temperature (fever) of above 38C (100.4F) loss of appetite and weight loss In some cases, serious complications can develop, such as damage to the bowel or severe dehydration, which may cause drowsiness, confusion, a rapid heart rate and fainting. Who’s most at risk of C. difficile? C. difficile mostly affects people who: have been treated with broad-spectrum antibiotics (antibiotics that work against several types of bacteria) or several different antibiotics at the same time, or those taking long-term antibiotics have had to stay in a healthcare setting, such as a hospital or care home, for a long time are over 65 years old have certain underlying conditions, including inflammatory bowel disease (IBD), cancer or kidney disease have a weakened immune system, which can be


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have certain underlying conditions, including inflammatory bowel disease (IBD), cancer or kidney disease have a weakened immune system, which can be because of a condition such as diabetes or a side effect of a treatment such as chemotherapy or steroid medication are taking a medication called a proton pump inhibitor (PPI) to reduce the amount of stomach acid they produce have had surgery on their digestive system Many C. difficile infections used to occur in places where many people take antibiotics and are in close contact with each other, such as hospitals and care homes. However, strict infection control measures have helped to reduce this risk, and an increasing number of C. difficile infections now occur outside these settings. When to get medical advice Visiting your GP surgery with a possible C. difficile infection can put others at risk, so it’s best to phone your GP or NHS 111 if you’re concerned or feel you need advice. Phone your GP if: you have persistent diarrhoea after


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at risk, so it’s best to phone your GP or NHS 111 if you’re concerned or feel you need advice. Phone your GP if: you have persistent diarrhoea after finishing a course of antibiotics you have bloody diarrhoea you have diarrhoea and experience severe tummy pain, a high fever, a rapid heart rate or fainting you have symptoms of severe dehydration, such as confusion, drowsiness, only passing small amounts of urine or no urine at all If your GP is closed, phone 111. Diarrhoea can be caused by a number of conditions and is a common side effect of antibiotics, so having diarrhoea while taking antibiotics doesn’t necessarily mean you have a C. difficile infection. Your GP may suggest sending off a sample of your poo to confirm whether you have C. difficile. A blood test may also be carried out to help determine how severe the infection is, and sometimes you may need tests or scans in hospital to check if your bowel is damaged. Treatment for C. difficile Your GP will decide whether you need


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sometimes you may need tests or scans in hospital to check if your bowel is damaged. Treatment for C. difficile Your GP will decide whether you need hospital treatment (if you’re not already in hospital). If the infection is relatively mild, you may be treated at home. If you’re in hospital, you might be moved to a room of your own during treatment to reduce the risk of the infection spreading to others. Treatment for C. difficile can include: stopping the antibiotics thought to be causing the infection, if possible – in mild cases, this may be the only treatment that’s needed taking a 10 to 14-day course of antibiotics that are known to kill C. difficile bacteria rarely, serious infections may require surgery to remove a damaged section of the bowel C. difficile infections usually respond well to treatment, with most people making a full recovery in a week or two. However, the symptoms come back in around 1 in 5 cases and treatment may need to be repeated. Looking after yourself at


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recovery in a week or two. However, the symptoms come back in around 1 in 5 cases and treatment may need to be repeated. Looking after yourself at home If you’re well enough to be treated at home, the following measures can help relieve your symptoms and prevent the infection spreading. Do make sure you finish the entire course of any antibiotics you’re prescribed, even if you’re feeling betterdrink plenty of fluids to avoid dehydration and eat plain foods such as soup, rice, pasta and bread if you feel hungrytake paracetamol for tummy pain or a feverregularly wash your hands and contaminated surfaces, objects or sheetsstay at home until at least 48 hours after your last episode of diarrhoea Don’t do not take anti-diarrhoeal medication, as this can stop the infection being cleared from your body Your GP may contact you regularly to make sure you’re getting better. Phone them if your symptoms return after treatment finishes, as it may need to be repeated. How you get C. difficile C.


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sure you’re getting better. Phone them if your symptoms return after treatment finishes, as it may need to be repeated. How you get C. difficile C. difficile bacteria are found in the digestive system of about 1 in every 30 healthy adults. The bacteria often live harmlessly because the other bacteria normally found in the bowel keep it under control. However, some antibiotics can interfere with the balance of bacteria in the bowel, which can cause the C. difficile bacteria to multiply and produce toxins that make the person ill. When this happens, C. difficile can spread easily to other people because the bacteria are passed out of the body in the person’s diarrhoea. Once out of the body, the bacteria turn into resistant cells called spores. These can survive for long periods on hands, surfaces (such as toilets), objects and clothing unless they’re thoroughly cleaned, and can infect someone else if they get into their mouth. Someone with a C. difficile infection is generally


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unless they’re thoroughly cleaned, and can infect someone else if they get into their mouth. Someone with a C. difficile infection is generally considered to be infectious until at least 48 hours after their symptoms have cleared up. How to stop C. difficile spreading C. difficile infections can be passed on very easily. You can reduce your risk of picking it up or spreading it by practising good hygiene, both at home and in healthcare settings. The following measures can help: stay at home until at least 48 hours after your symptoms have cleared up wash your hands regularly with soap and water, particularly after going to the toilet and before eating – use liquid rather than bar soap and don’t use flannels or nail brushes clean contaminated surfaces – such as the toilet, flush handle, light switches and door handles – with a bleach-based cleaner after each use don’t share towels and flannels wash contaminated clothes and sheets separately from other washing at the highest possible


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cleaner after each use don’t share towels and flannels wash contaminated clothes and sheets separately from other washing at the highest possible temperature when visiting someone in hospital, observe any visiting guidelines, avoid taking any children under the age of 12, and wash your hands with liquid soap and water when entering and leaving ward areas – don’t rely on alcohol hand gels, as they’re not effective against C. difficile avoid visiting hospital if you’re feeling unwell or have recently had diarrhoea 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 Antibiotics Preparing and cooking food safely Other health sites Lab Tests Online UK: C.


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feedback Add this page to Info For Me Also on NHS inform Antibiotics Preparing and cooking food safely Other health sites Lab Tests Online UK: C. difficile test Food Standards Scotland: Food safety and hygeine 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/coeliac-disease/coeliac-disease/


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Cold sore | 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 Cold sore Cold sore Cold sores are small blisters that develop on the lips or around the mouth. They’re caused by the herpes simplex virus (HSV) and usually clear up without treatment within 7 to 10 days. Symptoms of cold sores You may not have any symptoms when you first become infected with HSV (the primary infection). An outbreak of cold sores may occur later and keep coming back (recurrent infection). However, if the primary infection does cause symptoms, they can be quite severe. In children Symptoms of the primary infection are most likely to develop in children younger than 5 years old. These include: swollen and irritated gums with small, painful sores in and around the mouth – this is known as herpes simplex gingivostomatitis sore throat and swollen glands producing more


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with small, painful sores in and around the mouth – this is known as herpes simplex gingivostomatitis sore throat and swollen glands producing more saliva than normal high temperature (fever) of 38C (100.4F) or above dehydration feeling sick (nausea) headaches Herpes simplex gingivostomatitis usually affects young children, but adults can also develop it. It can last 7 to 14 days, with the sores taking up to 3 weeks to heal. However, gingivostomatitis doesn’t usually happen after the primary infection. In adults Symptoms of the primary infection are rare in adults but are similar to those experienced by children. You’ll usually have a sore throat with or without swollen glands. You may also have bad breath (halitosis) and painful sores in and around your mouth. These can develop into ulcers with grey or yellow centres. If you develop HSV at an early age, it may be triggered periodically in later life and can cause recurring bouts of cold sores. After the primary infection, the


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HSV at an early age, it may be triggered periodically in later life and can cause recurring bouts of cold sores. After the primary infection, the symptoms are usually reduced to just the cold sores themselves. When to get medical advice If you have cold sores you can get advice and treatment directly from a pharmacy. Your pharmacist may recommend that you speak to your GP if required. Find your local pharmacy Speak to your GP practice if: the cold sore has not started to heal within 10 days you’re worried about a cold sore or think it’s something else the cold sore is very large or painful you or your child have swollen, painful gums and sores in the mouth (gingivostomatitis) you have a weakened immune system – for example, because of chemotherapy, diabetes, or HIV Treatment for cold sores Things you can do Do eat cool, soft foods wash your hands with soap and water before and after applying cream avoid anything that triggers your cold sores use sunblock lip balm (SPF 15 or above) if


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hands with soap and water before and after applying cream avoid anything that triggers your cold sores use sunblock lip balm (SPF 15 or above) if you’re outside in the sun use an antiseptic mouthwash if brushing your teeth is painful take paracetamol or ibuprofen to ease pain and swelling (both come in liquid form for young children) – do not give aspirin to children under 16 drink plenty of fluids to avoid dehydration Don’t do not kiss anyone while you have a cold sore do not have oral sex until your cold sore completely heals do not touch your cold sore (apart from applying cream) – if you do, wash your hands do not rub cream into the cold sore – dab it on instead do not eat acidic or salty foods if they make your cold sore feel worse Treatment from a pharmacist If you get cold sores, a pharmacist may recommend: creams to ease pain and irritation antiviral creams to speed up the healing time cold sore patches to protect the skin while it heals You can buy electronic devices from


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and irritation antiviral creams to speed up the healing time cold sore patches to protect the skin while it heals You can buy electronic devices from pharmacies that treat cold sores with light or lasers. Some people find these helpful, but there have not been many studies to confirm if they work. If you regularly get cold sores, use antiviral creams as soon as you recognise the early tingling feeling. They do not always work after blisters appear. Treatment from a GP If your cold sores are very large, painful and keep coming back, your GP may prescribe antiviral tablets. Newborn babies, pregnant women and people with a weakened immune system who have cold sores may be referred to hospital for advice or treatment. What causes cold sores Cold sores are usually caused by the herpes simplex virus type 1 (HSV-1). In most cases, the virus is passed on in early childhood. For example, when a child is kissed by a family member or friend with a cold sore. The virus passes through the skin and


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on in early childhood. For example, when a child is kissed by a family member or friend with a cold sore. The virus passes through the skin and travels up the nerves, where it lies inactive (dormant) until it’s triggered at a later date. Cold sore triggers Things that can trigger a cold sore outbreak include: having another infection, such as a respiratory tract infection having a high temperature (fever) emotional upset or psychological stress tiredness and fatigue an injury to the affected area menstruation (periods) strong sunlight However, in many cases, there’s no obvious trigger for an outbreak. Herpes simplex virus type 2 Sometimes, cold sores can be caused by the herpes simplex virus type 2 (HSV-2). This can happen after having oral sex with someone who has genital herpes, which is usually caused by HSV-2. In genital herpes, painful blisters develop on your genitals and the surrounding area. Preventing infection It’s not possible to prevent infection with the herpes simplex


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blisters develop on your genitals and the surrounding area. Preventing infection It’s not possible to prevent infection with the herpes simplex virus or prevent outbreaks of cold sores. However, there are things you can do to minimise the spread of infection. Cold sores are at their most contagious when they burst (rupture), but remain contagious until they’re completely healed. Avoid close contact with others until your cold sore has completely healed and disappeared. However, there’s no need to stay away from work or miss school if you or your child have a cold sore. Complications of cold sores Cold sores are usually mild, but may cause complications in rare cases. People with weak immune systems caused by illness or treatments such as chemotherapy are particularly at risk of complications. Dehydration sometimes occurs if drinking fluids becomes painful. Young children are particularly at risk of becoming dehydrated. Other complications of cold sores include: skin infections – these


