Cystic fibrosis (which is also known as mucoviscidosis) was first described in 1938. It is an inherited condition in which mucous producing glands throughout the body produce an abnormally thick and sticky form of mucous. Such glands are present in the lungs, the bowel and the testes. The thick mucous blocks the outlet from the glands – this causes the glands to dilate and become susceptible to infection and scarring. The glands cannot perform their normal function and eventually they become ineffective and subject to recurrent infections. Because of this combination of effects, cystic fibrosis causes problems with bowel function and with breathing. Males will have impaired fertility.

What Causes Cystic Fibrosis?

Cystic fibrosis is the most commonly inherited condition of childhood. One in 25 persons is a carrier and it occurs in about 1 in every 3000 births in the UK. Not all children born into a family will be affected since the condition is inherited in an autosomal recessive manner. This means that both parents need to carry the gene and even then, only one in four children will be affected. Both boys and girls are equally affected. To develop cystic fibrosis, a baby has to inherit two cystic fibrosis genes (one from its mother and one its father). If a baby inherits one cystic fibrosis gene (from either the mother or father) and one normal gene, the baby will be a ‘carrier’ and will not develop cystic fibrosis.

Cystic fibrosis is most common in Caucasians. It is uncommon in Asians and in Africans.

What Are The Signs And Symptoms?

There Are Three Different Presentations Of The Cystic Fibrosis Disease:

1. Meconium Ileus:

This form presents at birth with a paralytic obstruction of the bowel, which sometimes perforates. It is caused by blockage of the bowel by the abnormal mucous produced by glands in the bowel wall. The perforation may occur while the baby is still in the mother’s womb, giving rise to peritonitis at the time of birth.

2. Gastro-intestinal:

This form of the disease is usually first noticed between three and eighteen months of life. Because there is a lack of digestive enzymes there is reduced absorption of foodstuffs, particularly fat, fat-soluble vitamins and protein. There is likely to be diarrhoea (loose, pale, fatty and offensive stools often containing undigested meat and starch granules) and a general failure of the baby to grow properly. Sometimes there may be a small hernia at the tummy button or a prolapse (the sinking down or falling down) of the rectum seen at the anus.

3. Respiratory:

Sooner or later respiratory infections occur because of lack of protective mucous and infection of the glands in the breathing tubes themselves. There is sometimes collapse of a lung, widening of the air-spaces (emphysema) or pneumonia. This group of respiratory symptoms usually start between six and eighteen months of life and may overlap with bowel symptoms.

Will There Be Any Tests Or Investigations?

People with cystic fibrosis produce more concentrated sweat than normal individuals and a ‘sweat test’ is usually used to make the diagnosis. The test is simple, takes only a short time and is usually performed twice. A small amount of a chemical called pilocarpine is placed on the skin. This causes sweating and the sweat is collected for measurement using a special absorptive dressing. In children with cystic fibrosis the concentration of sodium salt in the sweat is usually above 60mEq/litre.

The diagnosis can be further confirmed by passing a small tube down the throat, through the stomach, and into the duodenum. From there, digestive juices can be sampled. In cystic fibrosis, this juice is thicker than usual and lacking in the normal digestive enzymes. This is not a hard-and-fast rule however, since normal children may show low levels of digestive enzymes if they have had a recent bowel infection. Other more sophisticated blood tests can also be used to confirm the diagnosis. If the diagnosis is suspected at birth, blood from a heel prick may show an elevated level of an enzyme called trypsin.
Mothers who have had one child with cystic fibrosis will be offered screening tests during subsequent pregnancies to determine whether the child they are carrying is also affected. It is also possible to screen member of the population using cells from the lining of the mouth to determine whether they are carriers of cystic fibrosis.

What Treatment Might Be Necessary For Cystic Fibrosis?

Children with cystic fibrosis should receive at least part of their treatment in a specialist centre where regular monitoring of lung function, digestion and general condition can take place.

If the child is lacking in digestive enzymes, these can be given in the form of granules or capsules with meals. 5-15 grams of these enzymes (known as pancreatin) can be given each day according to the child’s age and this can improve digestion and absorption of protein, fat and other food substances. To make nutrition more successful, the child’s diet should be made as nourishing as possible with a high protein content. Fatty foods should be avoided but supplements of vitamins and minerals (particularly iron) are useful.

Every effort needs to be made to reduce the likelihood of respiratory symptoms and to treat these early and effectively when they occur. These days, the management of children with cystic fibrosis usually takes place at least partly in specialist centres where parents will be taught how to perform regular chest physiotherapy and postural drainage; how to recognise the early signs of infection, and what to do should this occur. A small and restricted choice of antibiotics is usually recommended for use in cystic fibrosis, in an attempt to reduce the likelihood of resistance to these antibiotics emerging in each individual patient.

Because absorption by mouth is often impaired by bowel problems, antibiotics are sometimes given by nebuliser. An aerosol of the antibiotic is breathed in by the patient over 15 to 30 minutes. Alternatively therapy can be delivered directly into the bloodstream through a long-term indwelling catheter. These days these are easy to use and well tolerated. A new treatment called recombinant Dnase (rhDNase) can be used by nebuliser to break down the thick mucous and reduce the frequency of respiratory infections. Oxygen therapy from a portable cylinder may be needed during severe lung infections.

