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A

ACNE: SKIN

• Acne is more common in teenagers and young adults, but overall, it can affect people of all ages. Acne may sometimes be a few spots, but in many cases, the condition can be more severe and widespread. Acne is more visible than other medical conditions and as a result, those suffering from it may experience a lack of confidence and self esteem.
• Causes of Acne
  Acne develops when your skin suffers an adverse reaction to the male hormone, testosterone. During the teen years, levels of testosterone increase which subsequently causes body hair to develop, and therefore makes the skin produce more oil (sebum) in the sebaceous glands in the skin. In unison with this, the skin pores from which the oil usually comes out from, begin to narrow. Together, they lead to the outbreak of spots and bacteria that generally lives on the skin then breaks down the sebum to produce swelling and irritation causing acne.
• Symptoms of Acne
  Skin tends to feel greasier than usual, and the spots that form can be more tender and painful, varying in both size and appearance. Spots can appear in the form of blackheads and white heads (comedones). White heads are usually skin coloured lumps and tend to be more common than blackheads. Acne may also appear as small red lumps called papules, or yellow puss filled lumps known as pustules. These spots tend to be more painful and generally mean that a bacterial infection is present. When left untreated, they are more likely to form scars. In females, symptoms may get worse before a period because of hormonal changes in the body. Spots may also get worse if you get hot and sweaty.
• Treatment of Acne
  There are a number of treatments that one can buy over the counter, and these come in many different forms including creams, lotions, gels and washes. Acne treatments must be used continuously, and may therefore result in some time being waited out before they begin to work. These treatments are generally divided into keratolytics, antibacterials and cleansing agents. Keratolytics including salicylic acid and sulphur, break open blocked pores and help to remove the top layers of the skin. Antibacterials such as benzoyl peroxide and triclosan remove bacteria responsible for the outbreak of spots. Alcohol and detergent based cleansing agents remove the excess oil and any loose dead skin.
  
  Your doctor will have a choice of treatments to prescribe for you including antibiotics, retinoids (vitamin A derivative) and hormones. The two month rule should be applied here, and you should go back to your doctor if you see no improvement. Scars may be helped by retinoid creams, dermabrasion (an operation that smoothes the top layer of the skin) or collagen injection.
• When to consult a doctor
  If over the counter remedies have not worked for you, and your spots have not improved, see your doctor. If your acne is particularly bad, and there is prominent scarring, see your doctor.

ALZHEIMER'S DISEASE: CENTRAL NERVOUS SYSTEM

• Description
  Alzheimer's disease is the most common cause of dementia in the United Kingdom, forming 50% of the 670 000 cases of dementia currently being treated.
• Causes of Alzheimer's Disease
  Alzheimer's has a common effect on the brain. The levels of dopamine, a chemical that acts as a messenger in the brain, fall severely. In unison with this, the nerve endings and brain cells begin to die. This causes the brain to shrink, and gaps to appear in relevant areas. These areas that are affected are those which have the important role in receiving and storing information. Age seems to be the biggest cause implicated in the development of Alzheimer's, but some people may develop the disease as a result of certain genes that they have inherited. If you have endured a severe head injury, or have Down's Syndrome, the risk of developing the disease is increased.
• Symptoms of Alzheimer's Disease
  Alzheimer's disease commonly begins with lapses in the memory, including difficulty in finding the correct words for everyday objects and mood swings. These symptoms are often mistaken for natural signs of ageing, however, within six months, a pattern will begin to emerge. Appointments may be routinely forgotten, names and faces may get mixed up, and handling money or driving may become an ordeal when denominations make no sense and left and right may get mixed up. Personality changes can also occur, and sufferers may occasionally break down in tears for no reason. In more serious cases, inhibitions are lost and the behaviour of the individual in question may become more unsettling. The final stages of Alzheimer's disease shows the disintegration of the personality, and sufferers become wholly dependent on their carers.
• Treatment of Alzheimer's Disease
  There is no known cause for Alzheimer's disease and there is not likely to be one in the near future. However, there are some new drugs that work by slowing down the rate of mental decline, and recently, s drug called donepezil was introduced to help treat cases of mild to moderate dementia in Alzheimer's disease. The best way to fight against the disease is mainly to establish and maintain a structured routine, and to try and lead a normal life as best as you can. As the disease develops, people tend to need more support and supervision and eventually, nursing care.
• When to consult a doctor
  You should consult your doctor if you suspect that either yourself, or a relative suffers from Alzheimer's disease.

ARTHRITIS: MUSKULOSKELETAL

• Description of Arthritis
  Arthritis is one of the biggest causes of disability in the UK. 'Arthritis' itself means inflammation of the joints, and there are over 200 types of 'arthritis' that have been identified. Some forms of arthritis may be symptoms of other diseases, such as lupus erythematosus. However, on a wider scale, we take the term 'arthritis' in its most common forms, such as osteoarthritis, rheumatoid arthritis and gout. These types of arthritis tend to affect the knee, finger and hip joints, which are also known as synovial joints because of the synovial fluid that is found beneath them.
• Causes of Arthritis
  Arthritis can affect people of all ages, though one of the most common forms, osteoarthritis is mainly down to wear and tear. With osteoarthritis, cartilage breaks down in joints that bear weight, such as the hips, knees and lower back. Children and young adults may also suffer from arthritis, commonly rheumatoid arthritis which affects the hands and neck. This form of arthritis tends to be inherited, and is mainly caused by the body's defence mechanism reacting in an abnormal way to the lining of the joint capsule. Gout is caused by crystal formation in the joints and may also be inherited or triggered by certain medicines, alcohol and some foods.
• Symptoms of Arthritis
  More common symptoms include discomfort, aches and pains, swelling and inflammation, stiffness and also fatigue. Symptoms of arthritis may vary from one form to another and can produce short term, or long term effects. For example, with osteoarthritis, pain and discomfort are more likely to be restricted to the affected joint area, while rheumatoid arthritis causes more general aches and pains. People that suffer from arthritis may develop disabilities including the loss of strength and grip, while more severe cases of arthritis could potentially advance to a deformity of the joint and permanent loss of movement.
• Treatment
  Your doctor may use a combination of medicines, physiotherapy, occupational therapy and other support services to help manage your arthritis. Osteoarthritis is more manageable with much more simple measures such as weight loss and pain relief. Rheumatoid arthritis is sometimes treated with medicines that restrain the immune system. Surgery may have to be considered in more serious cases of arthritis. Drugs used to relieve the symptoms of arthritis include anti inflammatories, painkillers and disease modifying drugs. Non steroidal anti inflammatory drugs include ibuprofen and can be brought from the pharmacy to relieve any pain or inflammation. They come in forms that can either be taken orally, or rubbed into the skin on the affected area. It is always important to ask your pharmacist about which ones are safe for you to take, even more so if you are already taking other prescription, or over the counter medicines, or have a history of allergies.
• Treatment
  You should consult a doctor if you suspect that you have a form of arthritis but you have not yet been officially diagnosed. If your symptoms do not improve, or they worsen while taking medication, you should go back to your doctor for a review.

ASTHMA: RESPIRATORY

• Description of Asthma
  Asthma is the condition that affects the system of airways that carry air in and out of the lungs. This causes the narrowing of the airways, and consequently the inflammation of the airway lining. As a result of this, airways tend to become sensitive and swollen, and full of mucus which makes it difficult to breathe. Symptoms may escalate when you have a cold or chest infection, or when you come into contact with an asthma 'trigger', which can include an allergy or exercise that will set off the asthma.
• Causes of Asthma
  A number of different factors can trigger symptoms for an individual that suffers from asthma, however, it is not exactly known as to why some people develop asthma. It may run in families, but it can also be caused by environmental factors such as housing, diet, pets and traffic pollution. Smoking can also cause asthma, and mothers who smoke during pregnancy also increase the chance of their child developing asthma.
• Symptoms of Asthma
  A cough, chest tightness, wheezing and shortness of breath are the four main symptoms of asthma. You should consult your doctor should you experience any of these symptoms. Many asthma symptoms are able to be controlled if appropriate medication is taken. By simply discussing symptoms with your doctor, a suitable treatment will be able to be found.
• Treatment of Asthma
  Asthma treatment involves using an inhaler which is the main asthma medication device that delivers the drug directly into the lungs. There are a number of different types of inhaler and your doctor or nurse will be able to show you how to use them in the right way. Asthma medication falls into three main categories, which include relievers, preventers and protectors. Relievers tend to be more short acting and usually open the airways quick enough to relieve symptoms almost straight away. These are the blue inhalers and should be used as needed for when symptoms occur. Preventer inhalers are usually orange or brown and are taken twice a day. Many of these contain corticosteroids, which work by gradually reducing any inflammation of the airways. The aim of preventers is to prevent symptoms from starting and should be used everyday regardless of whether or not you are feeling well. Protectors are similar to relievers but tend to work for much longer so to protect symptoms that may occur during the day and at night. These usually come in the form of green inhalers and are usually taken twice a day in unison with a preventer. Other combination inhalers are usually purple of white with a red base. These contain both a protector and preventer in the form of one inhaler. Although treatments may do different jobs, they can work together to help control your asthma.
• Treatment
  If you suspect that you may have asthma, and have not been diagnosed before, you should make an appointment to see your doctor. If you have already been diagnosed with asthma, you should make an appointment to see your doctor or practice nurse to talk about your asthma, if:
  
  
  • You are taking more than two puffs of your reliever inhaler everyday.
  • You have asthma type symptoms during your normal routine, including cough, wheezing, chest tightness and breathlessness.
  • You have trouble sleeping because of these symptoms.
  • Your asthma is interfering with your everyday routine
  • Your asthma prevents you from taking part in physical activities, including climbing the stairs, running and sports.
  • You are having difficulties or worries about using your asthma treatment, your inhaler or peak flow meter, if you have one.

ATHLETE'S FOOT: SKIN

• Description of Athlete's Foot
  Athlete's foot is a common fungal infection affecting the skin and toe nails on the foot. It tends to be irritating and is also contagious. It affects people of all ages.
• Causes of Athlete's Foot
  Athlete's foot is caused by tinea pedis which is a contagious fungus that is present in warm, damp environments including swimming pools and changing rooms making the infection permissible to be passed from person to person. Moisture and warmth that is created by shoes and socks also provide an ideal environment for athlete's foot to flourish in between the toes. Skin that is affected by athlete's foot tends to become itchy and sore, most notably between the fourth and fifth toe. The skin can then flake, peel or crack. Toenails that have become infected may become discoloured, thickened and brittle.
• Treatment of Athlete's Foot
  For Athlete's foot treatment, creams, sprays and powders can be bought in pharmacies to help treat the infection. These usually include an antifungal agent (e.g clotrimazole, miconazole or econazole) which helps to treat the fungal infection. Some powders may also help to absorb the moisture and can contain antiseptic to help get rid of any accompanying bacterial infection. Treatment should be continued for two weeks even after any invisible signs of infection have gone to be sure of thorough elimination of the infection. However, toenail infections are more difficult to clear and therefore, may need prescribed antibiotics.
• Treatment
  You should consult your doctor if over the counter remedies have not worked or if the problem is recurring. However, if you are a diabetic, it is important for you to consult your doctor before buying any over the counter remedies as poor circulation and high sugar levels in the blood can consequently make the infection worse.

B

BAD BREATH: EAR, NOSE AND THROAT

• Description
  Bad breath or halitosis as it is also known is a condition where your breath smells unpleasant to other people.
• Symptoms
  Most people are unaware that they have bad breath, and it tends to only be dealt with when the individual notices the reactions of other people. For example, you may notice people moving away when you start to talk to them. There is a simple test that one can do if they think that they are suffering from bad breath which includes licking the inside of your wrist and then smelling it. If the smell is bad, it is likely that your breath smells also. You can also smell dental floss after flossing, and check to see if your breath smells.
• Causes
  The most common cause of bad breath is the bacteria that forms and builds up on your teeth and gums. Bacteria usually tends to build up when you don't brush or floss your teeth regularly. This bacteria then produces sulphur gases which are also known as volatile sulphur compounds (VSC's) which then form the typical smell of bad breath. Eating particularly strong foods including garlic and onions can also add to the problem. This food can then become trapped between the teeth causing breath to smell. Known medical conditions can also contribute to bad breath, including diabetes, liver or kidney problems or dry mouth (xerostomia). Dry mouth can also be caused by some medicines, salivary gland problems or by constantly breathing through the mouth and not using the nose. Another known factor contributing to bad breath is smoking.
• Treatment
  Teeth should be kept healthy, and gums should be free of gum disease when dealing with bad breath. Teeth should be brushed twice a day with fluoride toothpaste to help remove the bacteria and plaque. The tongue should also be brushed, and it is recommended that dental floss be used once a day to clean between the teeth. Mouthwashes that contain an antibacterial agent also helps. In unison with visiting your dentist regularly, your dentist will clean all of the hard to reach areas in your mouth, and in turn, help to prevent dental decay and gum disease developing. Other ways to ensure your mouth be kept clean and fresh all of the time include taking out dentures at night, giving up smoking and brushing your teeth after every meal, if you find that food gets stuck between your teeth. If you suffer from dry mouth, you should drink plenty of water all throughout the day and cut down on drinks such as tea or coffee, which are dehydrating. If you have increased your fluid intake, and this does not seem to be helping your dry mouth, your dentist may be able to recommend or prescribe an artificial saliva product.
• Treatment
  If your dentist or hygienist finds your mouth to be healthy, you may be referred to your GP or a specialist to determine the cause of your bad breath.

BACK PAIN: MUSCULO-SKELETAL

• Description of Back pain
  Back pain refers to any complaint affecting the spine or the muscles and tissue connected to it. Common forms of back pain include lumbago, sciatica and slipped discs. However, back pain can also be found to affect the neck, arms and legs. Lumbago affects the lower back and is the most common form of back pain. Slipped discs occur when the cartilage that separates and protects the bones in the spine (the vertebrae) pops out of place. Sciatica is a pain in the lower back that can be felt down the legs and is caused by nerves that have been twisted, or pushed out of place.
• Causes of Back pain
  There are many apparent causes of back pain which can include lifting heavy loads incorrectly, bending the spine too much, falling, and even being overweight. Standing up and sitting down for too long can also be seen to cause back pain. Cars, public transport, and deskbound jobs are just a few examples of how our muscles and spines are weaker than they used to be and the risk of back injury has increased.
• Symptoms of Back pain
  Pain that usually occurs in the lower back or neck, with movement, is the first indicator of back pain. Back spasms that include sudden and uncontrollable muscular contractions may also occur, and these can be fairly painful. Stiffness in the back after long periods of inactivity also indicate the beginning of back pain.
• Treatment of Back pain
  A majority of cases of back pain do not require specialist treatment and are more than likely to clear up within a month or so. Heat rubs provide some form of back pain relief, also, when applied to the affected area(s). Analgesics taken by mouth or rubbed onto the skin, such as ibuprofen, can also be effective in relieving pain. In more severe cases of back pain, physiotherapy may be needed, and this will involve stretching exercises that have been designed to strengthen the spine and back muscles in a more natural way.
• Treatment
  You should contact your doctor immediately if you come to find that the pain in your back persists, and if your movement is seriously impaired.

BED WETTING: URINARY SYSTEM

• Description of Bed Wetting
  Bed wetting or nocturnal enuresis is a condition that is common from childhood. The problem is more common in boys than it is in girls. If you find that your child is bed wetting, you may often wonder if you're doing something wrong or if it's normal for your child to continue wetting the bed.
• Causes of Bed Wetting
  Children come to learn to recognise the sensation of a full bladder and begin to 'hold on' until a toilet or potty is found. By the age of three, most children would have gained day time control, but night time control may take a little longer, and girls often achieve this before boys. If the child is of four years of age, it is still normal for them to be wetting the bed and accidents may continue to occur for a number of years. Situations that may cause a child anxiety can also delay bladder control or trigger bed wetting in children who were once dry at night.
• Symptoms of Bed Wetting
  There are two types of nocturnal enuresis which include primary and secondary nocturnal enuresis. Primary nocturnal enuresis is when bladder control has never been gained. Secondary nocturnal enuresis is when bladder control has been gained for at least six months, and has then been lost again. A healthy child over the age of five with no congenital abnormalities or health issues who wets the bed at least once a month would be classed as having nocturnal enuresis.
• Treatment of Bed Wetting
  Bed wetting is very common, especially amongst young children. You must find out whether or not your child wants to become dry at night, as this will make it easier on them to become comfortable with the methods that you are trying to use. One common treatment is that of an enuresis alarm or buzzer. This will wake up your child to the sensation of a full bladder. These are a successful form of treatment with a 70% success rate. However, if this treatment has failed, your GP can prescribe a medicine called desmopressin. This works by reducing the amount of urine produced during sleep. This treatment continues until the child has been dry for up to a total of six weeks. Desmopressin is available as tablets or in the form of a nasal spray. Night time protection pants also help and are available from most supermarkets and pharmacies.
• When to consult a doctor
  You should consult your doctor if your child is over five years old and wets the bed at least once a month.

BITES AND STINGS: SKIN

• Description
  Although some people may class these two as very similar, bites and stings actually form quite different attacks on our skin. Stings occur when an insect is protecting itself when it feels threatened. The venom released from the sting can cause different degrees of allergic reaction. A bite is different in a sense that the insect seeks out their victim in order to feed from their blood. After the bite, it injects a saliva that allows the blood to flow and this is what causes inflammation and itching.
• Causes
  Insects that live in our environment inflict such pain and discomfort on us to either protect themselves from any harm or to feed themselves and their young. Those that sting include Wasps, Bees, Hornets and Ants and those that bite include Mosquitoes, Midges, Sand Flies, Horse Flies and Ticks amongst others.
• Symptoms
  Stings: Once stung, the victim will feel immediate pain. Bees leave their sting behind, but wasps do not. If you find that the sting has been left behind, do not attempt to remove the bee sting with your fingers. Instead, remove with tweezers by gripping the shaft of the sting and not the small sack at the top, as this will house the venom and if squeezed, injects the remaining venom into the victim. The area around the sting will swell and redden; and this may be followed by blistering and an itchy rash. Some allergic reactions may be more serious, resulting in dizziness, fainting, breathing difficulties, rash, raised pulse, sickness, or a swollen mouth and face. In more severe cases, the patient may also collapse.
  