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becomes painful. Young children are particularly at risk of becoming dehydrated. Other complications of cold sores include: skin infections – these often happen if the virus comes into contact with broken skin, such as a cut or graze, or a skin condition such as eczema herpetic whitlow (whitlow finger) – this causes painful sores and blisters to appear on and around your fingers herpetic keratoconjunctivitis – this causes swelling and irritation (inflammation) of your eye area and sores to develop on your eyelids Source: NHS 24 - Opens in new browser window Last updated: 13 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 Search for a pharmacy near you Enter a place or postcode NHS inform About NHS inform Editorial policy


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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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Common cold | 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 Common cold Common cold A cold is a very common mild viral infection. You can often treat a cold without seeing a GP. You should begin to feel better in about 1 to 2 weeks. There is a separate page on if your child has cold or flu symptoms. Symptoms of a cold The main symptoms of a cold include: a sore throat a blocked or runny nose sneezing a cough a hoarse voice generally feeling unwell Less common symptoms of a cold include: high temperature (fever) – this is usually about 37°C to 39°C (98.6°F to 102.2°F) a headache earache – severe earache may be a sign of a middle ear infection muscle aches loss of taste and smell mild irritation of your eyes a feeling of pressure in your ears and face When to get medical advice Speak to your GP practice if you or your child:


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mild irritation of your eyes a feeling of pressure in your ears and face When to get medical advice Speak to your GP practice if you or your child: are more short of breath than usual have pain when breathing in or coughing feel confused, dizzy or lightheaded have a very high or low temperature – for example, you feel either hot or cold to touch or you’re shivering have had a fever for more than 3 days have symptoms that are not improving or they are affecting your daily life have a long-term medical condition – for example, diabetes, or a heart, lung or kidney condition have a weakened immune system – for example, because you’re having chemotherapy If your GP is closed, phone 111. Speak to a pharmacist if you have a cold and would like advice and treatment. Find your local pharmacy Treatment for a cold There’s no cure for a cold, but there are things you can do to look after yourself at home. You should begin to feel better in about 1 to 2 weeks. Things you can do to help your


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but there are things you can do to look after yourself at home. You should begin to feel better in about 1 to 2 weeks. Things you can do to help your symptoms Do rest drink plenty of fluids eat healthily take over-the-counter pain relief, such as paracetamol or ibuprofen, to relieve high temperature and aches use decongestant sprays or tablets to relieve a blocked nose try remedies such as gargling salt water and sucking on menthol sweets 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. Be careful not to use cough and cold medicines if you’re taking paracetamol and ibuprofen tablets. Cough and cold medicines often also contain paracetamol and ibuprofen so it can be easy to take more than the recommended dose. How do colds spread? A person can start spreading a cold from a few days before their symptoms start until


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to take more than the recommended dose. How do colds spread? A person can start spreading a cold from a few days before their symptoms start until their symptoms have gone. You can catch the virus from an infectious person by: touching an object or surface contaminated by infected droplets and then touching your mouth, nose or eyes touching the skin of someone who has the infected droplets on their skin and then touching your mouth, nose or eyes breathing in tiny droplets of fluid that contain the cold virus – these are launched into the air when an infected person coughs or sneezes Different viruses can cause a cold. It’s possible to have different colds one after the other, as each one may be caused by a different virus. How to prevent a cold from spreading Do wash your hands often, especially before touching your nose or mouth and before handling food always sneeze and cough into tissues throw away used tissues straight away and wash your hands clean surfaces regularly use your own


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handling food always sneeze and cough into tissues throw away used tissues straight away and wash your hands clean surfaces regularly use your own cup, plates, cutlery and kitchen utensils do not share towels or toys with someone who has a cold Is it a cold or flu? It can sometimes be difficult to tell if you have a cold or flu, as the symptoms can be similar. The main differences are that flu symptoms: come on quickly usually include a headache, high temperature (fever) and sore muscles make you feel too unwell to continue your usual activities Cold symptoms: come on slowly mainly affect your nose and throat are fairly mild, so you can still get around and are usually well enough to go to work What’s the difference between a cold and flu? Complications of a common cold Colds usually clear up without causing any further problems. But the infection can sometimes spread to your chest, ears or sinuses. Source: NHS 24 - Opens in new browser window Last updated: 12 December 2024 How can we


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infection can sometimes spread to your chest, ears or sinuses. Source: NHS 24 - Opens in new browser window Last updated: 12 December 2024 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Don’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 If your child has cold or flu symptoms 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/cardiovascular-disease/heart-disease/congenital-heart-disease/


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Congenital heart conditions | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotland’s Service Directory 0 Home Illnesses and conditions Cardiovascular disease Heart disease Congenital heart disease Congenital heart disease About congenital heart disease Symptoms of congenital heart disease Causes of congenital heart disease Diagnosing congenital heart disease Treating congenital heart disease Complications of congenital heart disease About congenital heart disease Congenital heart disease is a general term used to refer to a series of birth defects that affect the heart. Types of congenital heart disease There are over 30 different types of heart defect. The two main types of congenital heart disease are: cyanotic heart disease acyanotic heart disease Cyanotic heart disease Cyanotic heart is where problems with the heart mean there isn’t enough oxygen present in the blood. Babies born with cyanotic heart


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heart disease Cyanotic heart is where problems with the heart mean there isn’t enough oxygen present in the blood. Babies born with cyanotic heart disease generally have a blue-coloured tinge to areas such as their fingers, toes and lips because of a lack of oxygen. They may also experience symptoms of: breathlessness chest pain palpitations fainting fatigue Acyanotic heart disease Acyanotic heart disease is where the blood contains enough oxygen but it’s pumped abnormally around the body. Babies born with acyanotic heart disease may not have any apparent symptoms but, over time, the condition can cause health problems. In this group of conditions there can be a significant increase in blood pressure, putting the heart under more strain as it works much harder. This can weaken the heart, and increases the risk of developing heart failure, where the muscle is unable to efficiently pump blood around the body. In addition, the blood pressure in the lungs is often too high. This is known


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where the muscle is unable to efficiently pump blood around the body. In addition, the blood pressure in the lungs is often too high. This is known as pulmonary hypertension and can damage the lungs and cause symptoms such as: breathlessness fatigue dizziness fainting How common is congenital heart disease? Congenital heart disease is the most common type of birth defect, with 1 in 180 babies being born with the condition. Some babies born with congenital heart disease will require immediate surgery after birth, while many others will probably require surgery or medication at some point during their childhood. Congenital heart disease can sometimes develop alongside certain genetic conditions, such as Down’s syndrome. An infection during pregnancy, such as rubella, can also cause congenital heart disease. However, many cases of congenital heart disease have no clear cause. Outlook for congenital heart disease The outlook for congenital heart disease varies depending on the type and


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heart disease have no clear cause. Outlook for congenital heart disease The outlook for congenital heart disease varies depending on the type and severity of the heart defect. Research into the causes and improved treatments have meant that, 80% of children with congenital heart disease will survive into adulthood. This poses new challenges for healthcare services because some of these adults have complex health needs and require life-long specialised care. In response to this, the Department of Health has recommended the creation of specialised centres to care for adults with congenital heart disease. Congenital heart disease in adults is sometimes known as ‘grown-up congenital heart disease’ (GUCH) or Adult Congenital Heart Disease (ACHD). Symptoms of congenital heart disease As stated in the introduction, the two main types of congenital heart disease are: cyanotic heart disease acyanotic heart disease Symptoms of cyanotic heart disease The symptoms of cyanotic heart disease


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heart disease are: cyanotic heart disease acyanotic heart disease Symptoms of cyanotic heart disease The symptoms of cyanotic heart disease include: a blue coloured tinge to the lips, fingers and toes (cyanosis) palpitations fainting fatigue chest pains breathing problems Children with cyanotic heart disease have lower levels of oxygen in their blood, this is known as hypoxia. Sometimes, their oxygen levels can fall further and cause additional symptoms such as anxiety and confusion or disorientation. Symptoms of acyanotic heart disease The symptoms of acyanotic heart disease include: severe tiredness palpitations chest pain shortness of breath (particularly during activities such as climbing the stairs) Common symptoms of congenital heart disease There are some symptoms that are present in both cyanotic and acyanotic heart disease. These include: poor appetite and feeding difficulties sweating, particularly when a baby is feeding delayed growth Children with acyanotic heart disease


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include: poor appetite and feeding difficulties sweating, particularly when a baby is feeding delayed growth Children with acyanotic heart disease are usually underweight, and children with cyanotic heart disease are usually underweight and small for their age. Causes of congenital heart disease To understand how congenital heart disease can affect your child’s heart and general health, it’s useful to first understand how a healthy heart works. Find out how your heart works, on the British Heart Foundation website. Congenital heart disease develops when abnormalities in the heart’s structure prevent it from working as it should. The 2 main types of congenital heart disease are: cyanotic heart disease acyanotic heart disease Common types of acyanotic heart disease Ventricular septal defect (VSD) Ventricular septal defect (VSD) is a very common cause of acyanotic heart disease. In cases of VSD, there is a hole between the left and right ventricle. As blood pressure is higher on the


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common cause of acyanotic heart disease. In cases of VSD, there is a hole between the left and right ventricle. As blood pressure is higher on the left-hand side of the heart, blood is pushed through the hole and into the right ventricle. The heart then has to work harder to pump the excess blood out of the right ventricle, which can put a strain on the heart. The excess level and pressure of the blood can also increase the blood pressure in the lungs and damage them (pulmonary hypertension). Atrial septal defect (ASD) Atrial septal defect (ASD) is a similar type of defect to VSD, but the hole is between the left and right atria rather than the ventricles. ASD can place extra strain on the heart, and potentially damage the lungs. When referring to a ‘hole in the heart’, healthcare professionals are usually referring to either VSD or ASD. Find out more about ASD on the British Heart Foundation website Pulmonary stenosis In pulmonary stenosis, the pulmonary valve in the right side of


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Find out more about ASD on the British Heart Foundation website Pulmonary stenosis In pulmonary stenosis, the pulmonary valve in the right side of the heart is unusually narrow meaning that the heart has to work harder to pump blood into the lungs, which can put a strain on the heart. Aortic stenosis In aortic stenosis, the aortic valve in the left side of the heart is unusually narrow, which means that the heart has to work harder to pump blood through the valve. Because the aortic valve is the main route for oxygen-rich blood to supply the body, the narrowing can lower the body’s oxygen supply, which can cause symptoms of breathlessness and dizziness. Patent ductus ateriosus (PDA) Patent ductus ateriosus (PDA) is a duct or passage in the heart that is meant to close shortly after birth. When an unborn baby is in the womb, there is no need for the baby’s heart to send blood to the lungs because the baby is getting all the oxygen it needs from the mother through the placenta.