Because of improved management, patients with cystic fibrosis are now living much longer than ever before and a number of other long-term conditions are emerging. They include diabetes, liver problems, infertility in men and osteoporosis. Each can be treated if and when it occurs.

What Course Will The Illness Follow?

At the present time cystic fibrosis is not curable and treatment is supportive so as to optimise nutrition and growth and prevent recurrent respiratory infections. With modern treatment, children with cystic fibrosis can look forward to many years of enjoyable and high quality life. It is anticipated that 85 percent of children with cystic fibrosis will live to at least 50 years of age.

In some cases, lung problems may become severe. In this situation, lung transplant has revolutionised the outlook. There are other reasons to be optimistic. The gene which is responsible for cystic fibrosis has recently been identified and there is hope that, in the future, new genetic techniques may enable us to develop improved ways of managing the condition or perhaps even finding a cure.

Tell Your Doctor

• if you have had any relatives who have had children with an inherited condition like cystic fibrosis

• if you have any concerns regarding your pregnancy

• if you have any concerns regarding your child’s growth

• if your child has any persistent breathing or bowel symptoms

Ask your doctor

• if there is a genetic counselling service in the area

• where the local child development clinic is held

• to ensure your child receives all the normal childhood immunisations including BCG

• where you can get your child weighed and measured regularly

• the telephone number of the health visitor

This article on medical information is by Dr Vivienne Balonwu on the free medical information website, http://www.viviennebalonwu.com.

Quality Free Medical Advice Online by Vivienne Balonwu. A variety of general health advice and news online.

Cystic fibrosis (CF) is an inherited condition affecting the glands that produce body fluids or secretions.

In CF, these secretions are stickier and thicker than normal. This hinders the functioning of important organs, such as the lungs and digestive system.

The exact cause of CF is a single faulty gene found on chromosome 7, which controls salt and water movement in and out of cells within the body. To develop CF, a baby has to inherit the faulty gene from both parents. About one in 25 people in the UK is a carrier of the CF gene.

Inheritance is autosomal recessive. This means if both parents are carriers there’s a one in four chance their child will have CF and a two in four chance their child will be a carrier but won’t have the disease. There’s a one in four chance their child will neither have CF nor be a carrier.

Common problems people with CF experience include:

The life expectancy of CF patients continues to increase. About 75 per cent of affected children survive to young adulthood and the average life expectancy is between 30 and 40.

As yet there’s no cure for CF or any way of preventing it. However, since the faulty gene has been identified, much work and research is being done to try to find ways to either repair or replace this gene through gene therapy.

All newborn babies are screened for cystic fibrosis. Antenatal tests for the disease are also available.

Treatment can help people to live with cystic fibrosis. It can also prevent or reduce long-term damage from infection and other complications.

High-energy foods, enzyme supplements, and vitamin and mineral supplements help a person with CF to get the nutrients they need. Regular exercise is important to keep the body fit and healthy.

Daily physiotherapy and breathing exercises help to keep the body healthy and to prevent excessive build up of mucus in the lungs.

Antibiotics and other medicines are used to control lung infections and inflammation. If respiratory failure occurs, a lung transplant may be necessary.

Advice and support – Cystic Fibrosis Trust

Helpline: 0845 859 1000

Email: enquiries@cftrust.org.uk

Website: www.cftrust.org.uk

Author. Medical Advice By Vivienne Balonwu, Free Medical Advice Online.

Quality Free Medical Advice Online by Vivienne Balonwu. A variety of general health advice and news online.

The lungs are lined with a double layer of membrane (pleura) , the inner one covering the lung surface and the outer one covering the inside of the chest wall, separating them from the chest wall. If air gets between these two layers, into what is known as the pleural space, it’s called a pneumothorax. Once air is drawn into this space, it cannot easily escape and the air compresses the lung and interferes with the mechanics of breathing. This makes the lung collapse, causing chest pain and making breathing difficult.

Symptoms include:

Chest pain and tightness, Shortness of breath and Dry cough

The severity of symptoms depends on how much air gets into the space.

In a particular type, called a tension pneumothorax, which is a medical emergency, the air gets into the space but cannot escape at all, and with each breath more air is drawn in. Under these circumstances, chest pain and shortness of breath are severe and may rapidly worsen as the lung and chest contents are compressed.

Blood is prevented from returning from the lungs to the heart because of the high pressure caused by the trapped air. This results in low blood pressure and collapsed lungs.

Most commonly air gets into the space when a little air sac on the surface of the lungs, called a bulla, which has been present from birth, bursts. Vigorous exercise, for example, may cause it to burst, allowing the air to escape from the lung. This is called a ‘spontaneous pneumothorax’

Air may also escape from the lung into the pleural space as a complication of other lung problems such as asthma and chronic obstructive pulmonary disease, or the rare connective tissue disease Marfan syndrome.

In a ‘traumatic pneumothorax’ air may also get into the pleural space from outside the body. This may be caused by a traumatic penetrating chest injury, such as a stabbing, by broken ribs or when surgical operations are performed on the chest. Tall, thin, fit men are most often affected. Pneumothorax is six times more common in men than women, and usually occurs in their 20s or 30s.