  Bites: Where the insect is bitten, a sharp jab is initially felt. In this case, the saliva has already been injected. It may take several minutes before the bite becomes itchy and swell or redden into a lump. In the case of midges, when they attack in swarms, there may be several areas where they have successfully attacked. These areas tend to become hot and itchy and can remain so for several days to follow. The main danger with bites, especially outside of the UK is a serious risk of disease. 20 million people in the world die of malaria each year, making the mosquito the most dangerous creature on earth. Many other diseases are transmitted by insect bite each year such as Yellow fever, Dengue fever and West Nile disease.
• Treatment
  Special treatment is not required for most bites and stings. The affected area should be washed and an antiseptic cream applied. If itching persists, calamine lotion or an antihistamine cream will also help. Antihistamine tablets can also be prescribed by your GP if the reaction is particularly bad. To relieve pain and itching, there are also products available that contain a mild local anaesthetic or steroids. You should always check with the pharmacist what product is most suitable for you. Those with a severe allergy to bites or stings will be prescribed a special self injection device containing adrenaline. Where biting insects are known to be active, you should use an insect repellent.
  
  When travelling abroad, you should ask your GP what precautions you should take against potential disease. A course of anti malarial pills may be advised ahead of foreign travels to areas in which malaria is prevalent. You should also use an insect repellent that is chemically based using either dimethyl phthalate (DMP) or diethyl-N-toluamide (DEET). The effective ingredient should be between 30 and 50%. Only low level DEET (~10%) concentration should be applied to small children.
• Treatment
  You should consult your doctor when you're planning foreign travels to known risk areas, if you return from abroad feeling feverish and unwell and if you have been stung in the mouth or throat, you should always seek medical advice as swelling may interfere with breathing.

BLADDER WEAKNESS: GENITO-URINARY/ GASTROINTESTINAL

• Description
  OF BLADDER WEAKNESS Bladder weakness causes accidental leakage of urine from the bladder, or in more extreme cases, faeces from the bowel. Although people may find it embarrassing, bladder weakness is actually very common, and it can also be controlled and subsequently cured. There is a wide range of products readily available to manage the condition comfortably and discreetly.
• Causes
  OF BLADDER WEAKNESS Leakage from the bladder (urinary incontinence) can be caused by several factors. Stress incontinence is very common and happens when pressure is put on the bladder. For example, when you sneeze, cough, or carry something heavy. Women may suffer from stress incontinence as the muscles that control the bladder may be weakened and damaged during childbirth. Women who are going through the menopause and men who have had a prostate operation may also be affected. Other causes include an unstable bladder, when you get an urge to go to the toilet but you don't get there in time, and reflex bladder where there is a loss of control over the bladder after an injury or illness. Leakage may also occur as a result of problems in bladder emptying, and a bladder infection and some medicines such as water tablets for high blood pressure can also cause leakage. In the short term, constipation and diarrhoea can cause bowel leakage and in the long term, it can be the result of injury or illness.
• Symptoms
  OF BLADDER WEAKNESS Symptoms include leakage from the bladder or bowel and you may feel sudden or frequent urges to empty your bladder.
• Treatment
  OF BLADDER WEAKNESS There are a number of ways to treat urinary incontinence. Wearing an appropriate pad or pants is a quick, short term solution for stress incontinence, but strengthening your pelvic floor muscles through exercise is a good way to reduce the problem. Your doctor, nurse or physiotherapist can also advise you and recommend devices that will do the same thing. Bladder retraining and good drinking habits- for example, cutting down on tea, coffee and alcohol can also help with an unstable bladder. These options should be tried first, but medicines such as oxybutinin, propantheline, propiverine, tolterodine and anti depressants can also be prescribed and surgery is another possible route to help to cure the problem. Changes in diet can also help, but this should be discussed with your doctor or nurse. Propriety products to help control all types of urinary and bowel incontinence can be brought from the pharmacy or prescribed by your doctor or nurse.
• Treatment
  You should see your doctor if you experience any kind of leakage from your bladder or bowel. If you have recently had a baby and are experiencing some problems, it is worth seeking advice as pelvic floor exercises may help to combat the problem.

BLOOD PRESSURE: CARDIOVASCULAR SYSTEM

• Description
  Blood pressure is the pressure of blood in your arteries. The higher your blood pressure, the greater the risk of developing narrowed arteries, which can lead to heart problems and strokes. Your blood pressure goes up when the heart contracts and forces blood through your arteries and when the heart relaxes, it goes down. This pressure can be measured and is usually written down like this: 140/90. The first number which is called the systolic pressure, shows the pressure in your arteries when your heart is forcing blood through them. The second number is called the diastolic pressure and shows the pressure in your arteries when your heart relaxes. High blood pressure is identified when your blood pressure is consistently raised above 140/90mmHg.
• Causes of High blood pressure
  Secondary hypertension is when there is an underlying cause of high blood pressure. This persists in a small number of people, but for most people there is no definite cause for their high blood pressure and doctors call this essential hypertension. The small blood vessels in the body narrow and this results in the pressure building up. High blood pressure can affect anyone. However, there are some groups of people that are more likely to have it than others:
  
  
  • Those with a family history of high blood pressure
  • Black/African Caribbean people
  • Those with an unhealthy lifestyle. If you are overweight, eat too much salt and not enough fruits and vegetables, take little exercise and drink too much alcohol, you are more likely to have high blood pressure
  • Older people, as blood pressure tends to rise as you get older
  • Those with diabetes, kidney disease and heart disease.
• Symptoms of High blood pressure
  The only way to know whether or not you have high blood pressure is to get it measured as most people cannot tell if their blood pressure is high any other way.
• Treatment of High blood pressure
  High blood pressure is not something that can be cured, however, it can be treated. People should make lifestyle changes, and this alone could be enough to lower your blood pressure significantly. Medication can also be prescribed, and usually two or more medicines can be taken together. Blood pressure should go down to 140/85 or less, as once your blood pressure comes down, so does your risk of heart attack and stroke.
• Treatment
  You should consult a doctor if your blood pressure is measured, and it is above 140/90. If this is the case, it should not be ignored.

BUNIONS, BLISTERS, CORNS AND CALLUSES: FOOT DISORDERS

• Description
  A bunion is where the big toe curves outwards and the joint becomes tender and swollen. Blisters are a bubble like swelling on the skin that are filled with a watery fluid.
  
  Corns develop on the feet and can be either soft or hard. Hard corns are small areas of hard skin that are usually the size of a small pea. Soft corns, however, are rubbery and white and are usually developed between the toes.
  
  A callus is a large area of thickened skin on the feet.
• Symptoms
  Bunions, blisters, corns and calluses can all be rather painful. If you have a bunion, you may also find that walking is difficult because of the swelling.
• Causes
  People may develop bunions either because of a family history of them, or because of the way they walk. Ill fitting shoes can also make the bunion worse than it already is.
  
  Blisters can be caused due to any type of friction, or rubbing of the skin. Badly fitting shoes or shoes worn without socks are the main reason that blisters develop.
  
  Corns and calluses form on certain areas of the foot where pressure is present from the weight of the body or a tight fitting shoe. Where there is excessive pressure present, areas of the skin will thicken as a protective response. Corns occur over the bony parts of the foot such as joints, and a callus can appear anywhere that the skin rubs against a bone or shoe.
• Treatment
  If you find that a bunion has developed on your foot, further damage can be prevented by wearing shoes with a straight inside edge and rounded toe. You should see a state registered chiropodist if you think that you have a bunion. They may suggest you wear protective pads or insoles to ease the pressure, and in more severe cases, you may be referred for surgery to realign your big toe.
  
  Blisters should not be burst. Small blisters will usually heal by themselves. You can apply a dressing to the blister to stop any further rubbing.
  
  Corns and calluses should not be cut by yourself. A pumice stone can be used to remove thickened skin gradually while you are in the bath, and pressure can also be relieved by using foam padding to cushion the affected area. Do not try and remove hard skin over a boney area or joint. If you find that the corn or callus is very painful, you should see a chiropodist who will be able to remove the hard skin. Chiropodists and podiatrists do not recommend any over the counter treatments for corns, such as corn plasters or paints because they can burn the healthy tissue around a corn. They advise that commercially available products should only be used following professional advice.
• Treatment
  Medical advice should always be sought if you are diabetic or have any sort of foot problem. If you have a blister that has burst and then become red and inflamed, it could be infected, and in this case, you should also see a doctor.

BURNS AND SCALDS: SKIN

• Description of burns scalds
  Heat and fire damages skin cells, and results in burns and scalds. The damage can only be classified as to ho severe the burn is. First degree or minor burns only affect the top layer of skin known as the epidermis, whereas second degree or partial burns extend below the epidermis. Third degree burns are those which damage the entire layer of the skin, and with these types of burns, there is a greater risk of infection.
• Causes of burns scalds
  Non liquid substances including fire, electricity, the sun and friction cause burns. Chemicals such as acid, bleach or weed killer can also result in burns. Scalds are caused, however, by hot liquids such as boiling water, steam or cooking fat.
• Symptoms of burns scalds
  Intense pain is caused as a result of a burn or scald. Slight swelling and redness can be identified as first degree burns whereas in the case of second degree burns, the skin looks more raw, red, and you will see blisters beginning to appear. Black, charred or waxy skin indicates that the burn is serious. Serious burns can cause shock, and symptoms of shock include shortness of breath, dizziness, a rapid pulse and in more severe cases, unconsciousness and may be even death. If your mouth or throat has been scalded, there may be a swelling that can make breathing difficult.
• Treatment of burns scalds
  All minor burns should be bathed in cold water for approximately 15 minutes, and you clean away any dirt from the damaged area of skin whilst the wound is still underwater. Plastic gloves should be worn to protect the skin from infection. Minor burns should heal within a few days, but antiseptic creams and sterile bandages are available from pharmacies and will also help to soothe the burn, kill bacteria and protect the damaged skin. Medical advice should be sought as soon as possible with more severe burns. You should rinse the burn immediately if it has been caused by a household chemical, and if the substance is swallowed, the container should be shown to those treating you. If the victim experiences or shows any kind of shock, lie them on the floor, loosen any tight clothing, check that their airway is clear and keep them warm with a blanket until help arrives.
• Treatment
  You should call an ambulance if a burn or scald is severe or when symptoms of shock have been witnessed. All second degree burns and bad first degree burns should be seen to and assessed by a doctor as soon as possible.

C

CHAPPED LIPS: SKIN

• Description of Chapped lips
  Chapped lips are caused with the scaling and cracking and dryness of lips. Lips that are severely chapped are more prone to infection.
• Causes of Chapped lips
  There are several causes that cause may cause chapped lips, including dry weather, overexposure to the sun and having to work outside in extremely windy conditions. The biting and sucking of lips including breathing through the mouth, vitamin deficiencies and ill fitting dentures can also cause chapped lips. Chapped lips are common in children as they may be sensitive to substances found in toys, foods and by children licking their lips together. This causes wetness which dries in the air to cause chapping with even more irritation.
• Symptoms of Chapped lips
  The skin on the lips will subsequently become flaky and sore, and as the skin eventually flakes off, it exposes raw areas underneath which are tender to irritants including salt, hot foods and spices. As a result, these areas may bleed easily. When exposed to the sun, the lips can become sunburnt in the same way as other areas of the skin. You will know that an infection is present when crusts form on the lips with an underlying pus. Other infections including cold sores or thrush infections of the mouth are often seen as appearing craked at the angles of the mouth. Cold sores will occur around the lips as a small collection of tiny transparent blisters over reddened skin. Usually, they itch and burn, but generally disappear after a week or so. If thrush is present, it can be seen as white plaques inside the cheeks.
• Treatment of Chapped lips
  Firstly, you should re hydrate your lips by applying a moisturising lip balm, or petroleum jelly.
  
  If you suffer from chapped lips on a regular occasion, the most important part is to prevent this from continuing. If you are going to be outside, you should use a lip bam that contains a sun block. Children may need a bland ointment to stop them from sucking and licking their lips. If the lips do become infected, an antibiotic cream will be needed. Sores that you may find at the angles of the mouth may be caused by dentures that have been badly fitted, and this will need to be corrected by your dentist or you may have a Vitamin E deficiency (riboflavin) which can also be treated with vitamin supplements. Cold sores may require an anti viral cream.
• Treatment
  As severely cracked lips can become infected, or you find that you have pus or bleeding, an antibiotic ointment may be needed from your doctor.

CHICKEN POX AND SHINGLES: IMMUNE SYSTEM

• Description of Chicken pox and shingles
  Chicken pox is an infectious disease caused by a virus. It is contagious and can spread from one person to another very quickly. A person usually only has chicken pox once as your body will subsequently produce antibodies to the virus which will protect you against re infection. Shingles is the infection of a nerve by the same virus caused by chicken pox. People that have had chicken pox in the past may go on to develop shingles, and shingles is not infectious.
• Symptoms of Chicken pox and shingles
  If you have chicken pox, you may find that you're feeling unwell with a high temperature and a headache. These will often occur before the rash from chicken pox appears on the skin. The rash will consist of small crops of spots, which may look like tiny blisters. The chicken pox spots will be very itchy, and you may find that you are suffering from a cough and a sore throat.
  
  It is likely that you will be infectious from 48 hours before the rash appears until the spots have scabbed over, which will usually take about a week. The spots will not scar unless you keep scratching them.
  
  With the case of shingles, you will experience pain and a rash. The rash tends to appear after a few days of experiencing pain, and the rash will then eventually blister. Pain is usually found around whichever nerve is affected by the virus. The most commonly affected nerves are in the skin of the abdomen and chest and symptoms will occur in a band around the trunk. Nerves in the face can also sometimes be involved.
• Causes of Chicken pox and shingles
  Herpes Zoster virus is the virus that causes chicken pox. Most people tend to catch this virus as a child. If caught in adults, however, this can be more serious than in children. It will take between two to three weeks to develop the infection after being in contact with the infected person. Even after you have chicken pox, the virus will remain in the nerves but is not active. For an unknown reason, some years later the virus can become active again, hence causing the symptoms of shingles.
• Treatment of Chicken pox and shingles
  Regular doses of paracetamol and aspirin should be taken if you have chicken pox, as this will help to relieve any aches and pains that you may have. Children can also take paracetamol so long as the correct dose for infants is taken. Calamine lotion can also be applied to the rash. If your child is having trouble sleeping, your pharmacist can also recommend an effective antihistamine to help with the itch.
  
  Those that have mild symptoms of shingles may not need treatment at all, and painkillers such as paracetamol and aspirin can help to relieve the pain. Calamine lotion can also be applied to the shingles rash.
• Treatment
  You should see your doctor immediately if you are pregnant and find that you have chicken pox or shingles. Those with diseases of the immune system, such as leukaemia and HIV should also seek medical advice as soon as they can. If you think that your chicken pox or shingles may have become infected, you should also see your doctor.
  
  Those with shingles, they may find the pain to be more severe and prolonged. In some people, the pain can go on for more than a month and this is called 'post herpetic neuralgia', and your doctor will be able to prescribe you medicines to help deal with this pain. Older people with shingles, or those in whom the virus is affecting the eye, should also see their doctor who may choose to provide them with antiviral medication.

CHOLESTEROL: CARDIOVASCULAR SYSTEM

• Description of Cholesterol
  Cholesterol is a fatty substance produced in the body. It is made in the liver from saturated fats in food. Little cholesterol is found in foods, except for eggs, liver and kidneys. Cholesterol plays an important role in ensuring that every cell wall works throughout the whole of the body. The body also uses it to make other important vital chemicals. Too much cholesterol in the blood however can increase your chances of developing coronary heart disease. High blood cholesterol is one of the main risk factors for this disease, closely followed by the lack of exercise. It is known that 70% of adults in the UK have blood cholesterol levels that are far too high. Men and women are at equal risk and this is not just a worry for those who are older, anymore.
• Causes of Cholesterol
  Two common causes of high blood cholesterol level in the UK is too much fat in the diet, and also, being overweight. Others may have high cholesterol levels as a result of an under active thyroid gland, chronic renal (kidney) failure, or alcohol abuse. 1 in 5000 people have high cholesterol levels as a result of an inherited disorder known as familial hyperlipidaemia. Saturated fats and some vegetable oils including coconut and palm oil also increase the risk of high cholesterol in your blood. This then causes narrowing or furring of the arteries and also increases the risk of a heart attack or stroke. This risk is increased if you also have high blood pressure. In some foods, saturated fat will be easy to see, for example, the fat on meat and cream on a pint of whole milk. However, much of the saturated fat that we consume is hidden in processed foods.
• Symptoms of Cholesterol
  Those who have high cholesterol do not tend to experience any obvious problems. The first sign of an underlying problem however, might be chest pain, heart attack or stroke. This is why it is important to keep track of your cholesterol levels, including a risk assessment and a blood test. If you have high cholesterol levels, you may have more visible symptoms. One more common symptom of high cholesterol is xanthomas, which are tiny filled cholesterol filled bumps that may appear on the elbows, knees and buttocks. Xanthomas are commonly mistaken sometimes for being pimples or warts.
• Treatment of Cholesterol
  Those looking to achieve good levels of cholesterol should, amongst other things, follow healthy eating and cholesterol lowering advice. The higher your risk of coronary heart disease, the more likely it is that your doctor will recommend cholesterol lowering drugs for you. Doctors tend to provide statins which are a long term and effective treatment for those who have high blood cholesterol levels, and those who are at a greater risk including:
  
  
  • Those who have already suffered from a heart attack
  • Those who have angina or peripheral vascular disease
  • Those who have had bypass surgery or angioplasty
  The risks may also be high for you if you are a smoker, have high blood pressure or have diabetes. If this is the case, the doctor should also be able to supply statins to you too.
• Treatment
  If you have any suspicions that you have high cholesterol, you should consult your doctor immediately. Likewise, for further advice on lowering your cholesterol, you should speak to your doctor, nurse or dietician as well as seeking advice from HEART UK on 01628 628 638 or visit www.heartuk.org.uk

COLD: RESPIRATORY

• Description of a cold
  There are many different viruses that cause the common cold. These viruses change so much every year, which explains why people catch colds year after year. Children suffer from a cold more than adults, averaging to approximately six colds a year. However, adults have built up immunity to cold viruses throughout their life.
• Causes of a cold
  Viruses that cause the cold are spread in droplets when you cough or sneeze, from one person to another. The viruses then attack the lining of the nasal passages which then subsequently go on to produce the symptoms.
• Symptoms of a cold
  The most common symptom of a cold is a blocked or runny nose in unison with a feeling of being tired and unwell. Your temperature may be raised, and you may have a sore throat and cough caused by mucus running down the nose. Due to congested nasal passages, you may also find that you have a headache.
• Treatment of a cold
  Although there is no real cure for the common cold, you will find that symptoms tend to get better by themselves. Symptoms can be relieved by taking painkillers such as paracetamol, aspirin and ibuprofen which can also reduce fever as well as easing aches and pains. Gargling with soluble aspirin before swallowing it can also help to ease a sore throat. If you find that you have a cough also, your pharmacist will be able to recommend a good cough medicine to help relieve your cough.
  