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is no need for the baby’s heart to send blood to the lungs because the baby is getting all the oxygen it needs from the mother through the placenta. Therefore, the ductus ateriosus acts as a bypass, meaning that the blood can flow back into the heart without entering the lungs. Shortly after birth, the duct should close as the baby begins to breathe normally. However, in cases of PDA, the duct fails to completely close, which means that some oxygen-rich blood that is meant to be pumped away from the lungs leaks back through the duct and back into the lungs. This can place strain on the heart and the lungs because they have to work harder to compensate for the problems caused by the duct. Common types of cyanotic heart disease Tetralogy of Fallot (TOF) Tetralogy of Fallot (TOF) is the most common cause of cyanotic heart disease. TOF is not one heart defect but a combination of four different heart defects. Tetralogy is a Greek word that means ‘four-fold’, and Fallot is the name of the


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one heart defect but a combination of four different heart defects. Tetralogy is a Greek word that means ‘four-fold’, and Fallot is the name of the doctor who first identified the condition. In cases of TOF, there are four defects that affect the heart: A hole between the left and right ventricle (Ventricular Septal Defect). A narrowing of the pulmonary valve (pulmonary stenosis). The muscles of the right ventricle are unusually thick (right ventricular hypertrophy). The aorta sits over both the left and right ventricles, instead of just the left ventricle in a normal heart (overriding aorta). As a result of this complex set of heart defects, oxygen-rich blood and oxygen-low blood become mixed. This leads to blood with lower-than-normal oxygen content being pumped around the body. As the body’s cells and tissue are not receiving enough oxygen, the child will develop symptoms of cyanotic heart disease. Find out more about TOF on the British Heart Foundation website Transposition of the


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the child will develop symptoms of cyanotic heart disease. Find out more about TOF on the British Heart Foundation website Transposition of the great arteries (TGA) Transposition of the great arteries (TGA) is a major cause of cyanotic heart disease. In cases of TGA, the pulmonary artery is attached to the left side of the heart, and the aorta is attached to the right side of the heart. This leads to oxygen-low blood, which should be pumped into the lungs, being pumped around the body, causing symptoms of cyanotic heart disease. Find out more about TGA on the British Heart Foundation website Risk factors for congenital heart disease In many cases of congenital heart disease, there is no clear reason why a baby is born with a defective heart. The known risk factors for congenital heart disease are listed below. Maternal diabetes Women with diabetes are five times more likely to give birth to a baby with congenital heart disease compared with women who do not have diabetes. It is


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with diabetes are five times more likely to give birth to a baby with congenital heart disease compared with women who do not have diabetes. It is estimated that out of every 100 pregnancies in women with diabetes, three to four will result in the birth of a baby with a heart defect. The increased risk is thought to be due to the high levels of insulin in the blood, which may interfere with the development of the foetus. Rubella The viral infection rubella (also known as German measles) is a major risk factor for congenital heart disease if a woman contracts an infection during early pregnancy. If a woman contracts the viral infection rubella (also known as German measles) during the first 12 weeks of pregnancy, there is an 80% chance that her baby will be born with a birth defect, such as congenital heart disease. Maternal alcohol abuse Mothers who exceed the recommended daily alcohol intake during pregnancy have an increased risk of their baby being born with congenital heart


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abuse Mothers who exceed the recommended daily alcohol intake during pregnancy have an increased risk of their baby being born with congenital heart disease. Alcohol is best avoided during pregnancy; however no more than 2-3 units should be consumed on a daily basis for any adult. Genetic conditions There are a number of genetic conditions (health conditions that a baby inherits from one or both parents) that can cause congenital heart disease. Down’s syndrome is the most widely known genetic condition that can cause congenital heart disease. Down’s syndrome is a condition where children are born with a range of disabilities as the result of a genetic abnormality. Approximately half of children with Down’s syndrome will have congenital heart disease. Other genetic conditions linked to congenital heart disease include: Turner syndrome Noonan syndrome Diagnosing congenital heart disease An increasing number of cases of congenital heart disease are now diagnosed by carrying out a foetal


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syndrome Diagnosing congenital heart disease An increasing number of cases of congenital heart disease are now diagnosed by carrying out a foetal echocardiograph before a baby is born. A foetal echocardiograph is made possible by using a type of ultrasound scanner that has been specially designed to build a picture of the unborn baby’s heart. It should be carried out during routine antenatal examinations, usually sometime between the 18th and 20th week of pregnancy. It is not always possible to detect heart defects (particularly mild ones) using a foetal echocardiography. Postnatal diagnosis If a baby is born with cyanotic heart disease, a diagnosis can usually be made quickly and confidently due to the distinctive blue colour of their skin. If your baby is born with acyanotic heart disease, their symptoms may not become immediately apparent for several months, or possibly years, after birth. Possible signs that your child may have a cyanotic heart disease include: problems feeding


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for several months, or possibly years, after birth. Possible signs that your child may have a cyanotic heart disease include: problems feeding slow growth shortness of breath after exercising tiredness after exercising swelling of their hands, feet and ankles You should contact your GP if your child has any of the above symptoms. Further testing can confirm or disprove a diagnosis of congenital heart disease. Further testing Echocardiogram An echocardiogram may be used to check your child’s heart. Sometimes, underlying problems with the heart, which were missed during a foetal echocardiogram, can be detected as a child grows up. Find out more about an echocardiogram on the British Heart Foundation website Electrocardiogram (ECG) An electrocardiogram (ECG) is a test that measures the electrical activity of the child’s heart. Electrodes are placed on the skin across the chest, arms and legs, and then connected to an ECG machine. The machine analyses the electrical signals produced by


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are placed on the skin across the chest, arms and legs, and then connected to an ECG machine. The machine analyses the electrical signals produced by the heart in order to assess the heart rhythm. Find out more about an ECG on the British Heart Foundation website Chest X-ray A chest X-ray of the heart and lungs can check whether there are any abnormalities in the lungs, or whether the heart is larger than normal. Both of these can be signs of congenital heart disease. Find out more about a chest x-ray on the British Heart Foundation website Pulse oximetry Pulse oximetry is a test that measures how much oxygen is present in the blood. The test involves placing a special sensor on your child’s fingertip, ear or toe. The sensor sends out light waves. A computer that is connected to the sensor measures how the light waves are being absorbed, and gives a percentage reading. A healthy person should have a reading of 94% or above. It is common for those with cyanotic heart defects to have


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and gives a percentage reading. A healthy person should have a reading of 94% or above. It is common for those with cyanotic heart defects to have readings below this value. Cardiac catheterisation Cardiac catheterisation is a useful way of finding out more information about exactly how the blood is pumping through the child’s heart. During a cardiac catheterisation, a small flexible tube, known as a catheter, will be inserted into one of the child’s blood vessels, usually in the groin or arm. The tube is moved up into the heart, using X-rays to help guide it. A contrast dye that shows up on X-rays can be injected into the tube. The dye can then be studied as it moves through the heart, enabling medical staff to see how well each chamber of the heart is working. Blood pressure readings in different parts of the heart can also be taken; this will help with diagnosis and treatment planning. Cardiac catheterisation is usually performed under a local anaesthetic and is a relatively


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this will help with diagnosis and treatment planning. Cardiac catheterisation is usually performed under a local anaesthetic and is a relatively painless procedure. Treating congenital heart disease There are a number of different surgical techniques that can be used to treat congenital heart disease. Some of these are explained below. Catheters A catheter, similar to the tube that is used during diagnosis, is inserted into the heart and tools are passed down the catheter to repair the heart defects. The advantage of this type of surgery is that it’s minimally invasive, which means that your child will not have to have open heart surgery. Open heart surgery For more serious types of heart defects, it may be necessary to operate directly on the heart. During open heart surgery, the heart may be stopped and a machine used to pump blood around your child’s body (bypass machine). An incision is made in your child’s chest so that the heart defects can be surgically repaired, or damaged


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around your child’s body (bypass machine). An incision is made in your child’s chest so that the heart defects can be surgically repaired, or damaged parts of the heart, such as the valves, can be replaced. Heart transplant In more serious cases of congenital heart disease, the heart may be too damaged, and the child too ill, for corrective surgery to be safely carried out. In this circumstance, their heart may have to be replaced with a donated heart. If your child requires a heart transplant, their details will be placed on the National Transplant Database (NTD). Depending on the condition of your child’s heart, it may be necessary to keep them in hospital in order to support the function of their heart until a donated heart becomes available. Machines, such as the ventricle assist device (VAD), act like an external mechanical heart, and can assist in pumping blood around the body. Priority for heart transplants is based on clinical need, rather than on a first-come-first-served


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and can assist in pumping blood around the body. Priority for heart transplants is based on clinical need, rather than on a first-come-first-served basis. If your child is in a very unstable condition, they will be prioritised whereas more stable children will have to wait for a longer period of time. Once a donated heart of the right size and blood group becomes available, you will be contacted by the transplant team and asked to go to the transplant unit as soon as possible. You may be given a bleeper so that you can be contacted as soon as possible. Find out more about heart transplantation on the British Heart Foundation website. Treatment for common types of congenital heart disease Specific treatments for the most common types of congenital heart disease are described below. Septal defects If your child is diagnosed with a ventricular septal defect (VSD) or an atrial septal defect (ASD), the recommended treatment will depend on the size of the defect. If the defect is small, a


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septal defect (VSD) or an atrial septal defect (ASD), the recommended treatment will depend on the size of the defect. If the defect is small, a policy of ‘watchful waiting’ may be recommended, where your child receives no immediate treatment but their health is carefully monitored. This is because 90% of small defects will close as the child grows older. In cases of mild to medium-sized defects, it may be possible to seal the defect using a catheter. The catheter is guided to the site of the hole, and a specially designed mesh is passed through the catheter to seal the defect. In cases of medium to large-sized defects, open-heart surgery may be required. This involves a patch being stitched directly over the defect. Stenosis If your child is diagnosed with a stenosis (a narrowing one of their valves) the treatment that is recommended will depend on the extent of the stenosis and if they are symptomatic. In mild cases, a policy of ‘watchful waiting’ may be recommended. Medication that


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depend on the extent of the stenosis and if they are symptomatic. In mild cases, a policy of ‘watchful waiting’ may be recommended. Medication that lowers blood pressure may also be recommended to reduce the strain on your child’s heart and lungs. In more serious cases of stenosis, a catheter can be used to widen the valve. A small balloon is passed up through the catheter and then inflated to widen the affected valve. This is known as a balloon angioplasty. Once the valve has been widened, the balloon is removed. Sometimes, a metal coil (stent) is used to keep the valve widened. In more serious cases of stenosis, it’s sometimes necessary to replace the valve using open heart surgery. Replacement valves can be obtained from human donors, or made from artificial materials, such as titanium, or taken from pigs and modified for human use. Pigs are used because their hearts are the most similar to the human heart. For people who are too ill or weak to withstand the effects of open heart


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Pigs are used because their hearts are the most similar to the human heart. For people who are too ill or weak to withstand the effects of open heart surgery, a catheter approach can be used. The catheter is passed through a blood vessel in the groin and up into the heart. A replacement valve is passed through the catheter and into position. Patent ductus ateriosus (PDA) Many cases of patent ductus ateriosus (PDA) can be treated shortly after birth, using medication. Two types of medication – indomethacin and a special type of ibuprofen – have been shown to effectively stimulate the closure of the duct that is responsible for PDA. If a PDA does not respond to medication, a catheter can be used to seal the duct with a metal coil or plug. Tetralogy of Fallot (TOF) Babies born with Tetralogy of Fallot (TOF) who are experiencing severe symptoms of breathlessness may require emergency surgery such as a Blalock-Taussig shunt (a BT shunt). During a BT shunt, an artery is diverted (or