In the vast majority of cases only one lung is affected at a time, although very rarely both are. There are reports of sportsmen such as weight-lifters suffering pneumothoraces on both sides at the same time.

After a pneumothorax, there’s approximately a one in five chance of it happening again within a year. Those who smoke are at greater risk.

Pneumothorax can be confirmed by an x-ray of the lungs, although symptoms, and an examination of the chest with a stethoscope usually point towards the diagnosis. Small ones will clear without treatment over a few days as the body heals the leak and the air is gradually absorbed.

A larger pneumothorax needs to have the air drawn out to relieve the symptoms. This is done in hospital with a syringe and needle, or by placing a drainage tube into the space to allow the air to come out again. This is called a chest drain and is inserted under local anaesthetic. It may need to stay in place from between a couple of days to a few weeks, until the lung heals.

With a tension pneumothorax, the air is released by putting a large bore hollow needle directly into the chest. Immediate relief of symptoms follows.

If air continues to find its way between the pleural layers a process called pleurodesis is used. This uses a chemical irritant to stick the two layers of pleura together, preventing further lung collapse.

Author. Medical Advice By Vivienne Balonwu, Free Medical Advice Online.

Quality Free Medical Advice Online by Vivienne Balonwu. A variety of general health advice and news online.

COPD is the overall term used to describe a variety of illnesses, including chronic bronchitis, emphysema and chronic obstructive airways disease. People with COPD have permanently damaged lungs and find it difficult to breathe most of the time.

COPD usually affects people over the age of 40. Approximately 900,000 people in the UK have been diagnosed with COPD in the UK but more recent research suggests that COPD may be hugely under-diagnosed – based on reported symptoms, over 3.2 million people may have the condition (that’s as many as one in ten people over 40).

COPD is closely linked with smoking in many cases and the changes in smoking habits several decades ago mean than although COPD is more common among men, cases are rising three times as fast among women.

COPD is the sixth most common cause of death in England and Wales, causing over 30,000 deaths a year. But its estimated that by 2020 it will be the 3rd biggest killer in the world – it’s the only major cause of death that has actually increased significantly in recent years.

The damage to the lungs that results in COPD is gradual, which is why most people are over 40 by the time symptoms begin. Research suggests that it takes about 20 years from onset of initial damage to the lung until it is actually diagnosed.

An early morning cough, often called a smoker’s cough, is common and produces a lot of phlegm. Wheezing, chest tightness and difficulty breathing are often noticed first. People may find themselves short of breath when doing very little or even when they’re just sitting down. It becomes harder and harder to do any exercise until even crossing a room becomes impossible.

These symptoms are usually worse in winter, with recurrent lung infections adding to the problem. If severe, these recurrent infections and worsening of lung function (known as exacerbations) may prove fatal – ten per cent of those admitted to hospital with an exacerbation will die in hospital and as many as 40 per cent will die within a year.

COPD impairs quality of life, by preventing people with the condition from socialising and enjoying their hobbies. It also makes many feel frustrated and angry about not being able to do the things they want to.

Smoking is to blame for COPD in the majority of cases. The chemicals in cigarette smoke causes inflammation and fibrosis or scarring in the lungs and destroy the elasticity that allows the lungs to expand and contract as we breathe.

It also damages the alveoli, the tiny air sacs at the end of the airways from which oxygen is absorbed into the bloodstream.

Other causes include occupational exposure to dusts, indoor pollution from wood-burning and coal-burning stoves, air pollution and certain inherited diseases. For example, a minority of people have a rare inherited form of emphysema caused by a lack of the protein known as alpha-1-antitrypsin.

The diseases collectively known as COPD – chronic bronchitis, emphysema and chronic obstructive airways disease – are now understood to be aspects of the same problem: a narrowing of the airways, which obstructs the flow of air in and out of the lungs, making it difficult to breathe. Unlike asthma, where narrowing of the airways can be reversed, the narrowing in COPD is progressive and not fully reversible.

In chronic bronchitis, for example, excess mucus is made in the airways so people have a lot of phlegm and cough all the time. This mucus also narrows the airways.

In emphysema, the air sacs are left over-inflated when air becomes trapped in them and their elastic fibres are destroyed. Small holes also develop in their walls, leaving them unable to work properly. As a result the person chest may become expanded and barrel-like.

It’s not possible to cure COPD, but the damage can be slowed – this is the main aim of treatment. Treatment also aims to improve symptoms like breathlessness, increase the amount of exercise a person can manage, reduce the risk of exacerbations, hospital admissions and complications, and generally improve their quality of life.

By far the best way to do this is to stop smoking. It’s also vital to avoid other people’s smoke.

Exercising as much as you’re able to helps keep the lungs (and heart) strong and builds self-confidence. Pulmonary rehabilitation programmes help improve symptoms and increase exercise capacity. Physiotherapy helps to clear mucus from the lungs and most people with COPD are taught exercises they can do every day to help themselves.