  Decongestants such as pseudoephedrine and xylometazoline can also help to clear a blocked nose but should not be sed long term. Other ways to relieve your symptoms include steam inhalation which can help with nasal congestion, throat lozenges to soothe a sore throat as well as gargling. Plenty of fluids should also be consumed to replace body fluid that is lost by sweating.
  
  If your baby has a cold, your doctor may provide drops to clear the nose and help with feeds. Aspirin and aspirin based products should not be given to children under 12 years of age and infant paracetamol preparations are recommended instead.
• Treatment
  Within a week, cold symptoms usually disappear and it is not usually necessary to consult your doctor unless a secondary bacterial infection is present such as sinusitis, bronchitis or an ear infection. You should see your doctor if you produce green or yellow mucus and if your cold symptoms have not eased within a week. In children, wheezing, persistent earache, fast or difficult breathing, persistent high temperature, drowsiness and chest pain are signs of a more serious infection.
  
  If babies and children have a very high temperature, you should also see the doctor, and if your baby or child is showing signs of suspected Meningitis and refusing to drink anything, you should seek medical advice straight away also.

COLD SORE: SKIN

• Description of a cold sore
  Usually a blister that appears around an on the mouth or lips, a cold sore is caused by a viral infection and is highly contagious.
• Causes of a cold sore
  Cold sores are caused by the herpes simplex virus (HSV). There are two different types of herpes simplex virus which include HSV-1 which is responsible for cold sores and HSV-2 which is the cause of genital herpes. However, having one type does not generally mean that you will get the other. The virus can be caught through physical contact with someone who also gets cold sores, i.e kissing, or from people who don't usually get cold sores but who still carry the virus in their skin, unbeknown to them. The virus can be caught like this in early childhood but symptoms will not appear until your teen years or early adulthood. Once it has been caught, then you become a carrier of it. The virus stays dormant most of the time and lives in the nerve ending of the skin. Once the virus is woken by a trigger, (i.e emotional upset, menstrual period, exams, sunlight, temperature) it is then that it starts to multiply and move down the nerve endings to the skins surface where it then forms a blister.
• Symptoms of a cold sore
  The first time that you catch the infection, you will only show mild symptoms or no symptoms at all. Once you get the cold sore virus, it is likely that you will have recurring cold sores in the same place for years to come. Cold sore blisters tend to be painful, red and tender and are usually filled with a pus-like fluid. Blisters form either as one or in clusters and they last about ten days. Within this time, they tend to rupture and then form a scab. You may feel when a cold sore is about to erupt as you may get a tingling, burning or itching sensation around your lips and mouth. Cold sores will only get worse if a bacterial infection sets in.
• Treatment of a cold sore
  Cold sores usually go away by themselves within two weeks, and do not leave scars. You should try and avoid the triggers that may bring on cold sores. You can also use over the counter treatments which include creams that contain the anti viral acyclovir or lotions that contain iodine. These should be used as early as possible, during the tingling stage to prevent the blister from appearing in the first place. If you use these treatments early, the cold sore may be prevented from appearing and they can also shorten the duration of the attack, even at the blister stage. There are other treatments available that will help to soothe, numb and dry up the blister. The virus can also be transferred from the cold sore to your eyes through touch. If this is the case, you will need to see your doctor for treatment of the eye.
• Treatment
  If the cold sore lasts for longer than two weeks, and has not improved with treatment, you should consult your doctor. You may have an eye infection if your eye becomes sore, and to avoid damaging your sight, it is advisable that you seek immediate medical attention.

COLIC: GASTROINTESTINAL

• Description
  A baby has infant colic if he or she has episodes of being irritable and inconsolable, but is still healthy and well fed. This generally occurs in the early months of a baby's life, but is still extremely emotionally draining and stressful for parents. Colic usually eases however, by the time a baby is three months old. Colic affects 10-15% off all babies.
• Causes
  A popular explanation of why a baby develops colic is that of too much wind in the baby's stomach, causing cramps and pains. Some doctors suggest that certain foods that the baby or a mother who is breast feeding eats, makes colic worse. These types of food include onions, broccoli, garlic, dairy products and caffeine. However, there is still no clear evidence that these foods will definitely affect your baby.
• Symptoms
  A baby who has colic will cry very loudly for hours at a time. The baby will seem to have pain in the stomach, and appear to be quite tense to you. Sometimes, the baby may also draw their knees up to their chest, and some babies may have a rumbling stomach and produce more wind. Colic tends to be more common in the early evening, but is still capable of occurring at any time.
• Treatment
  Infant colic drops can be brought from the pharmacy and are highly recommended. You should always check with the pharmacist before buying any medicine to treat colic. In older babies, alcohol free gripe water can also help.
  
  Some babies will calm down if they are gently rocked or carried over the arm when gentle pressure is applied to the stomach. Carrying your baby in a sling close to you can also be soothing for them. Some babies like to be swaddles in a blanket whilst others will settle down if you take them for a ride in the car.
  
  You should experiment to find out what soothes your baby the most, as different babies act and react differently to different things.
• Treatment
  To exclude any underlying problems with your baby, you should always double check the cause of your baby's persistent crying with your GP or health visitor.

CONJUNCTIVITIS

• Description
  The most commonest cause of red eyes in conjunctivitis. This happens when the conjunctiva, which is the membrane lining of the inside of the eyelids becomes inflamed and infected. This can be contagious and is easily spread to the other eye and to other individuals.
• Causes
  There are a number of causes of conjunctivitis. It can be caused by allergies, such as pollen to irritants such as chlorine in swimming pools. Even a bacterial virus or infection can lead to conjunctivitis. If conjunctivitis is present in one eye, this is less common and may be caused by a foreign body. In the elderly, lower eyelids can turn inwards and grow weak. If this happens, the eyelashes may then rub against the inside of the lid or eyeball which causes inflammation and irritation which then leads to conjunctivitis.
• Symptoms
  Common symptoms of conjunctivitis include a sticky discharge which usually occurs in both eyes and worst when you have just woken up. Another symptom is gritty and painful eyes, also. Eyes may also become sensitive to the light, which is known as photophobia, but eyesight is generally not affected overall.
• Treatment
  The discharge that you may experience can be kept clear by gently bathing your eye using cotton wool and water. Known irritants such as tobacco, chlorine in water and pollen should be avoided, and the eyes should be bathed with some warm saline water, or an eye lotion that has been recommended by the pharmacist. For infectious conjunctivitis, your doctor may prescribe antibiotic drops which should be used frequently. Do not pad or cover your eye. A foreign body in your eye is likely to cause watering, pain and redness. If caused by some dust or an insect, it may be possible to bathe it out, otherwise you should seek medical advice to remove the foreign body. Surgical correction may be required if the eyelid has turned in- and you should try and rest the eyes and avoid bright lights.
• Treatment
  If you experience severe pain in the eye as opposed to itching, burning and grittiness you should seek medical advice immediately. If you find a thick discharge in your eye, or the symptoms do not settle within 48 hours, you should also see your doctor straightaway. If your eye has been damaged, and this is why irritation is caused, this will require immediate expert treatment.

CONSTIPATION: GASTRO-INTESTINAL

• Description
  OF CONSTIPATION When bowel movements become less frequent, and stools become dry, hard and difficult to pass, this is a condition known as constipation. Bowel movement varies greatly from person to person. Some people may pass stools twice a day whereas others may do so only two or three times a week. People tend to be considered as being constipated if they have fewer than three bowel movements a week, or if they are having difficulty in passing a stool.
• Causes
  OF CONSTIPATION A diet that is low in fibre, and a lack or exercise form common causes of constipation. Different medicines such as painkillers containing codeine or indigestion remedies that contain calcium or aluminium can also cause constipation. A symptom of irritable bowel syndrome can also be that of constipation, where the intestines can go into spasm or diverticular disease where the colon narrows.
• Symptoms
  OF CONSTIPATION The main symptom of constipation is when bowel movements tend to become less frequent and you may find that stools are small, painful and hard to pass. As well as stomach pain, bloating and discomfort may also be experienced when you're suffering from constipation.
• Treatment
  OF CONSTIPATION Increasing the fibre content in your diet by eating more cereals fruit and vegetables can benefit you in treating constipation. Some other things that may help include drinking more water and liquids and by taking more regular exercise. Laxatives such as bisacodyl, senna or sodium picosulphate can also offer overnight relief and are also helpful for short term use. However, if you suffer from long term constipation, fibre supplements are highly recommended. Laxatives can also be used orally as tablets, liquid or pearls, and can be also used rectally as suppositories.
• Treatment
  If blood is present in stools, you should consult a doctor immediately as this could result in more serious conditions. If you find any major change in your bowel habits, especially if you are middle aged, or elderly, you should seek medical advice also.
  
  Abdominal pain or prolonged discomfort also needs medical advice as does anyone who is taking laxatives everyday.

COPD: RESPIRATORY

• Description
  Chronic obstructive pulmonary disease (COPD) is a term to describe a number of different conditions that affect the airways, including chronic bronchitis, small airways disease and smoker's cough. This is a condition that is common in most people who are over the age of 45. The airways become obstructed due to mucus and inflammation which makes breathing difficult. Symptoms tend to get worse during a cold or infection and are usually brought on by physical activity.
• Causes
  COPD is generally caused by smoking as cigarette smoke causes inflammation of the airways and damages the lungs. Whether or not you have stopped smoking is irrelevant as even if you did smoke in the past, you have a greater risk of COPD. Inhaling noxious fumes or particles can also cause COPD. Inherited factors may also be involved.
• Symptoms
  The first symptom of COPD is a chronic cough which will become persistent during both day and night. A COPD cough may be productive due to an increase in the amount of phlegm being produced. You may also find yourself experiencing bouts of breathlessness on exertion and a general difficulty in breathing. These tend to vary on a day to day basis for no reason whatsoever. Your normal everyday activities such as climbing the stairs may also become affected. COPD is diagnosed using a spirometer which measures your breathing and any obstruction in airflow that you may be experiencing.
• Treatment
  Although there is no cure for COPD, much can be done to help to relieve its symptoms. Effective treatments include inhaled bronchodilators which help to relax and open up the airways making breathing easier. These may be given as short acting relievers as they are able to relieve symptoms almost straightaway. These should be used only when needed when symptoms occur. Long acting bronchodilators are taken more regularly to reduce symptoms and should therefore be used everyday even when you are feelingwell. Bronchodilators and corticosteroids may be prescribed together in one inhaler.
  
  Many different types of inhaler are available and your doctor of nurse will show you how to use them in the correct manner. In more serious cases of COPD, your doctor may consider treatment with a nebuliser. These contain a liquid medicine that you are able to inhale as a vapour. Oxygen therapy may also be prescribed for you.
• Treatment
  If you have any suspicions that you have COPD and have not been diagnosed before, you should see your doctor. If you have been diagnosed before, you should talk to your doctor about your COPD if:
  
  
  • You want to quit smoking
  • You feel as though your inhaler medicine is not working properly
  • You find that your symptoms are getting worse
  • You experience an increase in coughing, or the phlegm produced increases in quantity or changes colour
  If you're breathing quickly, and you find that this is worse than usual, you should go to the hospital straightaway. Help should also be sought if you are suddenly finding it hard to walk or talk, your lips or fingertips turn grey or blue, your heartbeat or pulse is irregular or that your medicine does not work for very long or doesn't work at all.

COUGH: RESPIRATORY

• Description
  OF REPIRATORY COUGH Coughs are associated with the common cold, making sleep difficult and promoting the fact that we may be sick.
• Causes
  OF REPIRATORY COUGH Coughing is what the body uses as a protective mechanism to clear the airways. If something irritates the airways, what results is coughing. For example, when you have a cold, the mucus dripping down the back of the nose onto the throat is what results in you coughing.
• Symptoms
  AND TREATMENT OF REPIRATORY COUGH Many coughs are different from one another and each sufferer needs to know how to treat their individual cough. Coughs often follow on from a cold and are the body's way of getting rid of the remnants of the cold. There are three types of cough and is important that each should be treated with the correct kind of cough medicine:
  
  
  • Chesty (produces phlegm)
    Those with productive coughs generally produce phlegm as a result of constant mucus secretions fighting an infection. Chesty coughs are the body's way of getting rid of unwanted material from the lungs, so any treatment that you undertake should aim to assist this process rather than suppress it.
  • The most common treatment for productive chesty coughs are expectorants. They work by reducing the thickness of the phlegm, making it easier for you to cough. Products that contain guaiphenesin are also widely used and are recommended treatments for chesty coughs.
  • Dry/hacking
    A dry hacking cough is unproductive, consisting of no phlegm and can often be consistent and repetitive causing pain to the muscles in the chest and stomach. Common treatment for a dry cough is a cough syrup that contains dextromethorphan.
  • Tickly
    Although light, this cough is repetitive which is exacerbated by being in dry or centrally heated areas or smoky environments. This cough tends to occur high up in the back of your throat. If you find that your throat feels dry and tickly, you will need something to give you fast and effective relief. Products that contain glycerol are the best ones to treat a tickly cough.
  If your symptoms persist, you should consult your doctor or pharmacist.

CRAMP: MUSCULO-SKELETAL

• Description
  The spasm of a muscle or group of muscles that usually occur in the legs are known as cramps. Cramps can happen during vigorous activity such as running or swimming or even while resting. Sweating in very hot weather can also cause cramp. Night cramps are those that occur mainly in bed at night are a common cause sleep disturbance in the elderly.
• Causes
  If levels of oxygen in the blood drop from either exercise or following digestion of a heavy meal, a build up of waste product in the muscle, known as lactic acid can occur. Muscles can only store a limited amount of lactic acid, and when this limit has exceeded, the affected muscle may go into spasm, which will cause the cramp.
• Symptoms
  The main symptom of a cramp is pain that is usually confined to the area over the muscle involved. The muscle may be knotted and tense, and can be felt as a hard, tender cord.
• Treatment
  Rubbing and stretching the muscle will help to relieve the pain felt during cramp. Walking on the affected leg will also inevitably stretch the muscle and relieve the cramp. Lotions that are called embrocations can also ease the cramp. If you experience cramps at night, these can be treated by gentle circular rubbing with the tips of your fingers over the affected muscle.
  
  Stretching exercises can also cure many cases within a month. You should stand three feet from a wall with your heels firmly on the floor and tilt forward with your hands against the wall. You should stretch until you feel a moderate pulling sensation in the calves and you should hold this position for 10 seconds and then return to an upright posture and relax for 10 seconds before repeating the process. You should continue for 5-10 minutes at least three times a day until symptoms have improved. Severe and more persistent night cramps may need medication such as quinine sulphate tablets, which should be taken regularly to help prevent attacks.
• Treatment
  If your sleep is becoming seriously impaired or if troublesome attacks continue on a regular basis, you should consult your doctor.

CYSTITIS: GENITO-URINARY

• Description
  When the lining of the bladder becomes inflamed, that is when cystitis occurs. Affecting nearly 50% of women at some time or another, it is a fairly common condition.
• Causes
  The two types of known cystitis are the bacterial and non bacterial type. Cystitis is caused when bacteria from the back passage enters the bladder through the opening, which is known as the urethra. In women, because the opening to the bowel and bladder are so close together, it is easier for bacteria to pass from one to the other. Non bacterial cystitis is when the bladder has been irritated by perfumed soaps, bath additives, vaginal deodorants or bruising during sex.
• Symptoms
  Common symptoms of cystitis include an urge to pass urine more often and a sharp or burning sensation when you pass water, and feeling that your bladder has not been completely emptied. Cystitis is also sometimes accompanied with a pain in the lower back.
• Treatment
  With your first suspicion of cystitis, you must drink as much fluid as possible to flush out the bacteria. Remedies are available over the counter, working by neutralising the urine, and therefore making it harder for bacteria to flourish. These products are likely to contain potassium citrate, sodium citrate or sodium bicarbonate. If these do not relieve the symptoms in a few days, you should consult your doctor.
• Treatment
  If you find blood in your urine, have a heavy vaginal discharge, or are pregnant with a high temperature, you should see your doctor immediately. If you experience any pain in your lower back or abdomen, you should also see your doctor. Even men and children with cystitis should see a doctor, and you should finally see a doctor if you have kidney or heart disease, high blood pressure or diabetes.

D

DANDRUFF: SKIN

• Description of Dandruff
  Dandruff is when there is excessive scaliness of the scalp. Because the cells on the scalp are always being renewed, you cannot usually see the dead cells being shed. However, for those who suffer from dandruff, the cell turnover is faster and the dead cells are larger and therefore more visible.
• Causes of Dandruff
  A fungus that occurs naturally on everyone's scalp is what causes dandruff. This, however, does not cause any symptoms. However, certain factors that may cause the fungus to multiply include climate, hormonal changes and stress. This causes irritation of the skin and then leads to an increased turnover of skin cells which cause typical symptoms such as itching and flaking.
• Symptoms of Dandruff
  Dandruff is usually in the form of white, transparent flakes that vary in size, depending on the stage of the problem. You may also find that you have an itchy scalp, which is not caused by the flakes, or greasy hair, but usually as a result of inflammation of the scalp.
• Treatment of Dandruff
  Many different shampoos are available over the counter to help with dandruff. These contain antimicrobial agents such as climbazole, pyrithione, zinc, selenium sulphide, coal tar or salicylic acid. Shampoos that contain the antifungal ketoconazole are also available to buy from pharmacies without a prescription. In more serious conditions, your doctor may also be able to provide you with corticosteroid preparations.
• Treatment of Dandruff
  If your scalp is very red, you may have a condition known as seborrhoeic dermatitis, and you should therefore consult your doctor for advice.

DIABETES MELLITIUS: ENDOCRINE DISORDERS

• Description
  Diabetes comes in two forms. Type 1 diabetes generally tend to affect younger people and Type 2 diabetes is more common in middle aged and elderly people, as well as those who are overweight. Diabetes can also be hereditary and is more common in Asian and Afro-Caribbean communities. Type 1 diabetes develops after a bacterial or viral infection that triggers the destruction of cells that produce insulin in the pancreas. Type 2 diabetes develops when your pancreas stops producing insulin, or begins to react abnormally to its own insulin. Obesity can also lead to Type 2 diabetes.
• Causes
  Diabetes develops when there is too much glucose sugar circulating in the blood, as a result of a lack of insulin or insulin not functioning properly.
• Symptoms
  The main symptoms of diabetes include an increased thirst, frequent trips to relieve the bladder, especially at night, increased tiredness, weight loss, genital itching, blurred vision and thrush in women. If diabetes is left untreated, this can lead to more long term problems including heart disease, nerve damage and stroke. Type 1 diabetes develops more quickly, and the symptoms are very obvious. Type 2 diabetes tends to develop more slowly, and because it has less severe symptoms, it is not usually picked up until you undergo a routine medical check up.
• Treatment
  If you have Type 1 diabetes, this is usually treated by following a healthy diet and regular injections of insulin. Type 2 diabetes is also usually treated by following a healthy diet, and in some cases, your doctor may prescribe you some tablets also. These tablets will allow the pancreas to produce more insulin, help the body make better use of the insulin that it already has or it can stop glucose from entering the blood stream quickly from the intestine. Those who have Type 2 diabetes may also need to take insulin, also. It is very important to keep an eye on your blood glucose levels if you are diabetic. This can be one at home by simply carrying out a blood test on yourself by using a drop of blood picked from your finger, or by taking a urine test. If you do these two things, you will be able to adjust your insulin and diet depending on your blood glucose levels.
• Treatment
  If you have not been diagnosed with diabetes, but find yourself experiencing some of the above symptoms, you should seek medical advice. However, if you already suffer from diabetes, but find yourself having some unusual symptoms, including pins and needles or recurring infections, you should go back to your doctor. If your urine and blood measurements are above or below your normal range, you should also see your doctor about this.