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symptoms of breathlessness may require emergency surgery such as a Blalock-Taussig shunt (a BT shunt). During a BT shunt, an artery is diverted (or shunted) into the lungs so that a supply of oxygen-rich blood becomes available. Further open-heart surgery is then recommended when the baby is old enough to withstand the after-effects of surgery. During open-heart surgery, the defect between the ventricles is sealed and the pulmonary valve is widened. Transposition of the great arteries (TGA) Transposition of the great arteries (TGA) will require open-heart surgery, which is usually done shortly after your baby is born. A surgical technique, known as an arterial switch, is usually used to treat cases of TGA. During an arterial switch, the affected arteries are cut and reattached to their correct position on the other side of the heart. Congenital heart disease in adulthood About 80% of children with congenital heart disease will survive into adulthood. Living as an adult with congenital


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heart disease in adulthood About 80% of children with congenital heart disease will survive into adulthood. Living as an adult with congenital heart disease involves a new set of challenges. Some adults will require specialised care. Routine medical procedures, such as giving birth or having a general anaesthetic, will need to be closely supervised by specialist staff with experience in treating adults with congenital heart disease. There is also the risk that previous heart surgery, such as the insertion of a replacement valve, will fail and that further surgery will be required. Due to these factors, it’s recommended that older teenagers register with a specialised adult congenital heart disease clinic. The clinic will be able to provide regular check-ups and assessments, liaise with other specialised medical services as required, and provide on-going support and advice. Your GP or treatment team can give you more information about services in your area for adults with congenital


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provide on-going support and advice. Your GP or treatment team can give you more information about services in your area for adults with congenital heart disease. Complications of congenital heart disease Many children with congenital heart disease will experience delays in their development, and may take longer to reach certain stages in their development, such as walking or talking. Some children with congenital heart disease also have associated learning difficulties and require specialised educational and psychological assistance. If your child has congenital heart disease, your local educational authority should draw up an individual education plan (IEP). The IEP makes an assessment of your child’s current and future needs, and provides access to any specialised services that your child needs, such as speech and language therapy or an educational psychologist. The IEP will take into account what level of physical activity is safe for your child. Children with congenital heart


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or an educational psychologist. The IEP will take into account what level of physical activity is safe for your child. Children with congenital heart disease should be encouraged to be as active as possible, but certain activities, such as contact sports, may have to be avoided. Endocarditis Both children and adults with congenital heart disease have an increased risk of developing endocarditis. Endocarditis is an infection of the lining of the heart and, left untreated, it can be life-threatening because it damages the valves of the heart. Symptoms of endocarditis include: fever chills sweating (including night sweats) muscular aches and pains chest pain coughs weakness and fatigue headache shortness of breath Endocarditis will need to be with injections of antibiotics (intravenous antibiotics). This will involve a hospital stay for several weeks. Endocarditis usually develops when an infection in another part of the body, such as on the skin or the gums spreads through the blood


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several weeks. Endocarditis usually develops when an infection in another part of the body, such as on the skin or the gums spreads through the blood into the heart. Due to the risk of gum disease leading to endocarditis, it is very important that you have excellent oral hygiene if you have congenital heart disease. It is also usually recommended that you avoid having any cosmetic procedure that involves the piercing of the skin, such tattoos or body piercings. Source: Chest Heart & Stroke Scotland - Opens in new browser window Last updated: 09 January 2025 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Don’t include personal information e.g. name, location or any personal health conditions. Email Address e.g. you@example.com Message Maximum of 500 characters Send feedback Add this page to Info For Me Also on NHS inform British Heart Foundation: Congenital heart disease NHS inform About NHS inform Editorial policy Contact us Webchat


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to Info For Me Also on NHS inform British Heart Foundation: Congenital heart 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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Conjunctivitis | 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 Eyes Conjunctivitis Conjunctivitis Return to Symptoms Enter age Last Updated: Next Review Date: Review my answers Find your local services Search for a service near you by entering your postcode below. Please input your postcode in the following format: A12 1BC GP Practices Dental Services Pharmacies Opticians Postcode Search NHS inform has more information on this condition. Read more Previous Start guide Review my answers × You told us your credentials were: : You said: Based on the information you gave us, we made the following recommendation: Close Keep a copy View PDF Conjunctivitis (or red eye) is a common eye condition. It usually gets better in a few weeks without treatment. Symptoms of conjunctivitis Conjunctivitis usually causes symptoms in both eyes like: inflammation redness


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better in a few weeks without treatment. Symptoms of conjunctivitis Conjunctivitis usually causes symptoms in both eyes like: inflammation redness itching a burning or gritty feeling watering pus that sticks to the eyelashes Causes of conjunctivitis Conjunctivitis happens when the conjunctiva becomes inflamed. This is a thin layer of cells covering the front of your eyes. The 3 most common causes of this inflammation are: infection (infective conjunctivitis) an allergic reaction (allergic conjunctivitis) something irritating the conjunctiva, like a loose eyelash (irritant conjunctivitis) Treating and preventing conjunctivitis Do boil water and let it cool down before you gently wipe your eyelashes to clean off crusts with a clean cotton wool pad (1 piece for each eye) hold a cold towel over your eyes for a few minutes wash your hands regularly – this is particularly important after touching your eyes use lubricant eye drops – these are available at pharmacies or they may be prescribed


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– this is particularly important after touching your eyes use lubricant eye drops – these are available at pharmacies or they may be prescribed for you Don’t do not rub your eyes do not wear contact lenses until the symptoms have cleared up don’t re-use old lenses after the infection has gone – they could cause re-infection do not not share pillows or towels You don’t need to take time off school or work if you have conjunctivitis unless you’re feeling very unwell. Get advice from a pharmacist Speak to a pharmacist for advice about conjunctivitis. They can suggest eyedrops or antihistamines to help with your symptoms. Find your nearest pharmacy Phone an optometrist urgently if you have: pain in your eyes sensitivity to light changes in your vision, like wavy lines or flashing very red eyes (1 eye or both eyes) a baby less than 28 days old with red eyes These can be signs of a more serious eye problem. If your optometrist is closed phone 111. Speak to an optometrist if: your baby has


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with red eyes These can be signs of a more serious eye problem. If your optometrist is closed phone 111. Speak to an optometrist if: your baby has red eyes – get an urgent appointment if your baby is less than 28 days old you wear contact lenses and have conjunctivitis symptoms as well as spots on your eyelids – you might be allergic to the lenses you have symptoms that haven’t cleared up after 2 weeks Treatments for conjunctivitis Treatment for conjunctivitis will depend on what’s causing it. You may be prescribed antibiotics to treat a bacterial infection. But these won’t work if the symptoms are caused by a virus or an allergy. Allergic conjunctivitis can usually be treated with antihistamines. If possible, you should also try to avoid the substance that triggered the allergy. Irritant conjunctivitis will ease when whatever is causing the symptoms is removed. Some sexually transmitted infections (STIs) can cause conjunctivitis. This type takes longer to get better. Eye problems


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the symptoms is removed. Some sexually transmitted infections (STIs) can cause conjunctivitis. This type takes longer to get better. Eye problems self-help guide Complete our self-help guide to check your symptoms and find out what to do next. Source: Scottish Government - Opens in new browser window Last updated: 27 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 Self-help guide: Eye problems Other health sites Look after your eyes: conjunctivitis 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/constipation/


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


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Coronary heart disease | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotland’s Service Directory 0 Home Illnesses and conditions Cardiovascular disease Heart disease Coronary heart disease Coronary heart disease Phone 999 if: You or someone else has symptoms like: central chest pain or discomfort in the chest that doesn’t go away – it may feel like pressure, tightness or squeezing pain that radiates down the left arm, or both arms, or to the neck, jaw, back or stomach unconsciousness seizures or fitting difficulty breathing (snoring or rasping) rapid heart beat low or undetectable heart beat chest pain and breathlessness, nausea, sweating or coughing up blood What is coronary heart disease? Coronary heart disease (CHD) is a term used to describe what happens when the blood flow to the heart is interrupted or reduced. It is also known as ischaemic heart disease. Often, the reduction or blockage in blood


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when the blood flow to the heart is interrupted or reduced. It is also known as ischaemic heart disease. Often, the reduction or blockage in blood flow is caused by atherosclerosis. This is when a fatty material called atheroma builds up inside the coronary arteries. This can narrow the coronary arteries, reducing the blood flow. If a piece of atheroma breaks off, this can cause a blockage and cut off blood supply to the heart. This is known as a heart attack. Further information is available about the diagnosis, treatment and management of: a heart attack angina Symptoms of coronary heart disease The main symptoms of coronary heart disease are: chest pain (angina) shortness of breath pain throughout the body feeling faint feeling sick (nausea) Phone 999 if: you think you or someone else is having a heart attack Heart failure and coronary heart disease Heart failure can sometimes occur in people with CHD. This is when the heart becomes too weak to pump blood around the body. This can


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heart disease Heart failure can sometimes occur in people with CHD. This is when the heart becomes too weak to pump blood around the body. This can cause fluid to build up in the lungs, making it increasingly difficult to breathe. Chest pains without coronary disease Microvascular angina is a problem with tiny blood vessels that supply blood to your heart. It may be caused when these tiny blood vessels: can’t open up properly to let your blood flow severely narrow, blocking blood flow to the heart The main symptom of microvascular angina is chest pain. You may feel it at any time. Lifestyle changes can often improve symptoms. Read further information about microvascular angina Further information is available on the impact of heart disease on women Diagnosing coronary heart disease Many different tests may be used to diagnose coronary heart disease, including: CT coronary angiography (CTCA) coronary angiography electrocardiogram (ECG) thallium scan (myocardial perfusion scintigraphy)


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disease, including: CT coronary angiography (CTCA) coronary angiography electrocardiogram (ECG) thallium scan (myocardial perfusion scintigraphy) magnetic resonance imaging (MRI) Risk factors for coronary heart disease There are various risk factors for heart disease, some of which you have control over and others that you don’t. Uncontrollable risk factors Uncontrollable risk factors for heart disease include: age family history of heart disease or stroke ethnicity being post-menopausal Lifestyle risk factors Your risk can also be increased by certain lifestyle factors. These are sometimes called controllable risk factors. For example, your diet, level of physical activity and smoking habits. You can make lifestyle changes to reduce your risk of heart disease, including: eating a balanced diet weight management keeping active and exercising regularly stopping smoking Health conditions If you’ve been diagnosed with some other health conditions, you might also be at increased risk of


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regularly stopping smoking Health conditions If you’ve been diagnosed with some other health conditions, you might also be at increased risk of heart disease. These conditions include: hypertension (high blood pressure) high cholesterol type 2 diabetes polycystic ovary syndrome (PCOS) inflammatory diseases, including rheumatoid arthritis Support groups You might find support groups useful if you: have a heart condition have had a heart condition in the past are caring for someone with a heart condition Your GP or specialist should be able to provide you with details about your nearest support group. You can also search Scotland’s Services Directory. Information and support for people living with a heart condition is also provided by: The British Heart Foundation Chest, Heart & Stroke Scotland Source: Scottish Government - Opens in new browser window Last updated: 04 July 2024 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Don’t


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browser window Last updated: 04 July 2024 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Don’t include personal information e.g. name, location or any personal health conditions. Email Address e.g. you@example.com Message Maximum of 500 characters Send feedback Add this page to Info For Me Other health sites British Heart Foundation: Coronary heart disease Chest Heart & Stroke Scotland: Coronary heart 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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https://www.nhsinform.scot/illnesses-and-conditions/muscle-bone-and-joints/chest-and-rib-problems-and-conditions/costochondritis/