Medicines that make the airways wider so it’s easier to breathe can be given through an inhaler or as tablets. Another important target for medicines is to reduce the inflammation in the lungs in COPD – the best drugs for this are steroids which are also usually given through an inhaler type of device. Steam inhalation and humidifying rooms can also help breathing by loosening mucus. Medication is available that helps to thin mucus so it’s easier to cough up.

When lung infections arise, it’s important they’re treated quickly with antibiotics. Recurrent or severe chest infections often need hospital treatment. When COPD is very severe, oxygen can be used at home.

It’s vital that people with COPD are vaccinated against flu every year (usually in autumn) and against the most common cause of pneumonia, the pneumococcus bacteria, when advised. It’s also vital to avoid lung infections and further damage to the lungs.

Eating a healthy diet and drinking enough liquid is essential.

Advice and support

British Lung Foundation

Tel: 08458 505 020

Website: www.britishlungfoundation.org.uk

Author. Medical Advice By Vivienne Balonwu, Free Medical Advice Online.

Quality Free Medical Advice Online by Vivienne Balonwu. A variety of general health advice and news online.

COPD is the overall term used to describe a variety of illnesses, including chronic bronchitis, emphysema and chronic obstructive airways disease. People with COPD have permanently damaged lungs and find it difficult to breathe most of the time.

COPD usually affects people over the age of 40. Approximately 900,000 people in the UK have been diagnosed with COPD in the UK but more recent research suggests that COPD may be hugely under-diagnosed – based on reported symptoms, over 3.2 million people may have the condition (that’s as many as one in ten people over 40).

COPD is closely linked with smoking in many cases and the changes in smoking habits several decades ago mean than although COPD is more common among men, cases are rising three times as fast among women.

COPD is the sixth most common cause of death in England and Wales, causing over 30,000 deaths a year. But its estimated that by 2020 it will be the 3rd biggest killer in the world – it’s the only major cause of death that has actually increased significantly in recent years.

The damage to the lungs that results in COPD is gradual, which is why most people are over 40 by the time symptoms begin. Research suggests that it takes about 20 years from onset of initial damage to the lung until it is actually diagnosed.

An early morning cough, often called a smoker’s cough, is common and produces a lot of phlegm. Wheezing, chest tightness and difficulty breathing are often noticed first. People may find themselves short of breath when doing very little or even when they’re just sitting down. It becomes harder and harder to do any exercise until even crossing a room becomes impossible.

These symptoms are usually worse in winter, with recurrent lung infections adding to the problem. If severe, these recurrent infections and worsening of lung function (known as exacerbations) may prove fatal – ten per cent of those admitted to hospital with an exacerbation will die in hospital and as many as 40 per cent will die within a year.

COPD impairs quality of life, by preventing people with the condition from socialising and enjoying their hobbies. It also makes many feel frustrated and angry about not being able to do the things they want to.

Smoking is to blame for COPD in the majority of cases. The chemicals in cigarette smoke causes inflammation and fibrosis or scarring in the lungs and destroy the elasticity that allows the lungs to expand and contract as we breathe.

It also damages the alveoli, the tiny air sacs at the end of the airways from which oxygen is absorbed into the bloodstream.

Other causes include occupational exposure to dusts, indoor pollution from wood-burning and coal-burning stoves, air pollution and certain inherited diseases. For example, a minority of people have a rare inherited form of emphysema caused by a lack of the protein known as alpha-1-antitrypsin.

The diseases collectively known as COPD – chronic bronchitis, emphysema and chronic obstructive airways disease – are now understood to be aspects of the same problem: a narrowing of the airways, which obstructs the flow of air in and out of the lungs, making it difficult to breathe. Unlike asthma, where narrowing of the airways can be reversed, the narrowing in COPD is progressive and not fully reversible.

In chronic bronchitis, for example, excess mucus is made in the airways so people have a lot of phlegm and cough all the time. This mucus also narrows the airways.

In emphysema, the air sacs are left over-inflated when air becomes trapped in them and their elastic fibres are destroyed. Small holes also develop in their walls, leaving them unable to work properly. As a result the person chest may become expanded and barrel-like.

It’s not possible to cure COPD, but the damage can be slowed – this is the main aim of treatment. Treatment also aims to improve symptoms like breathlessness, increase the amount of exercise a person can manage, reduce the risk of exacerbations, hospital admissions and complications, and generally improve their quality of life.

By far the best way to do this is to stop smoking. It’s also vital to avoid other people’s smoke.

Exercising as much as you’re able to helps keep the lungs (and heart) strong and builds self-confidence. Pulmonary rehabilitation programmes help improve symptoms and increase exercise capacity. Physiotherapy helps to clear mucus from the lungs and most people with COPD are taught exercises they can do every day to help themselves.

Medicines that make the airways wider so it’s easier to breathe can be given through an inhaler or as tablets. Another important target for medicines is to reduce the inflammation in the lungs in COPD – the best drugs for this are steroids which are also usually given through an inhaler type of device. Steam inhalation and humidifying rooms can also help breathing by loosening mucus. Medication is available that helps to thin mucus so it’s easier to cough up.

When lung infections arise, it’s important they’re treated quickly with antibiotics. Recurrent or severe chest infections often need hospital treatment. When COPD is very severe, oxygen can be used at home.