DIARRHOEA: GASTRO-INTESTINAL

• Description of Diarrhoea
  Diarrhoea is when you suffer from uncontrollable bowel movements that produce loose, watery stools. These are usually accompanied by stomach ache and vomiting, and these bowel movements also tend to be frequent, but random. Those who suffer from diarrhoea should be careful that they do not dehydrate, as large amounts of water can be lost during diarrhoea. Those most vulnerable to dehydration are the very young and the elderly.
• Causes of Diarrhoea
  The most common causes of diarrhoea are viral and bacterial infections. Food contamination which may be a result of undercooked or poorly stored food is one of the main reasons in bringing these germs into the gut. If water has not been filtered or treated, this can also carry germs that cause diarrhoea. Other causes of diarrhoea may also include stress, spicy foods, excessive consumption of alcohol, and prescribed medicines such as antibiotics.
• Symptoms of Diarrhoea
  Symptoms include very loose and watery stools that are passed at frequent intervals throughout the day and night. Bowel movement will be uncontrollable, and you may find yourself vomiting and experiencing some stomach pains. If there is dehydration, you may find yourself experiencing headaches and feeling tired. A fever will also be present if you have an infection.
• Treatment of Diarrhoea
  You should drink plenty of water and take a rehydration supplement to help replace lost salts and sugars. You should avoid eating food until the diarrhoea has settled, and until then, eat plain foods such as boiled rice or dry toast. You should avoid fresh foods and dairy produce which may increase the urge to move the bowel. Absorbent powders such as kaolin and methylcellulose can also help to remove toxins from the gut. Anti diarrhoeal treatments including loperamide from the pharmacy also help to reduce the gut spasm and help to stem the flow of diarrhoea. However, these should be avoided if an infection is suspected. If you also have a fever, you should seek medical advice.
• Treatment
  If diarrhoea persists for more than a few days, you seek medical advice. You should also consult your doctor if blood is found in stools, if there is a fever present, if the bouts are severe (i.e powerful and continuous), or if diarrhoea is a side effect of some prescribed medicines that you are taking.

DRY EYES: EYECARE

• Description
  Every time we blink, the eye is coated with a film of tears which help to keep the surface of the eye smooth and therefore ensure good, clear vision. Dry eye occurs when few tears are produced to lubricate the eye. This film of tears is made up of three layers. One layer is an oily outer layer which is produced by glands in the eyelids which helps to stop fluid from evaporating from then eye. Another is a watery middle layer which is produced by the tear gland which cleans the eye and washes out any foreign particles present within it. The third layer is an inner layer consisting of mucus that is produced by the conjunctiva, which is the thin lining inside the eyelid, and this third layer helps tears to spread evenly across the eye.
• Causes of dry eyes
  As we get older, glands that produce the tear film layers begin to deteriorate and eyes gradually lose their natural lubrication. Women suffer from dry eyes as a result of ageing and dry eyes can also be one of the symptoms of the menopause. Those with Sjogren's syndrome may also suffer from dry eyes, but they will also experience drying out of other normal secretions such as saliva in the mouth. Those with rheumatoid arthritis may also suffer from this syndrome and dry eyes in general. The environment that you live in can also cause short term dry eye conditions. Main culprits are air conditioning, and central heating in the home. These result in lower moisture levels in the air, which lead to dry eyes. Staring at a computer for long periods of time will also dry out your eyes as when you are looking at the screen, you will tend to blink less. Tablets including antihistamines and travel sickness tablets also inhibit tear secretion and can lead to dry eyes.
• Symptoms of dry eyes
  Those with a long term dry eye condition will rarely feel that their eyes actually feel 'dry'. Instead, they will feel irritation, burning, scratchiness and a continuous sensation that there is something in their eye. They may find that their vision is blurred, and may occasionally get mucus discharge in their eyes. In more severe cases, blinking may even become painful.
• Treatment of dry eyes
  Your doctor can do a series of tests to find out the cause and what type of dry eye condition you may have. The aim of the treatment will be to relieve any discomfort you may be feeling and prevent damage to the front of the eye, (the cornea). Artificial tear eye drops and other lubricant eye drops can either be prescribed by your doctor or brought from the pharmacy. These contain preservatives to help stop germs from growing in them and it means that they are safe to use for a month after opening. However, some may not be able to tolerate the preservative, in which case they will need single dose vials which do not need a preservative. Lubricant oils are best used at night, as it is similar to having oil in your eye and can blur your vision. Women who experience dry eyes during the menopause may benefit from hormone replacement therapy as prescribed by your doctor. If none of these treatments help, surgery may have to be an option. This consists of a minor operation and involves permanently shutting off the tear drainage holes in the eyelids so that tears are able to stay in the eyes for longer.
• Treatment
  If over the counter eye drops have not helped, you should see your doctor so that they can find out the cause and subsequently recommend the right treatment for you. If you have rheumatoid arthritis, going through the menopause and are suffering from dry eyes, you should go to see you doctor, also.

E

EARACHE: EAR, NOSE AND THROAT

• Description
  If you experience pain in your ears, this usually means that the middle ear has become infected. Children, compared to adults, are more likely to experience middle ear infections and earache. This is because the tube that links the throat and the ear, known as the Eustachian tube, is shorter in children than adults, allowing infection to pass more easily to the middle ear.
• Causes
  Middle ear infection is the most common cause of earache, and is also known as otisis media. This starts with a cold usually, but there can be other causes. A build up of fluid in the middle ear, usually after a cold, can cause a mild earache but this fluid tends to drain itself away. A build up of wax within the ear can also cause toothache and pain, which can also sometimes lead to earache.
• Symptoms
  You may have a high temperature as well as an earache if you have an ear infection. You may also find yourself suffering from a temporary loss of hearing. If children have an earache, they can often feel unwell and sick, and persistent crying can also be a sign of an ear infection in babies. With more severe infections, the eardrum may burst which will release the infected fluid out of the ear which can sometimes relieve the pain.
• Treatment
  Mild earache tends to get better by itself, ad over the counter painkillers are available that will help to treat the pain. If the earache does not get better after two days in adult and one day in a child, you should see your doctor who will check your ears to see if antibiotics are needed. If you feel as though your ear may be blocked with wax, you can try and soften the wax with over the counter eardrops.
• Treatment
  You should consult a doctor if painkillers do not ease your earache or if it lasts for more than two days. If you are worried about your hearing or if fluid is coming out of the ear, you should seek medical advice. You should also always check with your doctor if you find yourself feeling dizzy, drowsy or have a sudden loss of hearing.

ECZEMA AND DERMATITIS: SKIN

• Description of Eczema and Dermatitis
  Eczema describes a number of skin conditions with similar symptoms. It is also more commonly referred to as dermatitis. The most common type of eczema is known as atopic eczema which tends to occur more in childhood as is a part of the family with similar allergic and 'atopic' conditions including hayfever and asthma. Another common type of eczema is that of contact eczema which is caused by direct contact with a substance that causes the skin to react badly.
• Causes of Eczema and Dermatitis
  Eczema is not infectious or contagious. Although the causes of eczema are not known, it may sometimes develop as an allergic response to a particular substance (an allergen) which may include the droppings of the dust house mite. In allergic contact dermatitis, causes may include glue, specific medicines applied to the skin, dyes and even plants.
• Symptoms of Eczema and Dermatitis
  Symptoms will include dryness and flakiness of the skin including inflammation of the skin. A mild form of eczema tends to simply be itchy and dry skin. In its more severe cases, however, the whole body can be affected causing itching and inflammation.
• Treatment of Eczema and Dermatitis
  Although there is no known cure for eczema, regular treatments can still help to manage it. These include emollients and topical steroids that are applied directly onto the skin. Emollients help to keep the skin moisturised and are a combination of oils, fats and water. Anti pruritic emollients that contain lauromacrogals are also effective as they act as a local anaesthetic to prevent the itch of eczema. Topical steroids are anti inflammatory medicines which bring eczema under control faster. Other treatments may include antihistamines which will help to control the itching and antibiotics if the eczema has become infected. Topical steroids are mainly only available on prescription, and you should listen to your doctor's advice as over using such products will have side effects such as thinning of the skin. Other treatments include wet wrapping with bandages and UV light treatment.
• Treatment
  If you suspect that you have eczema but have not yet been diagnosed, you should seek medical advice. If any of the symptoms worsen, you will also need attention. You should consult your doctor if the skin is weeping and does not heal if there is a suspected infection present. In the very young, the elderly and those with diabetes, eczema needs special attention.

EYES- SORE, RED AND TIRED: EYE HEALTH

• Description
  Eye problems are those that can affect anyone. They can become sore, red and tired, and you may feel as though there is something in your eye. Red eyes are caused by dilated blood vessels which cause redness on the surface of the eye. This is also sometimes referred to as 'bloodshot'. Your eyes should be well looked after, and it is highly recommended that you visit an optician every 2 years for a check up.
• Causes
  Eyes may become red because vessels in the surface of the white portion of the eye become enlarged. Eye problems can be caused by a number of different things including allergies, such as hayfever or the environment that you are in. Dry and smoky atmospheres can also cause eyes to become sore and irritated. When you're in the work place, computer screens or air conditioning can be responsible, and even past times such as swimming or socialising in smoky places can also be common causes.
  
  Pollen, grit and dirt also play a part and too much straining of the eyes at small objects can also cause fatigue of the muscles in your eyes causing pain and redness.
• Symptoms
  Common symptoms of eye problems include redness, itching, burning and tiredness of the eye as well as feeling as though there is something in your eye. More serious symptoms are those of pain, blurred vision, discharge and sensitivity to light.
• Treatment
  Most products to treat such eye problems can be purchased from pharmacies. These will contain astringents (for sore eyes), antihistamines (for allergy related symptoms), antibacterials (for minor infections), vasonconstrictors (for sore, red eyes) and lubricants (for dry eyes). Vasoconstrictors help to reduce swollen blood vessels and help to soothe and remove redness from eyes. Treatments cannot be used at the same time as wearing contact lenses, so you should always read the labels and instructions and speak to your pharmacist.
• Treatment
  If over the counter eye drops have not helped within a few days, and the problem is ongoing, you should see your doctor as they will be able to advise you on recommended treatment. If your eyes have been bloodshot for more than a few days, you should also see your doctor. And if you are suffering with a sudden pain, discharge, inflammation and discharge, you should seek medical advice immediately.

F

FLU: RESPIRATORY

• Description of the Flu
  The flu or influenza as it is also known is a viral infection that has symptoms similar to, but more severe than a serious cold. In cases of the flu, however, there is not usually a runny or blocked nose.
• Causes of the Flu
  There are many different 'strains' of certain viruses that cause the flu. This is why people tend to suffer from the flu repeatedly.
• Symptoms of the Flu
  Symptoms of the flu include a fever, severe aches and pains, headaches, sweating, shivering and in some cases, a cough. The flu usually lasts longer than a cold. More severe symptoms last for just a few days but it can take slightly longer to recover from the flu.
• Treatment of the Flu
  There is not a known cure for the flu, as it usually gets better by itself. Remedies that you can use are similar to those for a cold. These include paracetamol and aspirin, which will help to relieve any aches and pains you may have, and help to reduce your fever. Gargling with soluble aspirin also helps but it is not advised to give children under the age of 12 soluble aspirin.
  
  If you find that you have a cough, your pharmacist can recommend you a cough medicine, but you must check what the preparation for this is, as it is easy to take too much decongestant and painkiller if you are taking more than one remedy. You should also drink a lot of fluids to help replace body fluid that is lost by sweating.
  
  Every year, you will find that a new vaccine has been introduced to help protect against current strains of the flu virus. This vaccine is usually only given to high risk people including the elderly and those with low immunity and conditions such as asthma, heart disease and diabetes amongst others. A new inhaled treatment for the flu has also been recently introduced which helps to shorten episodes of the flu. However, this treatment is not widely prescribed by doctors as of yet.
• Treatment
  Those will be prone to a secondary bacterial chest infection if they have bad chests, or who were frail of ill before contracting the flu. If you suspect that this is the case with yourself, you should consult your doctor. If your flu symptoms have not been relieved after one week, you should also seek medical advice. Babies and children should see their doctor if they have a very high temperature or are refusing to drink and subsequently showing signs of meningitis.

H

HAIR LOSS: SKIN

• Description of Hair loss
  Many men will experience 'male pattern baldness' or hair loss as they grow older. Hair follicles shrink and hairs become short and thin so that they become barely visible to the naked eye. After this, hair follicles will shut down completely. Hair loss also affects approximately 2 million women in the UK.
• Symptoms of Hair loss
  If you are male and suffering from hair loss, you may feel your hair beginning to get a little bit thinner than before on the crown and at the temples. Your hairline will begin to recede but the hair on the back and sides of your hair will stay the same as usual. Although you will not get bald patches, your hair will thin all over your scalp.
• Causes of Hair loss
  The reason for hair loss is simply getting older. However, there are some things that can trigger hair loss which include poor nutrition, stress and other prolonged illnesses. Hair loss can also be hereditary in both men and women.
• Treatment for Hair loss
  Getting a good haircut can make your hair look better, and colouring your hair to a natural colour similar to your own hair colour can also make hair loss less noticeable. You can also wear various hairpieces and get your hair woven to your existing hair also. Surgical options include hair transplants, but it is important to remember that if you are considering having surgery, that you discuss options with your doctor and get proper advice. Products containing minoxidil are also available from pharmacies, and this solution should be applied to your scalp twice a day resulting in slower hair loss for both men and women.
• Treatment
  You should consult your doctor if you are beginning to dramatically lose hair or if you are concerned by your hair loss in any way.

HAYFEVER: RESPIRATORY

• Description
  Hayfever is when you suffer an allergic reaction to pollen. Hayfever varies from having very mild effects to more serious effects. Hayfever affects 20% of the population, making it a very common condition to have.
• Causes
  When your body's defence system reacts negatively to pollen, this is what causes hayfever. In Britain, it is mainly grass pollen that causes hayfever, but pollen from other plants and trees can also cause hayfever. May to September is usually the peak season for hayfever, but this does vary depending on where you are in the countries, and other allergies that you may have.
• Symptoms
  Symptoms include a mild irritation which is easy to deal with and more serious conditions. Hayfever will usually affect the eyes and nose and symptoms of hayfever include an itchy, blocked or runny nose. Eyes may also become red, swollen and watery. You may also experience headaches due to the swelling of your sinuses and congestion.
• Treatment
  Treatment depends on how serious your hayfever is and how bad your main symptoms are. If your hayfever is mild, you may not need or want to treat it at all- however, if it is only affecting your eyes, then anti allergy eye drops may be enough for you to use. Firstly, you should attempt to minimise your contact with pollen. You should then try to use over the counter treatments, and talk to the pharmacist about which one would be best for you. Antihistamines are the most popular treatments available, and also nasal antihistamines, eye drops, anti inflammatory nasal sprays and oral or nasal decongestants.
  
  All of these treatments will work differently, and antihistamines usually take effect within an hour which will treat symptoms such as an itchy runny nose and sneezing.
  
  Some people however, may not find antihistamines effective at all especially if they are suffering from nasal congestion and a blocked up groggy head. If you find that this is the case with you, you may find an anti inflammatory nasal spray more effective. If you are using this treatment, it should be started as early as possible as it builds up its effect over a 2 to 3 day period.
• Treatment
  If no over the counter remedies help, you should see your doctor who may refer you to an allergy specialist who will be able to find out exactly what is causing your allergy and will be able to recommend the right treatment for you. However, if you find that you have chesty symptoms such as wheeziness, you should seek medical advice to ensure that you do not have asthma.

HEADACHE: CENTRAL NERVOUS SYSTEM

• Description
  Many headaches are relieved by taking over the counter painkillers coupled with rest and something to eat. Other headaches may be more severe and frequent. There are a number of different types of headache and various ways to treat them.
  
  
  • Tension Headache
    This type of headache is usually a result of depression or stress. The feeling may be described as pressure or a tight band around the head. Painkillers will provide a temporary relief but you should always attempt to treat the cause as opposed to the symptoms. Relaxation techniques may help, and if depression is the underlying problem, your doctor may provide you with antidepressants.
  • Muscle Contraction Headache
    This type of headache is caused by neck pain or a muscle spasm in the head or neck. Heat and painkillers can help to relieve this kind of pain, and massages and relaxation exercises will also help.
  • Medication Misuse Headache
    Rebound headaches can develop when you are using medication over a long period of time. You will experience more and more headaches daily that will result in increasing the amount of medication that you are taking to relieve them. If you find yourself treating headaches more than twice a week you should see your doctor as you may be at risk of a medication misuse headache.
  • Cluster Headache
    This is a headache where pain is centred around one eye, and feels as though it is boring into the eye. The eyelid tends to droop and will become watery and red. These headaches tend to occur in 'clusters' ranging from once every other day to up to seven or eight times a day. Clusters will last for six to eight weeks with periods of remission that could last up to months or years. Your doctor will be able to provide you with a number of treatments for this headache.
  • Chronic Daily Headache
    This headache occurs on more than 15 days each month. It can consist of a number of different types of headache occurring throughout the month including tension headache and medication misuse headache with attacks of migraine in between.
• Treatment
  You should get an accurate diagnosis from your doctor if you think you are suffering from any one of the above headaches. If you find that your headache has occurred suddenly and if it is accompanied by a bout of fever, drowsiness or neurological problems you seek medical advice immediately.