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Costochondritis | 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 Chest and rib problems and conditions Costochondritis Costochondritis This information may be useful for those who have been diagnosed with costochondritis. If you’re experiencing new or ongoing symptoms you should contact your healthcare professional. You might need an assessment to help with diagnosis and treatment. When the costochondral joint becomes inflamed it can result in sharp chest pain and tenderness. These symptoms may develop gradually or start suddenly. Phone 999 immediately if: You or someone else has symptoms like: central chest pain or discomfort that doesn’t go away – it may feel like pressure, tightness or squeezing pain that radiates down the left arm, or both arms, or to the neck, jaw, back or stomach unconsciousness seizures or fitting


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tightness or squeezing pain that radiates down the left arm, or both arms, or to the neck, jaw, back or stomach unconsciousness seizures or fitting difficulty breathing (snoring or rasping) rapid heart beat low or undetectable heart beat blue or pale tingling of knees, hands and lips chest pain and breathlessness, nausea, sweating or coughing up blood Phone 111 if: there’s been new significant trauma within the last 7 days, for example a fall from height or direct blow to the chest or ribs there’s a change in the shape of the ribcage like lumps or indentations you have an increased shortness of breath or new breathing difficulties your pain levels are preventing you from breathing deeply you’re coughing up blood you start to feel generally unwell tingling or burning sensation in the chest, neck or arms Contact your GP if: you have a persistent cough you’re coughing up yellow/green mucus (phlegm) If your GP surgery is closed, contact 111. About costochondritis Costochondritis is the


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cough you’re coughing up yellow/green mucus (phlegm) If your GP surgery is closed, contact 111. About costochondritis Costochondritis is the medical term for inflammation of the cartilage that joins your ribs to your breastbone (sternum). Cartilage is tough but flexible connective tissue. It acts as a shock absorber, cushioning the joints. Costochondritis will normally improve on its own after a few weeks but sometimes takes longer. The condition doesn’t lead to any permanent problems, but can occasionally flare up. Symptoms of costochondritis The main symptom of costochondritis is chest pain that appears centrally. The pain doesn’t usually spread across the chest or into the arms. The pain may be made worse by: certain positions or activities, like wearing a seatbelt or hugging someone deep breathing coughing and sneezing Modifying your activities while you recover may help reduce your symptoms. Causes of costochondritis Inflammation is the body’s natural response to infection,


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your activities while you recover may help reduce your symptoms. Causes of costochondritis Inflammation is the body’s natural response to infection, irritation or injury. It’s not known exactly why this area becomes inflamed but in some cases it’s been linked to: severe coughing which strains your chest area an injury to your chest physical strain from repeated exercise or sudden exertion that you’re not used to, such as moving furniture an infection, including respiratory tract infections (RTIs) Diagnosing costochondritis For costochondritis to be diagnosed you’ll need an assessment from a healthcare professional. They’ll initially ask you questions and then carry out a physical examination. You may sometimes need to have a further examination. This is to rule out other possible health conditions. Treating costochondritis Costochondritis often gets better after a few weeks. It’s often referred to as a self limiting condition. This means it can get better on its own over time.


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often gets better after a few weeks. It’s often referred to as a self limiting condition. This means it can get better on its own over time. Self-help steps and painkillers can help manage your symptoms. Costochondritis can be made worse by any activity that places stress on your chest area, for example strenuous exercise or repetitive movements. Any movement that makes the pain in your chest area worse should be modified until the inflammation in your ribs and cartilage has improved. Some examples of modified activity include: taking regular breaks changing your position regularly while sitting or lying down holding objects close to your body when lifting them hugging a cushion while you cough Pain treatments The following can help to reduce the pain: pain medication – this can help you move more comfortably, which can help your recovery heat packs More about taking painkillers. Treating with heat Remember to never place heat directly on your skin. Use a barrier, like a towel, to


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heat packs More about taking painkillers. Treating with heat Remember to never place heat directly on your skin. Use a barrier, like a towel, to protect your skin from a burn. How long you use heat as a treatment can depend on the painful area. Generally up to 15 minutes of heat, leaving a few hours between treatments, is the most useful. You should stop treating the area with heat and seek advice from a medical professional if you notice: an increase in redness discolouration blistering of the skin If you have any issues with circulation or sensation, you shouldn’t use heat as a treatment. Keeping active It’s important to try to keep moving as normally as possible during your recovery. It’s best to avoid long periods of rest where possible. You can try to increase your activity gradually to help your recovery. Pacing your activity levels Too much rest can slow down your recovery. As soon as you can, start moving and using the affected area. Remember a little activity is better than


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Too much rest can slow down your recovery. As soon as you can, start moving and using the affected area. Remember a little activity is better than nothing. Continue to stay within acceptable pain limits but you don’t need to be pain free. Aim to do a little bit more each day or every few days. How to tell if you’re moving at the right level This guide can help you to understand if you’re pacing your daily activities at the right level as you progress. It’ll also let you see how much pain or discomfort is acceptable. It can be helpful to rate your pain out of 10 (0 being no pain, 10 being the worst pain you’ve ever had), for example: 0 to 3 – minimal pain 4 to 5 – acceptable pain 6 to 10 – excessive pain Pain during and after activity Activity should not make your existing pain worse overall. Increasing activity can lead to increased discomfort as your body gets used to regaining your activity levels. Aim to keep your pain within a rating of 0 to 5. If your pain gets above this level,


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as your body gets used to regaining your activity levels. Aim to keep your pain within a rating of 0 to 5. If your pain gets above this level, you can change the level of activity by: reducing the number of times you do a movement reducing the pace of an activity increasing rest time between activities Work Your return to work will depend on the type of work you do and your employer. It may be possible to discuss a phased return to work or changed duties. You don’t need to see a healthcare professional to return to work. Hobbies and interests Keep doing any activities you’re able to, as your pain allows. Gradually increase what you do. Your symptoms may make things more difficult to start with. This will get better as you slowly build up to all of your usual activities. Help and support If your symptoms worsen or haven’t improved within 8 weeks following this advice, it’s a good idea to talk to a healthcare professional. Find out how to access MSK services in your area. When dealing


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8 weeks following this advice, it’s a good idea to talk to a healthcare professional. 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: 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 NHS inform About NHS inform Editorial policy Contact us Webchat Give feedback about NHS inform Info for Me tool Terms and conditions Privacy and cookies policy Freedom of information (FOI) Accessibility Other languages and formats © 2025 NHS 24 – v1.1.1.17852


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


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Crohn's disease | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotland’s Service Directory 0 Home Illnesses and conditions Stomach, liver and gastrointestinal tract Inflammatory bowel disease (IBD) Crohn’s disease Crohn’s disease Crohn’s disease is a long-term condition that causes inflammation of the lining of the digestive system. Inflammation can affect any part of the digestive system, from the mouth to the back passage. But it mostly occurs in the last section of the small intestine (ileum) or the large intestine (colon). Crohn’s disease can affect people of all ages, but it’s usually diagnosed between the age of 15 and 40. Symptoms The symptoms of Crohn’s disease vary. They depend on which part of the digestive system is inflamed. Common symptoms include: recurring diarrhoea abdominal pain and cramping, which is usually worse after eating extreme tiredness (fatigue) unintended weight loss blood and


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recurring diarrhoea abdominal pain and cramping, which is usually worse after eating extreme tiredness (fatigue) unintended weight loss blood and mucus in your poo You may have long periods without symptoms, or very mild symptoms. This is known as remission. This may be followed by periods where the symptoms are particularly troublesome. These are known as flare-ups or relapses. Less common symptoms include: a high temperature (fever) of 38°C (100°F) or above feeling sick (nausea) being sick (vomiting) joint pain and swelling (arthritis) inflammation and irritation of the eyes (uveitis) areas of painful, red and swollen skin – most often the legs mouth ulcers anal pain and discharge due to perianal Crohn’s Children with Crohn’s disease may grow at a slower rate than expected. Speak to your GP practice if you have: diarrhoea for more than 7 days persistent abdominal pain unexplained weight loss blood in your poo concern about your child’s development Causes The exact cause of Crohn’s


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7 days persistent abdominal pain unexplained weight loss blood in your poo concern about your child’s development Causes The exact cause of Crohn’s disease is unknown. A combination of factors may be responsible, including: genetics – genes you inherit from your parents a problem with the immune system (the body’s defence against infection and illness) – where it attacks healthy bacteria in the gut and causes inflammation environmental factors – like air pollution, medication or previous infections smoking – smokers are twice as likely to develop Crohn’s disease, and usually have more severe symptoms than non-smokers Diagnosis Your GP will usually ask you about: your pattern of symptoms your diet any recent travel – for example, you may have developed travellers’ diarrhoea whether you’re taking any medication, including any over-the-counter medicines whether anyone else in your family has any bowel conditions Your GP may also carry out a tests to check your general health. For


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medicines whether anyone else in your family has any bowel conditions Your GP may also carry out a tests to check your general health. For example, they may: check your pulse check your blood pressure measure your height and weight measure your temperature examine your abdomen (tummy) Your GP may also: arrange blood tests to check for inflammation, infection and anaemia ask for a stool (poo) sample to use a qFIT test to check for blood and mucus, infection or inflammation via a faecal calprotectin test Referral to a specialist You may be referred to a gastroenterologist. A gastroenterologist is a specialist in conditions of the digestive system. They might recommend more tests, such as: gastroscopy – a thin flexible tube with a camera is put into your mouth to look at your food pipe and stomach colonoscopy – a thin, flexible tube with a camera is put into your bottom to look at the whole of your large bowel sigmoidoscopy – a thin, flexible tube with a camera is put into your bottom to


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is put into your bottom to look at the whole of your large bowel sigmoidoscopy – a thin, flexible tube with a camera is put into your bottom to look at the end of your large bowel a colon capsule endoscopy (pill camera) X-ray or barium enema MRI scan or CT scan You will be told what tests you need and what you need to do to prepare for them. Treatment There’s currently no cure for Crohn’s disease, but treatment can improve the symptoms and keep the inflammation under control. Your treatment will usually be provided by a range of healthcare professionals. Once your symptoms are under control, you are likely to be offered treatment to help keep them under control. If your Crohn’s stays under control for a long time, you may choose to stop treatment. You may need to start again if your symptoms come back. Steroid medication The first treatment offered is usually steroids, such as prednisolone or budesonide (corticosteroids) to reduce inflammation quickly. Steroids are often effective in


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offered is usually steroids, such as prednisolone or budesonide (corticosteroids) to reduce inflammation quickly. Steroids are often effective in reducing your symptoms. But they can have significant side effects. So they’re not suitable for long-term use and your dose will slowly be reduced when your symptoms start to improve. Medicines to suppress your immune system Medicines to suppress your immune system (immunosuppressants) may be given alongside steroids if your symptoms flare up twice or more during 12 months, or return when your steroid dose is reduced. Common types include azathioprine, mercaptopurine and methotrexate. Biological therapies If steroids and immunosuppressants don’t help or aren’t right for you, biological therapies may be used. Biological therapies block particular chemicals involved in the immune response, which helps reduce inflammation. They’re made using living cells in a lab. They can be given as a drip or an injection. Treatment usually lasts at least 12