It’s vital that people with COPD are vaccinated against flu every year (usually in autumn) and against the most common cause of pneumonia, the pneumococcus bacteria, when advised. It’s also vital to avoid lung infections and further damage to the lungs.

Eating a healthy diet and drinking enough liquid is essential.

Advice and support

British Lung Foundation

Tel: 08458 505 020

Website: www.britishlungfoundation.org.uk

Author. Medical Advice By Vivienne Balonwu, Free Medical Advice Online.

Quality Free Medical Advice Online by Vivienne Balonwu. A variety of general health advice and news online.

Many people think they have to “keep busy” when going smoke-free. They tend to pursue anything that involves continuous movement or distraction. These are certainly effective tools when navigating the quit process, but take caution that you don’t hit burnout.

Lasting changes are done both internally and externally, meaning your outward behavior and inner thoughts match up to get you new results. Once you are no longer smoking, you may be using external substitutes and changing your routines to make the lifestyle transition. However, you also need to allow your inner world to keep up.

Let yourself be in the discomfort of change. Don’t just rush past it or drive yourself so hard that you never really embody the changes you are making. Many people hit a threshold where they can’t sustain the pace they are running to keep up with avoiding smoking. This can lead to relapse, or falling back into old, familiar habits.

In many cases what’s really needed is a balance between activity and recovery. Plan activities for relaxation and rejuvenation. This occupies your time, your body and your mind just as much as “keeping busy,” but it also gives you the space you need to process change on a deeper level.

Schedule in a long, hot bath, listening to quiet music, getting a massage or sitting in nature. Let your mind find a quiet place where you feel peaceful and calm in the midst of transition. Taking time for this level of relaxation and just being in the moment will help you make the inner paradigm shift to becoming a non-smoker for good. Free Medical Advice published By Dr Vivienne Balonwu.

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Quality Free Medical Advice Online by Vivienne Balonwu. A variety of general health advice and news online.

Influenza Suffer

Like a cold, influenza or flu means you have picked up a virus, which is passed on by coughing, sneezing or physical contact. In both cases you cannot treat or cure the infection itself, only its symptoms. Antibiotics will make no difference to flu unless you have a ‘secondary’ infection of the middle ear or chest.

A heavy cold can easily be mistaken for influenza, although flu is much less common and often spreads rapidly as an outbreak or, worse, an epidemic. The effects of flu, which infects the body’s breathing passages or respiratory tract, are more severe and can take longer to clear up than cold symptoms.

Flu is not normally dangerous, unless it strikes someone who is already ill or weak, or triggers off acute pneumonia – which is rare. If you are in a high-risk group you can arrange for an annual flu vaccination, which is around 70 per cent effective at preventing infection.

Catching one of the three main types of flu virus (A, B and C) will give you resistance to that particular virus in the future. Unfortunately, type B and (especially) type A produce new strains that your body’s natural defences cannot recognise or fight off – so you may get flu again and again.

How Do I Know If I Have Influenza?

Flu often comes on quite suddenly. The first symptoms are usually a fever, shivering, weakness, a headache, aching muscles and bones, tiredness and loss of appetite. A cough, sore throat and runny nose will normally follow.
After a couple of days your temperature will probably come down and the initial symptoms should be gone within a week. The cough, sore throat and runny nose will take longer, however, and you may feel tired and under the weather for a good two weeks.

What Can I Do Immediately To Make My Influenza better?

• Rest in bed and make sure your room is warm and well-ventilated.

• Soothe your throat and replace lost fluids by having plenty to drink. A hot drink made with honey and lemon or blackcurrant is preferable to tea or coffee.

• Do not smoke as this will make your symptoms worse.

• Try to eat a little, even if you do not feel up to it. If children are reluctant to eat, you could try extra drinks and semi-solid foods such as porridge or yoghurt.

• Treat your symptoms as you would those of a heavy cold – e.g., painkillers for a headache and fever, throat lozenges or gargling salt water for a sore throat, steam inhalations or cough medicines for a cough.

• Bring down a child’s temperature by sponging with lukewarm water.

• Remember to cover your mouth and nose when you sneeze, put your hand over your mouth when you cough and wash your hands regularly. This will help to avoid spreading infection.

• Do not rush back to work as soon as you feel better. Allow time for a full recovery.
What can I do generally to avoid catching flu?

• Steer clear of people who have the virus.

• Avoid places that are crowded or badly ventilated, particularly in winter when flu is more common.

• During the winter months, stay fit and healthy (and keep your body’s natural defences in shape) by eating and sleeping properly. Too much stress or a hectic lifestyle can lower your resistance to infection.

• Ask your doctor about having a flu vaccination if you are elderly and living in a nursing or residential home, over 80 years old, pregnant or have:

¤ a chronic respiratory disorder such as bronchitis, asthma, emphysema or cystic fibrosis
¤ a chronic heart condition
¤ diabetes
¤ kidney disease
¤ liver disease
¤ reduced resistance to infection, e.g., if you are having chemotherapy.

What Treatments Can I Buy Without A Prescription?