HEARTBURN AND INDIGESTION: GASTRO-INTESTINAL

• Description
  Indigestion refers to discomfort or pain in the lower abdomen or chest, after meals. Heartburn is also a form of indigestion where discomfort is felt just behind the breastbone.
• Causes
  Indigestion can be caused by a number of things including excessive alcohol consumption, medication including aspirin and infection. If you have disorders of the intestine, gall bladder and pancreas, this can also subsequently lead to indigestion. The inflammation of the gullet is called Oesophagitis and is the result of the stomach's digestive juices moving back up. If you lie down after a heavy meal, this will aggravate this some more. If you find a stomach ulcer as a result of indigestion, the diagnosis is known as a peptic ulcer. If no ulcer is found, then the diagnosis is usually non ulcer dyspepsia. Ulcers are a result of a break in the lining of the stomach or duodenum which is the first part of the intestine, and the ulcer tends to look like ulcers that appear in the mouth.
• Symptoms
  Pain varies, and some may feel a hunger like pain while others may feel the pain after eating, The pain can however, also have no relation to food. Other symptoms may include a sense of feeling bloated, nausea and vomiting.
• Treatment
  A number of indigestion remedies and antacids can be brought from pharmacies. Antacids contain a mixture of aluminium and magnesium salts, sodium bicarbonate and calcium carbonate. Sodium based antacids should be avoided if you have a heart condition or high blood pressure. Liquid preparations tend to work faster but tablets tend to have a more long lasting effect.
• Treatment
  Angina an heart attack can sometimes be confused with indigestion. You should suspect angina if you experience any chest pain that is brought on by exercise and relieved by rest. You should suspect a heart attack if the pain is intense, in the centre of the chest that may spread to the arms and lower jaw, or if you feel any kind of heavy pressure. You should also consult a doctor if you get heartburn regularly, you have a family history of gastric problems and if you find that you have prolonged symptoms of indigestion. If you also experience recurrent and bloody vomiting, black stools, rapid weight loss and difficulty in swallowing, you should seek medical advice urgently.

HEARING LOSS: EAR, NOSE AND THROAT

• Description of Hearing loss
  Hearing loss is very common and a well recognised medical condition. More than 50% of people over 60 suffer from a loss of hearing.
• Causes of Hearing loss
  Loss of hearing tends to be experienced through ageing and is caused by the loss of tiny hair cells in the part of the ear known as the cochlea that processes sounds for your brain to interpret. As you get older, hair cells begin tom die and sounds are not as clear for you to hear as they used to be.
• Symptoms of Hearing loss
  High frequency sounds tend to disappear first for most people. Hearing will become less acute when you have difficulty in understanding what other people are saying as speech contains such high frequency sounds. Hearing loss also makes it harder for you to make out what other people are saying in more noisy environments such as bars and parties. You may also find it hard to hear people speak over the telephone. If you listen to your music or television too loud, this can also be a sign that you are subconsciously overcompensating for hearing loss.
• Treatment of Hearing loss
  You should always have your hearing investigated by your GP first. You will usually be referred to the audiology clinic or the ear, nose and throat department of your hospital for some hearing tests. After the results suggest that you are suffering from a loss of hearing, the audiologist will discuss the best remedy for you. For some people, a hearing aid proves itself to be very effective seeing as most of them are unobtrusive. Although the sounds that you hear are altered, your overall hearing would have improved a great deal.
• Treatment
  If you are under 60 and think you may have developed a loss of hearing, you should consult your doctor. It should be investigated as it is less likely to be age related hearing loss.

HERNIA: GASTRO INTESTINAL SYSTEM

• Description of Hernia
  If there is a weak area of muscle or ligaments that surround the gut, in the abdomen, some of the gut can push through which will appear as a lump under the skin. This is called a hernia. These tend to occur more in the groin area but can also occur on the stomach or under another weak point such as an operation scar.
• Causes of a Hernia
  Hernias can occur either after lifting something heavy or as a result of a bad cough, but sometimes they just tend to appear. If you are pregnant or overweight, this can also sometimes cause the intestine to push through the abdominal wall. A cause of hernia can also be the strain of severe constipation. Hernias don't tend to be very serious, but if too much gut comes out of the body, it can become squeezed which can be very painful.
• Symptoms of a Hernia
  A small lump will usually appear in the groin. Although it may not be painful, it will still ache and as time goes on, the lump will get larger.
• Treatment of a Hernia
  If you suspect that you have a squeezed or 'strangulated' hernia, you should seek medical advice straight away. A hernia can be treated by an operation which is carried out through a cut in the groin. You may only need day surgery, in which case you can usually be back to normal within a fortnight. Occasionally however, a hernia may come back in which case you may need a second operation. Whilst waiting for surgery, you may need a truss which is a belt like appliance with a pad that exerts pressure over the hernia. This will prevent the bowel coming out of the body. Although this will help with the discomfort of your hernia, it will not cure it.
• Treatment
  You should consult a doctor if you suspect that you or a relative has an undiagnosed hernia.

I

IMPOTENCE: SEXUAL HEALTH

• Description
  Impotence is also known as Erectile Dysfunction (ED) and is when a man cannot maintain or achieve an erection of the penis which will allow him to have successful sexual intercourse. There are many causes of ED as an erection is a complex process with both psychological and physical aspects to it. This, on average affects one in ten men in the UK. When a man is sexually aroused, blood starts flowing to the penis which fills the spongy tissue in the penis which leads to an erection.
• Causes
  Many men may feel that they've had problems getting an erection be it because of stress, anxiety or maybe even too much alcohol. There is nothing to worry about if this is the case. Worrying about it may make the problem worse which will lead to more anxiety and stress as the man will be pre occupied with 'fears of failure' as opposed to feelings of being aroused. ED is caused by a number of different physical and psychological factors. It is more likely to have a physical basis including problems that affect the normal blood flow to the penis due to ageing, hormone abnormalities and damage to the nerves in the penis. Prescription drugs including antidepressants and blood pressure tablets can also lead to impotence. Psychological factors may include stress, depression and relationship problems.
• Symptoms
  Symptoms include a persistent problem in achieving and being able to maintain an erection.
• Treatment
  Lifestyle changes such as reducing stress and anxiety can help to decrease the problem of erectile dysfunction. If the problem is psychological, sex therapy and counselling may also be helpful.
  
  Several oral treatments are available which are either swallowed, placed under the tongue and tend to work when there is sexual stimulation. You should discuss these with your doctor or nurse as these treatments vary in the way they work. For example, treatment may need to be taken just before sexual activity or any time up to 12 hours before sexual activity. The period of time over which treatments may work can vary between 3 and 24 hours. Your doctor will tell you that these treatments cannot be taken with nitrates and may also have some side effects including hot flushes and visual disturbances.
  
  Vacuum devices are plastic cylinders that are put over the penis. Then an attached vacuum pump is used to draw blood into the penis. When an adequate erection has been achieved, a tension band is then slipped around the base of the penis to help to maintain the erection.
  
  Intracavernosal injections involve injecting a drug into the shaft of the penis. It is used in a needle free, transurethral device which deposits the drug pellets straight into the urethra where urine passes from.
  
  Other treatments include hormone treatment, penile prosthesis which are splints inserted into the penis, and surgery which will help to correct blood flow to the penis.
  
  Problems in libido, ejaculation and orgasm are more likely to need psychological treatment.
• Treatment
  Consult a doctor if your impotence problems are recurrent and persistent. If you are diabetic and experiencing these problems, you should see your doctor immediately as it could be a symptom of your diabetes.

IRRITABLE BOWEL SYNDROME: GASTRO-INTESTINAL

• Description
  IBS is a condition that affects the gut. One third of people in the UK have symptoms of IBS whilst one in ten have symptoms that require medical attention. IBS can start at any age but commonly begins between the ages of 15 and 40.
• Causes
  The direct cause of IBS is not known but those who have sensitive bowels may find that it is this sensitivity that sets off a reaction which causes the symptoms. If the bowel is overactive, the contents from the bowel pass more rapidly which results in diarrhoea. However, more sluggish activity will cause constipation. Muscle spasms in the bowel will cause cramping pain and discomfort. Also, eating a meal or the presence of gas in the bowel can also trigger spasm and contraction which will lead to symptoms.
• Symptoms
  Symptoms generally include cramping and a feeling of being full or bloated. Changes in bowel habits range from diarrhoea to constipation, and can also alternate between the two.
• Treatment
  Regular meals and a well balanced diet will help to reduce symptoms. Foods that are high in fat should also be avoided. Sufferers may not associate attacks with more common foods including bread and dairy products. However, some patients may benefit from increasing the fibre content in their diet or by taking fibre supplements which can be prescribed or purchased from pharmacies. With other sufferers, however, they may find that reducing their fibre intake will help with their symptoms. Anxiety and stress can also trigger IBS and stress management strategies can also be helpful. Other therapies include laxatives and antispasmodic drugs, which vary in response to them from person to person.
• Treatment
  If you think that you may have IBS or if there is any change in your bowel habits or you find blood in your stools, you should seek medical advice immediately.

L

LICE: SKIN

• Description
  Lice are very small wingless insects that feed on blood from the human body. There are three different types of lice that appear on three different parts of the body which include head louse, body louse and pubic louse. Adult head lice are greyish brown in colour, are the size of a sesame seed and feed on blood from the scalp. Their eggs are oval shaped and very small (0.8mm long). After 7-10 days, the eggs hatch and leave empty cases, which are also known as nits. These are usually found further down the head shaft and are shiny and white. Once they have been hatched, it takes another 7-10 days for the growing louse to be able to lay their own eggs. Body louse are larger than head louse and are found in cloth fibres. Pubic lice are 1-2mm long and live in pubic hair, and sometimes eyelashes.
• Causes
  Head lice cannot fly or jump, but they can walk from one head to another which explains why infestations are so common in young children. Head lice also cannot be passed through things such as towels and bedding, either. Infestation of body lice is usually due to overcrowding and poor hygiene and they may also carry disease. Pubic lice tend to be transmitted through sexual contact and rarely through bedding and clothes.
• Symptoms
  Head lice are well camouflaged and may therefore be hard to see. They do not always result in an itchy scalp, and many people will be unaware that they are infected. Head lice should be detected by using a fine tooth comb that has been washed and treated with conditioner. The lice should become visible on the comb. Other family members should also be checked if louse are found. Symptoms of infestation by body louse include itching on the buttocks, shoulders, stomach and you will also find small red puncture type marks. Pubic lice bites appear as small, non itchy blue grey bumps.
• Treatment
  You should only use treatment once live louse have been found on the head. If they are present, the pharmacist will be able to recommend a range of insecticides which are available as liquids, lotions, crèmes and mousses. Preparations that contain alcohol are not recommended for young children and those who suffer from asthma. As lice can become resistant to some insecticides, local authorities have a rotation policy whereby different insecticides will be recommended on a rotational basis. Other preparations that are used for head lice include piperonal, which help to repel head lice, herbal and essential oil products and also battery operated combs which are for use to 'stun' the lice. Some head lice preparations can also be used for boy and pubic lice, but you should ask your pharmacist for advice on this. Treatments that have actually been proved to eradicate the lice are treatments that contain an insecticide.
• Treatment
  If an over the counter treatment has not worked for you, you should see your doctor who can suggest an alternative method of getting rid of the lice. If the person being treated is under one year of age, suffering from allergies including asthma, or a woman who is pregnant or breastfeeding, you should also consult your doctor.

M

MEASLES, MUMPS AND RUBELLA: IMMUNE SYSTEM

• Description
  The effects of measles, mumps and rubella are very serious which is why most children in the UK are regularly immunised against them. Measles is very rare in the UK but is still a big cause of childhood death in developing countries. Mumps is a slightly milder infection, but can result in serious complications including sterility in men and deafness as it is the most common cause of viral meningitis. Rubella is also a milder infection but if a pregnant woman who has not been immunised catches rubella during pregnancy there is a possibility that the baby could be born blind, deaf and even brain damaged.
• Causes
  Viruses are the main causes of measles, mumps and rubella. They are all very highly infectious and spread very quickly between people and this explains why outbreaks occur amongst non immunised populations.
• Symptoms
  Symptoms of measles begin with a high temperature and a bad cough with a runny nose. A red blotchy rash will then appear and last for approximately a week before it disappears. Mumps will cause fever, tiredness and the swelling of the salivary glands. It can cause very serious complications including inflammation of the brain, bronchitis and also pneumonia. When one has rubella, you will find that the lymph nodes are swollen, usually in the neck, and there is a scattered rash of red patches and a slight fever.
• Treatment
  Most children are routinely vaccinated against measles, mumps and rubella in the UK with a vaccine known as MMR. Children will be given the vaccine between 12 and 18 months of age which is followed on by a booster between 4 and 5 years. Children will very commonly develop a rash and mild fever following immunisation. If the child develops a temperature, the recommended dose of paracetamol for their age group should be given to them.
  
  Due to some controversy regarding this vaccine, some parents may prefer to give the vaccine separately which may involve travelling abroad as doctors in the UK are not licensed to do this. Parents should always talk to their doctor before considering alternatives to the MMR vaccine.
• Treatment
  If you or your child are experiencing the symptoms of measles, mumps and rubella, you should consult your doctor straight away. If, following the MMR vaccine, your child is continuously crying and there is a persistent sign of a rash or fever, you should also consult your doctor immediately. Swelling may occur where the injection was given, but should not be any larger than the surface area of a 10p coin. If the swelling is larger than this, you should see your doctor.

MENINGITIS: INFECTIONS

• Description
  Meningitis is the inflammation of the lining around the brain and spinal cord which is known as the meninges. This is a result of a viral or bacterial infection. Meningitis is a serious condition that could be fatal if it is not caught in time or treated correctly, so it is important for you to act quickly if you suspect that you or a member of your family have it.
• Causes of Meningitis
  The two main types of meningitis are viral meningitis, caused by a viral infection and bacterial meningitis which is caused by a bacterial infection. The most common form of meningitis is viral meningitis and is very rarely fatal. Some people may not even be aware that they have it, although it will leave the person feeling very weak. Bacterial meningitis is extreme but less common. It kills one in ten people that have it and those who survive it are left with a serious disability including brain damage and hearing loss. Bacterial meningitis comes in three forms: meningococcal (A, B and C strains), pneumococcal and Haemophilus influenzae type b (Hib). These bacteria usually live in the nose, airways and throat and when the body's defences fail, leaving you feeling run down- this is when the bacteria multiplies and causes meningitis. Bacteria tends to be spread through close contact with other people, for example, through coughing, sneezing and kissing.
• Symptoms of Meningitis
  Meningitis comes with a number of different symptoms that are not always seen at the same time. The main symptoms present in older children and adults are those of high temperature, vomiting, severe headache, aversion to bright lights, pain in the muscles and joints, drowsiness and diarrhoea. Sufferers may also experience fits and feel disorientated and confused. In babies and infants, symptoms are slightly different and will include a fever, refusal to eat and be handled, high pitched moaning and whimpering, lethargy and vomiting. Their skin may also go pale and blotchy and they may have a blank staring expression on their faces. Another sign is when the baby pulls back its neck, and arches its back.
  
  The most common sign of meningitis in adults and children is a rash. This is a sign of septicaemia which is blood poisoning. The rash can appear anywhere on the body which looks like a cluster of spots at the beginning, but then join together to make it look like a bruise. The test for this rash is known as the 'glass test' when you press the side of a clear glass against the rash or bruise, and it doesn't fade, this means that there is septicaemia present. Once spotted, you should call your doctor immediately as it is often a later sign of meningitis to appear.
• Treatment for Meningitis
  Antibiotics can be used to treat bacterial meningitis, but it is essential that treatment starts early before more serious problems set in. With the case of viral meningitis, the only treatment is complete rest so that the body can heal itself. There are vaccines against meningococcal A and C strains. A combined meningococcal A and C vaccine is usually offered to travellers and meningococcal C vaccine has only been more recently introduced to children from the age of two months old to older children and teenagers who missed out on the vaccine the first time around. Pneumococcal meningitis vaccines are also given to people of high risk and a vaccine against Haemophilus influenzae type b (Hib) is given to children as a part of the routine immunisation programme that is currently run by the NHS.
• Treatment
  If you suspect any of the above symptoms, you should call your doctor immediately. Signs can be vague and therefore it is easy to misinterpret them as signs of the flu, and your doctor can tell you if it's something more serious.

MIGRAINE: CENTRAL NERVOUS SYSTEM

• Description of Migraine
  A migraine is more than just a headache as it comes with symptoms that will vary from person to person. Effects can keep you in bed for up to three days.
• Causes of Migraine
  Release of the chemical known as serotonin causes changes to the blood vessels in the brain which result in a migraine. What prompts this chain of events is not known, but there are many 'triggers' including emotional and physical stress. However, these may not be the same for everyone.
• Symptoms of Migraine
  A migraine can occur with or without visual disturbances known as 'aura'. Symptoms of migraine without this include a throbbing headache, vomiting, diarrhoea and an increased sensitivity to light, smells and sounds. Feeling strange a day before the attack begins is known as the prodrome. Symptoms of migraine with aura, which will occur before the headache include confusion, problems with concentration and co ordination, pins and needles and numbness on the affected side as well as visual disturbances. The attack will then proceed in the same way as a migraine without aura. This particular migraine only affects about 10 to 15 per cent of sufferers. Both types of migraine usually last between four and 72 hours.
• Treatment for Migraine
  If you experience a migraine attack, you should rest away from bright lights and noise. Over the counter painkillers such as aspirin and paracetamol can be effective if they are taken at the early stages of a migraine. If these do not bring you relief, your doctor will be able to prescribe you stronger painkillers or painkillers that are combined with anti sickness ingredients. Your doctor may also prescribe you drugs known as 5HT agonists which are also known as triptans which will act directly to correct the imbalance of the serotonin in the brain during a migraine attack.
• Treatment
  If you are suffering from disabling headaches on a regular basis, you should consult your doctor immediately. Acute treatments for migraines are not suitable for daily use so if you are using them daily, and for longer than the specified time, you should see your doctor. You should also see your doctor if you are experiencing four or more migraines a month as they will be able to prescribe you other drugs that can be taken everyday to help to control your attacks.