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helps reduce inflammation. They’re made using living cells in a lab. They can be given as a drip or an injection. Treatment usually lasts at least 12 months. Your inflammatory bowel disease (IBD) team will be able to discuss these with you. Common types are adalimumab, infliximab, ustekinumab or vedolizumab. There’s a risk that these medicines may cause side effects, which can cause symptoms such as: itchy skin a high temperature joint and muscle pain swelling of the hands or lips problems swallowing You should seek immediate medical help if you experience these symptoms. Reactions can occur immediately after treatment or months later, even after treatment stops. Surgery Surgery to treat Crohn’s disease may be an option if: you choose to have surgery instead of taking medications that may cause side effects medications don’t control your symptoms your quality of life is severely affected by your condition you have serious complications of Crohn’s disease Surgery might involve widening


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symptoms your quality of life is severely affected by your condition you have serious complications of Crohn’s disease Surgery might involve widening narrow parts of your bowel, or removing parts of it (resection). Resection involves removing the inflamed area of the intestine. If you have a resection, you might have the healthy sections of bowel joined back together. Or you might have the end of your small bowel joined to the skin of your tummy (an ileostomy or stoma). In this case, poo comes out of the opening on your tummy and is collected in special bags that you wear. An ileostomy might be temporary, to give your bowel time to heal, or it might be permanent. Your IBD team will tell you what surgery they recommend and let you know what to expect. Diet and smoking There is no evidence that a particular diet causes or triggers flare-ups of Crohn’s disease. But alongside medications, some changes to your diet may help control symptoms for some people. Do eat 5 to 6 small meals rather


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of Crohn’s disease. But alongside medications, some changes to your diet may help control symptoms for some people. Do eat 5 to 6 small meals rather than 3 main meals try to eat a healthy, varied diet that includes a wide variety of fruit, vegetables, nuts, seeds, proteins and wholegrains drink plenty of water Do not make major changes to your diet without talking to your IBD team and make sure you are still getting all the nutrients you need. You can speak to your IBD team about: keeping a food diary to find out if any particular foods affect your symptoms removing trigger foods from your diet taking a food supplement if you are struggling to get enough nutrients from your diet being referred to a dietitian If you smoke, it is advised that you make every effort to stop smoking, especially if you need to have surgery. If you smoke, smoking can make Crohn’s worse and is it important that you make every effort to stop smoking. Fertility and pregnancy A woman’s chance of becoming


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smoking can make Crohn’s worse and is it important that you make every effort to stop smoking. Fertility and pregnancy A woman’s chance of becoming pregnant isn’t usually affected by Crohn’s disease. However, surgery for Crohn’s disease might affect your fertility. Most women with Crohn’s disease will have a normal pregnancy and a healthy baby. But if you’re pregnant or planning a pregnancy you should discuss it with your IBD team. This is because they may need to change your medication. If you’re having a flare-up of Crohn’s disease you may also be advised to avoid getting pregnant until it’s under control. Complications Over time, inflammation can damage sections of the digestive system. This can result in complications such as: narrowing of the bowel (stricture) a channel developing between your bowel and your skin, another section of bowel or a body organ (fistula) These problems usually need surgical treatment. Information about you If you have Crohn’s disease, your clinical team


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bowel or a body organ (fistula) These problems usually need surgical treatment. Information about you If you have Crohn’s disease, your clinical team will pass information about you on to the National Congenital Anomaly and Rare Diseases Registration Service (NCARDRS). This helps scientists look for better ways to prevent and treat this condition. You can opt out of the register at any time. Find out more about the register Source: Scottish Government - Opens in new browser window Last updated: 24 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 Also on NHS inform Ulcerative colitis Inflammatory bowel disease (IBD) Other health sites Crohn's & Colitis UK: Crohn's Disease Crohn's & Colitis UK: Symptoms Crohn's & Colitis UK:


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Inflammatory bowel disease (IBD) Other health sites Crohn's & Colitis UK: Crohn's Disease Crohn's & Colitis UK: Symptoms Crohn's & Colitis UK: Tests and investigations Crohn's & Colitis UK: Fistulas Crohn's & Colitis UK: Stoma Crohn's & Colitis UK: Smoking Crohn's & Colitis UK: Treatments Crohn's & Colitis UK: Reproductive health Chron's & Colitis UK: Getting a diagnosis Chron's & Colitis UK: Joints Chron's & Colitis UK: Pregnancy and breastfeeding 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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Cystic fibrosis | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotland’s Service Directory 0 Home Illnesses and conditions Lungs and airways Cystic fibrosis Cystic fibrosis About cystic fibrosis Symptoms of cystic fibrosis Causes of cystic fibrosis Diagnosing cystic fibrosis Treating cystic fibrosis About cystic fibrosis Cystic fibrosis is an inherited condition in which the lungs and digestive system can become clogged with thick, sticky mucus. It can cause problems with breathing and digestion from a young age. Over many years, the lungs become increasingly damaged and may eventually stop working properly. Most cases of cystic fibrosis in the UK are now identified through screening tests carried out soon after birth. It’s estimated that 1 in every 2,500 babies born in the UK has cystic fibrosis. A number of treatments are available to help reduce the problems caused by the condition, but unfortunately


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born in the UK has cystic fibrosis. A number of treatments are available to help reduce the problems caused by the condition, but unfortunately average life expectancy is reduced for people who have it. Symptoms of cystic fibrosis Symptoms of cystic fibrosis tend to start in early childhood, although they can sometimes develop very soon after birth, or may not be obvious until adulthood. Some of the main symptoms of cystic fibrosis can include: recurring chest infections difficulty putting on weight frequent, wet-sounding coughs diarrhoea occasional wheezing and shortness of breath People with the condition can also develop a number of related conditions, including diabetes, thin, weakened bones (osteoporosis) and liver problems. Read more about the symptoms of cystic fibrosis Causes of cystic fibrosis Cystic fibrosis is caused by a faulty gene that a child inherits from both of their parents. The faulty gene means that some cells struggle to move salt and water across the cell wall.


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gene that a child inherits from both of their parents. The faulty gene means that some cells struggle to move salt and water across the cell wall. This, along with recurrent infections, can result in a build-up of thick, sticky mucus in the body’s tubes and passageways. To be born with cystic fibrosis, a child has to inherit two copies of this faulty gene – one from each of their parents. Their parents will not usually have the condition themselves, because they will only carry one faulty gene and one that works normally. If both parents carry the faulty gene, there’s a 25% chance that each child they have will be born with cystic fibrosis. Read more about the causes of cystic fibrosis Screening and testing for cystic fibrosis Most cases of cystic fibrosis are now detected soon after birth through the newborn blood spot test. This involves collecting a drop of blood from the baby’s heel and testing it for abnormalities that could indicate cystic fibrosis. More tests will be needed to


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collecting a drop of blood from the baby’s heel and testing it for abnormalities that could indicate cystic fibrosis. More tests will be needed to confirm the diagnosis, such as: a sweat test – to measure the amount of salt in sweat, as the sweat of someone with cystic fibrosis has higher levels of salt than normal a genetic test – where a sample of blood or saliva is checked for the faulty gene that causes cystic fibrosis These tests can also be carried out in older children and adults with symptoms of cystic fibrosis who haven’t been screened previously. If you have a family history of cystic fibrosis, you can be tested to determine if you’re at risk of having a child with the condition by checking if you’re a “carrier” of the faulty gene that causes it. Read more about how cystic fibrosis is diagnosed Treatments for cystic fibrosis There’s currently no cure for cystic fibrosis, but a number of treatments are available to help control the symptoms, prevent complications, and make


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There’s currently no cure for cystic fibrosis, but a number of treatments are available to help control the symptoms, prevent complications, and make the condition easier to live with. Possible treatments include: antibiotics to prevent and treat chest infections medicines to make the mucus in the lungs thinner and easier to cough up medicines to widen the airways and reduce inflammation special techniques and devices to help clear mucus from the lungs medicines that help the person absorb food better following a special diet and taking supplements to prevent malnutrition A lung transplant may eventually be needed if the lungs become greatly damaged. Read more about treating cystic fibrosis Outlook for cystic fibrosis Cystic fibrosis is a progressive condition, which means it tends to get worse over time. Eventually the condition can be fatal if it leads to a serious infection or the lungs stop working properly. The outlook for cystic fibrosis has improved considerably in recent years


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if it leads to a serious infection or the lungs stop working properly. The outlook for cystic fibrosis has improved considerably in recent years because of advancements in treatment, although most people with cystic fibrosis will have a shorter-than-average life expectancy. Currently, about half of the people with cystic fibrosis will live past the age of 40. Children born with the condition nowadays are likely to live longer than this. Symptoms of cystic fibrosis Cystic fibrosis can cause a range of problems. The lungs and digestive system are the main areas that are affected. Symptoms tend to start in early childhood, but sometimes they can develop soon after birth and very occasionally they may not be obvious until adulthood. Nowadays, cystic fibrosis is usually diagnosed before symptoms appear, through screening tests carried out soon after birth. Read more about screening for cystic fibrosis. The main problems associated with cystic fibrosis are outlined below. Lung problems


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soon after birth. Read more about screening for cystic fibrosis. The main problems associated with cystic fibrosis are outlined below. Lung problems Cystic fibrosis can cause sticky mucus to clog the lungs and airways. This can cause: recurring chest infections – these occur because mucus in the lungs is an ideal breeding ground for bacteria persistent inflammation of the airways, which can cause them to become abnormally widened (bronchiectasis) increased coughing occasional wheezing and shortness of breath Over time, the lungs can become increasingly damaged and may eventually stop working properly. Digestive system problems The mucus can also block parts of the digestive system, which can affect how food travels through the gut and how it’s broken down or absorbed. This can cause: a serious bowel obstruction in the first few days of life (meconium ileus) – this will often need an operation to remove the blockage jaundice diarrhoea or large, smelly stools problems putting on weight


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(meconium ileus) – this will often need an operation to remove the blockage jaundice diarrhoea or large, smelly stools problems putting on weight and growing – this can occur because the body struggles to digest and absorb nutrients (malnutrition) diabetes from late childhood or early adulthood – this can develop if the pancreas becomes severely damaged Other problems People with cystic fibrosis can also experience a number of other problems, including: sinusitis nasal polyps thin, weakened bones (osteoporosis) – this can occur as a result of repeated infections, poor growth, lack of physical activity and malnutrition swelling and pain in the joints (arthritis or arthralgia) from late childhood difficulty conceiving children – most men with cystic fibrosis are unable to have children naturally (although some fertility treatments may still work) because the tubes that carry sperm don’t develop correctly; women can become pregnant, however liver problems caused by the tiny bile ducts in


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work) because the tubes that carry sperm don’t develop correctly; women can become pregnant, however liver problems caused by the tiny bile ducts in the liver becoming blocked by mucus leaking of small amounts of urine, particularly during coughing fits (stress incontinence) Causes of cystic fibrosis Cystic fibrosis is caused by a faulty gene that a child inherits from both their parents. The faulty gene means that some cells struggle to move salt and water across the cell wall. This, along with recurrent infections, can result in a build-up of thick, sticky mucus in the body’s tubes and passageways – particularly the lungs and digestive system. The condition is present from birth and cannot be caught from someone else who has it. How cystic fibrosis is inherited Genes come in pairs. You inherit one set from your mother and one set from your father. To be born with cystic fibrosis, a child has to inherit a copy of the faulty gene from both of their parents. This can happen if the