Your pharmacist will stock a variety of products for relieving the symptoms of flu, either separately or in combination. Some products, for example, contain a strong dose of painkiller together with ingredients for cough and a blocked or runny nose.
Ask your pharmacist which product is best for you and be careful not to mix products with the same ingredients in them. If your child has flu, get advice from your pharmacist on suitable medicines. Never give aspirin to a child under 12 years old.
For adults, paracetamol is useful for relieving a headache and bringing down a fever, while aching muscles and bones can be eased with soluble aspirin or ibuprofen every four to six hours (do not exceed the recommended doses).

When Do I Need To See A Doctor?

• If you are elderly or frail.
• If your temperature rises above 40°C.
• If your child’s temperature stays above 39°C for more than 24 hours.
• If your baby’s temperature is higher than 38.5°C.
• If you still have a fever after four days.
• If you are in a high-risk category (see above).
• If your symptoms get worse, you develop chest pain or are short of breath.
• If you are coughing up yellow or greenish phlegm.
• If you have severe earache.
• If you were recently in a country where there is a risk of malaria.
• If your baby or child is refusing to drink.
• If your child is sick and starts behaving strangely.

You Should Contact A Doctor Immediately If:

• Your child is weak.
• Your child is having problems breathing.
• Your child seems to find it painful breathing in.
• Your child has diarrhoea and is vomiting or refusing to drink.
• You, your child or baby show any signs of meningitis, e.g.

¤ a high temperature
¤ a persistent headache
¤ a stiff neck
¤ nausea or vomiting
¤ drowsiness or confusion
¤ dislike of bright light
¤ a red/blue skin rash

Babies

¤ a tight or bulging fontanelle (the soft spot on top of a baby’s head)
¤ listlessness
¤ a blank expression
¤ heavy or repeated vomiting
¤ refusal to feed
¤ high-pitched crying
¤ an arched back
¤ pale or blotchy skin with red or blue/black bruises

Note: Babies may display these symptoms without having a fever.

In Summary …

• Rest in bed and stay at home until you have fully recovered.
• Have plenty of fluids, particularly hot drinks to soothe your throat.
• Try to eat
• Treat your symptoms with home remedies or non-prescription medicines such as painkillers.
• Call a doctor if you develop worrying symptoms or are in an at-risk group.

By Peter Mansell, Edited by Dr Peter Stott. Published by Dr Vivienne Balonwu at Free Medical Advice Online.

Quality Free Medical Advice Online by Vivienne Balonwu. A variety of general health advice and news online.

A Boy Coughing

When you cough, it means your body is trying to clear its air passages of something that is blocking or irritating them. The culprit can be dust, smoke or a piece of lodged food.

Often, though, a cough is the result of a viral infection such as a cold, which inflames the upper part of our breathing apparatus. This encourages the production of sticky mucus, which drips down the back of the nose and throat.

If your cough is caused by a bacterial infection, you may need to go to a doctor for treatment with antibiotics. Otherwise, there are treatments available from the pharmacist for every type of minor cough.

How Do I Know If I Have A Cough?

Coughs divide into two main types: ‘productive’ or chesty coughs, which bring up mucus or phlegm into your mouth; and dry (‘unproductive’) coughs, which do not bring up any phlegm and are felt as a persistent tickling at the back of your throat.

Before you buy a cough remedy from your local pharmacist, it is important that you recognise which kind of cough you have. Using the wrong product could do you more harm than good. If you have a heavy cough or are finding it difficult to breathe, you should see a doctor.

Coughing can also be a nervous reaction to stress, particularly in children.

 
What Can I Do Immediately To Make My Cough Better?

* Stop your throat from drying out by having plenty to drink. A dry atmosphere or abrupt changes in temperature may also make your cough worse.

* Stay away from smoky rooms and do not smoke yourself.

* You can soothe your cough by sucking a boiled sweet or throat lozenge, or making yourself a hot drink of lemon and honey.

* Prop up your head at night with extra pillows or by raising the mattress at one end.

* Breathing in steam from a bowl of hot water may help. You can also buy inhalation treatments that contain natural oils such as eucalyptus.

* Try to bring up mucus if you have a productive cough.

* Ask your pharmacist to recommend a suitable cough medicine.

What can I do generally to stop my cough from getting worse?

* Give up smoking. Your pharmacist or doctor will advise you about products that can help you quit.

* Make sure you cover your mouth with your hand when coughing, to avoid passing on infection.

What Treatments Can I Buy Without A Prescription?

There is a huge range of products available to treat cough symptoms, including special mixtures for children. Most cough remedies are syrups or other liquids containing either expectorants, which make it easier to cough up phlegm, or suppressants, which act on the part of the brain that makes us cough.

You should take an expectorant for a chesty (‘productive’) cough and a suppressant for a dry cough. Do not take a suppressant if you have a chesty cough, as this may prevent you from bringing up phlegm.

Ask you pharmacist which medicine is right for you. Cough suppressants can make you feel drowsy, so be careful about driving or operating machinery. They should also be avoided if you have asthma or chronic bronchitis.

When Do I Need To See A Doctor?

* If you are coughing up blood with your mucus.

* If you are consistently bringing up thick, green, yellow, grey or foul-smelling phlegm.