MUSCULAR PAINS, SPRAINS AND STRAINS: MUSCULO-SKELETAL SYSTEM

• Description
  When the ligaments of a joint are torn or over stretched, this is known as a sprain. The severity of a sprain depends on the degree of injury and the number of ligaments involved. A strain is when a tendon or muscle is either over stretched or torn, and the common area for these is the back and hamstring muscle. Muscular aches may affect a single muscle or a group of muscles.
• Symptoms
  Bruising, swelling, loss of function and pain are the most common symptoms of a sprain. You may notice a pop if the ligament has torn. Symptoms of a strain are muscle spasm, muscle weakness and pain. Severe strains which consist of a partial tear of the tendon or muscle are also often very painful. Viral causes of muscular pains tend to result in aches in certain groups of muscles such as the arms, legs, neck or chest wall.
• Causes
  A sprain happens when a joint has suddenly been forced out of its normal position. This then overstretches or may tear the supporting ligaments. Sprains therefore may often occur when a foot, knee or wrist becomes twisted during a fall, whereas in contrast, the pulling or twisting if a muscle usually causes strains. This can happen due to heavy lifting or awkward weights. Chronic strain develops due to overuse through repetitive movements of the muscle. Muscular aches may also occur as a result of viral infections that cause the cold or flu.
• Treatment
  Mild strains and sprains will heal with ice, rest, elevation and compression. Once the overall pain and swelling begin to calm down, you should begin gentle exercises to prevent stiffening of the joint that has been affected which will help to build up the strength of the muscles. Painkillers can also be taken for pain relief, and they should be taken with milk or food to help protect the stomach. Splinting may be required for moderate sprains to help rest the joint. Surgery may be required for more serious injuries that involve tears to the ligament. The time needed for recovery depends on the severity of the injury. A moderate ankle sprain may require 3 to 6 weeks before being able to make a full recovery whereas a more severe sprain which involves the tearing of a ligament may need 8 to 12 months before the ligament is fully healed. Care should be taken during recovery time to avoid re injury.
• Treatment
  If your injury is very painful and it you bear any weight on the joint and if the limb buckles or cannot move when you try to use it, you should consult a doctor. You should also see your doctor if the area over the joint is tender for you to touch or if it has unusual lumps or looks crooked. Any redness or red streaks that are spreading out from the injury should also be investigated. You may require an X ray to check for a possible fracture or break in the bone and you may need to see a specialist if there is a serious rupture that will need to be surgically repaired. After an injury, to help restore joint mobility and strengthen weakened muscles, you may also require some physiotherapy.

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NAPPY RASH: SKIN

• Description of Nappy rash
  A nappy rash describes irritation to the nappy area that causes the skin to become red and sore. It is very common and most likely to affect most babies at some time in their first year.
• Symptoms of Nappy rash
  There are four main types of nappy rash, and therefore symptoms may vary depending on the type of rash present. One type of nappy rash will appear as red and broken skin in the creases of the skin. Another is where the skin is inflamed resulting in the rash being red and painful. The skin may be blistered and hot to touch and will appear around the genitals and anus which will spread to the rest of the nappy area, but will not be present in the skin creases. A third will produce a red rash which may have white or red spots, starting around the anus and then spreading to the skin creases. A fourth type is a flaking, scaly rash that may weep. This can appear al over the nappy area and possibly elsewhere on the body.
• Causes of Nappy rash
  Babies' skin is thinner than an adults and is more prone to damage by simple things such as a nappy chaffing the skin. This means that one type of nappy rash can lead to another. The main causes of a nappy rash are:
  
  
  • Insufficient drying of the skin after a bath. This will cause broken skin and redness which appears around the genitals and anus spreading to the rest of the nappy area.
  • A baby's skin may react to irritants present in urine or faeces, a new food or a prescribed medicine.
  • Fungal infections including thrush which will cause a moist red rash, maybe seen with red or white spots, which starts around the anus and spreads to the skins creases.
  • Other causes of nappy rash include babies being sensitive to irritants such as soap powder or a fungal infection such as a ringworm. These will result in a weeping rash that may flake or scale.
  • Babies who are teething also suffer from a nappy rash.
• Treatment for Nappy rash
  There are a number of different treatment creams that are designed specifically for a nappy rash and should be applied to the affected area. Powders are not usually recommended as they can clog the nappy and can possibly get into the baby's nose or mouth which will cause the baby to cough. It is also recommended that you let your baby go without a nappy for a while for five or ten minutes after each nappy change as this will allow the skin to breathe and dry naturally in the air.
• Treatment
  If your baby's rash worsens or does not clear up after treatment, you should seek medical advice to discuss the matter further.

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OSTEOPOROSIS: MUSCULO-SKELETAL

• Description of Osteoporosis
  Osteoporosis occurs when holes in the bone mesh and become bigger resulting in the bone becoming more fragile and liable to break more easily. It can affect the whole of the skeleton but commonly causes fractures to bones in the wrist, hip and spine.
• Causes of Osteoporosis
  Bone is constantly renewing, but as we get older, bone loss begins to increase and this results in bone density falling. Osteoporosis sets in when this process speeds up. Women with low levels of oestrogen, the female hormone are particularly at risk as a result of over dieting or the menopause. Men with low levels of testosterone, which is the male hormone and those with asthma who have to use long term corticosteroid tablets are also most at risk. Osteoporosis can also affect those with bowel disease as nutrients that are needed to help maintain healthy bones are not absorbed as well. Brittle bones can also be developed due to factors such as drinking, smoking and a lack of exercise.
• Symptoms of Osteoporosis
  Osteoporosis is often described as a 'silent disease', so if you break a bone after a very minor bump, you should consider whether it is due to osteoporosis or not. Fractures that are caused due to osteoporosis often occur in the wrist and the hip when the elderly suffer a fall. Other warning signs include pain curvature of the spine which may result in digestive and breathing problems if this is the case.
• Treatment for Osteoporosis
  You will usually get sent to a hospital for a bone scan to determine whether or not you have osteoporosis. If you are diagnosed with it, there are a number of treatments available that will help you to deal with it, including hormone replacement therapy (HRT) or selective oestrogen receptor modulators (SERMS) which are selective hormone replacement treatments with less of the side effects that are associated with HRT. Non hormonal treatments that switch off the cells that break down the bone are also effective. Vitamin D and calcium supplements can also help reduce bone loss in the elderly also. Other treatments include calcitonin, testosterone and an anabolic steroid known as nandralone.
• Treatment
  You should consult your doctor if you feel as though you have osteoporosis but have not yet been diagnosed or if you have a family history of osteoporosis. If you are not eating properly or are going through the menopause, you should also let your doctor know of this.

OVERWEIGHT: GASTRO-INTESTINAL

• Description
  Overweight is described as having a body mass index (BMI) greater than 25kg/m, and to be defined as being clinically obese is when you have a BMI greater than 30. To calculate your BMI, you need to divide your body weight which is measured in kilograms by the square of your height in metres. Your doctor or practise nurse will help you to calculate your BMI.
• Causes
  Body weight is determined by establishing the amount of energy obtained by eating food compared with the amount of energy that your body uses. Most energy from the food and drink you consume will ultimately be stored as fat. Therefore to lose weight, the energy intake from your diet should be less than the energy you expend. The main causes of being overweight include over eating, eating the wrong food and a lack of exercise.
• Symptoms
  If you have put on a few pounds, you may feel more tired than you usually do, and you may also find yourself becoming a little short of breath from doing regular day to day activities. If you are very overweight, your health problems are more than likely to increase, and these can include problems such as heart disease, diabetes and back pain. If you find that you have more weight in the waist area as opposed to extra weight that lies on your hips and thighs, you are at a greater risk of having health problems.
• Treatment
  The aim of treatment should be to encourage a healthy balanced diet and lifestyle that promotes the right amount of physical activity. Weight loss should be gradual and losing one to two pounds a week is sufficient enough. Doctors usually recommend that you will be able to lose weight if you eat approximately 600 calories less each day compared to however many you usually eat, but this will obviously depend on how much weight you actually need to lose. Eating foods that are lower in fat and sugar are enough to promote a healthy diet. This does mean that you should also increase your intake of starch and fibre and eat more fruit and vegetables and eat leaner cuts of meat.
• Treatment
  If you have experienced difficulties in losing weight and are worried about your weight, you should seek accurate advice from your doctor. There are prescribed medicines available that help those who are overweight or obese. These are recommended more for those with a BMI of over 30, or those with a lower BMI if they have a pre existing condition such as diabetes.

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PANIC ATTACK: CENTRAL NERVOUS SYSTEM

• Description
  Panic attacks tend to come from nowhere and the exact cause of it is unclear. Attacks may also be a part of obsessive compulsive disorder or a phobia of some kind. Panic that arises from complete isolation is distressing for the sufferer because there is no logical reason as to why it has occurred.
• Symptoms
  Your heart races and your breathing changes when you have a panic attack. You may feel as though you need to gulp for air as you become short of breath, and your breathing may become very fast. Chest pain and losing the feeling in your fingers and toes are also symptoms. People may feel as though they cannot swallow and they feel sick, and another common sign is when you tend to sweat more and you may experience a feeling of fright and unreality.
• Causes
  During a panic attack, you will experience a strong sense of fear which acts as a protective mechanism for the body as it prepares the body for action which is sometimes described as the 'fight or flight' response. In doing so, the body is therefore preparing to fight, or to run away from danger. With the case of panic attacks however, this response will occur when there is actually no threat present at all.
• Treatment
  Controlled breathing and relaxation techniques can help during panic attacks. Some may find yoga an effective relaxation technique whilst others may find listening to a relaxation tape more harmonious. You should also practise breathing techniques when you are not having an attack. This generally means you taking long slow breaths in and very slowly exhaling. Whilst you are experiencing a panic attack, you may find counting backwards and talking to someone very helpful, also. You should think of positive reassuring thoughts, and you may not need medication. However, in some cases your doctor may prescribe a medicine to help you which may include antidepressants, beta blockers and short courses of tranquilizers.
• Treatment
  You should make an appointment to see a doctor if you find yourself getting panic attacks more regularly and you find that they are very seriously affecting your everyday activities.

PERIOD PAIN: WOMEN'S HEALTH

• Description
  A number of women experience period pain. Taking over the counter painkillers can help to relieve the symptoms, but for some women, the symptoms can be a lot more severe, combined with painful cramps. More extreme period pain can sometimes be the result of a condition known as endometriosis which is when fragments of the womb lining escape into the abdominal cavity as opposed to being flushed out during a period.
• Symptoms
  Symptoms of period pain include cramps in the lower back, tops of legs and in the lower abdomen. Other symptoms may include headaches, dizziness and diarrhoea. Symptoms are at the worst one day before you are due your period and during the first two days of your period.
• Causes
  If you are not pregnant during your menstrual cycle, the body will produce hormones which tell the womb to shed its lining, so that the following month it can start afresh. The womb then contacts to expel the lining and it is these contractions that cause painful periods.
• Treatment
  Mild and moderate pain can be helped by taking over the counter painkillers including paracetamol and aspirin. You should take a painkiller as soon as you begin to experience the pain. In more serious cases, the doctor may prescribe you a much stronger anti inflammatory drug such as mefenamic acid. These will help to reduce the contractions of the womb as well as the blood flow. Artificial hormones such as the oral contraceptive pill can also be used to help with very severe period pain, as heavy and painful periods are a lot less likely when you are on the Pill. Many women find that applying heat general area is very soothing, and this can be achieved by using a hot water bottle.
• Treatment
  If your periods are becoming painful to manage, you should consult your doctor. You should also consult your doctor if your periods become irregular, if there is an unusual discharge from the vagina, if you have fever after sex, and if you find yourself bleeding in between periods.

PILES: CARDIOVASCULAR SYSTEM

• Description
  Piles are swollen veins in the anal area and come in two forms: internal and external. Internal piles will occur in the anal canal, whereas external piles will appear so that they are visible outside the anus. These are visible to the naked eye and either look like small lumps of skin or like small bunches of grapes in more extreme cases.
  
  Internal and external piles are very uncomfortable and can even be painful, and you may find passing stools to be a painful experience also.
• Causes
  High blood pressure in the veins around the anus are what cause piles. This will prompt the veins to swell up, making them slightly larger than normal. Constipation is the most common reason for piles to occur which tends to lead to straining when you are trying to pass a stool. A low fibre diet and a lack of exercise can also lead to piles. Piles are also fairly common during late pregnancy when the enlarging womb presses on the pelvic veins, and also due to the straining of labour during childbirth.
• Symptoms
  A dragging sensation experienced in the back passage can indicate the presence of piles along with experiencing itching and pain around the anus, discomfort and bleeding when performing a bowel movement and also a discharge of mucus into the underwear.
• Treatment
  There are many ointments and creams available to help to treat piles which can be applied directly to the affected area. They tend to contain antiseptics, skin protectors, astringents and local anaesthetics which reduce itching and discomfort, shrink piles and therefore subsequently reduce the risk of infection. Hydrocortisone based products can also help with the pain caused by severe piles, but they should not be used for longer than 7 days or if you are pregnant. More recurrent and severe piles may require more complicated treatments including injections, rubber band ligation and sometimes even minor surgery.
• Treatment
  If using creams and ointments to help deal with piles prove to be ineffective, and if symptoms are still present for more than 2 or 3 weeks, you should consult your doctor. If any rectal bleeding occurs or any vomiting and abdominal pain are experienced, you should also speak to your doctor.

PREMATURE EJACULATION: SEXUAL HEALTH

• Description
  When a man ejaculates quicker than he or his partner wishes, this is known as premature ejaculation, and cause problems in a sexual relationship. In worse cases of this condition, the man will ejaculate before any direct stimulation of the penis occurs.
• Causes
  Psychological causes are the most common with a condition such as this. Stress and anxiety can all lead to premature ejaculation. For example, if a man ejaculates too quickly the first time he has sex, the concern that it could happen again will dominate his mind next time which will make him anxious for the next time, and he will find that the same thing will happen again.
• Symptoms
  Symptoms include an inability to sustain an erection, a loss of sexual desire and sometimes an isolated feeling of having come during intercourse. In cases like these, the man has become so reoccupied in attempting to control his ejaculation that it tends to stop him being absorbed in the pleasures of lovemaking. This condition is most common in young men but can still occur at any age.
• Treatment
  The problem should always be discussed first between you and your partner, as your partner may not have any problems with you ejaculating slightly quicker than normal. If the frequency of ejaculations is increased, men may find that the ejaculations will become less rapid. If this does not help, a technique involving masturbation can also be very effective.
  
  You or your partner should stimulate the penis until just before you come. You should then rest for between 30 to 60 seconds without stimulation and then begin stimulating again, stopping short of ejaculation. This cycle of stimulation should be repeated five or six times before allowing yourself to ejaculate. You should use this technique every time you masturbate by yourself or when you have sex with your partner.
• Treatment
  If the problem has not been sorted out with your partner, then you should consult a doctor. Your doctor may wish to refer you to a counsellor or therapist, or may even be able to prescribe you drugs that will help to delay ejaculation.

PREMENSTRUAL SYNDROME: WOMEN'S HEALTH

• Description
  Premenstrual syndrome (PMS) affects many women. It involves a range of symptoms that occur before your period, and this condition usually improves when your period begins.
• Causes
  The fluctuation in the levels of female hormones that occur during a female's monthly cycle relates to PMS.
• Symptoms
  There are over 150 symptoms of PMS that have been identified. Physical symptoms include breast tenderness, fatigue weight gain and headaches. Psychological symptoms include mood swings and poor concentration levels. These may range from feeling tearful and depressed to feeling irritable and aggressive. These symptoms tend to occur approximately two weeks before a period is due and generally disappear on the first day of your period.
• Treatment
  The best way to establish whether or not you are suffering from PMS is for you to keep yourself a menstrual diary. This will help you to identify any patterns and will help you to have a better understanding of the problem. Simple advice is what works best and may include making a few changes including dietary changes, avoiding stress and relaxing and exercising some more. Treatments that can be prescribed by your doctor include water tablets, (diuretics) which relieve bloating and other painkillers and hormonal drugs. Treatments and medication including aromatherapy and acupuncture can also help to manage the symptoms of PMS.
• Treatment
  If you experience symptoms but there is no improvement in the early stages of your period, you should speak to your doctor to establish a cause for these symptoms. If however, you are not sure as to whether or not you are suffering from PMS, you should keep a menstrual diary recording your symptoms for up to three months and then show it to your doctor.

PROSTATE PROBLEMS: GENITO-URINARY

• Description
  These problems are common in men over the age of 50 and may include needing to go to the toilet more than twice a night, finding it difficult to go and rushing to go to the toilet. These problems are usually linked to problems with the prostate gland.
• Causes
  There are three medical problems that can affect the prostate gland and these occur at three different stages in a man's life. Prostatitis is when the prostate gland becomes inflamed or infected and is common between the ages of 25 and 45. Benign prostatic hyperplasia (BPH) is when the prostate gland slowly enlarges, but this condition is not cancerous and it if does occur, occurs after the age of 45. Although prostate cancer can emerge at any age, it generally only affects men over the age of 55.
• Symptoms
  If you are male and over the age of 50, you or your partner may have experienced or recognised some of the following problems:
  • Needing to go to the toilet at least twice every night.
  • The need to rush to the toilet.
  • Finding it difficult to go and finding the need to push or strain.
  • The feeling of your bladder never being completely empty.
• Treatment
  If you experience any of these symptoms, going to see your doctor is the best thing that you can do. These symptoms are very common and it is important for you to know that you are not the only one suffering. A majority of these symptoms are not caused by cancer and for the most part, problems are able to be treated with simply and effectively.
• Treatment
  Symptoms should be discussed with your doctor and you should try and see your GP immediately if you are experiencing any of these symptoms. If your partner is suffering from any of these symptoms, you should also encourage them to speak to their doctor.

PSORIASIS: SKIN

• Description
  This is a skin condition that results in scaly and thickened patches that are caused by an increased production of skin. It can occur anywhere on the body, but the most common places affected include scalp, elbows and knees.
• Causes
  What causes increased skin production is unknown, but there may be a genetic tendency through family history that may cause psoriasis. Throat infection, physical and emotional stress and injury are just a number of factors that may trigger psoriasis.
• Symptoms
  Although there are many different types of this condition, the most common one is 'chronic plaque psoriasis' that occurs mainly in adults. As a result of this, you will see raised patches of skin that are covered with what look like silvery scales and tend to be itchy. 'Guttate psoriasis' occurs in children and tend to appear as tiny red spots. When the soles of the feet and palms of the hand are affected, this is known as 'palmar plantar pustular psoriasis' and you will see that yellow blisters have faded to leave a small stain which is brown in colour. 'Generalised pustular psoriasis' is where yellow pustules cover large areas of the body resulting in the sufferer feeling slightly feverish.
• Treatment
  There is presently no cure for psoriasis, but there are treatments available that work long term to treat the condition if it is already present on the skin. Some doctors may suggest a step by step approach to treating the problem beginning with creams and ointments that contain coal tar or dithranol. These products tend to be very strong and should therefore only be used in the affected areas. Ultra violet therapy used in unison with creams and ointments should be the next step if simply using creams and ointments by themselves does not work. Light therapy involves several treatments over a course of a few weeks with professional supervision. There are also oral tablets that available for those who do not benefit from simply using creams or if light therapy has not worked for them. Some of these can be dangerous if they are taken by pregnant women. Therefore, if you are suffering from psoriasis but are pregnant, or looking to become pregnant, this matter should be discussed with your doctor.
• Treatment
  You should seek medical advice if you think that you have psoriasis but have not yet been diagnosed with it.