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your father. To be born with cystic fibrosis, a child has to inherit a copy of the faulty gene from both of their parents. This can happen if the parents are ‘carriers’ of the faulty gene. This means they don’t have cystic fibrosis themselves, but they can have a child with the condition if their partner also carries the faulty gene. It’s estimated that around 1 in every 25 people in the UK are carriers of the faulty gene that causes cystic fibrosis. If both parents are carriers, there’s a: 25% chance that each child they have will not inherit any faulty genes and won’t have cystic fibrosis or be able to pass it on 50% chance that each child they have will just inherit one copy of the faulty gene from one parent and be a carrier 25% chance that each child they have will inherit copies of the faulty gene from both parents and will have cystic fibrosis This is known as an autosomal recessive inheritance pattern. Diagnosing cystic fibrosis Tests can be carried out to diagnose cystic


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cystic fibrosis This is known as an autosomal recessive inheritance pattern. Diagnosing cystic fibrosis Tests can be carried out to diagnose cystic fibrosis at any age. Most cases are now detected soon after birth through newborn screening, but older children and adults with symptoms of cystic fibrosis who weren’t screened can also have tests to check for the condition. Tests to find out if you are a ‘carrier’ of the faulty gene responsible for cystic fibrosis may also be recommended for some people. Newborn screening A newborn blood spot test is offered to all babies in Scotland to help detect problems early on, including cystic fibrosis. When your baby is five to eight days old, a health professional will prick their heel and collect drops of blood on a special card. The blood is then sent to a laboratory to be checked for abnormalities that could indicate cystic fibrosis. You should receive the results by the time your baby is six to eight weeks old. You will be contacted sooner if


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that could indicate cystic fibrosis. You should receive the results by the time your baby is six to eight weeks old. You will be contacted sooner if a problem is found, and you’ll be asked to attend a hospital appointment. The screening result isn’t 100% accurate, so more tests will be carried out to confirm the diagnosis. You, your partner and any other children you have may also be tested to see if you carry the faulty gene that causes cystic fibrosis. Confirming a diagnosis Tests to confirm a diagnosis will be carried out if screening suggests that your child may have cystic fibrosis, or your doctor thinks you could have the condition and you haven’t been screened previously. Two main tests can be used to diagnose cystic fibrosis: sweat test – a test to measure the amount of salt in sweat, as the sweat of someone with cystic fibrosis has higher levels of salt than normal genetic test – where a sample of blood or saliva is checked for the faulty gene that causes cystic fibrosis The


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has higher levels of salt than normal genetic test – where a sample of blood or saliva is checked for the faulty gene that causes cystic fibrosis The sweat test is most commonly used, although genetic testing may be done if the sweat test result is inconclusive or to identify the specific genetic fault that’s causing the condition. Carrier testing Testing to find out if you carry the faulty gene that causes cystic fibrosis may be useful if: you have a close relative, such as a child, sibling or parent, who’s a known carrier you have a close relative with cystic fibrosis your partner is known to carry the cystic fibrosis gene This can be done using a blood test, or occasionally a special mouthwash, to collect a sample of cells. The sample is then sent to a laboratory so it can be checked for the faulty gene. Finding out whether you’re a carrier of the faulty gene can help determine if you’re at risk of having a child with cystic fibrosis. A genetic counsellor will explain the results


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carrier of the faulty gene can help determine if you’re at risk of having a child with cystic fibrosis. A genetic counsellor will explain the results of the test to you and discuss the implications and options available for future pregnancies. Treating cystic fibrosis There’s currently no cure for cystic fibrosis, but it’s possible to help control the symptoms, prevent or reduce complications, and make the condition easier to live with. A person with cystic fibrosis will be supported by a team of healthcare professionals at a specialist cystic fibrosis centre. A care plan will be drawn up that’s tailored to their individual needs. A range of treatments may be used and sometimes treatment in hospital will be needed. Regular appointments to monitor the condition will also be recommended. Some of the main treatments for cystic fibrosis include: Medications for lung problems People with cystic fibrosis may need to take a number of different medicines to treat and prevent lung problems.


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Medications for lung problems People with cystic fibrosis may need to take a number of different medicines to treat and prevent lung problems. These may be swallowed, inhaled or injected. Some of the main medicines for cystic fibrosis are: antibiotics to prevent and treat chest infections medicines to make the sticky mucus in the lungs thinner, such as dornase alfa, hypertonic saline and mannitol dry powder a medicine called ivacaftor to help reduce the levels of mucus in the body – although this is only suitable for fewer than 1 in every 20 people (4%) with cystic fibrosis bronchodilators to widen the airways and help make breathing easier steroid medication to treat nasal polyps (small growths inside the nose) It’s also important that people with cystic fibrosis are up to date with all routine vaccinations and have the flu jab each year once they’re old enough. Airway clearance techniques In addition to medication, special techniques can be used to help keep the lungs and airways


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once they’re old enough. Airway clearance techniques In addition to medication, special techniques can be used to help keep the lungs and airways clear. A physiotherapist can give you advice. Some of the main techniques include: active cycle of breathing techniques (ACBT) – a technique that involves a sequence of relaxed breathing, followed by deep breathing exercises and then huffing autogenic drainage – a series of gentle breathing techniques that clear mucus from the lungs modified postural drainage – a technique that involves changing your position to make it easier to remove mucus from your lungs airway clearance devices – handheld devices that use vibration and air pressure to help remove mucus from your airways; you may have to pay in the region of £45-60 for one of these devices Your care team can provide more information on the techniques mentioned above. Dietary and nutritional advice For people with cystic fibrosis, getting the right nutrition is vital in helping them


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the techniques mentioned above. Dietary and nutritional advice For people with cystic fibrosis, getting the right nutrition is vital in helping them develop normally and stopping them becoming frequently ill. However, the majority of people with cystic fibrosis cannot digest food and absorb nutrients from when they’re a baby. Occasionally, the condition can cause the pancreas to become damaged over time, causing the same problem. A dietitian will advise on what you can do to help avoid malnutrition. They may recommend: taking digestive enzyme capsules with all meals and snacks to help with digestion – the number of capsules needed depends on the food being eaten and varies from person to person following a special balanced diet that’s high in calories (energy), fat and protein taking vitamin and mineral supplements Lung transplants In severe cases of cystic fibrosis, when the lungs stop working properly and all medical treatments have failed to help, a lung transplant may be


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In severe cases of cystic fibrosis, when the lungs stop working properly and all medical treatments have failed to help, a lung transplant may be recommended. A lung transplant is a serious operation that carries risks, but it can greatly improve the length and quality of life for people with severe cystic fibrosis. The outlook for people with cystic fibrosis is often better than for many transplant patients, as they’re often younger and in better general health. It’s estimated that up to 9 out of 10 people will survive for at least a year after a transplant. The Cystic Fibrosis Trust has information on lung transplants in cystic fibrosis. Treatments for associated problems People with cystic fibrosis can have a number of other problems that may benefit from treatment. For example: exercise can help keep bones and joints healthy, and is recommended for everyone with cystic fibrosis – any sport or exercise is usually good, but if you’re not sure about a particular activity, you should


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recommended for everyone with cystic fibrosis – any sport or exercise is usually good, but if you’re not sure about a particular activity, you should ask your physiotherapist for advice medicines called bisphosphonates can help treat weak and brittle bones that may occur as a result of cystic fibrosis if the person doesn’t get enough vitaminD and calcium (from their diet and/or from supplements) insulin medication and a special diet may help someone with diabetes caused by cystic fibrosis control their blood sugar levels Source: NHS 24 - Opens in new browser window Last updated: 26 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 Cystic Fibrosis Trust Genetic Alliance UK NHS inform About NHS inform Editorial


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Send feedback Add this page to Info For Me Other health sites Cystic Fibrosis Trust Genetic Alliance 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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Cystitis | NHS inform Home Illnesses and conditions Symptoms and self-help Tests and treatments Healthy living Care, support and rights Scotland’s Service Directory 0 Home Illnesses and conditions Kidneys, bladder and prostate Cystitis Cystitis Cystitis is a type of urinary tract infection (UTI) that affects the bladder. It’s common, particularly in women. Cystitis often gets better by itself but may sometimes be treated with antibiotics. If you experience frequent episodes of cystitis, you may need regular or long-term treatment. There’s also a chance that cystitis could lead to a more serious kidney infection. It’s important to seek professional advice if your symptoms don’t improve. Symptoms of cystitis Cystitis can cause problems with peeing and make you feel unwell. Symptoms of cystitis in adults Symptoms of cystitis in adults include: pain, burning or stinging when you pee needing to pee more often and urgently than normal feeling like you need to pee again soon after going to


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pain, burning or stinging when you pee needing to pee more often and urgently than normal feeling like you need to pee again soon after going to the toilet pee that’s dark, cloudy or strong-smelling pain low down in your tummy feeling generally unwell, achy, sick and tired blood in your urine In adults, cystitis doesn’t usually cause a high temperature (fever). If you have a temperature of 38C (100.4F) or above and pain in your lower back or sides, it may be a sign of a kidney infection. Symptoms of cystitis in children Symptoms of cystitis in children include: a high temperature (fever) of 38C (100.4F) or above weakness and tiredness irritability reduced appetite vomiting Children with cystitis can sometimes also have symptoms usually found in adults. This can include things like pain when peeing, peeing more often than normal, and pain in their tummy. When to get medical advice Contact your GP practice urgently if you or your child: have a very high or low temperature – for example,


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in their tummy. When to get medical advice Contact your GP practice urgently if you or your child: have a very high or low temperature – for example, you feel either hot or cold to touch or are shivering have pain in the lower tummy or in your back under the ribs are feeling confused, dizzy or lightheaded feel sick or are being sick – for example, you can’t keep food or fluids down have not had to pee all day or are showing other signs of dehydration have blood in your pee If your GP practice is closed, phone 111. Speak to your GP practice if you or your child: have symptoms of cystitis for the first time have symptoms of cystitis that have not improved within a few days have symptoms that have not gone away after treatment with antibiotics have severe symptoms of cystitis, such as severe pain in your lower tummy get cystitis frequently have symptoms of cystitis and you’re pregnant are male and have symptoms of cystitis Treatment for cystitis Mild cystitis will usually clear up on its


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symptoms of cystitis and you’re pregnant are male and have symptoms of cystitis Treatment for cystitis Mild cystitis will usually clear up on its own within a few days, although sometimes you may need to take antibiotics. Women who have had cystitis before don’t necessarily need to see their GP if the condition returns. Mild cases often get better without antibiotics. You can try the self-help measures or ask your pharmacist for advice. Things you can try yourself If you’ve had cystitis before and don’t feel you need to see your GP, there are some things you can do to help relieve your symptoms until the condition clears up. It may help to: take over-the-counter painkillers, like paracetamol or ibuprofen – always read the medicine information leaflet beforehand to check whether you can take it, and check with your pharmacist if you’re not sure drink plenty of water use a hot water bottle – holding a hot water bottle on your tummy or between your thighs may reduce any discomfort avoid