* If your cough carries on for more than two weeks or starts to get worse.

* If you have a cough and high temperature for more than five days (three days for a child).

* If coughing makes you wheezy or short of breath.

* If you are getting a sharp pain in your chest when you cough or breathe in.

* If a child with a cough is dribbling and cannot swallow.

You should contact a doctor immediately if:

* You are panting or generally having difficulty breathing.

* If your breathing is rapid or painful.

* If your child’s lips have a bluish tinge.

In summary …

* Stay away from dry or smoky environments.

* Soothe your throat with a hot honey and lemon drink.

* Work out which kind of cough you have and ask your pharmacist for the right treatment.

* Go to the doctor if your symptoms are severe or you are having problems breathing.
By Peter Mansell.

Free medical advice online presented by Vivienne Balonwu.

Quality Free Medical Advice Online by Vivienne Balonwu. A variety of general health advice and news online.

Boy Using Asthma Inhaler

Asthma is a condition that affects your airways – the small tubes that carry air in and out of the lungs. People with asthma have airways that are almost always red and sensitive (inflamed).

When a person has asthma their airways react to a trigger by becoming narrower, as the muscle surrounding the airway tightens and inflammation inside the airway leads to swelling and a build up of mucus. This causes a cough, wheezing or breathlessness. It is difficult to predict who is going to develop asthma. Like eczema and hayfever, it often runs in families and may be inherited. It can develop at any age. About one in seven children and one in 25 adults in the UK have asthma.

What Causes Asthma

A trigger is anything that irritates your airways and causes the symptoms of asthma to develop. Triggers vary from person to person. Most people will have several. Triggers include the following:

• Colds and viruses
• Exercise
• Pollen
• Mould
• Pet hairs
• Dust
• Tobacco smoke
• Certain types of medication
• Weather changes
• Certain foods may also cause problems

It is important to try and identify possible triggers: talk to your doctor or nurse about avoiding them.

Asthma Treatment

Asthma Inhaler

Most asthma medication is delivered using an inhaler. This makes sure that very small amounts of medication are delivered directly into the lungs. There are a variety of inhalers available. It is important that you use an inhaler that you are comfortable with and that is available with the appropriate medication. Your doctor or nurse will help you decide which is the most appropriate inhaler and should show you how to use it correctly.

There are three types of medication to treat asthma – relievers, preventers and protectors.

Asthma Relievers

Reliever inhalers are usually blue. They act by opening up the airways by causing the muscles to relax and so allowing you to breathe more easily. You should only use the reliever when the symptoms of asthma appear or, if recommended, before exercise. They do not reduce the inflammation in the airways.

If you need to use your reliever three times a week or more this may suggest that there is inflammation in your airways and so you need preventer treatment.

Preventers
Preventer inhalers are usually brown or orange They work by reducing the swelling and inflammation in the airways and can take between 10 and 14 days to build up the preventive effect. You need to use them every day, even when you are well.

Most preventers are steroids, but because they are inhaled only low doses need to be used. (It is important to understand that these steroids are NOT the same as anabolic steroids used by athletes to improve their performance.)

Protectors
Protectors are long-acting medicines which reduce asthma symptoms and work by keeping the airways open and relaxed. This makes it easier for air to get in and out of the lungs, and so helps to ease asthma symptoms. They are available as inhalers or tablets.

A protector would usually be taken with a preventer. Like preventers, it is important that you take protectors every day.

Managing Your Asthma

Asthma symptoms can happen at any time. It is important to understand what to do if you feel your asthma is getting worse.

Your nurse or doctor may provide a peak flow meter to help you manage your asthma. A peak flow meter measures the performance of your lungs. The meter has a marker which slides up and down as you blow into it. The marker stops at a point where you blow hardest. Each time you use the meter (usually morning and evening) you mark the result on a chart. It gives you a very clear idea of how you are controlling your asthma.

Your doctor or nurse may discuss a management plan with you. This enables you to take control of your asthma. The management plan has a step-wise approach. Each step shows what treatment is needed to control your asthma. If the treatment on one step is not controlling your asthma your doctor may recommend increasing your medication. If your asthma is well controlled your doctor may well consider reducing your medication.

Your Lifestyle

Asthma should not get in the way of you leading a full and active life. Always carry your reliever medication with you. It is important to know what might trigger your asthma so you can avoid triggers. Also, take your preventer medication regularly so that your asthma does not deteriorate.

What to do during an asthma attack
• Take your reliever medication immediately
• Try and stay calm
• The attack should pass off and you can continue with normal activities
If the reliever has no effect after 5-10 minutes do the following:
• Call your doctor or an ambulance
• Continue to take reliever medication every few minutes until help arrives.

By Dr Peter Stott.

Quality Free Medical Advice Online by Vivienne Balonwu. A variety of general health advice and news online.

If you suffer from an allergy, you are definitely not alone. In fact, the number of people suffering from allergies such as hayfever, asthma, eczema and food allergies is increasing.

Your immune system protects you against infections by producing antibodies to kill harmful organisms. When you have an allergy, your immune system overreacts to substances that are not harmful to other people. True allergies are reactions to substances called allergens.