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RINGWORM: SKIN

• Description of Ringworm
  This is an infection of the skin that is usually found around the scalp, nails feet and groin, yet it can still affect any part of the body.
• Causes of Ringworm
  This condition is caused by a fungus which can be caught directly from people or animals who already have the infection.
• Symptoms of Ringworm
  On the skin, you can usually see ringworms as itchy red patches on the skin that are oval shaped or circular and tend to become bigger in size over time. Athlete's foot, where you find the skin between your toes becomes itchy and red is also a form of ringworm. If athlete's foot is not treated in the right way, toenails may also become infected with ringworm.
• Treatment for Ringworm
  You can treat this condition by using an antifungal cream or shampoo from the pharmacist or as prescribed by your doctor. These treatments should be used for two weeks after symptoms have disappeared. You may be prescribed antifungal tablets by your doctor in more severe cases of ringworm.
• Treatment
  If you find that your toenails have been infected, you should see your doctor as cream preparations do not easily treat the condition if found in this area. If you find that these itchy patches are getting redder and they look like they are weeping, this could indicate a bacterial infection in which case you should consult your doctor.

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SCABIES: SKIN

• Description
  This is a skin infestation of mites. You can catch it by having direct contact with someone who already has the condition which explains why hands are usually the most affected areas. Symptoms begin to show about one or two months after the infestation has occurred, and scabies can affect people of all ages.
• Causes
  Mites are transferred between people when they are in close contact with one another. Once on the skin, the mite burrows into the top layers of the skin, and lay eggs which grow into even more mites.
• Symptoms
  The first symptom you will come to notice is that of itchy hands. Following this you will find other parts of your body feel itchy also. A rash can usually be seen wherever you itch as the itchiness is quite intense. The burrows of the mites can be seen on the skin surface, and more prominently in the webs of the fingers. Scabies should be treated as soon as possible as too much scratching may lead to a skin infection.
• Treatment
  Insecticide lotions ca be used to help treat scabies, and are applied all over the body especially in between the fingers and toes. These lotions are usually left on for 24 hours before being washed off. Most treatments are prescribed by your doctor or will be available at your pharmacy. You should make your doctor aware if the medicine is for a child, or if you are pregnant or breast feeding.
• Treatment
  Most scabies treatments are known to work although you may find that itchiness is still present for a few weeks following treatment. You should consult your doctor if the itchiness has not gone after two to three weeks following treatment.

SCHIZOPHRENIA: CENTRAL NERVOUS SYSTEM

• Description
  This is a very serious mental illness which is characterised by various changes in perception, thoughts and behaviour. It is more common during late teens and early twenties and a diagnosis of such a condition may be difficult for the sufferer, and the sufferer's family to come to terms with.
• Causes
  Although the cause of schizophrenia is unknown, there are several factors that can contribute to the condition. An individual's genetic make up may make a person more likely than others to develop schizophrenia. This will make an individual more vulnerable in attempting to deal with the stresses of life. Pre disposing factors include complications endured during pregnancy and childbirth, while other factors include drug and alcohol misuse coupled with stressful events endured in life.
• Symptoms
  There are two symptoms of schizophrenia which include positive and negative. Positive symptoms are hallucinations and delusions while negative symptoms include a slowness to move, think and speak. A person experiencing schizophrenia tends to hear his own thoughts in his head, as if they have just been spoken out loud. Those who experience hallucinations will try and find an explanation for what is happening, and these are what can be described as being delusions. The symptoms may occur together, separately or alternately. A person suffering from schizophrenia may also become socially withdrawn and find themselves suffering from depression.
• Treatment
  Drugs used to help combat the symptoms of schizophrenia include 'neuroleptics' or 'antin psychotics' which come in the form of tablets, syrups or injections. Responses to these medicines will vary and it may take some time to find the right medicine at the correct dose. Certain drugs used to help treat schizophrenia may have side effects and others may cause you to gain weight.
  
  You may feel as though you lack control of your life and it is important for you to find out all the information that you can about this condition so that you can understand exactly how it affects you.
• Treatment
  You should consult a doctor if you suspect that you or a relative have schizophrenia, but it has not been diagnosed yet.

S.A.D (SEASONAL AFFECTIVE DISORDER): MENTAL HEALTH

• Description
  This is a disorder that is a form of depression that occurs for people during the winter but not in the summer. Many may find that they are sleeping more and tend to dislike the dark mornings and early evenings.
• Causes
  SAD occurs from the lack of bright light in the winter. It has been researched that bright light makes a difference to brain chemistry and this difference is greater in those who have the condition. Melatonin, which makes us drowsy is subsequently suppressed by bright light entering the eyes. Exposure to bright light also increases the production of Serotonin which is a neurotransmitter that carries signals between the nerves and the brain. A lack of this can therefore cause depression.
  
  Problems may start for some in September, whilst they may start for others in December and can last up to four months. Symptoms tend to be at their worst during darker months, however.
  These symptoms include:
  
  
  • Sleep problems which include oversleeping, trouble getting up and generally not feeling refreshed.
  • Over eating whereby you tend to crave carbohydrates which can lead to weight gain.
  • Depression and feelings of despair including feeling more miserable and anxious than usual.
  • Personal problems including avoiding company and feeling more irritable than usual.
  • Lethargy when you become too tired to cope with anything.
  • Physical symptoms that include stomach problems and joint pain.
  • Behavioural problems which are most common in young people.
• Treatment
  The best treatment is to create a bright light by using a light box or something similar. Using a light for between ¼ and ¾ of an hour everyday will be enough to help relieve the Symptoms for most people. The light should be bright similar to a spring morning on a clear day and should be between 5 and 20 times brighter than a well lit office. For those with milder symptoms, a 'dawn simulator' alarm clock accompanied with a light that comes on slowly in the morning, similar to a natural sunrise may also be effective. If you find lights on their own are ineffective methods, your doctor may be able to prescribe you with some medicine after you have discussed your problems with them.
• Treatment
  You should always consult your doctor if you think that you are suffering from any kind of depressive illness.

SEXUALLY TRANSMITTED DISEASES: SEXUAL HEALTH

• DESCRIPTION
  These are infections that are caught and spread through sexual contact. Anyone who is sexually active can get an STD. The chances of you getting an STD however can increase with the more sexual partners you have. You should always use a condom which can protect you from getting an infection during sexual intercourse.
• CAUSES
  Bacterial and viral infections can both be classified as being sexually transmitted infections. These infections include Chlamydia, Syphilis, Gonorrhoea, Genital warts, Herpes and HIV.
• SYMPTOMS
  Symptoms of sexually transmitted diseases vary depending on the infection. Some infections may not show any symptoms at all. More common signs of infection include a discharge of liquid from the vagina or penis; pain or a burning sensation when passing urine, the appearance of rashes, lumps and blisters around the genital area, and bleeding or pain after or during sex. Some infections result in pelvic inflammatory disease in women and Symptoms of this include pain and fever and tenderness in the lower abdominal area. This should be seen to as soon as possible to avoid damage to fertility.
• TREATMENT
  If caught early enough, most STD's can be treated effectively. If they are left untreated however, they can result to permanent damage to your fertility and reproductive system. If left untreated, you also run the risk of passing the infection or disease to any other sexual partners that you may have in the future.
  
  You should visit a genito-urinary medicine (GUM) clinic for free treatment and advice, or should visit your doctor if you suspect that you have an STD. These clinics are usually situated in hospitals although your records will stay within the clinic only. You doctor also does not need to know that you have visited a clinic unless you authorise permission for them to be informed.
  
  To keep yourself protected, you should always use a male or female condom. Male latex condoms will carry the BSI Kitemark or European CE mark to show that they conform to quality standards.
• WHEN TO CONSULT A DOCTOR
  If you show any of the above symptoms or suspect that you have a sexually transmitted infection you should consult your doctor or GUM clinic as soon as possible.

SINUSITIS: EAR, NOSE AND THROAT

• DESCRIPTION
  Sinusitis is when your sinuses become inflamed which are the air filled spaces found in the bones of the face. These spaces can be found in the cheeks, forehead, between the eyes and nose. The sinuses produce mucus or 'catarrh'. If your sinuses become inflamed, and filled with mucus, this can lead to an infection.
• CAUSES
  Viral infections such as the cold or flu are the most common causes of sinusitis. An abscess in the root of a tooth can also lead to an infection and sometimes swimming in polluted water can also lead to sinusitis.
• SYMPTOMS
  Pain can be felt in the cheeks, forehead and nose when you have sinusitis and the pain tends to get worse when you bend the head or move down. More severe infections can also cause a toothache, and eating could also become painful too. Your nose will also feel blocked up and congested.
• TREATMENT
  If you have a cold or flu, blowing your nose more frequently and avoiding sniffing mucus back up your nose can help to relieve sinusitis. A steaming inhalation can also help to clear your sinuses as mucus will be broken up which will make it easier for it to be drained away. This can be done by adding menthol or eucalyptus oil to your steam. Putting a towel over your head will help to enhance the effect also. A variety of painkillers and decongestants can also be brought fro the pharmacy which will help to relieve the pain and congestion. Decongestant nasal drops will also help to reduce mucus production, but these should not be used over long periods of time as they can make the symptoms worse.
• WHEN TO CONSULT A DOCTOR
  If your symptoms have not gotten better within five days, you should consult your doctor who may provide you with a course of antibiotics. You should also see your doctor if you find that your face has swelled up and if you have developed a high temperature.

SLEEP DISTURBANCE: CENTRAL NERVOUS SYSTEM

• DESCRIPTION
  Insomnia is when you cannot fall asleep at night or your sleep is disrupted in some way or form. Sleeping is essential as it helps to keep the immune system strong and helps our brains work more efficiently. On average, a newborn baby will need 16.20 hours of sleep a night, an adult needs 7-8 hours of sleep, while an 80 year old will need about 5 hours of sleep a night. Two stages of sleep are absolutely vital for our bodies which include rapid eye movement (REM), where the brain restores itself, and non REM sleep where hormones are released and the body then gets a chance to repair itself.
• CAUSES
  Anxiety, stress and depression can all affect sleep. Insomnia can also be a symptom of other illnesses. Symptoms of insomnia include not being able to go to sleep easily, waking up in the middle of the night or finding yourself waking up early. If you feel sleepy the next day, this also means that you did not sleep to soundly the night before. You may also feel drowsy if you are snoring or suffer from a condition known as sleep apnoea, where you find that your breathing is disturbed during sleep.
• TREATMENT
  You can try over the counter remedies including diphen-hydramine or promethazine. These are not suitable for everyone, so you should always check with your pharmacist first. Herbal remedies that contain passiflora or wild lettuce may also help. If your insomnia is recurrent then your doctor may prescribe you some sleeping tablets. Most over the counter and prescribed remedies should only be used for a short amount of time only, until your regular sleeping pattern has been restored. You should avoid taking them over a long period of time as your body may start depending on them more than it should, making it more difficult for you to return to your normal pattern of sleep.
• WHEN TO CONSULT A DOCTOR
  If you have tried over the counter remedies and yet your insomnia continues, you should see your doctor as this could be a sign of another illness.

SNORING AND SLEEP APNOEA: RESPIRATORY

• DESCRIPTION
  Snoring occurs when breathing is being obstructed during sleep. The sound you hear is the sound of the walls of the throat, the roof of the mouth and the base of the tongue vibrating. When you lie down, the muscles found behind the tongue, which hold the mouth open, tend to relax and collapse onto themselves. This leads to the airway narrowing, and therefore restricting the airflow in and out of the lungs. This then leads to snoring. If the muscles collapse completely, no air will be able to pass through, therefore stopping the person breathing altogether. This is called obstructive sleep apnoea. Thankfully, the body has a natural mechanism which will detect this and will force you to wake up before you suffocate.
• CAUSE
  Restriction of the airflow through the throat, by anything during sleep can cause snoring and sleep apnoea. Those who are overweight are also more prone to snoring due to the extra pressure placed on the muscles around the throat. Allergies and smoking can also irritate the nasal passages which will also lead to snoring. If you drink alcohol, or are taking some kind of sedative, these are also seen as culprits as they relax the throat, affecting normal breathing. Serious causes of snoring include damage to the nose and throat or a malformed lower jaw. Enlarged tonsils tend to be the main cause of snoring in children.
• SYMPTOMS
  The most common symptom of snoring or sleep apnoea is the typical sound of grunting and snorting that you hear or make during sleep. If you experience increased tiredness during the day, mostly during quiet activities including reading and watching television, it is likely that you are suffering from heavy snoring or sleep apnoea at night.
• TREATMENT
  Cutting down on smoking and alcohol, losing a few pounds if you are slightly overweight can all help snoring and sleep apnoea. Gum shields can also be used and can be purchased from your dentist, which will help to relieve snoring and sleep apnoea also. Nasal continuous positive airway pressure (CPAP) is the only effective treatment for sleep apnoea and works by delivering pressurised air through a mask that is worn at night. This air will force the throat open and allow you to breathe normally. If nothing else has helped, you can also get surgery on the back of your throat.
• WHEN TO CONSULT A DOCTOR
  If you suffer from obstructive breathing or heavy snoring at night, you should consult your doctor. If you are sleeping more during the day this may be a sign that you are not sleeping well at night due to obstructive breathing, so this should therefore be discussed with your doctor.

SORE THROAT: EAR, NOSE AND THROAT

• DESCRIPTION
  A viral infection is what causes a sore throat. It usually only lasts for a few days and should be over with within a week.
• CAUSES
  Although a sore throat is usually caused by a viral infection, bacterial infection can also be the cause. For example, if your tonsils are affected, this can result in a sore throat too, and may need to be treated with antibiotics.
• SYMPTOMS
  Symptoms include swollen glands and a slight cough. Sore throats may also be a sign of another illness such as a cold or flu and so you may have a temperature or a headache.
• TREATMENT
  You may not want to take any medication for a mild sore throat as antibiotics do not work for viral infections. However, there are other ways in which you can ensure yourself a speedy recovery which include gargling, for a few minutes either with soluble aspirin or an antiseptic gargle. A recommended dose of paracetamol can also help to relieve the pain of a sore throat. Drinking plenty of fluids is always recommended and some may find that sucking on a medicated lozenge may also help them. Sore throat sprays are also very effective, and unlike lozenges, they are able to deliver the anaesthetic straight to the site of pain for quick relief.
• WHEN TO CONSULT A DOCTOR
  If symptoms are not getting better after a week, you should consult your doctor.

STRESS: CENTRAL NERVOUS SYSTEM

• DESCRIPTION
  Stress is a reaction to the everyday challenges that we face in life. Not all stress sis bad, but when it begins to have a negative effect on life in general, it should be dealt with straight away.
• CAUSES
  Anything that puts a physical or psychological strain on an individual is known as stress. Different health issues and personal life experiences all affect how an individual deals with stress. A lack of control over issues in your life can also lead to stress.
• SYMPTOMS
  Immediate symptoms of stress include anxiety, mood swings, low self esteem and poor concentration and memory. You may find that your sleep and eating patterns will also change. All of these symptoms are a result of the body producing emergency adrenaline to help deal with stress or danger. This is called the 'fight or flight' reaction which helps one to either stay and fight the danger or try to escape from it. This results in the body having no outlet for the stress, therefore manifesting itself physically and/or psychologically including experiencing high blood pressure, feeling depressed or getting a migraine.
• TREATMENT
  Drinking and smoking excessively can make stress even worse than it already is. You should always see your doctor in cases of stress as leaving it untreated can lead to even more health problems. If you are experiencing short term stress, your doctor may be able to prescribe you beta blocker tablets to help you deal with palpitations that you may be enduring.
• WHEN TO CONSULT A DOCTOR
  If stress is having an effect on your overall health, and you are finding it hard to come to terms with, you should consult your doctor who may also be able to put you in touch with a therapist or a stress counsellor.

STYES: EYE HEALTH

• DESCRIPTION
  A stye is a small spot found in the root of an eyelash which forms a small swelling on the inside or outside of the eyelid. Styes can occur at any age but do not cause any problems with vision. It can be distinguished from another swelling in the eyelid which is known as a chalazion which is caused by the enlargement of a blocked oil gland in the eyelid. This may look like a stye for the first few days but it found fourhter back from the edge of the lid.
• CAUSES
  Staphylococcus is the bacteria that causes styes. This is present in the nose and it can be transferred to the eye by rubbing. Styes do not indicate that you are feeling run down so taking vitamins and food supplements will not help.
• SYMPTOMS
  You will find pain, redness, tenderness and swelling over the stye at first and then a small pimple like area will appear. You may feel as though something is in the eye, and you may notice the affected eye watering also. You may also be extra sensitive to light. At the point of a stye, a small yellow head may appear and you will notice a bead of pus that may come out. The eyelash usually dislodges this at this time.
• TREATMENT
  Styes tend to heal by themselves within a few days or with hot compress treatment. Pain can be relieved by bathing the eye that is affected with a hot flannel. Once a stye has been pointed, it can be treated by gently pulling out the affected eyelash with some tweezers. If you find that the pain is severe, you should take a painkiller until the symptoms have reduced themselves. If you find that the infection has spread to involve the whole eyelid, or you get more than one stye, an antibiotic treatment may be needed to help deal with this. Medical help may be needed if styes have formed inside the eyelid, as this can be very painful.
• WHEN TO CONSULT A DOCTOR
  You should see your doctor if the infection has spread from the stye to cover the whole eyelid, if styes develop inside the eyelid and if you find repeated styes developing.

SUNBURN: SKIN

• DESCRIPTION
  Sunburn forms with overexposure to the sun, and if you have not used adequate sun protection. Sunburn results in the skin becoming red and tender, but it is important to remember that this problem can be avoided. If you apply sunscreen regularly, and you cover up in the sun, under shade, the risk of you getting sunburn is significantly reduced.
• CAUSES
  The sun gives off two types of ultraviolet radiation which include UVA and UVB that cause skin damage such as premature ageing, and sunburn. Radiation levels will vary from country to country, but if the country is nearer to the equator, higher sun protection will be required as UV radiation will be stronger there. UV radiation levels may also depend on the position of the sun and how much cloud cover there is. You are most at risk if you have freckles and are fair skinned- although too much sun is still bad for everyone's skin.
• SYMPTOMS
  Skin tends to become red, hot and painful, and in serious cases, blistering may also occur. Skin may peel after a few days after your skin has been burnt.
• TREATMENT
  After sun products following exposure to the sun will soothe any redness and help to keep your skin hydrated. Lotions that contain Calamine and Aloe Vera are also very effective but should not be used on broken skin. After you have been sunburnt, taking a cool bath or shower will also be effective in relieving the symptoms. Painkillers will also help to ease the pain, and you should increase your intake of fluids to protect you against dehydration.
  