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sure drink plenty of water use a hot water bottle – holding a hot water bottle on your tummy or between your thighs may reduce any discomfort avoid having sex avoid drinks that may irritate your bladder, like fruit juices, coffee and alcohol pee frequently Some people find that drinking cranberry juice or using products that reduce the acidity of their pee (such as sodium bicarbonate or potassium citrate) reduces their symptoms. However, there’s no evidence that they help symptoms or treat cystitis. Treatment from a pharmacist Speak to your local pharmacist about cystitis treatments. Your pharmacist can: offer advice on how to treat your symptoms suggest which medication to take advise you on whether you need to see a GP about your symptoms Find your local pharmacist What to do if cystitis keeps coming back If you keep getting cystitis (known as recurrent cystitis) your doctor may prescribe stand-by antibiotics or continuous antibiotics. A stand-by antibiotic is a prescription you can


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as recurrent cystitis) your doctor may prescribe stand-by antibiotics or continuous antibiotics. A stand-by antibiotic is a prescription you can take to a pharmacy the next time you have symptoms of cystitis, without needing to visit your GP first. Continuous antibiotics are taken for several months to prevent further episodes of cystitis. These may be prescribed if cystitis: usually occurs after having sex – you may be given a prescription for antibiotics to take within 2 hours of having sex is not related to having sex – you may be given a low-dose antibiotic to take for a trial period of 6 months What causes cystitis? Cystitis is usually caused by a bacterial infection. Sometimes it’s caused by the bladder being irritated or damaged. Women have a shorter urethra than men. This means bacteria are more likely to reach the bladder and cause an infection. Things that can cause bacteria to reach the bladder include: having sex wiping your bottom after going to the toilet – particularly


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an infection. Things that can cause bacteria to reach the bladder include: having sex wiping your bottom after going to the toilet – particularly if you wipe from back to front inserting a tampon or urinary catheter (a thin tube inserted into the urethra to drain the bladder) using a diaphragm for contraception using spermicide with contraception a blockage in the urinary tract, such as kidney stones pregnancy conditions that make it difficult to empty the bladder fully, such as an enlarged prostate in men having been through menopause diabetes having a weakened immune system How to prevent cystitis If you get cystitis often, there are some things you can try to prevent it from coming back. Do wipe from front to back after going to the toilet empty your bladder as soon as possible after sex stay well hydrated – drinking plenty of fluids may help to stop bacteria multiplying in your bladder have a shower rather than a bath – this avoids exposing your genitals to the chemicals in your


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may help to stop bacteria multiplying in your bladder have a shower rather than a bath – this avoids exposing your genitals to the chemicals in your cleaning products for too long go to the toilet as soon as you need to pee and always empty your bladder fully wear underwear made from cotton, rather than synthetic material like nylon keep the genital area clean and dry change soiled nappies or incontinence pads frequently Don’t do not use perfumed bubble bath, soap or talcum powder around your genitals do not use spermicide with a diaphragm or condoms – try using lubricant (lube) that does not contain spermicide or a different method of contraception do not hold your pee in if you have to go to the toilet do not not wear tight jeans and trousers do not drink lots of alcohol or coffee as they may irritate your bladder Source: NHS 24 - Opens in new browser window Last updated: 07 May 2025 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received


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in new browser window Last updated: 07 May 2025 How can we improve this page? Help us improve NHS inform Thank You Your feedback has been received Don’t include personal information e.g. name, location or any personal health conditions. Email Address e.g. you@example.com Message Maximum of 500 characters Send feedback Add this page to Info For Me Also on NHS inform Kidney infection Self-help guide: Urinary infection Urinary tract infection (UTI) 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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Deafblindness | 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 Eyes Deafblindness Deafblindness About deafblindness Signs and symptoms of deafblindness Causes of deafblindness Diagnosing deafblindness Managing deafblindness About deafblindness Deafblindness is a combination of sight and hearing loss that affects a person’s ability to communicate, access information and get around. It’s also sometimes called ‘dual sensory loss’ or ‘multi-sensory impairment’. A deafblind person won’t usually be totally deaf and totally blind, but both senses will be reduced enough to cause significant difficulties in everyday life. These problems can occur even if hearing loss and vision loss are mild, as the 2 senses work together and 1 would usually help compensate for loss of the other. Signs of deafblindness Deafblindness most commonly affects older adults,


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work together and 1 would usually help compensate for loss of the other. Signs of deafblindness Deafblindness most commonly affects older adults, although it can affect people of all ages, including babies and young children. In older people, it may develop gradually and the person themselves may not realise their vision and/or hearing is getting worse at first. Signs of a problem can include: needing to turn up the volume on the television or radio difficulty following a conversation not hearing noises such as a knock at the door asking others to speak loudly, slowly and more clearly needing to hold books or newspapers very close, or sitting close to the television difficulty moving around unfamiliar places If someone already has either a hearing or vision problem, it’s important to look out for signs that suggest the other sense may be getting worse too. Read more about the symptoms of deafblindness Seeing your GP Visit your GP if you think your hearing and/or eyesight may be


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may be getting worse too. Read more about the symptoms of deafblindness Seeing your GP Visit your GP if you think your hearing and/or eyesight may be getting worse. If you’re worried about a friend or family member, encourage them to speak to their GP. It’s best to seek advice as soon as possible, as treatment for some underlying causes of deafblindness can be more effective if started early. Early diagnosis will also ensure the person is able to access local support services sooner. Read more about diagnosing and assessing deafblindness What causes deafblindness? There are many potential causes of deafblindness. Some babies are born deafblind, but in many cases the hearing and/or vision loss occurs later in life. Causes of deafblindness include: age-related hearing loss genetic conditions, such as Usher syndrome an infection picked up during pregnancy, such as rubella (German measles) cerebral palsy – a problem with the brain and nervous system that mainly affects movement and


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up during pregnancy, such as rubella (German measles) cerebral palsy – a problem with the brain and nervous system that mainly affects movement and co-ordination eye problems associated with increasing age, such as cataracts Read more about the causes of deafblindness Living with deafblindness A range of care and support services is available to help deafblind people. Each deafblind person will have a different level of hearing and sight loss, which means they’ll have their own individual care needs. The general aims of care for a deafblind person are to: preserve and maximise any remaining sight or hearing the person has – this could involve treating underlying conditions like cataracts, wearing glasses or using a hearing aid teach alternative methods of communication – such as hand on hand signing or braille help retain or develop as much independence as possible – for example, by training the person to use a long cane, a guide dog or offering a communicator guide Your local


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as much independence as possible – for example, by training the person to use a long cane, a guide dog or offering a communicator guide Your local authority should arrange an assessment to determine exactly what care and support is needed. Read more about managing deafblindness Signs and symptoms of deafblindness A person who’s deafblind won’t usually be totally deaf and totally blind, but both senses will be reduced enough to cause difficulties with everyday activities. The hearing and/or vision problems may be present from birth, but in many cases one or both problems develop gradually as a person gets older and they may not notice it themselves at first. If someone you know has a combination of the signs mentioned below, it’s possible they have some degree of deafblindness and should seek medical advice. Signs of a hearing problem Hearing loss can occur from birth or may develop gradually or suddenly later on. Signs that someone may have a problem with their hearing include: not


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loss can occur from birth or may develop gradually or suddenly later on. Signs that someone may have a problem with their hearing include: not hearing you if you speak to them from behind needing to turn up the volume on the television or radio difficulty following a conversation – particularly if several people are speaking or the person they’re speaking to is unfamiliar not hearing noises around them, such as a knock at the door or the doorbell ringing asking others to speak loudly, slowly and more clearly leaning in very close to hear what’s being said If someone already has a hearing problem – for example, they wear a hearing aid or use sign language – keep an eye out for signs of vision problems that could develop (see below). Signs of a vision problem Vision loss can also be present from birth or develop later on. Signs that someone may have a problem with their vision include: problems seeing in low light or bright light difficulty recognising people they know finding it hard


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may have a problem with their vision include: problems seeing in low light or bright light difficulty recognising people they know finding it hard to read facial expressions relying on touch to find and identify items more than usual needing to hold books or newspapers close to their face, or sitting near the television difficulty moving around unfamiliar places – they may bump into or trip over things regularly not looking directly at you or making proper eye contact If a person already has a problem with their vision – for example, they wear glasses, use a cane to get around, or have a condition such as glaucoma or cataracts – keep an eye out for signs of hearing problems that could develop (see above). Getting medical advice Visit your GP if you notice any deterioration in your hearing or eyesight. If you’re worried about a friend or family member’s vision and hearing, encourage them to speak to their GP. It’s best to seek advice as soon as possible, as treatment for some


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or family member’s vision and hearing, encourage them to speak to their GP. It’s best to seek advice as soon as possible, as treatment for some underlying causes of deafblindness can be more effective if started early. Early diagnosis will also ensure the person is able to access local support services sooner, and enable them to plan for the future (such as learning new communication methods). Read more about diagnosing deafblindness and managing deafblindness Causes of deafblindness There are many possible causes of deafblindness. The condition can either be present at birth or develop later in life. Deafblindness from birth Deafblindness from birth is known as congenital deafblindness. It can be caused by: problems associated with premature birth (birth before 37 weeks of pregnancy) an infection picked up during pregnancy, such as rubella (German measles), toxoplasmosis or cytomegalovirus (CMV) genetic conditions, such as CHARGE syndrome or Down’s syndrome cerebral palsy – a problem


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(German measles), toxoplasmosis or cytomegalovirus (CMV) genetic conditions, such as CHARGE syndrome or Down’s syndrome cerebral palsy – a problem with the brain and nervous system that mainly affects movement and co-ordination foetal alcohol syndrome – health problems caused by drinking alcohol in pregnancy Deafblindness later in life In most cases, deafblindness develops later in life. This is known as acquired deafblindness. A person with acquired deafblindness may be born without a hearing or sight problem and then later loses part or all of both senses. Alternatively, someone may be born with either a hearing or vision problem, and then later loses part or all of the other sense later on. Problems that can contribute to acquired deafblindness include: age-related hearing loss Usher syndrome – a genetic condition that affects hearing, vision and balance eye problems associated with increasing age, such as age-related macular degeneration (AMD), cataracts and glaucoma diabetic


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vision and balance eye problems associated with increasing age, such as age-related macular degeneration (AMD), cataracts and glaucoma diabetic retinopathy – a complication of diabetes where the cells lining the back of the eye are damaged by high blood sugar levels damage to the brain, such as from meningitis, encephalitis, a stroke or severe head injury Sense has further information about the causes of deafblindness. Diagnosing deafblindness Deafblindness may be detected soon after a baby is born, or after tests carried out later in life. Speak to your GP if you have any concerns about your or your child’s hearing and/or vision at any point. If you’re worried about a family member or friend, try to encourage them to speak to their GP. Newborn screening If your baby is born deafblind, this will usually be picked up during newborn screening. These are a series of checks carried out to see if your baby has any serious health problems from birth, including any problems with their eyes


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These are a series of checks carried out to see if your baby has any serious health problems from birth, including any problems with their eyes or hearing. If no problems are picked up at this stage, they may be detected during routine checks as your child gets older. Hearing and vision tests for adults In most cases, deafblindness develops as a person gets older. It can happen gradually, so you may not notice that your vision and/or hearing are getting worse at first. It’s therefore important to have routine eye tests to check for any problems. Adults should normally have their eyes tested every two years. You can request a hearing test at your GP surgery at any point if you think you may be losing your hearing. A person may be diagnosed with deafblindness if tests show they have both hearing and vision problems. Their hearing and vision should continue to be regularly assessed even after they’ve been diagnosed, as the level of care and support they need will depend on how severely