Common allergens are pollen, mould, house dust mites, animal hairs, feathers, nickel, rubber and certain foods. Reducing your exposure to allergens can be an effective way of preventing an allergic reaction; however, this is not always possible. There are many treatments available to help reduce the symptoms of allergies, although at the moment there are no cures.

What Are The Most Common Allergens?

The house dust mite, which feeds on flakes of human skin, is one of the most common allergens, and causes symptoms all year round. Every household has house dust mites, no matter how clean and hygienic it is, but house dust mites are only a problem if you are allergic to them. Pollen, mould and animal hairs are other common allergens. You can even become allergic to a substance you have used or eaten for years.

All of these allergens are mostly breathed in. They cause sneezing, running or blocked noses, watery eyes and wheezing in up to 40 per cent of the population. Food allergies are most commonly caused by eggs, cow’s milk, nuts, fish and shellfish (such as prawns).

Food allergies may cause eczema to develop in babies, but older children and young adults often develop a rash (hives). Hives affect one in five people during their lifetime.

Why Are Allergies Increasing?

There have been a number of possible reasons put forward for the rise in allergies. It could be due to an increase in house dust mites because of the way we build and furnish homes. Most homes now have wall-to-wall carpets, and ventilation is reduced to keep warmth in winter and coolness in summer. This results in an even temperature and high humidity – ideal conditions for house dust mites.

Air pollution may be playing a role in increasing asthma, and processed foods containing artificial colour and preservatives could be responsible for an increase in food allergies. Changes in children’s diets mean they are being exposed to a much wider variety of foods earlier on in life than in the past, possibly stimulating their immune system.

How Do You Find Out What Causes Your Allergies?

Keep a record of when and where your symptoms appear. For example:
• Do you sneeze or wheeze when you clean the house or empty the vacuum cleaner bag?
• Do your symptoms occur when you are in a room with a cat (even if you don’t handle the cat)?
• Do your symptoms occur throughout the year, or only in certain seasons, such as spring and early summer?
• Do your symptoms occur at particular times in the day, for example in the morning and evening?

Noticing your own pattern of symptoms is the most useful way of identifying the cause of your allergies. Allergy testing is not routinely done as the results can be confusing, but in certain cases blood tests and skin pricks can be helpful. A positive reaction identifies an allergen but does not necessarily mean that it is responsible for your symptoms at that time.

Using blood test and skin pricks to test for food allergies is difficult and cutting certain foods from your diet and then reintroducing them is the best way to identify the allergen causing the problem. This needs to be done carefully and under the supervision of a dietitian, particularly for children, who may otherwise lose out on essential nutrients.

Allergies Treatment

First you have to work with your GP to identify the allergens responsible for your symptoms and then try to avoid them. You can do this by doing the following:
• Remove carpets and soft furnishings to reduce house dust mites
• Keep your house well ventilated and free from damp
• Buy special mattresses and pillow coverings that are resistant to house dust mites
• Don’t buy pets (such as cats, mice or guinea pigs) if family members are allergic to animal hairs
• Place soft toys and teddy bears in the freezer every 6 months to kill the house dust mites
• Mow your lawn regularly to prevent the grass from flowering
• Avoid visiting rural areas during high pollen seasons
• Don’t allow people to smoke cigarettes in the house.
• Breastfeeding your baby for as long as possible (preferably 4 to 6 months) can help your child build up an immunity to allergens. Try to avoid exposing your baby to pets and dust during this time.
• Avoid sheepskin underlays as they encourage house dust mites.

It is also important to improve your general health. These measures include having a good diet, getting plenty of exercise, getting enough sleep and not smoking.

Antihistamines

If you have an allergy, you may need to take antihistamines. Rashes are also often well controlled by the newer non-drowsy antihistamines. Antihistamines prevent symptoms (like itching, sneezing, watery eyes, runny noses and rashes) that are caused by the body releasing a substance called histamine during an allergic reaction. The newer antihistamines have very few side-effects. Your doctor will help you find one that does not make you drowsy.

If your symptoms cannot be controlled by avoiding allergens or taking antihistamines, your GP may prescribe a steroid nasal spray. These sprays are anti-inflammatory drugs that will help the symptoms of allergies. Because they are applied to the lining of the nose and lungs, the newer steroid drug is hardly absorbed into the blood stream, so the risk of side-effects is reduced. Many different home remedies have been used for treating allergies, but there is no evidence that they are effective.

What is anaphylaxis?

Anaphylaxis or anaphylactic shock is a sudden, severe reaction to a substance, but it is very rare. The reaction rarely occurs in response to allergens in the air (like pollen) but may be in response to a food, bee sting or a drug. The severe reaction causes swelling of the face and throat, difficulty in breathing and a drop in blood pressure.

You should call for an ambulance unless your GP’s surgery or casualty department is very close. After your first attack you will probably be given an adrenaline injection to carry with you in case it occurs again.

Edited by Dr Carol Blow, MB BS, MRCP, MRCGP, DRCOG.

Free medical advice online published by Vivienne Balonwu.

Quality Free Medical Advice Online by Vivienne Balonwu. A variety of general health advice and news online.