  Understanding sun protection
  
  Skin needs to be protected from both types of UV rays and labels will be clearly labelled with an SPF factor and a star rating. SPF stands for sun protection factor and the higher the SPF factor, the better this is for you. For example, SPF 15 indicates that your skin will be protected 15 times longer in the sun. The star rating system indicates the level of protection against UVA rays and star ratings between 1 and 4 (one being the lowest) are the easiest way to understand the level of UVA protection offered. For skin protection against ageing and wrinkling, a product with at least 3 stars should be used.
• WHEN TO CONSULT A DOCTOR
  You may have sunstroke if you find that you are vomiting, have a fever or suffering from headaches. If this is the case, you should consult your doctor. Sunburn on babies and children may lead to a serious illness and if this is the case, you should seek medical attention for them immediately.

T

TEETHING: EAR, NOSE AND THROAT

• DESCRIPTION
  Teething occurs in babies when their first teeth come up through their gums. The first teeth that appear are the two middle teeth in the lower jaw, which are the incisors. And these are followed by the incisors in the upper jaw one month later. Your baby will eventually have 20 milk teeth which will appear periodically over the year. Milk teeth begin to fall out when the child is of 6 years of age, and these are replaced by permanent teeth.
• CAUSES
  Teething is what is used to describe the pain and discomfort of when new teeth are coming up through the gum.
• SYMPTOMS
  The pain varies, and some babies may have more pain than others. The upper and lower incisors don't tend to cause the baby much pain or discomfort, but the molars cause more pain in babies, especially if there is more than one coming through at one time. Babies will dribble when teething and this may form a rash around the mouth. Other babies may have flushed cheeks- feeding patterns for your baby may change and your baby may seem more irritable than usual. Many babies will bite and chew on an object to help relieve gum pain, which can extend up to the ears resulting in babies pulling and rubbing at their ears.
• TREATMENT
  A teething ring can be used, and some may be able to be put into the fridge so that they appear more icy and cold on the gums. Babies may like to chew on more chilled foods also, including cucumber or carrots, or maybe a teething biscuit. You should always supervise your baby in case they choke and very gently rubbing your baby's gum with a clean finger will also help to ease the pain. Teething gel can be rubbed onto the gums also, and is available at pharmacies. If the teething is very painful for your baby, then giving them the infant recommended dose of infant paracetamol can also help to ease the pain.
• WHEN TO CONSULT A DOCTOR
  Symptoms of teething must be distinguished, and these include dribbling, irritability, signs of illness and flushed cheeks. Teething does not tend to cause a high temperature, and if your baby has looser stools or has diarrhoea, this could be an indication of a more serious illness. If your baby is pulling or rubbing their ears, this could also indicate a middle ear infection which should be treated as soon as possible. You should always seek advice from your doctor if you are worried about your baby.

TEMPERATURE: IMMUNE SYSTEM

• DESCRIPTION
  A temperature usually means when you have a higher body temperature than 37C or 98.4F, which is supposed to be the normal body temperature to have. When you develop a temperature, this is usually a sign that your body is fighting an infection.
• CAUSES
  A bacterial or viral infection is what causes your temperature to rise. These may include the flu or common cold, more serious infections will include chicken pox and measles and sometimes a having a temperature may also be a symptom of meningitis.
• SYMPTOMS
  People who have a high temperature may feel hot, cold, shivery or sweaty. Children will look flushed, and will be miserable while babies will seem sleepy, and will not want to be fed.
• TREATMENT
  You should find out exactly what your temperature is and what is may be a symptom of, to ensure effective treatment. A mercury thermometer should be used to check your temperature, and you usually leave it under the tongue or in the armpit for some time before you are able to record the temperature. The thermometer should always be washed thoroughly after every use.
  
  The best way to check the temperature of babies and young children is simply by touching the forehead to see if it is slightly warmer than usual. Anal thermometers are not often used in the UK but do give an accurate reading. These can be used safely on small children and babies and will show a slightly higher temperature reading than a thermometer that has been placed under the arm or under the tongue. A special thermometer can also be used by being placed briefly in the ear, which will also give a very accurate result.
  
  To keep the temperature down in adults, regular dose of paracetamol can also be taken, and children can be given the recommended dose of infant paracetamol, also. The room should be kept at a comfortable temperature and you should keep up your intake of fluids.
• WHEN TO CONSULT A DOCTOR
  You should consult your doctor straight away if your temperature reaches over 40C or 104F. If you find that you are suffering from a stiff neck, are vomiting and are experiencing cramps, you should consult your doctor immediately. If your child seems weak and suffers a fit or convulsion, you should contact your doctor. Patients that have a weak immune system and are suffering from a raised temperature are also advised to seek medical advice. If your baby or child is showing symptoms of meningitis, you should also see your doctor straight away.

TENDONITIS: MUSCULO-SKELETAL

• DESCRIPTION
  Inflammation of tendons, which are strong, cord like white fibrous tissues that connect muscles to bones is what causes tendonitis. Tendons run through a sheath known as the synovial sheath which cam also become inflamed. Inflammation of this is known as synovitis, whereas inflammation of the sheath and tendon together is known as tenosynovitis.
• CAUSES
  Tendonitis is usually the over use of the tendon. If you have chronic tendonitis, this can result in the weakening of the tendon, and in more sever cases, the tendon may tear. Tendonitis tends to be linked to a certain sport or physical activity including tennis elbow, from constant overstretching of the arm muscles, tendonitis in the feet and ankles of those who run, and strain injury in the tendons found in the wrists in keyboard operators. Other Causesmay be obesity, which puts a strain on the legs and feet, or poorly fitted shoes which rub against the tendons of the feet.
• SYMPTOMS
  Symptoms will tend to come and go depending on how often the tendon is rested or used. If you have an affected tendon, you will feel a sharp or aching pain coupled with swelling and tenderness. Due to pain, you may also find restricted movement or weakness in the affected area. If the tendon moves, you may feel an excess fluid forming also.
  
  With Achilles tendonitis, if you continue to run, you run the risk of the tendon rupturing. If you find that this has happened, you will often see bleeding into the space around the tear, and the blood tracks up the muscle and will appear under the skin as a bruise, some distance away from the original tear.
• TREATMENT
  Resting the affected area and applying ice to it will help to reduce the swelling for the first 24-48 hours and will help to relieve the pain. Once the swelling has been reduced, applying gentle heat will also help to relax the muscle some more. Anti inflammatory pain relievers including ibuprofen and aspirin will be able to help ease pain and inflammation in adults, and these should be taken with milk or food to help protect the stomach. Many ruptured tendons tend to repair themselves with plenty of rest and treatment, but for more severe cases, splinting may be required to provide complete rest to the tendon. For conditions such as tennis elbow, splints are available from the pharmacist. If you find the pain to be very serious and occurring very frequently, your doctor may be able to prescribe you an injection containing an anti inflammatory or steroid drug. Treatment is the same for both tenosynovitis and tendonitis.
• WHEN TO CONSULT A DOCTOR
  You should see your doctor if pain has not eased after some days of rest and treatment as your tendon sheath may require an injection containing a steroid drug or anti inflammatory to help reduce the inflammation.

THRUSH: WOMEN'S HEALTH

• DESCRIPTION
  Thrush is an infection that is caused by a yeast type fungus known as Candida albicans. This fungus is generally quite harmless and is present throughout the body. This type of infection occurs when the pH in the body becomes disturbed. Vaginal thrush is when the Ph balance of the vagina changes. Thrush that develops in the mouth is known as oral thrush and is common in newborn babies.
• CAUSES
  Candida fungus tends to multiply when there is any change to the acidic environment of the body, as thrush strives in moist and warm environments. One common cause of thrush can simply be by taking a course of antibiotics while vaginal thrush can be caused by taking the contraceptive pill, or by hormonal changes of pregnancy or menstruation. Vaginal thrush can also develop by wearing tight or synthetic clothing, and even by using perfumed bubble baths and soaps. Having sexual intercourse can also alter the acidity of the vagina as semen is alkaline. Oral thrush in babies can be caught during childbirth or during breastfeeding. If baby equipment has not been sterilised properly, this can also lead to thrush, and finally poor toilet hygiene can cause thrush as Candida is present in the bowels and can therefore be very easily be passed to the vagina.
• SYMPTOMS
  If you find yourself itching around the genital area and find that it is very sore, this can indicate vaginal thrush. You will also find yourself passing a white discharge, which resembles cottage cheese. You may also find it painful in passing urine. If you have oral thrush, this can be seen as small white patches on the roof of the mouth or on gums, and if rubbed off, will leave a raw red patch.
• TREATMENT
  Anti fungal pessaries are usually used to treat vaginal thrush, and these are inserted into the vagina with an applicator. Creams can also be used to help soothe the itching outside the vagina. Oral tablets that help deal with Candida wherever it is in the body are also proven to be very effective. All of these are available from pharmacies. Avoiding yeast type foods and eating live yoghurt are also said to help during an attack of thrush.
• WHEN TO CONSULT A DOCTOR
  If you have never had thrush before, but are experiencing more than two attacks in six months, and experience pain when passing urine, you should consult your doctor. If you are pregnant and find that you have any kind of discharge and abnormal bleeding, you should also seek advice from your doctor. Those who are diabetic or under 16 years of age or over 60 years of age should seek medical advice, and if over the counter remedies do not help in relieving symptoms of thrush, you should also consult your doctor.

TONSILLITIS: EAR NOSE AND THROAT

• DESCRIPTION
  Tonsils appear on either side of the throat and look like two pale and flat circles of tissue. You will know when tonsils have become affected as they begin look red and swollen and feel painful. Tonsillitis attacks only tend to last for about a week in total.
• CAUSES
  Viral infections cause tonsillitis, and very rarely is the infection bacterial.
• SYMPTOMS
  Tonsils will look large and red when you open your mouth and you may also find that they have white spots on them. Glands in the neck can also become painful and swollen, and tonsillitis is usually accompanied by having a sore throat, cough and a headache. You may also feel more lethargic than usual and find that you have a high temperature. Swallowing in general will also be very uncomfortable, therefore eating and drinking could be a problem.
• TREATMENT
  Antibiotics are not usually prescribed for tonsillitis as it is a viral infection. Paracetamol can be taken to help reduce your temperature and ease the pain and gargling with soluble aspirin that has been dissolved in water for a few minutes, three or four times a day is also very effective at helping to reduce the pain. You may have developed a bacterial infection if the infection has not improved after a few days, and if this is the case, the doctor may prescribe you a course of antibiotics. Removal of the tonsils which is known as a tonsillectomy is only recommended if you keep on getting the infection.
• WHEN TO CONSULT A DOCTOR
  After three days if your symptoms are not getting any better, you should see your doctor. You should also seek medical advice if you find that your symptoms are more severe than usual and if you suspect that your child has tonsillitis.

TRAVEL SICKNESS: CENTRAL NERVOUS SYSTEM

• DESCRIPTION
  Travel sickness is very common in children and affects a third of the population. Travel sickness can occur either when you are travelling by sea, air or road. Travel sickness can affect both men and women equally.
• SYMPTOMS
  If you suffer from travel sickness, your symptoms may include nausea and dizziness and you may sometimes feel hot and sweaty. Sometimes the mouth may produce excess saliva and you may actually be sick as a result of this. Symptoms usually start soon after you have started your trip or journey.
• CAUSES
  The brain receiving conflicting signals from the body and eyes is what is thought to cause travel sickness. The fluid filled canal in the inner ear which is used to detect motion sends signals to the brain which give the indication that the body is moving, whereas the eyes tell it that the body is still.
• TREATMENT
  A number of different tablets are available from the pharmacy to help treat travel sickness. The first dose should be taken right before you travel, which will be more effective in treating the problem before it gets any worse. Others may find that acupressure wristbands are also helpful for travel sickness. In more severe cases of travel sickness, your doctor may prescribe you patches that contain an anti nausea drug known as hyoscine. If you do suffer from travel sickness, symptoms tend to relieve themselves as soon as the journey is over.
• WHEN TO CONSULT A DOCTOR
  If you have glaucoma, urinary problems, high blood pressure, heart disease, or are pregnant or breast feeding, you should always consult with your doctor before taking any travel sickness medicines.

V

VARICOSE VEINS: CARDIOVASCULAR SYSTEM

• DESCRIPTION
  These types of veins appear as raised, lumpy blood vessels in the skin which are usually found on the legs but may also be present in the anus, the vulva or the scrotum. The problem tends to run in families, and it seems to be more common in women than in men.
• CAUSES
  Varicose veins occur when the one way valves, which take blood back to the heart, in the veins do not work properly. These valves make sure that blood does not flow in the wrong direction. Blood begins to pool in the vein, making it swell and stand out more, if these valves leak. If you have pre existing medical conditions, these can also cause the veins to appear. With regard to pregnant women, they may often develop varicose veins partly because their hormones are what cause the muscle walls to relax, to allow the veins to pop out, and partly because of the pressure of the baby. Those who have thrombosis (blood clot) in the leg may also develop varicose veins more than others.
• SYMPTOMS
  You may not experience any symptoms at all if varicose veins are not too serious, however some may find that their varicose veins will ache, or the skin around the veins becomes itchy. In more serious cases, you may also find that your feet swell up.
• TREATMENT
  Wearing support hosiery is effective and can help the flow of blood into the veins. Some of this hosiery is available on prescription whilst most others are readily available in most pharmacies. Swimming is an exercise that may also help as the muscles in the leg will squeeze blood back to the heart. If the varicose veins are very unsightly, you can discuss surgery to remove them with your doctor.
• WHEN TO CONSULT A DOCTOR
  You should discuss options with your doctor if you do not like the way varicose veins look on your leg.

W

WARTS AND VERRUCAE: SKIN

• Description
  Warts are usually harmless and appear as small growths on the skin. There are a number of different types of warts. Common warts are round, have a rough surface, and are usually the same colour as the skin, or they may appear brown in colour. Plane or flat warts are flatter and smaller than common warts and tend to occur more on the face and hands. Warts that are situated on the soles of the feet or around the toes are known as plantar warts or verrucae. A verruca forms by looking like a very small pink area that is speckled with black dots- but it can also become dark with a rough crumbly layer of skin. Verrucae vary in size, and can be as big as half an inch. They can either be spread around the foot or grouped together. Genital warts tend to be pink in colour and can have a cauliflower appearance. A number of small warts can also mass together to form a mosaic wart.
• Causes
  Warts are caused by an infection with the human papilloma virus (HPV) which is mildly contagious but can still be passed on by having direct contact with towels and infected surfaces. This virus lives in damp, and more communal areas including swimming pools and showers, and those who use these facilities more such as children and young adults- find that they are more likely to suffer from warts and verrucae. You have an increased risk of picking up the virus if your skin is broken.
• Symptoms
  Verrucae can become very painful to walk on as they are on the sole on the foot, and they can also be very easily confused as being corns and calluses. Corns and calluses are more painful when direct pressure is applied, and they are more likely to appear on areas that bear a lot of weight.
• Treatment
  Warts can disappear by themselves within a few months and do not usually need treatment. Even covering the affected area with a plaster is enough to suffice as adequate treatment. However, you may need to see a chiropodist if you find that the wart or verrucae is getting larger or feeling more painful than usual. Verruca's may be removed surgically under a local anaesthetic either by electro surgery or freezing it. Gels, ointments and paints can also be applied to help remove the wart or verrucae and these are available over the counter at most pharmacies. You should read the instructions to these very carefully however, as they can very easily burn the skin surrounding the affected area.
• When to consut a doctor
  If you are pregnant, diabetic, or taking long term medication such as steroids, you should always seek medical advice before treatment. You should see a doctor if you think that you may have genital warts or if your wart changes colour or begins to bleed.

Wind: Gastro-intestinal

• Description
  Gases which are produced in the stomach are passed into the small intestine where food is digested and absorbed. Residues, including dietary fibre and carbohydrates then pass onto the colon. The colon contains many different kinds of bacteria which then ferment these residues producing an increased volume of gas in the process. These gases are then absorbed into the blood stream which is excreted in the breath and the rest of them are passed as wind.
• Symptoms
  A person can pass wind by the back passage up to 15 times a day depending on their diet.
• Causes
  Most wind tends to be generated by the normal bacterial fermentation of food residues in the colon. Some foods including garlic, onions and strong herbs may give rise to gases with slightly strong odours. Drinks including white wine and fruit juices can give rise to hydrogen sulphide gas which has a well known 'rotten egg' odour. Wind can also have other causes including being lactose intolerant, which is when the lactose is fermented by the bacteria in the colon which then goes on to produce large amounts of carbon dioxide and hydrogen. Other medical conditions including Crohn's disease and coeliac disease can also cause excess wind due to impaired digestion.
• Treatment
  A diet high in fibre is recommended as it produces soft stools and keeps the bowels healthy. The downside to a high fibre diet however, is that it can produce a lot of wind. Activated charcoal can be brought from the pharmacy and can help to reduce the mount of wind, as well as the odour that comes with it.
• When to consult a doctor
  If you find your symptoms are more troublesome and severe than usual, you should see your doctor. You should also seek medical advice if you have a constant feeling of feeling full, bloated or if you find yourself developing new digestive symptoms.

Worms: Gastro-intestinal

• Description
  Better described as being threadworms, these look like small pieces of white thread which are about two millimetres long. They live in the intestines and the female worm will lay her eggs t night around the anus. Worms are not usually harmful, but can disturb sleep as they can be very irritable. Although they are not common in children, worms can occur in both children and adults.
• Causes
  If you tend to scratch your bottom, these eggs can be very easily transferred back to your mouth if you do not wash your hands and nails properly. Threadworms are more common in children as it is children who are less interested in hygiene than adults. If eggs are swallowed, they grow into more worms, and so the cycle continues. Threadworm eggs can also be present in dust for a couple of weeks.
• Symptoms
  Itching around the back passage is the most common symptom of having worms, as eggs are laid here. You may even be able to see threadworms in a child's faeces, or coming out of their bottom especially at night.
• Treatment
  Over the counter remedies can be purchased to help to treat threadworms and all members of the family should be treated even if no symptoms exist. The treatment may have to be repeated two weeks later than the original treatment to ensure you get rid of all of the worms. Washing all sheets and towels at a high temperature will also help to kill and eggs from a threadworm.
• When to consult a doctor
  You should see a doctor if over the counter remedies have not helped you. If you think you have worms and are pregnant or breastfeeding, you should also seek medical advice as over the counter remedies will not be suitable for you. If you have a child under twp years of age, and think that he or she may have worms, you should also see your doctor.